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Keys to your practice: Table Talk

Educating your patients about chiropracti


April 24, 2017
By Angelo Santini

A patient’s most important visit to a chiropractor is their regular adjustment visit. Most chiropractors would argue that the report of findings or health care class is where a patient learns about chiropractic. In my experience, people need small bits of information repeated many times in order to really learn something.

Learning is an experiential process and what better place to have an experience than on an adjustment visit. The “adjustitorium” is a place for education not conversation.  

Let us take a look at how regular table talk can improve your practice members’ understanding on what this wonderful thing called chiropractic really is.

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The basics
Many chiropractors often share with me that they struggle getting their patients on the table in a timely manner. The most common reason for this is the chiropractor’s need to ask the person how they are doing. Whether you run a subluxation practice or rehab practice, asking how someone is doing is a cardinal mistake. The last time I checked we really don’t have control over whether a person is in pain or not. In addition, if you want to run your practice outside the normal “pain model,” then talking about how someone is doing is counter productive to what you are trying to accomplish.  

So why not start the adjustment visit with asking for permission to check and see how they are holding or to see where their spine is at that day? I’m not saying not to honour their concerns or questions about pain. I’m suggesting we should begin to change our conversation and habits to enforce a practice model that focuses on function versus feeling.

Local talk
We all know that subluxation will have an effect locally on the body. It will change the tone of muscles, restrict movement, reduce strength, affect sensation, and have an effect locally with organs and glands.  I believe this is where your initial table talk should begin.  

Let us take a look at a typical scenario of a person coming in with lower back pain. They have subluxations present in the lower lumbar spine and degenerative changes seen on x-rays. They have hopefully been examined in a way that demonstrates subluxation’s effect on strength and motion. They are aware from the report that the nerve interference will also affect the internal pelvic organs. Now it is time to re-enforce this information on each and every visit. A simple tool like tracing works well. This means touching the subluxation (usually tender) and tracing where it goes. In our example of an L5 subluxation you would touch down the leg where the nerve travels reminding the patient it will weaken the leg and is likely the cause of their numbness. It is then wise to add the nerve that also travels to the bladder and is contributing to their extra trips to the washroom. Discipline and repetition are essential to ensure the patient receives the foundations about how their spine and nervous system operate.  

Once you have this nailed down you can have fun with it and make it your own. For example, touch the subluxation and instead of telling them where the nerve goes you ask them. They may struggle at first so ensure you support them in this educational process.

Thinking bigger
Chiropractic research is beginning to reveal what we have already known for years. This is that the adjustment changes things globally and not just locally. It changes the brain, immune system and hormonal system just to name a few. It is critical to advance our table talk to match this level of knowledge so that your practice members understand the true benefits of chiropractic. On every visit would it not be a good idea to remind them that people under chiropractic care experience better sleep, co-ordination, memory, and immune system function? In fact, if you don’t point this out people will often attribute these benefits to other things like their new workout regime, vitamins or diet changes.  Even though these things are all beneficial it’s time for chiropractic to start taking more of the deserved credit.

These are small but powerful tools to start changing the conversation on regular adjustment visits. The level you commit yourselves to improving this area is directly related to the level of engagement from your patients, including keeping their appointments and making referrals. Excelling in this will lead to a busier and more fruitful practice.  The change, as always, must begin with you.


Dr. Angelo Santin operates a busy subluxation-based family practice in Thunder Bay, Ont., and is president of the Thunder Bay Chiropractic Society. Santin is also a Carter Universal proficiency-rated chiropractic coach. He can be reached at angelosantin@gmail.com or 807-344-4606.


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