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How do I implement Nutrition into my office?

A question posted on Facebook was, “To what extent do you incorporate nutrition into your patients wellness plan? Do you only make recommendations or do you stock particular products in office?”

There are several pieces to this puzzle. First is to clarify how you want to use nutrition and what you are trying to accomplish. Some docs just want people to get high quality basic nutrients; others of us go very deep into the entire “functional nutrition” paradigm.

From my perspective our goal is to correct their present subluxations and their causes, and show them ways not to recreate them in the future. If their subluxation is a viscera-somatic component and the viscera is causing this aberrant input because of a nutritional deficiency or a congested organ, then giving them the appropriate nutrients to support their system is a great idea. We do need to be careful here to keep away from trying to treat their symptoms vs. getting to the underlying cause. I.e. you may give them a particular nutrient to deal with the symptom of heartburn which may help the symptom but not really get to the cause. On the other hand if the reason they have heartburn is because of a congested gall bladder and T-4 keeps resubluxating no matter how many times you adjust it, then giving them Standard Process AF Betafood (or whatever you find works) to help clean up the gall bladder congestion seems like a reasonable approach.

Again I realize there are many different versions of chiropractic and this concept may feel foreign or even bad or wrong to some “straight chiropractors” but my main goal as a “True Wellness Chiropractor” is to correct the subluxations and their causes and show them ways not to recreate them in the future. In my health care class I first help people realize what a subluxation is and the 3 dimensions of stress (mental/emotional, physical and biochemical) stress that cause subluxations and health problems. I then pretend to bang my head against the wall and tell them that I have a headache. I then “go see Dr. Rosen” and pretend to adjust myself and tell them how my headache went away. I then pretend to bang my head against the wall again and come back to Dr. Rosen and tell him he sucks! My headache came back! I do that several times in a row until I finally ask the group what they think I should do if want my headaches to stop coming back. They of course tell me to stop banging my head against the wall. I then ask each one of them what they are doing to keep recreating their chief complaints or their subuxations. Are they not eating well, not exercising, under mental stress etc.

So now the question of at what level do you want to play in the nutrition game? Do you want to refer to a nutritionist? Make specific basic recommendations and refer to the local health food store? (This by the way can be a mutually beneficial relationship. I like to “Cross pollinate” with these types of relationships i.e. do talks together etc. and make sure they also refer to you.) Do you want to carry basic products or do you want to dive deep into making nutritional recommendations by doing techniques like CRA, NRT, Functional Nutrition etc.?

I think there are some basic nutrients that most human beings in the 21st century should all take. Some would be a basic whole food multivitamin, mercury free fish oil, digestive enzyme, vitamin D, green powder, probiotics etc. I think it is very valuable to carry these. You can get extremely high quality products that they most likely will not get at their local store. You can carry them out of your office; you can sell them on your website and get them on a 30 day reorder etc. It can be a great service for your patients and lucrative for you.

You must be very careful if you go down the rabbit hole of nutrition. If you want to do a volume practice you really need to separate out your adjusting times from your nutrition times, but that is for another conversation.

Now, how to sell the products, there are several ways that work and certain things you want to be very careful of. The trick is to help them realize that they want it vs. telling them that they have to have it. We go into great detail of how to do this in the LAASR course. The long and the short of it is it will come down to your consult and TTAT in the exam.

If you are just recommending a few products you can mention it in the ROF and let them know you will get to that later in care and first get them signed up for their subluxation care. Sometimes doing too much right up front puts them in overwhelm and they have to “go home and think about it.” On the other hand if you really helped them experience in the exam that this midback problem that has been adjusted by another chiropractor 100 times but never seems to resolve may be caused by a congested gall bladder (which you made painfully clear in the exam i.e. touched T4, pointed to the chart and palpated the hot and swollen gallbladder) then they really do want to start to get to that underlying cause right now! In that case you can sell the nutrients right off the bat.

The doctors I coach who do functional nutrition of course sell the nutrients, the series of lab tests etc. in the ROF in the whole package including their adjustments.

So the long and short of it is to clarify how you want to practice. If you are going to merely dabble with nutrients you will probably want to make mention of them in the ROF and then over time, maybe at your health care talk or nutrition talk help people realize they also want to take certain nutrients. On the other hand if you are serious about your nutrition and you feel the success of their subluxation care is dependent on them taking the appropriate nutrients then you will want to make it make sense to the patient and show them how they can finance the entire package of care (including nutrients.)

I hope that helps. Please share this with our colleagues!

Much love and aloha,

Russ

Russ Rosen, D.C. - May 14, 2010