Part 49

Door Sign

Your door should bear a sign in gold or black, setting forth your name and business and perhaps your office hours. It may read, “W. R. Jones, Chiropractor,” or, “Jones & Jones, Chiropractors,” with office hours appended. Avoid repetitions such as “Dr. W. R. Jones, Chiropractor,” or “W. R. Jones, D. C., Chiropractor.”

Advertising

The word of a satisfied patient to his friend is the best advertisement. Beyond this, considerable diversity of opinion exists as to what constitutes proper, ethical, and wise advertising. I shall make no attempt to settle this question but shall simply suggest that while it is undoubtedly necessary often to explain to the public through various avenues what Chiropractic is and what it can do it is wise to be as reserved and dignified as possible and to avoid offense to any. Thus it is clearly unwise to advertise that your competitor is a fraud, much wiser to convince your readers by the logic and strength of your statements that you are not. Consider good taste and avoid unpleasant references to loathsome or vulgar diseases. Such advertising is associated in the public mind with quackery, with patent medicines and medical institutes, and no matter how sincere and right your motives may be it will be misinterpreted by those you wish to reach.

Consider also the legal side of advertising. Study the laws of your state and avoid any statement which will conflict with the law. In some states it is illegal to advertise with the term “Dr.” unless you hold a medical license. In others to advertise to “treat,” “cure,” or “heal” disease is to practice medicine technically. Such statements miss the truth, in any case, because the Chiropractor administers an adjustment and not a treatment and because Nature alone can cure or heal.

Collection Cards

Different communities respond to different collection methods. With one class of patients it may be better never to mention fees except to answer inquiry and simply to submit monthly statements of account to all patients. With another it is necessary to charge in advance. More Chiropractors use this method than any other and many use cards for the purpose.

These cards are best printed with name, address, telephone number, etc., on one side and on the other six or twelve spaces ruled off at one end for punching to indicate adjustments given, and the words, “Good for six (or twelve) Chiropractic adjustments at (office) (residence) when properly countersigned.” A line should be left below for your signature and at the bottom the price of the card should be printed plainly. If desired a space may be left for the patient’s name so that the card may be made non-transferable.

The card is issued at the beginning of a course of adjustments and a duplicate is kept on file. Each time the patient is adjusted he presents his card before leaving and one space is punched out. By this system both the patient and the adjuster may know exactly the number of adjustments given and accounts may be easily kept. Without it, a book entry of some sort must be made for every adjustment.

The best thing about this system is that it reminds the patient that you expect to be paid in advance without the necessity of your saying so, since the words “in advance” follow the statement of price on the card. At the time of payment you give him, as a receipt, a card entitling him to a certain amount of your service at a stipulated place.

Schedule of Examination

This method of procedure for the investigation of new cases is offered as a suggestion to be followed as far as the education of the Chiropractor will permit. If every practitioner adopts some such method of making his own diagnoses he will advance in ability much more rapidly than by accepting the diagnoses given his patients by physicians or others. We should remember, though without arrogance, that our special ability to discover subluxations and our knowledge of their significance as the primary causes of disease renders us better prepared for correct diagnosis than our medical friends, other education being equal.

It should be quite obvious that in attempting the accomplishment of any object it is necessary first to have in mind a clear preconception of the things to be accomplished, and second, to have a clear and concise, yet complete, outline of the steps to be taken, their order or sequence, and their relative importance in the accomplishment. These two needs, as regards a Chiropractic diagnosis, we shall endeavor to supply in this section.

Chiropractic Diagnosis properly consists of three parts, Vertebral Palpation, Nerve-Tracing, and Symptomatology, together with the reasoning necessary to properly weigh and summarize the facts ascertained. Of these three divisions two fall properly under the head of Physical Diagnosis and the third, symptomatology, should consist principally of physical diagnosis.

Everywhere the physical or objective sign is given preference over the subjective symptom. Before a single question is asked of the patient relative to the case or its history, every other means of obtaining information properly coming under the head of a Chiropractic diagnosis should be utilized. The questions should come last and be very few and direct. They should serve only to illuminate the few remaining doubtful points in the mind of the examiner, points which perhaps exist only because of some fault or weakness in his methods of examination.

The proper order of examination is as follows:

1. General Observation.

2. Vertebral Palpation.

3. Nerve Tracing.

4. Special Examination.

5. History of Case.

6. Summary.

General Observation

Observation of the patient with a view to determining any signs of disease should begin with the moment the patient steps into the office. It should continue during your conversation and during the Vertebral Palpation and Nerve Tracing which follow. The mind of the examiner should be constantly on the alert to note any sign on any exposed part of the patient’s body, or any motion which may betray the nature of the disease or diseases with which he suffers.

Before preparing the patient for palpation observe temperament, position and carriage of head, body, and limbs, and facies.

Ask male patients to strip to the waist and female patients to remove all clothing down to the waist except a loose gown or kimono, which is worn reversed so that it opens behind and exposes the spine to direct examination. No greater error can be committed than to attempt examination of the vertebral column through clothing or other covering. Examine with patient seated on a bench or stool with feet evenly placed upon the floor. If the patient is for any reason unable to assume this position the examination may be varied somewhat.

While in this position continue observation of points mentioned above and observe also condition of skin, whether abnormal in color, moisture or nutrition, or whether there is flushing, cyanosis, or pallor, roughness, eruption, etc.; the condition of bones and joints other than vertebral; general emaciation or obesity, local malnutrition or hypertrophy; evidences of operation, scars etc.; and action of muscles more in detail than is indicated under position and carriage of parts.

Having observed these things discontinue general observation and all other considerations for the time in favor of Vertebral Palpation.