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April, 2010

Selecting an Instrument Adjusting System: Adjust Your Thinking First

By DCPI Staff

It's not something chiropractors like to consider, but performing manual adjusting or positioning patients is not without its hazards to the DC. In fact, one study noted that as many as 40 percent of chiropractors had suffered a serious injury within the first five years of practice from either manipulating (67 percent) or positioning (11 percent) a patient.1 In light of this, perhaps the time has come for you to consider how to do the work you love with less wear and tear on your own body. The obvious answer may seem to be switch to an instrument adjusting system.

Perhaps you have a high proportion of patients who are nervous from a manual adjustment. Let's face it, that distinctive sound from a cavitation can be disconcerting to a patient unused to chiropractic care. And there are always those patients who are simply not comfortable with hands-on contact, no matter what you do.

Nevertheless, adjusting systems may not be for you. And, even in you think an instrument may be the right tool for your practice, do not rush out and purchase one. Take a few moments and consider not only how such devices may benefit you, but more specifically, your personal and practice goals.

In essence, readjust your thinking before you start using an instrument device to adjust patients.

In preparing this story, Dynamic Chiropractic PracticeINSIGHTS asked a panel of industy experts how they would go about investigating an instrument adjusting system if they were in the market to buy one themselves.

(Obviously, an expert allied with a particular company will tend to be biased to that company's products. Therefore, in this series we report the comments that reflect a consensus on the general characteristics that make for a good product in order that you may make an informed decision as you do your research into a particular product or service.)

Many Factors to Consider

As mentioned previously, there can be a multitude of reasons to switch to an instrument adjusting system. As Joe Evans, DC, with Pennsylvania-based Sense Technology, explained, there can be a multitude of considerations and questions to ask before selecting an instrument-adjusting system: "Can instrumentation help me extend my career? Can instrumentation help me treat difficult cases? Can instrumentation help me recruit more patients? Can instrumentation simplify billing?"

John Crunick with Sigma Instruments, also based in Pennsylvania, agrees that there may need to be some serious soul-searching before purchasing an instrument adjusting system: "What is the doctor's goal? Treating more patients? Dealing with the aging population? Practice building? It is important that the doctor explore his/her particular reasons for moving to instrument adjusting. This will help guide the doctor in determining the level of sophistication they need in their practice."

Understand What You Are Getting

All our experts agreed that a significant part of considering how you want an instrument adjusting system to work for you is to know precisely how the system works. If you understand that, you will have a better sense of exactly how it will fit into your practice.

Arlan W. Fuhr, DC, of Activator Methods International, based in Phoenix, Ariz., explains that it is vital to really know what you are getting for your investment. He explains, "When selecting an adjusting instrument, doctors should take the time to truly understand what an instrument has to offer. Most importantly, the doctor should determine if the instrument is supported by research, and whether it has been studied in clinical trials that have resulted in peer-reviewed publications. Such research and the associated clinical trials likely prove the efficacy of the instrument."

Dr. Evans seconds the importance of looking at the research supporting the instrument: "Many chiropractic techniques claim benefits that are completely unsupported by valid research. Instrumentation techniques are no exception. Examine the research that each company has produced, particularly research that documents the clinical results that can be obtained with the instrument."

Ed Miller, with IMPAC Inc., out of Salem, Ore., believes that the most important understanding a chiropractor should have of an instrument adjusting system is its potential technological advantages, depending on the practitioner's needs. This will, in turn, lead to greater versatility. He says, "What technological advantages does an instrument offer? Do the due diligence, ask the vital questions and then distance yourself for a span to obtain a balanced perspective. This allows for the best decision. Not all instruments are created equal. Some instruments offer convenience and versatility while other instruments may restrict a practitioner to just two or three forced settings. Greater versatility allows you to tailor the thrusting forces to match the needs of your individual patients."

In addition to understanding the research behind instrument adjusting systems and the potential advantages (or disadvantages, depending upon your practice), it's also important to look at the different effects produced by different devices to get a full understanding. As Crunick explains, "With the expanding number of choices in the marketplace, it is important to understand the underlying technology. The treatment modalities fall into two very different categories: percussive and vibratory."

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