Open, or not...focus is ESSENTIAL!
This in from the ethers...
Dear Dr. Heun,
Four recent incidents led to the subject title of this e-mail. A couple of months ago I was adjusting a patient when my wife came in with my kids. My three and a half year old son came running up to me to tell me all sorts of things. I gave him a hug, went back to adjusting my patients and he continued to ask me things as I was adjusting, I became distracted and adjusted the wrong segment or side. The patient was ok, but I should have used the warning better.
Also a couple of months ago, a patient dropped out of my practice and when asked why said she wanted another opinion and was uncomfortable with kids running around the office and the lack of privacy.
About a week ago I was adjusting a patient who was dizzy several times after cervical adjusting and we had agreed I would not adjust her neck. After being distracted, dealing with patients on traction, I looked at her chart, saw her posture diagrams and adjusted her neck accordingly. I have not seen her since.
Two days ago I saw a new patient. His side view cervical showed a grade I anterolisthesis along with 27 degrees of extension of C6 on C7. There was a slightly reversed curve at C3-4 and only 3 degrees of extension in the rest of his neck. Of course I would not adjust him without numerous motion views to determine degree of instability, and may not at all. But it occurred to me if I was to adjust him and became distracted, I could do serious damage.
I have decided on the following steps:
1. Speak to staff, wife, kids and parents in my practice about minimizing distractions and the importance of my being able to focus to give the patient on the table all my attention.
2. When I do have to deal with someone on traction and return to adjusting, take a moment to refocus, read the chart carefully and be present with the patient.
3. Teach my staff how to take people off traction.
4. Send my unstable patient for a neurosurgical consult after taking motion views.
Do you have any other thoughts on handling these problems?
My answer was...
Good suggestions all. Laser beam focus is MANDATORY! For those doctors that have challenges multitasking, open adjusting is a bad idea.
Never adjust a patient unless your focus is completely on the patient you are adjusting.
Also...
The team you assemble must revere the adjustment as well as respect it. The correct application of forces into the human frame has the potential to initiate wonderful positive changes. The wrong application or poorly delivered adjustment can do immeasurable harm. Furthermore, the more focused the doctor applying the force, and visualizing the adjustment, the better the correction. After all, adjusting is a physical skill not unlike other precision athletic actions; golf shots and putting, tennis, billiards. The visualization and focus component makes all the difference.
If you are routinely distracted, make whatever changes you must immediately...the price is too high not to.
SJH
Dear Dr. Heun,
Four recent incidents led to the subject title of this e-mail. A couple of months ago I was adjusting a patient when my wife came in with my kids. My three and a half year old son came running up to me to tell me all sorts of things. I gave him a hug, went back to adjusting my patients and he continued to ask me things as I was adjusting, I became distracted and adjusted the wrong segment or side. The patient was ok, but I should have used the warning better.
Also a couple of months ago, a patient dropped out of my practice and when asked why said she wanted another opinion and was uncomfortable with kids running around the office and the lack of privacy.
About a week ago I was adjusting a patient who was dizzy several times after cervical adjusting and we had agreed I would not adjust her neck. After being distracted, dealing with patients on traction, I looked at her chart, saw her posture diagrams and adjusted her neck accordingly. I have not seen her since.
Two days ago I saw a new patient. His side view cervical showed a grade I anterolisthesis along with 27 degrees of extension of C6 on C7. There was a slightly reversed curve at C3-4 and only 3 degrees of extension in the rest of his neck. Of course I would not adjust him without numerous motion views to determine degree of instability, and may not at all. But it occurred to me if I was to adjust him and became distracted, I could do serious damage.
I have decided on the following steps:
1. Speak to staff, wife, kids and parents in my practice about minimizing distractions and the importance of my being able to focus to give the patient on the table all my attention.
2. When I do have to deal with someone on traction and return to adjusting, take a moment to refocus, read the chart carefully and be present with the patient.
3. Teach my staff how to take people off traction.
4. Send my unstable patient for a neurosurgical consult after taking motion views.
Do you have any other thoughts on handling these problems?
My answer was...
Good suggestions all. Laser beam focus is MANDATORY! For those doctors that have challenges multitasking, open adjusting is a bad idea.
Never adjust a patient unless your focus is completely on the patient you are adjusting.
Also...
The team you assemble must revere the adjustment as well as respect it. The correct application of forces into the human frame has the potential to initiate wonderful positive changes. The wrong application or poorly delivered adjustment can do immeasurable harm. Furthermore, the more focused the doctor applying the force, and visualizing the adjustment, the better the correction. After all, adjusting is a physical skill not unlike other precision athletic actions; golf shots and putting, tennis, billiards. The visualization and focus component makes all the difference.
If you are routinely distracted, make whatever changes you must immediately...the price is too high not to.
SJH
posted by Dr. Scott J. Heun at
11:50 AM
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