I have learned that confidence is one of the most common traits in successful chiropractors. Of course, certainty affects confidence, and that is where I have noticed some hang ups. Mastering a technique can improve the confidence we have in what we are doing and certainty can improve how and why we are doing it. This is where the fuzziness comes in. When a patient asks if you can help them with a specific health problem, how do we really know we can? How can we show or be "certain" that we can help them. I was reading an earlier post about how egotistical a medical doctor can be when they tell a patient they only have X amount of months to live. Of course, they cannot be certain that will happen. So how can we be certain we can help a patient? As a chiropractor masters a technique, he can increase his confidence by being more certain at what may need to be adjusted, but how does he know this will help the patient overcome their problem? Of course I know and believe that removing nerve interference in the spine with a chiropractic adjustment will help innate do what it needs to do for that body, but how can we relay that to a patient who is coming in "condition specific"? I believe I know the answers to these questions, I was just looking for some input from the tribe as to how to best communicate that to a patient. For instance, "Hey doc, I have this numbness in my feet, can you help me?"
Confidence vs. Certainty
(24 posts) (8 voices)-
Posted 1 year ago #
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It sounds like you do know the answers. "As a chiropractor masters a technique, he can increase his confidence by being more certain at what may need to be adjusted, but how does he know this will help the patient overcome their problem?" Answer: You don't! :) That is why we can't tell anyone with certainty that we will cure them. BUT! We can say that "I have seen many patients with the same symptoms that had similar misalignment patterns and when we relaigned them the symptoms went away, so I expect the same should happen for you. Although there is only one way to find out for sure and that is to realign what I know is misaligned and definitely causing problems. Only once everything is positioned to function correctly can we know for sure how well you can function." This is an experiment with every patient so the only thing we can determine is if the odds are in their favor or not. Then give it a go knowing that you will inherently make them better than they are at present if their nervous system was free to function more fully. It is no different than most of the time when you turn the knob on the left at the sink hot water will come out, but not always, some people have bad plumbing. :) Some things you will not know till after and that is why we begin with a four week series of treatment to see how your body responds and then take it from there. I think your chances are very good of making a full recovery/ improvement/ no worse and we can hope for more. Depends on which you believe applies. The need for the technique mastery is to atleast "know" something! Since we can't predict their outcome definitively then the only thing we can be confident about is if they have nerve interference currently that we can address. If a chiropractor is not "certain" that they can find that then they are not able to be "certain" of anything and that is a much harder place to be when giving an RYF or even just responding to "I am still sore." On day two, with a 10 year old problem. So the way I see it is there is only one thing that we can gain more and more certainty in and that is our analysis and adjustment. The we let the body do as it sees fit. Hope that made any sense.
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Further to what Chris just said, this also comes back to the need to be right! We just do not need to know all the answers (sadly we just dont have that crystal ball) and nor do we have to - so this is simply a case of admitting what we dont know but clearly and honestly stating what we do, and certainly using past experiences, yet all without making hollow promises! For example I had a patient in recently who was scheduled to have her hip replaced and she was a little reluctant because of her age and wondered whether we could help! In this case I simply told her that that was a decision that only she and her surgeon could make, but what I did know was that she would be better off being adjusted than not - not only would that give us a chance of avoiding surgery but even if surgery was still necessary her post op recovery and rehabilitation would be greatly improved! Now whether she followed through with care or not, did not matter because that was not my decision to make!
But this issue is also where the philosophy modules are going to be so helpful! Further differentiating the difference between neo vitalism and the allopathic mechanistic model will simplify this process so much easier! Recognising where our patients are coming from and how they perceive their problem certainly helps yet that does not mean we have to jump down the rabbit hole with them! Curzie the Whittakers have set the bar pretty damn high so the pressure is really on!Posted 1 year ago # -
Great response Chris and Ed and thank you helping to clarify this for me. I guess it's no different than someone that is overweight and out of shape going to a personal trainer and asking about results. If you change your eating habits and do these exercises you have a good chance at getting in the shape you are looking for. Thanks Ed for reminding me of the need to be right, I can sense that creeping out now and then along with my friend "control". I tend to deal more in absolutes, and that does not fly with what we do. What we can "control" is our pursuit of mastery which will build confidence and certainty with what we do. Since patients can feel you before they hear you, feeling confident and certain can only help improve their outcome. Here comes that quantum stuff again! Love it!
Posted 1 year ago # -
Some excellent insights here. The timing is interesting because I read an article this morning written by a university professor who, at the beginning of each of her lectures, puts a quote on a board for the students to reflect on while they find their seats and get ready for class. Well, on this particularly day she found herself going on "an involuntary rant" about the subject of her quote before delivering her lecture- which interestingly enough was going to be about evolution. This was her quote,
"There are in fact two things, science and opinion; the former begets knowledge, the latter ignorance."
-HippocratesShe proceeded to rant about the difference between science and opinion, skeptics and believers.....she used climate change as her example subject. Very well stated argument and quite eloquent....but a few things she said struck me.
"Indeed, true skepticism is healthy. It allows a person to begin from doubt and move toward something. Skepticism is about moving toward certainty by testing one's own assumptions. It is about knowledge; the realm of the mind."
Here's where it gets better.
"True belief can also be healthy. It allows a person to begin from a private experience or emotion and move toward the unknown. Belief often involves a leap of faith because evidence is not available. It is about transcendence; the realm of the spirit."
As chiropractors, I believe we need to dance between the two. Too often (and I'm sure Ed can attest to this) I see today's chiropractic student (perhaps young graduates as well) allow very large seeds of doubt to be sewn into their psyches by those who aren't true skeptics but just those who deny actual evidence, believe in the rightness of their cause and then cherry pick their facts. On the flip side, there are those who begin with belief only and because it was said by a guy with a pointy beard and slicked back hair in a green book, it precludes them from a sensible approach to knowledge. "Prophet-based Technique Masters" with really poor diagnostic and analytical skills (because their technique does everything for them....not singling out anyone here) and nary a neurological clue, fall into this trap. I am as big a fan of BJ Palmer as the next guy but that doesn't mean I won't ask the rigorous questions, test assumptions and scrutinize another's logic. Sometimes, the strongest belief and greatest doubts pave the way to "certainty" and "confidence". But at the same time if your "certainty" is based on a false premise and you don't make the change.....you don't grow and neither does the profession. At one time a large population of people were very "certain" and "confident" that the earth was flat. I may say that universal/innate intelligence is a fact but I must also say it is a theory because it is understood using theoretical constructs and paradigms that are constantly tested. The outcome of research is not a matter of opinion but the interpretation of its results can be.
So the line about "needing to be right" is a poignant point. A true scientist is a person who simply seeks to know. They want to remove doubt from the equation. This healthy approach will serve our profession well. Lets not always "leave the healing to the patient" and wash our hands of it....lets find out why- could you have approach it differently, is there a piece of knowledge that you are lacking which would have made the difference in that patient's life. Not in a way that cripples you with doubt but in a way that makes you, and therefore the profession...better.
Thanks for the posts. They are great.
Posted 1 year ago # -
Well said all.
Dr. Rich, I would suggest that also as one's technique improves there is a higher level of results gained consistently by the patients that we serve. Not just because we think we are better but because we actually are better at helping them solve their problems. Throw into the mix the "good vibrations" and there is likely an exponential improvement when you are humming on both fronts. Which ties into Dr. Jay's comments. You can only improve if you think their is room for improvement. He uses skeptic, I prefer open-minded (Jay is edgier then me :), Dr. Frank likes Beginner's mind (he is more Zen than me :), but all referring to the same thing. Keeping the radar running for picking up on things that can make us better. It is funny the styles of students that Jay described and I have viewed the same factions even when I was in school. I looked at it as A students that could explain things in theroy but not always deliver the goods, the C students that might of had "touch" but might not know what the heck to do with it and then the B students that were a blend of the two. Since that time, I think we have all been exposed to the studies that show that on average B students are the most successful in their career lives. Amusing. There is that little dance between the two.
As we all continue to "master" our technique, keep in mind that there is no end point. If you do Activator, it is most definitely not when you have memorized the gazillion isolation tests they have put out there, sorry :). There is always more, which is why I really don't like the term mastery. To me it rings that one has conquered what there is to conquer which really never happens so how can one really be a master? Ponder my friends.Posted 1 year ago # -
Chris, it's interesting you say skeptic is "edgier" (come on I know you mean Jay is grumpier..;)..) but I was using this professor's own words in her speech and she even mentioned that because of the media and how the word "skeptic" is portrayed, it has much more of a negative ring to it. That it's lost it's true meaning. Especially most of these "skeptic" blogs that have popped up all over the place.....such biased garbage, full of cherry picking pseudo facts, denials and emotionally laced opinions (like the one I just gave...LOL!).
Posted 1 year ago # -
On mastery: Yesterday was the 18th anniversary of my sobriety birthday. I saw my FIRST! patient (visualize one name on my new Big Book...) at my new office called Recovery Health Care where I work with recovering addicts. Later, I gave a presentation/lecture at a local recovery treatment center where people were dying to learn how to LIVE again. Really, no distinction of who'd been in the process for a relatively long time or who was brand new in the work as it is all about today. Tears of joy and gratitude for this gift of a day. There is something powerfully true/paradoxical about your disdain for the word, "mastery", Dr. Perron. It truly is paying pristine attention to right here, right now. One of the few things I know for sure is that I care very deeply about my life and my relationships and I'm proud to be associated with this crew who seek to deepen that experience every day.
Posted 1 year ago # -
Congrats on an awesome post, achievement, NP and day altogether, my fellow Jedi friend.
Posted 1 year ago # -
The use of the Mastery is like using the word Perfection. We may never reach either, it is more "the pursuit of". When we work towards mastering a technique, we may never reach it but the more purposeful practice we put into it, the better we become. Of course this benefits us, our families, our profession and most of all our patients.
Posted 1 year ago # -
Progression not perfection! I agree there is no such thing as total mastery, as that implies that there is a finite level to our improvement! Thus if you are not growing you are dying! And it is interesting talking about true belief and true skepticism, I agree it all hinges on how much you know and understand or indeed what you dont know but what is important is what you do with what you dont know! (if that makes any sense - in other words do you make things happen or are you a victim). Are you prepared to admit that you dont know things, yet are willing to learn! Define not defend; and I am beginning to see the validity and use of Senzons quadrant theory in this process. And Jay I would say it is not just the students and new grads who find themselves struggling with conflicting attitudes and opinions! I dare say that the majority of us on this Forum are still struggling in refining and defining our philosophy, changing certain deep seated beliefs that we have had for years! Yet it is so understandable to see why the students in particular have cause to struggle - certainly in the UK the education system is diammetrically opposed to what is truly chiropractic, they are being taught in a totally allopathic model! The emphasis is 100% on best available research yet as Dr Frank stated this loses sight of those 2 other crucial components of true evidence based clinical practice - patient preference and clinical experience! Which is why the whole of the DC Mentors tribe have such a crucial role in changing the course of our profession! Everyone needs an authority/leader who has integrity, knowledge and experience which is also why it is imperative that we get our acts together! As individuals we wont change much but as a collective we can change anything!
So Chris do you mean to tell me that that new test we taught last weekend for a hidden, hot, enhanced, chronic C5 will not change our practices? Crikey - that will be a shock to some!
Posted 1 year ago # -
Ed, that test is the difference between 150/week and 450/week. :)
Cooincidentally, I will be teaching it this weekend. It is actually a good example of leaving the responsibility for success outside of ones self. Relying a great deal on any outside party. Alot of us are familiar with Activator so it is easy to kid, but it is not Activator's fault if the doctors, many of which I come in contact with, rely almost solely on what is spoon fed instead of using this information as a great start to then explore "what else?"
I know that is what you were joking about.Posted 1 year ago # -
Just on the topic of confidence, I just wanted to share this:
Somebody asked: "You're a nurse?!? That's cool, I wanted to do that when I was a kid. How much do you make?" The nurse replied: "HOW MUCH DO I MAKE?" ... I can make holding your hand seem like the most important thing in the world when you're scared. ... I can make your child breathe when they stop... I can help your father survive a heart attack...I can make myself get up at 4:30 AM to make sure your mother has the medicine she needs to live...I work all day to save the lives of strangers... I make my family wait for dinner until I know your family member is taken care of... I make myself skip lunch so that I can make sure that everything I did for your wife today is charted... I make myself work weekends and holidays because people don't just get sick Monday thru Friday... Today, I might save your life... How much do I make? All I know is, I make a difference.
Just gives you a bit of an idea of how you can fill in the blanks for yourself.
Posted 1 year ago # -
Great post Dr. Huynh. Along those lines, there is a great book I just started called "House calls and hitching posts" about a country doctor that practices in the largest amish community in the US. Great stories about the complete trust this community developed for an "Englischer". It gives you tremendous perspective on delivering what is needed by your community. I just looked and it is available on Amazon. My father got to go to lunch with the doctor while he was visiting the area and heard many more amazing stories. Very cool.
Posted 1 year ago # -
Anonymous
UnregisteredIsn't that doctor named Dr. Tad?
Posted 1 year ago #
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