When I started utilizing Activator in the school clinic, “critics” of the technique said it was a “cookbook” approach. This comment was supposed to be somehow derogatory, but I never understood what was wrong with a step-by-step procedure. I would always remind the critics that science requires a step-by-step process. Why wouldn’t you want to know what you are doing? Decades have passed, and I’m still using the procedure that today has been enhanced by yet another step-by-step approach – research that proves its effectiveness. So much for the critics!

Dr. Joseph Steinhouser, DC, is a member of the Activator Methods Clinical Advisory Board and has been an instructor for years.

The patient’s main complaint in his visit to me was low back pain. He did have restriction of the lumbar motion, some of which I attributed to the extensive taping applied to his back. Despite his condition, it quickly became apparent that adjusting this patient was easy, thanks to the Activator Method. With the patient in a comfortable neutral prone position and using an Activator IV with the small contact point, I was able to place the Activator between the tubing and on the appropriate lumbar contacts. Resolution of his pain and return of his motion occurred within six treatments.  

Dr. Joseph Steinhouser, DC, is a member of the Activator Methods Clinical Advisory Board and has been an instructor for years.

It is a good idea to ask yourself and evaluate your results with your patients.  Am I adjusting and checking enough or too much?  There are time factors to consider.  We all need to value not only our patient’s time schedule, but value our own services for their true worth.  Most chiropractors are very giving, patient-serving doctors.  That doesn’t mean you have to spend 15 minutes per patient and perform at least 50 Activator tests on them.   A 2-minute, 5-adjustment treatment can be just as effective as a 15-minute, 50-adjustment treatment.  Which way is right?

The Protocol outlined in The Activator Method, Second Edition provides some answers.
1.    Always start with the Basic Scan.  Once you approach the area of chief complaint, both biomechanically and neurologically, then you can start adding extra tests.
2.  Make sure you utilize all your Positions in areas of chronic subluxation and the active complaint areas.  Every time you go from Position #1, to #2, then #3 and so on, you are accumulating neurology.
3.  Look for the BIG change in leg length reactivity.  This should give you more confidence in giving your patient the best adjustment.  Remind yourself how the joints are coupled.  Don’t let yourself get caught up in minutiae.  Follow our chiropractic philosophy of the “whole.”
4.  Add your extra tests relative to the chronic subluxations and patient complaint.  In the back of the textbook is a great reference to help you remember all the additional tests per area.  Utilize this by copying and putting it in each or your adjusting rooms.  If you are stagnating with a patient’s progress, make some notes of tests to perform prior to the visit.
5.  For extra tests not in the textbook, look through your manuals from the Advanced seminars and make yourself a list.  Add a new test each day or week to focus on until you have confidence to be able to see how patterns emerge per conditions.  “Favorite” tests will start to appear as you are in practice longer and utilize the new tests.  Instead of performing all 45 knee tests, start with your favorites, or “majors” as I like to call them.  On subsequent visits, start adding others.  Over time you will find tests that seem best per condition.
6.  At the end of your treatment, take a few seconds to ask your patients if there is anything else they would like for you to check or focus on.  This is a great way to instill confidence in your patients, demonstrating how you care about them and their treatment.  It is also a great step to take to assess if you are under testing or under adjusting.

Dr. Rebecca Fischer, DC, is an Activator Methods Clinical Advisory Board member and longtime clinical instructor.

Following the rules is an imperative that is ingrained in me, and has served me well in my personal and professional paths. Unfortunately, I have observed some recent behavior in the chiropractic world that leaves me unsettled and hoping that I am not witnessing a trend.

I am reminded of a time when I attended a prominent chiropractic seminar at which doctors take courses that qualify for license renewal. I saw a handful of registrants check in to a given session, leave the room, and then return near the end of the session to “prove” their attendance. I was so frustrated by this behavior that I left the seminar feeling rather defeated.  As a proponent of continuing education, not only for licensure but also for mastery of a given technique or strategy, I felt the doctors that failed to attend the full course were not only cheating the system, but also cheating themselves out of a tremendous professional growth opportunity.

When our state Board of Chiropractic Examiners took a hard line on inadequate record keeping, many of the doctors reacted strongly, complaining that the regulatory body was overstepping its bounds and being too aggressive.  Somewhere along the way, those doctors forgot why the Board exists in the first place:  To protect both patients and doctors.  After all, shouldn’t we seek to offer the best patient care possible, which includes keeping accurate and substantial documentation on each patient? Why would we want to put our patients at risk, and for that matter, our practices, by not keeping proper records?  And if those considerations don’t resonate, then think about the third-party payers who cannot justify reimbursement because of sub-standard record keeping.

It is detrimental to our profession when a few of us elect to sidestep guidelines or rules, when so many others are working diligently to maintain the integrity of chiropractic.  Not only does it detract from our credibility, but there is clearly an explicit price to be paid when rules are broken.

I am still a firm believer that the majority of chiropractors are following the rules, and ultimately realizing great benefits as a result. I can think of two colleagues in particular who underwent Medicare audits in recent months.  Because their documentation was intact, they did not incur any fines or additional fees from Medicare, and could take pride in the fact that their practices are managed efficiently and in conjunction with regulatory standards. By following the rules, these two doctors did not suffer financially as a result of the audit, and have even stronger confidence that a system that supports rule-following is one that pays dividends in the end.

I also know that following the rules can lead to positive patient outcomes.  The doctor who adheres to the guidelines associated with a given chiropractic technique is more likely to see results in his or her patients than the doctor who is unwilling to commit to the rules. Utilizing proper technique will help the patient heal faster, and also protects the doctor from extensive third-party investigation.  For example, a patient who is treated three times per week for a year without seeing results is probably not being treated using the correct protocols.  This leaves the patient suffering but also calls into question whether all of these visits can be reimbursed by insurance. And in more than one case that I can think of, reimbursements were declined because the insurance company couldn’t support so many visits if they weren’t yielding results. 

By following the rules, we maintain our professional credibility, help support our bottom lines, and protect the integrity of chiropractic on the whole. So, the next time you feel compelled to skip a step in documentation, leave a course early, or deviate from technique protocol, remember that the value of following the rules far outweighs the consequences of trying to skirt them.  And know that, in the process, you are upholding the chiropractic image for which we all strive.

Examination revealed limited range of motion of the cervical spine along with muscle spasm and tightness of the SCM, trapezius and levator scapulae muscles bilaterally. Besides the 10mm mouth opening measurement on anterior /posterior stressed motion, there was significant pain bilaterally along with popping of the TMJ. The same issues occurred with lateral to medial motion of the joint under stress. Neck pain disability index revealed a score of 30 which was also significantly high.

Adjusting protocol started with the Activator Basic protocol, working up the spine with adjustments in the pelvis , thoracic and cervical spine. After the Basic protocol was completed, advanced tests of the TMJ protocol were utilized with adjustments to specific jaw areas as found. This protocol was followed over a three week period of time with a re-evaluation to determine outcomes at three weeks. She was also taught postural consideration for her neck in particular, along with specific cervical spine exercises. She was told to cut her food into small pieces and to chew slowly and completely with each mouthful. She was to avoid hard crusty foods, and if she ate an apple, she should cut it into slices as opposed to taking a big bite.

On re-exam her mouth opening measurement went from 10mm to 35mm. On stressing the TMJ with AP and lateral to medial motion, pain was minimal with less popping and clicking. Cervical range of motion improved in all ranges with less pain and discomfort; headaches were no longer an issue.  The patient also explained that eating was now significantly easier and close to normal. Frequency of care was decreased and the adjusting and exercise protocol continued. At the end of six weeks of care her mouth opening was at 40mm and pain was very minimal in the jaw. Residual popping and clicking remained but at a very mild level. She was then moved to monthly care and told to continue with her postural and exercise protocols as well as chewing slowly while eating. Utilizing Activator Methods Basic and Advanced protocols enabled us to have a good outcome with this case.

Dr. Tom DeVita, DC, is a longtime seminar instructor and Clinical Advisory Board member with Activator Methods International.

That brings me to the importance of focusing on function and not chasing symptoms.  When I teach doctors and students the Activator Method, I always try to reinforce the importance of following the “system” of analysis when they are treating patients.  When you stick to the protocol, it eliminates jumping all over the place as the patient rattles off symptoms while lying on the table.  If there are other areas to evaluate for the patient, then we have the tests that allow us to do so.

Systematized analysis and adjusting ensure that we are consistent with every patient on every visit. We are thorough in our analysis, and most importantly, we know when to leave the patient alone so the body can respond to the changes we have introduced; or in some cases, when the patient may require additional evaluation or treatment.

In the process of applying the Activator Method, we are influencing the nervous system globally and often we see the body respond to this by resolving other symptoms that the patient, and even the doctor, did not anticipate.  This is obviously the best practice building tool you could ever employ and it does not cost you a dime.  It also presents a unique teaching opportunity to educate the patient on how the nervous system controls and coordinates all functions of the body, and how chiropractic adjustments help to restore normal function and the body’s ability to adapt to its environment.

Dr. Galvin is a longtime Activator instructor and member of the Activator Methods Clinical Advisory Board.

That day, as a result of her positive experience with the Activator Method, she brought her three children as new patients. The middle child had fallen off a bed and injured herself, and the oldest had only minor pelvic subluxations. The new baby, whose birth was difficult, was also seen. While with the family, my CA asked if it was alright for me to step out between exams for a few minutes to see a patient in the waiting room. The mom said, “Sure, take your time.”

In the waiting room sat a new mother who, late in her pregnancy and anticipating being induced, had also seen me for an adjustment. She was there with a big smile, her new baby and a plant as thanks for “getting the process in gear.” This was the second time she had avoided labor being artificially induced thanks to an Activator adjustment. She was here to make an appointment for her child who could not lie down to sleep and always slept sitting up. Her grandmother had referred her to me originally, so I was helping schedule an appointment for a 4th generation of this family.

I returned to my patient with her three children in the adjusting room. Her great grandmother was also attending the appointment to help with the children, so I checked her spine. She then made an appointment to return as a new patient.

What struck me about these experiences is that they really demonstrate how Activator has answers for the challenges of every decade of life. My advice to my fellow doctors: Learn, study, read and attend seminars regularly, so you can be the best you can be and prepared to treat any patient who walks through your door. This is not a dress rehearsal, but rather, an opportunity to make a difference in someone’s life.

 Dr. Jan Roberts is a chiropractic physician and longtime member of the Activator Methods Clinical Advisory Board.

While perusing my bookshelf recently, my eyes landed on a favorite book by Malcolm Gladwell titled “Outliers: The Story of Success.”

The book was wildly popular a few years ago, and I consider it a business classic. One of the most interesting points the author makes is through examples of extremely successful people who everyone assumes became successes overnight.  But actually, they had committed to mastering their skills so they could eventually rise to the top of their professions. A prime example was the Beatles. They had been together seven years before their famous arrival in America. They spent a lot of time playing in strip clubs in Germany, sometimes for as long as eight hours a night. Gladwell estimated that the band performed 1,200 times before being discovered in 1964. By comparison, most bands don’t perform 1,200 times over the course of an entire career.

The story reminded me of the many Monday and Thursday nights I dedicated to practicing and perfecting my adjusting technique – I treated more patients in those evenings than most practitioners did in a week. And when I finally took the platform for the first time many years ago at Parker to explain what I had mastered, I had already invested a decade of time to get there.

Though each of us has unique talents, the formula for mastery, and ultimately success, are the same for all of us:  Hard work and lots of it.

Recently, I was talking to a friend who is an MD practicing in my town. He was telling me how stressful it is to guide his patients through the end of life. He related how he was not prepared to see the patients with whom he started his practice grow older and pass on. I agreed wholeheartedly.

As a clinician taking care of patients in various decades of life, I have learned each decade has different challenges. Activator Methods is so well suited to delivering the right adjustments for each of those decades. But as a doctor, my responsibilities extend beyond just adjusting patients. One of the most challenging responsibilities I have is telling a patient it’s time to “hang up the keys” and discontinue driving. Last week, I had to advise a patient of 20-plus years it was time.  It was an unpleasant experience for both of us, but the patient respected my advice and the relationship we’ve developed over the years. He agreed his response time had slowed and that it probably was time.

He looked me in the eye, shook my hand, and thanked me. Afterwards, I reflected on his two decades of office visits and felt proud that I had served him well, from the time that he started as a patient and I first learned about injuries he incurred while serving our country in Vietnam. It’s hard to watch life pass before our eyes, but as a chiropractor, I’m rewarded by the experiences and relationships I’ve enjoyed with each and every one of my patients.

Dr. Jan Roberts is a chiropractic physician and longtime member of the Activator Methods Clinical Advisory Board.