By Freddie Ulan, DC, CCN


There are many different patient management systems. Most of them are designed for chiropractors and dentists. I studied most of them and found that many of them are incredibly workable if used in the proper venue.

For example, there are several different ways to properly manage chiropractic patients. There are different workable systems for managing dental patients. But if you try to use any of those systems to manage a nutritional patient you find yourself falling short and not quite able to figure out what’s going on.

I have people who are great chiropractic practitioners who cannot manage a nutritional patient because they are using the same system of management that works for them in their chiropractic practice. I have great empathy with these fellows because I had the same exact problem myself. Having been a very successful chiropractor, using proven workable patient management systems for a chiropractic practice, then finding that those things did not work in the nutritional practice.

We are dealing with two different types of patients here. The hardest thing to separate out is that when you are dealing with a nutritional patient, he might also be a chiropractic patient, a medical patient, an acupuncture patient, and a dental patient.

All those are actually separate. If you address the person from the right point of view at the right time you get a much better result. If you happen to be a chiropractor and you’re managing a patient, if you manage the chiropractic case as the chiropractic case, and you manage the nutritional case as a nutritional case, you’ll find that with that type of setup things go much smoother. As we go through this subject you’ll see what some of the obvious differences are in the management requirements.

I hope that just by giving you some of this information you’ll be able to immediately start thinking with how you would implement this in order to improve the nutritional side of your practice.

When I’ve been called upon to help out chiropractors who want to do more nutrition, the biggest problem I run into is they try to do it all in one place, in one space, in one visit. As a result, since many of them are running insurance-based practices, they can’t charge for the nutritional part.

They do a regular chiropractic visit. They can put the right insurance code for that. Then they spend an extra 10 or 15 minutes doing the nutritional visit and that’s cash. But the patient is not used to paying cash, so half the time the chiropractor just says, “Forget about it.” And then the patient may or may not buy the nutrition and they don’t have a system for really getting the patient onto the nutritional program.

Why do we even need to have nutritional patient management? The reason is we’ve got a serious health crisis in this country that goes back to chronic nutritional deficiencies.

The evidence of the health crisis is in the fact that billions of dollars are spent on health expenditures in the United States. They doubled from the year 1990 to the year 2000. And they’re expecting to at least double again by the year 2010* and, quite frankly, I know this last number is a projection and they usually try to keep the projections low. I’m sure it’s going to go way higher than that unless some big changes are made in the health care system in this country.

The interesting thing about this is that there is this much money being spent and what are we getting in exchange for this amount of money? What are we getting for all this money that is tax dollars, 14% of the gross domestic product? A large percentage of your tax dollar is supporting this. What are we buying for that? By spending the largest amount per citizen on health care ($4,000 per person in the United States per year in health care) 13.6% of the gross domestic product, with that expenditure we have gotten ourselves into a situation where we have the highest rate of infant mortality rate of all the so-called civilized or industrialized countries. And, even more significant, we rank number 37 out of 37 in overall health. That’s what we’re buying with those billions of dollars. So, there’s obviously something wrong there.

The truth of the matter is that when you’re trying to solve the wrong problem, you get a worse result. If you’re trying to solve the right problem and have the right solution, you get a good result. So, it’s an obvious thing to somebody who can apply logic that all that money we’re spending is either the wrong solution to the right problem or it’s just the wrong problem being addressed in the first place.

What is the problem? How did we get into this situation? To review something from Royal Lee, his answer to this very question quite a few years ago was that we’ve drifted into this deplorable position of national malnutrition quite inadvertently. It’s the result of scientific research with the objective of finding the best ways to create foods that are non-perishable, that could be made by mass production methods in central factories and distributed so cheaply that they can sweep all local competition from the market.

He went on to say that after these foods hit the market, there develops a suspicion that these “foods” are inadequate to support life. Then modern advertising steps in to propagandize the people into believing that there’s nothing wrong with them. They’re the products of scientific research intended to afford a food that is the last word in nutritive value. And the confused public is totally unable to arrive at any conclusion of fact. They can’t figure out what the truth is, so they continue to buy the rubbish that is killing them off years ahead of their time…Royal Lee, June, 1943.

That actually pinpoints what the problem is. And of those billions of dollars that are being spent every year in health expenditure, there’s very little of that that is being spent in actually correcting the underlying problem. All of that money is being spent on handling the effects of malnutrition which expresses itself in literally hundreds of different ways. Any of you who have had experience in dealing with people with their diverse health problems and then have seen these people recover as a result of proper nutritional programs can vouch to that piece of information. Malnutrition is the problem. If malnutrition is the problem, the answer is not toxic chemical. The answer is not medications. The answer is not pharmaceuticals.

*This article was originally published in March 2005.

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