How to Tell If You Are Seeing the Right Healthcare Provider

You're listening to the Restoring Human Movement podcast, and now your host. Hello everyone. Welcome to the Restoring Human Movement podcast. Thanks for joining the Movement Movement. My name is Dawne Costantino, and if this is your first time, welcome. If you are returning, thanks for coming back. Don't forget that we have tons of videos on YouTube and other recordings on this podcast platform that you can check out that covers a lot of areas of the body. So any questions you may have, go ahead and use those as a resource. Today, we are going to be covering the topic of how do you know if you're seeing the right provider? I have intern Garrett here with me today. You guys probably have heard his voice a few times on this podcast now. He's around to the end of the year, so I'm going to take advantage of being able to have cool conversations with him and record them so you guys can listen.

So we were discussing today, actually, what ignited this idea to record this one? What was going on in your brain to kind of ask the question of like, is it a red flag to be seeing this type of provider? Yeah. Recently, I went on a trip with some friends, and if you are in chiropractic school or PT school or any sort of provider school that's niche, you will get questions or you'll get asked things when people have pain or people have injuries. And I had a friend that had some questions about a provider they were seeing confided to me like, hey, is this person? They're pretty famous. Are they doing the right things for me? Or are they doing they're seeing my sister too? Are they doing the right things for me and giving me the right care that I need? Because it's kind of a far drive. So that kind of sparked a conversation I had to have with two people that were kind of unfamiliar with this space. And they were brought up. They said, we're flying blind here. You know, most people don't know what's a good chiropractor. It's a bad chiropractor. And I don't like saying good or bad a lot. But are they doing the right things for me? Are they selling me packages? Are you just scamming me out of money? Are they getting me better? So those are important questions that need to be asked. Because if we don't check ourselves, and as I don't know, industry, if we don't police ourselves, then we're not going to give people the proper care. Absolutely. Yeah. So what was maybe one of the first questions that she asked you that you thought was pretty important to kind of help her with? The first one would be, is he a good provider because he has a TikTok? So do I trust somebody because they have such a huge following on social media? Yeah. That's a hard one. And that is a hard question. Because that takes an eye of somebody who's in the space to look at it. And like, is this good content? Is this quality content? Are they just adjusting people? Are they just showing, giving us a show? Are they there to entertain or educate? Or market? Because those are three different things. Sure. Let me actually come back to that. I think it's really interesting. This is something that actually was on my mind when I was a first a new doc as well. And then I think it's changed as years have gone on. This idea of like, if you're only adjusting, you're not a good chiropractor. Do you think that that's true?

I would say not good, but not bad. I would say it's like I said, it's not necessarily the good or bad, at least what I've seen. Because you try to take a neutral approach with everything and nothing is ever as good as it seems. Nothing is ever as bad as it seems. If you're just adjusting, could you be doing more? Sure. I don't think it's fair to judge. But are you selling them that what they're doing is more? That's exactly. So you can do the adjusting. Just don't tell them it's doing more than it actually is. Absolutely. And I think that's the big thing. I don't think there's anything wrong. And that's what's changed for me. Because I definitely, in the beginning, and even to this day, am not somebody who will only adjust a patient. And that's a choice of mine. That's just what I've learned along the way. Tools that I've acquired that I know work for people. I just decided that as a chiropractor, I wasn't only going to adjust. And I think I knew that before I even went into school.

So then I was a little judgmental when it was the kind of offices where you have, you know, a patient in four different rooms that you have. You walk in, you say hello, ask them where their pain is, adjust that area, move on to the next. Spend 30 seconds, maybe five minutes with a patient before you move on. But then my, like, you know, it's kind of changed where I'm like, you know, there's nothing wrong with that being your only tool. It is a powerful tool. But I do think the way that it's explained or the way that it's used to claim that it's going to fix this or, you know, you come to see me four times a week for the next 12 weeks. I will adjust the area of pain, maybe some other areas too. And then I promise you at the end, you're going to be feeling better and moving better and your pain's never going to return. It really is about how you educate the patient, how you give them maybe more options on other things that could be a good supplement to the adjusting. So yeah, I've changed my thought process on there's nothing about, nothing wrong with that being the only tool. It's educating the patient about that tool and other options I think is important. Yeah, absolutely. And in one of my clinical rotations right now, we have 15-minute appointments. So it's very quick. And, you know, primarily we're a more active care-based clinic here. And that's kind of how I want to run my practice. But in there, I don't have that option. So what I try to do is, yeah, I'll do a lot of adjustments. I do a lot of soft tissue.

But educating them on exercises, and I frame it as like what you can do in the gym. If you, you know, you're clear in their history, if they go to the gym, it's like, hey, here's something you can do so we can fix this problem faster so you don't have to come see me every week. And I think that transparency as well gets more buy-in. And more buy-in is better word of mouth, which is the best form of advertising. So at least with that too, is you can just adjust. But like you said, it's like educate the patient. Like, hey, we want to do these kind of shapes. Like we're having issues in our mid-back. I always have to adjust your mid-back. Well, let's do some rows in the gym.

Sometimes it's just a suggestion, right? You don't have to teach them how to do it. Exactly. I mean, we do, right? Because we know we want to make sure that this person is doing it right for them, right for their injury. They're feeling it in the right spots. We know that coaching one simple exercise is a different type of coaching for each person. But if you adjust that area and you notice, I keep having to adjust this area, like what you're saying. So you suggest something that they could do outside of the office to help with what you're doing. It goes even that much further. Right. Yeah, absolutely.

What do we know that an adjustment does? I think now that we're talking about that so much, I'm curious to, or I know a lot of people always wonder like, why adjust? Like what does it actually do? Does it need to be a part of my treatment or not? What is, what's school teaching you these days about the adjustment? School doesn't, to me, doesn't really teach me much about the adjusting. When I walked into school, it was more, almost like this assumption, like we're chiropractors, we're going to adjust. So they don't really explain what and why we're doing it. It's almost jumped in. It's like, hey, we're going to palpate here. We're going to look for this joint restriction. Not why we have this joint restriction. We're going to look for this joint restriction. Other classes, like we're going to set up and we're going to learn how to adjust this joint restriction. Now it's a very niche and specific skill. It's very difficult to learn all different kinds of adjustments. But to me, what they do is probably the most efficient and effective way to increase the range of motion of a joint. And what I've seen, and you can disagree with this with me if you want, but what I've seen is it's usually should be designed for people who can't get in those positions actively on their own.

Or if you can't coach them into a position, they're like, hey, I literally just cannot move it. Okay, let's see if we can assess it and see if there's a joint restriction around the area they're complaining and adjust it. Because then we can increase that range of motion. We can give them that temporary freedom of movement so that we can go and load the position in all forms and capacities. You know, we do many things out here in the clinic that we can load differently. But let's give them the capacity to create that range of motion. Absolutely. And if you feel like you always need an adjustment, to me, I've learned that's for personally, maybe we shouldn't adjust it. Yeah.

That means your body's screaming for stability, not mobility. Yeah. Which is what an adjustment does. Absolutely. I think another thing to clarify about that, and we'll get back to the topic of how to know that you're in the right office, but I think this is a common question and something that like even these, you know, the provider that you're seeing may or may not be explaining this to you, which goes back to look for that. As long as that's important to you. Not everybody wants to learn. Some people just come in and they're like, fix me. Sure. Right? Help me figure out what I need to do. I don't necessarily care to be educated on why. Yeah. That's fine. But another thing too, people scared of the adjustment. When we say an adjustment increases range of motion, I think a lot of times they think popping your joints like that, right? Or putting pressure through those joints, there's a lot of movement that occurs from that. Oh yeah. And what we know is it's very minimal amount of movement that actually occurs in that joint after an adjustment. But the reason why you can increase range of motion afterwards or access more range of motion is because it probably feels better afterwards because it does bring feel-good chemicals to that area. So now your brain brings awareness to that spot. And now your brain knows how to properly find the joint better, how to properly move a little bit better. Right? So there's a lot of things that come along with the adjustment. And don't shy away from it too quickly. I mean, nobody, again, going back to the topic of the podcast, nobody should force you to do a treatment that you are not comfortable with.

And so going to see a chiropractor should not mean you are automatically going to be adjusted. Right? So if somebody is forcing you into a treatment that you're uncomfortable with, you are probably not in the right office. But yes, there's a lot about using that as a tool that could help improve range of motion. But don't shy away from it because you think, oh my gosh, you're going to, I don't know, dislocate my shoulder if you adjust it or something of that sort. Right? There's very, very, very minimal amount of movement that's occurring when you do an adjustment that improves a lot of things. Yeah, absolutely. Cool. So back to the topic. So what were some other things that that conversation you had with your friend, some other like questions she had, concerns she had, anything that pops into your head? Yeah. The other one was x-rays, which is seeming to be, I don't understand why that's still a major thing, but it is. It's something that's been around the chiropractic for a very long time that you're in office and they're taking x-rays of your spine and telling you where you're off. Yeah. And even a lot of times that's maybe not even for your chief complaint. Like, oh, you're next here, but my chief complaint is my low back. That was something else we discussed is like, do you have to take x-rays every time? Unless you have a fear or a potential risk for a fracture, which if you do, it should be assessed effectively by the clinician, by the chiropractor. You don't have to have an x-ray. If you have maybe a history of cancer, I'd say that's maybe another reason you might have one just to rule any metastasis or anything like that. But if you have no history of red flags, fractures, cancers, anything big, bad, or scary, you don't have to have an x-ray initially or anytime you're in office. Yeah. An x-ray should be used as a way to make sure a certain treatment is safe for you. Sure. To make sure that you are getting, you are ruling in or ruling out certain thought processes and diagnoses, right? So we send for imaging because we need more information, right? I don't know where this came from. I don't know the reasoning behind it. But for some reason, there are offices that are still out there, and I think it was more prevalent back then, where before you even start treatment, here's your x-ray. We're going to identify the position of this vertebrae, the position of this vertebrae, and that's how we're going to adjust it based on a still image. I don't know if that's been disproven, but I'm pretty sure that's been disproven.

Yeah. So to me, personally, it is a red flag. If you are walking into an office, they are taking an x-ray of you and they're basing your treatment off of what they found on your x-ray. What are your thoughts on that? Yeah, I would agree. I think one of the most important parts of treatment for you as a patient is to give you power to take over your pain or whatever dysfunction is going on because you feel helpless. Even we feel helpless. If we have something going on, it's like, can someone help take care of me? And, you know, our job as providers, we should be guiding and facilitating treatment and ultimately trying to give the patient back the power of their pain.

What an x-ray does, if you're basing your outcome measure off of an x-ray every time, you're literally creating a problem from an image and putting it in the power of the docs is the only thing they can do to fix it. So they're roping you. They can intentionally or unintentionally be roping you in to adjusting as your only source to get out of this pain. And we know that adjustments don't last very long. Sometimes 20 minutes, sometimes a day, depending on how many times you've been adjusted in that area. It lasts very, it's a very short amount of time it can last, the changes you can get. So it essentially is just creating a feedback loop of here's your problem.

The only way you can fix it is going to the doc and then you're going three times a week, four times a week for the next six months. If your insurance covers it, okay. But if you're paying out of pocket, that's an endless supply chain of cash flow into the doc's pocket. And are you getting better? Don't know. That is the question, right? Are you improving is the way to know. I think that's like the end answer. Are you finding the progress you're looking for in this office that you are currently going to, right? Another thing about the x-rays I was thinking is like, how many of these patients actually know what they're looking at when that's put in front of them? So they're going based on anything that that provider describes to them, which a lot of them use as a fear tactic. You see this, you see this, they put a bunch of scribbles and circles and it's usually in a red pen and it's just all these like kind of sales tactics. I'm not saying that's all offices that do that, that ones that take x-rays of you, that's their purpose of it. But I think it is pretty prevalent that they can use that as a fear tactic so that you buy a package, show up and hope for the best, right? So I think it's, yeah, it's really scary when like your bones are right there in front of you. You have no freaking idea what you're looking at and they're describing it to you in a way that's only I can fix this for you, right? So red flags to keep out, to, you know, keep an eye on. So to recap really quickly what we've covered, ones that take x-rays and then ask you to pay for 24 sessions, come in multiple times a week for this many weeks and rely on me only. Ones that claim that the adjustment is so powerful, it's all you're going to need to fix every single problem that you're coming in with.

Another one that is forcing you maybe to do treatment and not giving you other options on treatment that you are not necessarily excited about, right? Or scared of. They should not force you into anything that you don't want to do. Anything else we've covered? I think that was a good recap. We briefly talked about social media. Social, oh yeah, oh yeah, we didn't really go on to that though. Yeah. We have a big social media following for sure and there are a lot of times. So something I had to get used to is people have been listening to us for a while, following us for a while. The world we live in now creates these parasocial relationships where the moment that I meet them for the first time, they feel like they have already known me for a while. So they already have this trust in me and I actually encourage them to be skeptical. I think it's really cool that they already trust me and I really hope that I can continue that trust, but I don't know anything about them. I don't know at that moment when I first meet them if I can actually help them.

So please ask questions. Please be skeptical. Please make sure that the program I'm laying out for you actually involves the things that you want in your program, right? And we're leading you towards your goals that you have in mind. So yeah, just because somebody has a big following, it might be because they've just figured out the algorithm. They know how to edit videos really well. It might be super good looking so it just works in their favor. Not to say that they're not good at what they do. I don't know. You don't know until you go see that person, do a consultation with them, see what they have to offer. How does it feel talking to that person, right? How do they answer your questions? How do they look you in the eye? All of that just kind of just like those social cues.

Just go with your gut, I tell people all the time. I try my best with each person, but I'm not going to be everybody's favorite flavor. So go with somebody that you feel like they're listening to you, they care about you. They're willing to change things according to your comfort level and your goals. And I think that that's really, really important. So don't just trust somebody because they have millions of followers. Millions of followers does not always mean that they're good at what they do. They're just good at the social media part of things. Yeah. And to piggyback off a little part of that was to ask questions, not only for yourself, which is important, but as far as like, at least I encourage us, as I'm also a personal trainer, I encourage questions being asked because it helps me clarify what I'm doing.

You know, and it may, I may answer something in the way that you didn't mean to ask it. But if you're not following up with questions, I don't know that. And I think it's really important because we like to talk about what we do all the time because we think it's important and we think we help people. So ask us questions. We'll talk your ear off. But if they can't talk your ear off about your questions about how we're going to solve this problem or at least transparent and say, hey, I'm not entirely sure I can 100% help this problem, but I can try and give you options. Like I've seen something like this before. Yeah. If they can't do that, get bring that level of transparency in your questions. That's another red flag. I think when you come into the office, it's like if they have, if their answer is always the same, if their tool is only a hammer, every problem looks like a nail. So if that's the adjustment part, if everything you come at them, they circle it back to one way of treating, maybe, maybe that may not be the provider for you, but it's important to ask those questions. Absolutely. How many times do you hear me throughout a patient interaction be like, any questions? All the time.

I feel like an annoying amount of times, honestly, now that I'm thinking about it. I do feel like it's important. And I do feel like sometimes people may not feel comfortable with coming up and with their questions, right? Or asking them or they don't know when is the right time. So I always give people multiple times throughout the visit to ask questions. But I do feel like there is also like on a personal level, the people pleasing part of me that wants to make sure this person is getting what they're looking for, right? I have people all the time. I actually last week had a new patient who, you know, he had his own views of, you know, what he thought was going to work for him. And then he would ask me questions and I would give my suggestions. And then I, you know, I created a program where we were meeting in the middle, right? Because his thing was, I just need the adjustments. I'm already doing all of these exercises throughout my day.

I don't know if I need more rehab at home. Okay. Well, I'm not going to force you into that right away, but maybe we can meet somewhere in the middle. And then as I created a program that I felt like was a good, all-encompassing, like a little bit of what he wanted, a little bit of what I thought was going to be helpful for him. He goes, but you're the professional. So just tell me what to do. I'm like, that's just not how it works though. Because if you don't like what you're doing, you're not enjoying what you're doing. How are you going to build that into your day-to-day, right? So it's super important to take into consideration like what the person enjoys, what their expectations are out of their visit and their treatment. Because if you're forcing them into something that they don't want to do, they're going to go find it somewhere else, right? So anyways, that's the, again, the people-pleasing part of me, but then also just, yeah, we want to make this program, this exercise. How do you feel about that exercise? Or I explained what I thought was going on with them. Can you repeat back to me what I just said to you, right? What are you understanding about what I'm describing to you? So questions throughout the visit are super important, making sure that that provider is giving you time to ask those questions, not just coming in, coming out. And what is there any other time that they give you to be able to ask those questions?

So that's definitely something to look forward to. I feel like I'm rambling now, but anything else you think is important when it comes to what to look for in a provider or what might be more of a red flag for you in a provider? No, I think that that's pretty much it because everything else trickles down from there. Because you can get some clarification on what you're going to see. Maybe you're getting what you want. You just want adjustments. We have patients that come in, they just want adjustments all the time. They're like, okay, just make sure that those expectations are met. Your expectations are met. Where the doc's at, the doc's meeting you where you are. I think overall is like the biggest thing.

Yeah, absolutely. And as long as the treatment you're requesting is actually safe for you as well. It is our job to make sure that like this, I've had multiple people. I only want to come in to get my neck adjusted. I'm like, well, I can't promise you that that's going to happen because your exam and your history needs to prove to me that it is okay and safe to do that. One, for you and your safety, but two, my job, my license, right? So there's a lot of things and factors to consider. But yeah, one small thing that I just remembered, exam and history. They're not taking a true, like if they're not taking a thorough exam, I think our, you know, you graduated from the same school I'm about to graduate from, they beat that into us. It's like, take a good history and be thorough at your examinations because if you can rule out the big, bad, scary, and maybe the reasons why you shouldn't adjust, you're going to save yourself and your license, but also from, you can be ethical with your patients. So if they don't take a good history and they don't actually go through a good exam for you, like go through orthopedic testing, go through neurologic testing, maybe check your pulse heart rate or pulse blood pressure, things that respiratory rate, things like that.

If they're not doing that, that may be a red flag. Yeah. Probably the biggest red flag. I remember when I was an intern like you, I was at a random office that I only went to once because I just didn't jive with, you know, what I, who I wanted to learn from. But a, they were kind of what I described in the beginning. They had four patients in a span of 15 minutes. Each room was filled with a person and doctor walked into the room. I followed him in just to observe. And the patient goes, yeah, over the weekend, I jumped off of a boat and hit the top of my head. I can't remember on what, let's just say the, you know, the floor of wherever they jumped into and then describe their symptoms afterwards. And the doctor goes, okay, lays down, just poke, poke, prod, prod for about 10 seconds, adjusts. And I'm like, oh my gosh, I haven't been in school that long, but I know that that's not okay and safe. There should be follow-up questions to that. There should, we should be making sure all the big, bad, scary things that can happen when you hit the top of your head on the bottom of a pool or whatever it may be are not occurring before we go and adjust you. Like again, the adjustment is not a super risky treatment, but in certain conditions it can be risky. So it's super important your provider is examining you and asking follow-up questions to make sure that their treatment modality is safe for you. So I feel like we can talk about this one for like an hour, honestly.

If you have any questions, feel free to send those to our email or give us a phone call. We are open to discussing things with you. And yeah, we help people virtually or in person, in state and out of state in different ways. So just go ahead and reach out to us and we'd love to guide you in the right direction. Have a good one.