Back in the Saddle Update from Dr. Rosen PLUS Should I talk about symptoms?

By Dr. Russ Rosen | Patient Care

Should we talk symptoms?

I often get asked this question by doctors who are considering coaching with me.

More often than not they sheepishly ask this question as CLEARLY they are not comfortable NOT talking symptoms but feel that if they are a true, “Vitalistic” or “Straight” or “Subluxation based” chiropractor they should not talk symptoms.

Or they are religious zealots telling me how it is not “Real chiropractic” if you talk about symptoms!


Regardless, if we sheepishly ask that question or act like a religious zealot and to cram it down peoples' throats, we are all “Buck-toothed, inbred chiropractors”. Whether we consider ourselves one of the above types of chiropractors,  a technique freak, or a philosophy freak, we all seem to think that everyone else either sees things the way we do or are TOTALLY wrong!

Here is my opinion when it comes to speaking with patients about their symptoms.

I guess I should start off by saying: for several years, I did talk about symptoms in relationship to the subluxation and nervous system. Then, for 3 years, I would not talk about symptoms. I told my patients “If you are here for any other reason than connecting with spirit at a higher level, you are in the wrong office!”

Here's another way to look at that: if you were rushing into the ER on the brink of death, how would you feel if the doctor started out by asking you “Would you like to connect with spirit at a higher level?” After thinking through that, I then started talking about symptoms with patients again. 

I had a really funny experience when I was speaking in New Zealand. The speaker right before me was the legend Reggie Gold. Reggie was going on about how we should NEVER talk with our patients about any of their symptoms. That is just not what we do!

I was there at one time in my practice. The idea makes perfect sense. “I would not talk with you about what drugs to take, how to cut your hair, do your nails, or tune your guitar. All I do is address subluxations and not your symptoms.” Great rap, makes sense from a very limited point of view and has some great indignant and righteous teeth to it!

I was sitting in the audience listening to (at that time) a living legend, I was dripping sweat. You see, I was just about to go on stage and do my hour lecture on just how to talk with your patients about their symptoms, how to connect their symptoms to the nervous system from a vitalistic perspective, and why it is so critical to know how to speak with our patients about their symptoms when my dear friend Angus Pyke elbowed me in the ribs and whispers in my ear, “Mate, I would hate to be you right now!”

I think the real question is not “Should we talk about symptoms?" It is, “How should we talk about symptoms?" How do we put symptoms in context from our world view and through the lens of vitalism?

I think it is very harmful for our profession to NOT to talk about symptoms and I believe the pendulum swing from never talking about symptoms to only talking about symptoms and relieving their symptoms with no context of the subluxation and vitalism is a huge mistake and very harmful.

Let me ask you this question: If your patient is getting healthier, does it make sense that- in time - they should feel better, too? Yes, I get it can feel worse before it feels better and I get retracing or reactivation. I am just asking us to get out of our dogma for just a moment and answer this question. In most cases, if someone is actually getting healthier shouldn’t they eventually feel better? I believe most of us would say yes.

The problem is that so many doctors that do talk symptoms use it as THE indicator of their patient’s health.

If you are feeling better, then you must be better. You must be healthy. Nothing could be further from the truth! Just ask uncle Joe: never sick a day in his life, goes to the doctor, does all the tests and exams, leaves with a clean bill of health and on the way home, dies of a heart attack.

Did the heart go from 100% healthy to dead in an hour? I don’t think so! People can go from feeling a lot of pain to little to no pain because of adrenalin or endorphins. Fall in love, go shopping and buy something, break up with your lover, these can all dramatically effect symptoms.

So using symptoms as THE indicator as to whether our patient is getting healthier or not is not a good idea.

But I believe it should be AN indicator. I want to have tons of reliable OBJECTIVE tests as well as a very detailed outcome assessment questionnaire that not only looks at how they may feel different over time but also how their quality of life is changing over time. But yes I also want to hear from them how they are feeling. I think it is a critical indicator that too many of us either will not talk about or if we do that is nearly all we talk about.

Along those lines one of my favorite lines relating to symptoms goes like this. Patient walks in and says, “My RD (real doctor) said nothing is wrong with me.” And I say, “So it is all in your head? I am so sorry that your doctor misinformed you like that. What they meant to say was I am sorry I am so arrogant as to believe that there is nothing wrong with you and everything is in your head. The truth is my limited tests do not show me where the real problem is. And since I cannot be wrong. It must be you!”

Thanks for getting this far, doc! I hope that this content was helpful and interesting to you. Shoot me a message and let's talk about it some more. I'm always happy to hear from another member of the profession who is ready to better connect with their community and grow their practice!

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