Measuring the Tone of the Nervous System

Chiropractors love to talk about alignment and movement. In fact we love to show and discuss how spinal alignment is related to deteriorating postures and degenerative spines.  This is all true, of course, but it opens up a new round of questions like: How is Chiropractic  much different than physiotherapy or massage therapy?

There’s a much simpler approach to introducing Chiropractic and one that makes a LOT of sense at every level. It’s called ‘tuning and toning’. It’s not akin to tuning guitars or toning your abs. Or is it? 

The way that chiropractic adjustments work is that they tune-up the communication of the spinal nerves.

That means that the tone of the entire nervous system is less ‘noisy’ and it can perform much better.  

Stress leaves a stain on the nervous system

People understand that stress is generally a negative experience. It sucks the energy out of life and it sucks the efficiency out of the nervous system. At times, stress can be a positive experience if it’s used constructively, such as when it is in combination with exercise or solving complex problems. Rather, it is the ongoing toxic stress, that is often a huge part of everyone’s daily life, that interferes with the way that the nervous system listens and communicates. 

Here’s a little something to remember. Stressful events don’t just pass through you without leaving a mark. Your body and mind memorise these events and store them in the dark recesses of your nervous system. Repetitive stressors like toxic dietary and medication habits or toxic relationships are memorised and gradually, the sum of all these layers of old distress alter the efficiency in the way the body responds and adapts. Stress is heavy. It’s like a stain on the nervous system. Imagine a glass of red wine spilling on a beautiful white carpet. That’s going to leave a mark! Deep repetitive stress is like that. It interferes in the perfection of how the nervous system communicates. These stains are actually tension patterns, put in place to resist the ongoing stress and reduce the potential damage. Over time they need to be ‘adjusted’ to be more at ease and this becomes the measure of how well a patient is responding and recovering under the Chiropractors watchful schedule of adjustments. The beauty of using INSiGHT scanning technologies is that you can easily see the stains by assessing the patient’s scans. These include heart rate variability which shows resiliency, EMG that identities areas of postural energy wasting and thermography that helps pinpoint the stained patterns. 

The importance of thoughtful care planning can not be undervalued here. 

Tuning and Toning isn’t only for Guitars and Abs

Let’s revisit the concept of guitar and abs. A guitar string has to have just the right tension on it to be in tune. Too much or too little tension makes the guitar perform out of tune. The guitar strings are like the nerves that bring messages to the brain and take messages from the brain to all the body systems. You don’t want those ‘guitar strings’ to be out of tune. 

Now about those abs. Muscle tone is controlled by the nerves. If you have poorly tuned nerves then you will develop too tight or even flabby muscles. Let’s take that a bit further. Poorly tuned nerves lead to poorly toned muscles. How is anyone supposed to survive in our world governed by gravity with that combination of poor nervous system and muscle function? The answer is they don’t… or at least they don’t perform well. Their posture warps and eventually they start to feel misaligned and then comes the pain manifests and expresses itself. It takes us back to the idea of spinal alignment and poor postures. The neuroCORE (EMG) can be used tableside or in the exam room to instantly show how the spine is being supported by the postural muscles. 

Clinical certainty can be summed up by the statement,  ‘Test, don’t guess’

In my opinion, the real difference between chiropractic and physiotherapy or massage therapy is that Chiropractors get the sequencing right. 

‘The genius of the Chiropractic approach is that it begins by assessing and measuring the tone of the nervous system and then setting a plan in place to keep the nervous system tuned to the max’. 

Palpating muscle tone is a good start but it’s the deeper neurological connections that tell a bigger story. Using scanning technologies is the ideal way to detect patterns of dissonance in the nervous system. INSiGHT scans reveal the stains on the nervous system that affect the way a person relates and adapts to all the nuances of their life. They also reveal the power of the Chiropractic adjustment. The Chiropractic adjustment releases unhealthy tension patterns and provides a roadmap on how to restore the tone to more optimal levels. 

Remember, guitars and abs love to be tuned, so does the nervous system! 

If it all begins with the nervous system, who said the beginning was the end? If you love aligning spines and restoring postures. GO FOR IT.  But first and always, check the tone in the nervous system and become masterful at tuning it along with the body it controls. Without those neurological controls in place, we all get out of control and stay out of control. Ask yourself, are you satisfied with how your clients feel or how they function?  Checking how their nervous system functions is incredibly simple and reliable when you use INSiGHT scanning.

Last thought

Chiropractic has answers to making lives stronger and more flexible, just like spines. Focus on tuning and toning and trust the inner wisdom that has guided human health and performance from the beginning. 

– Dr. David

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ABOUT THE AUTHOR

Dr. David Fletcher is actively involved in all aspects of innovation teaching and research connected to the INSiGHT™ scanning technologies. He is widely recognized for his ability to share his expertise in compelling and easy to understand ways.

Dr David is a renowned chiropractor who practiced for many years with his associates in a scan-centric thriving principled family-based practice in Toronto. He is a sought-after teacher mentor and keynote speaker who takes every opportunity to share the wisdom and the power of chiropractic as it is meant to be.

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Dr. David Fletcher
DC FRCCSS(C) – Founder & CEO CLA Inc.
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Care Planning begins with the mindset of values and abundance

Your core values go far beyond managing symptoms and your patients value a life without symptoms but also a safe and healthy future. They dream about untapped potential and performance. Focus on that and all else follows.   

Let’s dig in on the practical side and discuss the four CORE steps to creating a rock solid  care plan.

CORE 1: The Scout’s motto: “Be Prepared”

We’ve all done it.  Best intentions and a busy practice can lead to a hastily thought out care plan that isn’t customised to the actual needs of the patient in front of you. The assessment and objective test results are the basis of a neuroplastic care plan. You need to look at how DEEP the problem has embedded itself in the neurology and the structure. Remember, this is not simply a chance to provide therapy to a symptom but the basis of how well they will live their lives from this point forward. Your patients live their lives through their nervous system. 

What does DEEP sound and look like? Listen and look for FUNCTIONAL changes and loss of wellness markers. Symptoms are typically the tip of the iceberg. Some points to consider are heavy medication use, past injuries, toxic diets, altered sleep and emotional distress.  These are the clues that will move your planning and expectations from weeks to months and even years in the care planning process.

CORE 2: The Vital Metrics: Nerve First

Neuroplastic care planning focuses on the nervous system! The vital metrics in a chiropractic care plan need to shift away from a Spine First approach to the Nerve First approach. The care plan is designed around releasing older habits within the nervous system that have impaired its ability to adapt, maintain postures and regulate the body’s internal environment. The metrics behind all of these functions can be measured by INSiGHT scanning technologies. When the neuroPULSE (HRV) data is combined with the neuroCORE (sEMG) and neuroTHERMAL scans, a CORESCORE is created. This neural efficiency index rates  the nervous system’s efficiency and performance. Achieving a combined score from these 3 technologies above 80 is the initial goal when care begins.

Each of the scanning instruments generate vital data and metrics that are used to refine the frequency of adjustments. Remember, the initial visits are critical to establish RELIEF and RELEASE and so neuroplastic care planning is based on the Rule of 12.

The first 12 visits, in fast succession, are the beginning of an intensified 12 week program.  This frequency and duration is essential to start to gain back control in a deeply subluxated system that registers less than 80 on the initial CORESCORE.  

CORE 3: Rule of 12 defined: The 12-12-12 sequence

Of course the initial12 visits are a golden time where change can be apparent. However, the power of chiropractic relates to the reprogramming of the nervous system while improving the function and performance of the structural core over extended time frames. The principle of care planning is centred on achieving a “new normal” with a CORESCORE well above 80. 

To understand this process we have to look at the 12-12-12 strategy. 

Your commitment to watchful and progressive care is to reassess and report after every 12 visits. The initial 12 weeks of care may have up to 4 exams within it depending on the frequency of care being daily or 3 times weekly. Regardless, the most important aspect of care planning is to create signposts along the journey which are the re-exams and reports. 

The CORESCORE is designed to be reported after the INITIAL, PROGRESS and COMPARATIVE exams with new information and detailed objective findings. 

Once the release and relief of early care has occurred in the first 12 weeks, the goals change towards reorganisational healing which is a longer dedicated process to challenging the system to become more efficient and stable. 

This can be structured over months and can be accomplished with a lesser frequency if the CORESCORE remains above 80. A CORESCORE at or above 80, on a continuing basis, means that the client has achieved a high level of neurological performance and stability but there is still much room to continue improving. The next goal is to achieve a CORESCORE in the range of 85-90 which represents a combination of regular chiropractic check ins combined with a wellness lifestyle. 

Using the Rule of 12-12-12 begins by getting the patient focused on their first 12 visits of the 12 weeks of intensified remodelling of their nervous system and spine. The neuroplastic care plan must always discuss the expectation of what a full 12 months of continuous and progressive chiropractic care can offer. 

Remember, there is no race to the finish line. Each step is a step along the journey to a life full of expression.

CORE 4: The Concierge Close

The frequency and repetition of visits are like a map that must be followed. Everyone knows that a guide or trusted advisor is an essential part of the ultimate experience. I liken this to having a concierge who is ready to assist. As part of the care planning offer, the concierge need not be a specific person but rather the procedures and added support tools that you organise in your office. For example, a team member can set the schedule at convenient times and arrange convenient pay models to accomplish the recommended care plan.  Added online or in-person educational services are discussed and are strategies that add on to the experience like supplemental training or products. A concierge mentality is made to be evident in every aspect of the care plan because your care planning skill set is a reflection of your intention and dedication to the patient’s well being and your reputation as a trusted and skilled Chiropractor.

Using the four CORE elements brings neuroplastic care planning to life.  

Given that a care plan is the basis of your business and a reflection of your personal values and intention it only makes sense to dedicate the time and energy to streamline and refine this process.  

CLA is seen as the leader of the neuroplastic care planning movement because of its dedication to chiropractors and the development of the INSiGHT scanning technologies. This 3 part Blog series was created to catch your attention and get you thinking and planning about care plans as a key element in providing the best care possible for your patients..

– Dr. David

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ABOUT THE AUTHOR

Dr. David Fletcher is actively involved in all aspects of innovation teaching and research connected to the INSiGHT™ scanning technologies. He is widely recognized for his ability to share his expertise in compelling and easy to understand ways.

Dr David is a renowned chiropractor who practiced for many years with his associates in a scan-centric thriving principled family-based practice in Toronto. He is a sought-after teacher mentor and keynote speaker who takes every opportunity to share the wisdom and the power of chiropractic as it is meant to be.

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Dr. David Fletcher
DC FRCCSS(C) – Founder & CEO CLA Inc.
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Your Guide to Transformational Reporting

Read more about how the CORESCORE is an integrated neural efficiency index that is calculated when the INSiGHT technologies are combined in an exam to create a profile. Learn about how this single number index, gives the chiropractor and the patient something to compare to over time.

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Care Planning has traditionally been the mic drop moment after a consultation, examination and Report of Findings. Why?

It’s the culmination of the clinical impression combined with the time and frequency “equation” of scheduled care and the financial arrangements. What if we were to re-engineer this process and do as Steven Covey recommends and “Begin with the end in mind”. What if we oriented our entire culture of the practice to ensure that the care plan was the ultimate expression of our chiropractic model?  Perhaps we need to look at another real world example and see how well it has worked out.

Hands up if you have had braces on your teeth or been the parent of kids with braces.  Orthodontists run amazing care plan-oriented practices that are based on the undeniable truth that they can virtually guarantee their desired outcomes. Straightening teeth takes many different strategies but the one consistency in all approaches is that it takes time!

Let’s look at their practice positioning and see if they are consistent with chiropractic models of care. Orthodontists are originally trained as dentists; at the same time it’s unlikely you would call up an orthodontist if you had a toothache. You know that they are the experts in long term outcomes that align teeth and restore function to the jaw and other oral structures. Chiropractors are trained in spinal biomechanics but there is a role that we play by focusing directly on the performance of the nervous system. A neurologically focused chiropractor is more related to the orthodontist than the dentist because the changes and outcomes associated with retraining neurological performance takes time. 

The great news is that whichever path you choose in positioning your practice, you will be using neuroplastic principles to get the lasting results everyone is looking for.  Not so long ago, it was commonly perceived that once neurological function was lost, it was gone for goof, or so we thought. Along came the science and the discovery of neuroplasticity and the entire care planning model changed away from rehabilitation towards rehabituation. The new goal wasn’t limited to improved biomechanics, it now became all about locking in new habits in the neurological pathways and this was accomplished because the nervous system was found to be incredibly adaptive and “plastic” vs. rigid. We could go down a deep bunny hole and explore the science of neuroplasticity but from a care planning perspective it’s incredibly easy to understand. 

Neuroplasticity is based on 2 parameters: Time and Repetition. The very same principle that guides the development of a care plan!  

Remember the mic drop moment when we started this discussion? What would it look like in your practice if spinal symptoms and spinal dysfunction and even wellness and performance were based on the quality of the signal management within the nervous system? 

What if a broken down nervous system could be retrained to perform better and even fantastically if only we applied chiropractic adjustments using the neuroplastic principles of Time and Repetition? 

Let’s call it neuroplastic care planning!

You can see how important a comprehensive care plan is for their wellbeing. This neuroplastic care planning moves your practice into the ‘orthodontic’ realm where shifts are more significant that symptom management and wellness and performance are measured instead of only being discussed.

How the INSiGHT increases credibility

In an earlier Blog post, I shared that my first transformative moment came when I knew that I could stand by my recommendations because I was using objective data to track the shifts in the spine and the nervous system. 

The INSiGHT became the centrepiece of my exam and reports.

The second part of that transformation occurred when I applied the neuroplastic principles of time and repetition to my care plans and trusted the innate intelligence of the patient to use the adjustments wisely and perfectly to reorganise both structures and function. Again, the INSiGHT allowed me to track intricate changes and adaptive responses. 

A sage once asked, ‘How do you eat an elephant’? The answer is simple; ‘One bite at a time’.

Care planning is just like that. 

It begins with a giant intention or goal and if we tackle it one task at a time we can get it accomplished. Like all great journeys, it’s critical to have road signs to measure the distance of where you have been and give you a distance to your destination. These road signs are critical in setting goals and in confirmation as to how well the journey is progressing. You may have guessed it already but the road signs in a care plan are the re-exams and the reports.

The INSiGHT creates a series of CORESCORE reports specifically to highlight the changes from one exam to the next and uses comparative graphs.

There is a logical sequence of reports that give an objective number score with each report. The report is called a CORESCORE and is akin to a road sign that gives a number score representing progress along the patient’s journey. The exam to exam bundle of care is a bite of the elephant and the road signs keep the traveller inspired and informed. How big a bite?  

Follow the Rule of 12

As I was blending the time/repetition principles with the necessity of road signs, I came up with a strategy known as the Rule of 12. It’s used almost universally now since each ‘bite’  care plan uses a 12 visit model to schedule a re-exam and updated report. That means:

  • Every 12th visit an INSiGHT scan exam is scheduled with a progress or comparative report set for the ‘13th’ or next visit. 
  • The time it takes to schedule the repetition of 12 sequentially timed visits accomplishes the neuroplastic component while the goal setting of eating the elephant is always communicated and present as part of the rule of 12. 
  • There is an added dimension when using the Rule of 12. It is designed to give forward direction to the plan. 
  • If the first 12 visits can be reviewed to see how the person is responding to early care then the first 12 weeks is a time frame where structural and functional testing can be included to ensure there is a deeper change occurring. 
  • Twelve months from the first adjustments allows for a different set of parameters to measure performance.
  •  Imagine what you can accomplish in 12 years! 

The Rule of 12 inspires, informs and allows strategic implementation, all within the neuroplastic care plan that you designed and are getting handsomely paid to manage.

In Part 3 of this Blog Series, we will explore the four elements of neuroplastic care planning to create rock solid care plans.        

– Dr. David 

Get Started with INSiGHT Scanning

Take our Free Practice Strategy Assessment. A Personalized Guide and Expert Strategy Call to Help Determine How Scanning will Help you Grow
ABOUT THE AUTHOR

Dr. David Fletcher is actively involved in all aspects of innovation teaching and research connected to the INSiGHT™ scanning technologies. He is widely recognized for his ability to share his expertise in compelling and easy to understand ways.

Dr David is a renowned chiropractor who practiced for many years with his associates in a scan-centric thriving principled family-based practice in Toronto. He is a sought-after teacher mentor and keynote speaker who takes every opportunity to share the wisdom and the power of chiropractic as it is meant to be.

https://insightcla.com/wp-content/uploads/2022/07/david-1.png
Dr. David Fletcher
DC FRCCSS(C) – Founder & CEO CLA Inc.
LIKE THIS ARTICLE? HELP US SPREAD THE WORD

Your Guide to Transformational Reporting

Read more about how the CORESCORE is an integrated neural efficiency index that is calculated when the INSiGHT technologies are combined in an exam to create a profile. Learn about how this single number index, gives the chiropractor and the patient something to compare to over time.

Read these Next…

Get Informed

Join 23,121 other Chiropractors and receive topics covering day to day challenges of running your practice.

I regularly stand in front of chiropractic crowds and in the course of the conversation I ask, ‘What do you get paid for?’. The usual answers fly back. 

 ‘Adjustments’     ‘Time spent’        ‘Outcomes’  

All are partially correct but the real answer is that ‘you get paid to manage a care plan’

Care Planning focuses on outcomes. Adjustments are part of the service and it takes time to observe and measure results. However, what we get paid for is our skill in creating and managing a patient’s specific care plan. That’s why it is so critically important that you get this right and adopt the latest and best proven strategies in planning the care for your patients. 

I refer to this as the Paradigm Lost concept where there were two paths that could be taken with respect to care planning and neither of them are as relevant today:

  • Bait and Switch: This people-pleasing approach focuses on developing a short term plan to address symptoms and along the way your intention is to tell them the bigger story about chiropractic being useful in their overall health. This usually ends up with a preventative check-in plan which can be referred to as a maintenance plan; sort of like scheduling an oil change.
  • Sheeple: This pre-programmed and no fuss approach could also be referred to as the ‘3-2-1 and out the door’ plan.  Somewhere along your journey, a coach or trusted advisor has offered a standardised plan that is to be delivered at the time of the Day 2 Report. It’s usually well scripted and is similar, if not the same, for all adult patients and slightly modified to a lesser number of visits for paediatric care. The goal is usually to get them into a ‘wellness program’ on a 1 x month frequency. The wellness portion isn’t based on real-time objective data and the front desk staff are constantly recalling missed appointments since there is no ongoing strategic plan being followed.

In these paradigms, re-exams, if done regularly, are usually limited to palpation, range of motion (ROM) testing and asking the question, ‘How do you feel?’ or ‘Does that still hurt?’ questions. In most cases, the outcome of updated reporting is for the patient to be offered a less frequent care plan as some sort of reward for making it this far and everyone seems happy … until the problem arises again, and again.

The neuroAGE of Chiropractic care planning has arrived 

Care Planning, along with the timing and frequency of care delivery, need to be vastly different in today’s world. A paradigm shift has occurred as a result of the evolution of and increased use of instrument-based, functional neurological testing. These easy-to-use, objective tests create a new level of certainty for both the clinician and the patient. They force the communication and planning from symptom-based, feeling outcomes towards functional transformations. The shift has opened up the neuroAGE of chiropractic!

On the leading edge of this dynamic shift are the INSiGHT scanning technologies. These precision, neurological scanning devices are used exclusively to evaluate the impact of chiropractic adjustments as they are administered in a care plan. For over 30 years this technology has evolved within the profession so that the DNA of millions of chiropractic outcomes are built into the logic and engineering of every INSiGHT. This means that every exam and report in a monitored care plan brings to life the importance of remaining under watchful care while celebrating the amazing improvements in the functioning nervous system.

How does INSIGHT scanning make a difference in care planning?

The magic of chiropractic outcomes is based on adjusting the tone and tension within the spinal nervous system. Scanning the spine detects hidden patterns of autonomic and motor neurological distress when vertebral subluxations are present. Scanning the heart rate and rhythms provides a window into a patient’s adaptive response. The scope and relevance of these scans means that you can access neuroscience at your fingertips! Without looking deeply into the function of the central nervous system, chiropractors default to managing spinal and postural problems when the real issue lies deeper. You can’t get this data from X-rays and you can’t measure tension accurately by simply palpating, measuring Range Of Motion (ROM) or observing postures. 

Scanning creates the ‘RRTB’: the Real Reason to Believe 

Scanning backs up with hard data. Scanning also creates a journey map that forms the basis of any care plan. It’s only logical that when a scan is performed on an initial exam, subsequent re-exams can be compared at any stage of the ongoing care. 

Here are 5 ways you’ll get paid for leveraging today’s technologies in care-planning

1. Branding and Marketing: When you shift from Feeling to Functional care planning, you are known as the brand that delivers long term results instead of being the one-off miracle worker. Sure, it feels great to make such a dramatic difference in just a couple of visits but the real goal is to KNOW that the nervous system is returning to its functional state and that this process takes time and dedication. INSiGHT scanning also adds a wow-factor to care planning. Patients love to know that they are improving and also love to know that you know what is going on in their spine and neurological health at all times. You will soon be regarded as the expert in your community.

2. Watchful and Progressive Clinical Excellence: Care plans that are designed with an exam-exam sequence keeps the clinical presence at the forefront of all decisions.  CLA clients have adopted the mantra of ‘Test don’t Guess’. This means that regularly scheduled re-exams and reports are added into the total value of services being delivered when calculating the financial plan. You’ll be surprised at how multiple re-exams will improve your bottom line!

3. Built-in Retention: Functional, neuroAGE styled care plans generally span weeks and months. Part 2 of this care planning eBook teaches how the ‘Rule of 12’ organises your exam and reporting procedures around ethically delivering a care plan that follows a neuroplastic approach. Be sure to download it as well. Let’s face it:  Anytime a person sees the value in ongoing care and commits to change, they are motivated to show up. That’s retention! Scan-based exams emphasise the value of chiropractic and confirm that the care plan is working as planned. That’s why it’s called a CARE PLAN! 

4. Attracting families and their friends: Once the results of a properly presented care plan become obvious, patients are motivated to have their families and friends checked out neurologically. Not everyone has a back and neck problem but everyone needs a neurological performance check! The INSiGHT reporting methodology creates a CORESCORE for both adults and children which grades the level of performance in their neural processing. It’s never been easier to attract the right mix in a practice and get them on care plans that last a lifetime. If you are attracting well informed and inspired new patients, your practice will expand exponentially.

5. Reactivating patients that have lost their way: We all know that in every practice there is a graveyard of existing patient files. With best intentions they started care but dropped off for any number of reasons. INSiGHT scans can be used to invite them back for a neurological review. Offering them an opportunity to get an updated ‘stress score’ is perhaps the easiest way to stimulate growth in any practice. Once reconnected, a new or updated care plan can easily be organised.   

There are many more ways that care planning creates new levels of certainty and growth in any practice. I know from my own experience that once I mastered the art of care planning EVERYTHING fit into place. It was as if the care plan became the Magna Carta of my office. It represented my dedication to clinical excellence; my love of helping others; my passion for ethical relevance and my insatiable desire to showcase chiropractic, as it was always meant to be. Along the way, I developed the INSiGHT scanning technologies that you see today.  They represent the epitome of objective analysis and reporting which allow chiropractors to gain a newfound confidence for creating and delivering care plans. 

In Part 2 of this Blog series, we will explore the mechanics of creating an individualised care plan while introducing the neuroplastic rationale that makes function-based care planning the best option for your patients and your practice.   

– Dr. David   

Get Started with INSiGHT Scanning

Take our Free Practice Strategy Assessment. A Personalized Guide and Expert Strategy Call to Help Determine How Scanning will Help you Grow
ABOUT THE AUTHOR

Dr. David Fletcher is actively involved in all aspects of innovation teaching and research connected to the INSiGHT™ scanning technologies. He is widely recognized for his ability to share his expertise in compelling and easy to understand ways.

Dr David is a renowned chiropractor who practiced for many years with his associates in a scan-centric thriving principled family-based practice in Toronto. He is a sought-after teacher mentor and keynote speaker who takes every opportunity to share the wisdom and the power of chiropractic as it is meant to be.

https://insightcla.com/wp-content/uploads/2022/07/david-1.png
Dr. David Fletcher
DC FRCCSS(C) – Founder & CEO CLA Inc.
LIKE THIS ARTICLE? HELP US SPREAD THE WORD

INSiGHT Communication Guide

This quick read covers the importance of communicating clearly and simply to your practice members.

Read these Next…

Get Informed

Join 23,121 other Chiropractors and receive topics covering day to day challenges of running your practice.
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