Entries Tagged as 'Practice Tips of the Day'

Metabolic Hormones

There are 6 hormones chiefly responsible for determining whether the food we eat ends up as muscle, fat or get burned as energy.  They are: insulin, glucagon, growth hormone, thyroid hormone, cortisol and epinephrine.    Over 90% of people who lose weight by caloric restriction return to their original weight within two years. This is because there is a weight-regulating center in your hypothalamus, which tries to maintain a constant body weight. (The hypothalamus and pituitary gland together represent the master endocrine gland of the body, controlling all of your hormonal responses.) It works like a thermostat by controlling your hunger level and your body’s metabolic rate. These effects are mediated by the nervous system and by hormones and enzymes involved in fat metabolism.   

If you want to change your body weight, or your body composition, you have to change the set point. The ratio of insulin to glucagon is perhaps the most important determinant of the set point. Both insulin and glucagon are produced by the pancreas, but have opposite effects. The concern of these hormones is blood sugar regulation. After eating a carbohydrate, it is digested and sent into the bloodstream as glucose. As blood glucose levels rise, so does the release of insulin, which is required to move glucose into muscle cells for use as energy or to be stored as glycogen. If blood sugar levels rise too quickly, a large insulin release results. When this occurs, some of the glucose can be converted and stored as fat instead of being stored as glycogen in liver & muscle.   

Glucagon is released when blood glucose levels become too low. This hormone prepares fat to be used for energy as well as muscle glycogen stores. The net result is to keep blood glucose levels normalized. By manipulation of the diet, you can regulate the insulin to glucagon ratio. .  Excess insulin cannot create muscle mass, but it will promote fat storage. It’s not the calories in sugar that make you fat – it’s the insulin response. READ THAT AGAIN!  When you eat carbohydrates they are digested and absorbed by the small intestine and transported directly to the liver via the portal vein. Essentially, all of the carbohydrates you eat are converted to glucose by the liver before being released into the bloodstream.

   This is why it is vitally important to detoxify and cleanse the liver before starting a weight reduction program. The liver must be functioning at 100% capacity to metabolize carbohydrates effectively. Fitness nutrition is NOT about how good you eat, it is all about WHAT nutrients your body can absorb to permit weight loss!

   Glucagon is released several hours after a meal when blood sugar levels drop. Glucagon has the effect of reducing glucose for energy and stimulating breakdown of body fat and the use of fat for energy. Glucagon also stimulates the glycogen breakdown.The net result of glucagon is to raise the glucose levels back to normal and to signal the body to begin using fat for energy since it’s running low on carbs. This is how the body acts to regulate blood sugar levels. Insulin decreases blood sugar by moving glucose into the cells, stimulating glucose burning for energy and increasing glycogen stores by shifting the metabolism from carb-burning to fat-burning.   Remember, if insulin is present, fat burning is negative! This is why you only have high amounts if simple carbs after your workout. Because you carbed up AFTER the workout when it is most important and any further influx of carbs is going to leak out of a fully carbed up muscle and go to fat.

www.K-LaserUSA.com

1-866-595-7749 Ext. 102

Dr. Perry Nickelston, DC

VP Practice Development

What Recession?

‘Oh the economy is so bad!’ ‘How can I afford to invest in new equipment with the economy?’ ‘Our business is suffering from the economy!’ ‘It’s too expensive to advertise now with the cost of living!’ EXCUSES ALL!

If you want to be rich, successful and happy you have got to get your mindset straight right now! Thinking like this will inhibit your progress and you will attract hardship and lack into your life if you are always negative. WEALTH is a state-of-mind. You can’t get it until you believe you can get it. This is not pollyana positive mental attitude stuff. This is a Law. The Law of Attraction. Ever heard of it? If you are successful then I know you have. if you are struggling and poor then I know you have not, or chose to ignore it in disbelief. Rich and successful doctors can duplicate their status in any economy, ‘Good or Bad!’

 The time to invest in new equipment, new marketing, new employees, etc., is when the competition is NOT. They are scared too do it! But not you. You realize that competition is tough and it is the time to strike out with focused direction, innovation, and desire. Burning desire to succeed. Pain never follows the economy. What does that mean? Even in a ‘so called recession’ people are still suffering and pain is a great motivator. What do you offer them that is unique and different from the competition?

So the next time you are feeling sorry for yourself and the state of the economy suck it up and realize that success is dependant on two things, YOU and ACTION!. You have to do something about it. So stop whining and start thriving.

Here are some hints to start.

1. Buy new progrrssive technology and offer it to your patients (Class 4 laser, Decompression)

2. Do more grassroots marketing to appeal to the human need for value and appreciation.

3. Spend 30-minutes a day reading positive material to improve your life.

4. Stop watching the news. Better yet the TV entirely.

5. Spend 30-minutes a day going over your goals. You do have them written down right. If not they are just wishes, not goals.

6. Call 5 old patients everyday and check up on them. YOU, not the staff.

7. Find a mentor and talk to them on a weekly basis to keep your head into success. Buy Think and Grow Rich by Napolean Hill and read it everyday. Success leaves clues. Follow the greats.

 8. Send out 5 ‘Thank You’ notes a day to exisiting patients to appreciate them.

Have fun and be the one who does not follow the recession crowd. It’s a shorter line to the front. :) Trust me.

Dr. Perry Nickelston, DC

www.k-laserusa.com

1-866-595-7749 Ext. 102

Knee Pain Trigger Points

Ok here is a quick post before I leave for the NAALT (North American Association of Laser Therapy) Convention in West Palm Beach, Florida. Talking about and playing with therapy lasers all week. Now that is the definition of fun. I will be representing K-LaserUSA at the show. If you are going, make sure you stop by to say hello and I will even give you a laser treatment.

Knee pain can be complex to treat, especially with undetected trigger points causing unrelenting symptoms. The next time you have a patient with knee pain, make sure you evaluate the following muscles for trigger points. Some will be the actual culprits referring pain to the knee and others will be Kinetic Chain Dysfunction trigger points altering mechanical function of the joint. CHECK THEM ALL!

1. Vastus Medialis Obliques2. Vastus Lateralis

3. Popliteus

4. Sartorius

5, Posterior Tibialis

6. Soleus

7. Anterior Tibialis

8. Flexor hallucis

9. ITB and TFL

10. Gluteus Medius and minimus

11. All Adductors

12 Iliopsoas

Is this a lot to check? Yes! Will it make the difference? Yes! So take the time to check them all. Once detected work out the knots either via laser, manual therapy, or ultrasound. Of course you probably know my favorites. Laser each TP with 150-200 Joules and then do manual trigger point therapy. Great combination.  Have fun.

Oh yeah and don’t forget to check the femur head for anterior rotation, the knee joint and fibular head as well as the L3 vertebrae and Si joint. But of course you already knew that, right?

Dr. Perry NickelstonVP Practice Development K-LaserUSA

www.k-laserusa.com

1-866-595-7749 Ext. 102

Attitude Determines Success

Every great leader knows the value of a positive Attitude. In short ATTITUDE IS EVERYTHING! Talent is not enough to ensure success in chiropractic. There are a lot of very talented doctors who graduate from the top of their class, and yet they never become successful in business. Why? You would think that they of all people would be ensured of success. There are one of two reasons why. ONE: Zero business and communication skills TWO: Wrong attitude! Your attitude and your potential go hand in hand. Attitude is an inward feeling expressed by behavior. That is why an attitude can be seen without a word being said.

Attitude determines your ability to deal with people. The Stanford Research Institute says the money you make in any endeavor is determined only by 12.5% by knowledge and 87.5% by your ability to deal with people. Let’s do some math now.

87.5% people knowledge (attitude) + 12.5% product knowledge = Success

Where do you think you should be devoting your time after you graduate from school? Better yet, where should you be investing time WHILE still in school? Get ahead of the pack. The key to having a good attitude is the willingness to change. You are either the master or the victim of your attitude. It is a matter of personal choice. Who we are today is the result of choices we made yesterday. Tomorrow will become what we choose today. To change means to choose change. If you want to have a great attitude then make the following choices.

Choice #1: Evaluate Your Present Attitude-What is your starting point?
Choice #2: Write A Statement Of Purpose-Write specifically what you desire to accomplish, verbalize it everyday and take action!
Choice #3: Have The Desire To Change-Do you really want it?
Choice #4: Live One Day At A Time-Take it day by day and make subtle changes. The thought process will become a habit.
Choice #5: Change Your Thought Patterns-Thoughts become things. You are what you are because of your dominating thoughts.
Choice#6: Choose To Have The Right Attitude-You are the only one who can determine what you will think and how you will act.

The greatest battle you wage against failure occurs on the inside, not the outside. Every successful doctor in practice makes the following words a part of their vocabulary. Do it and you will too.

I can…I will…Expect the best… I know…I will make the time…Positively…I am confident…I do beleive…(promote) You…All things are possible.

Dr. Perry Nickelston, DC
VP Practice Development, K-LAser,USA
www.k-laserusa.com
1-866-595-7749 Ext. #102

What Is Your Rubber Chicken?

Ok Perry. What the heck are you talking about this time? You have officially lost your mind. Yes, while that is true, it still does not take away from the power of this question. What do I mean by this question? Let me tell you a story…

One of the most influential marketing consultants in sports had the job of turning around the dismal attendance at NY Nets basketball games. I mean, you could not give these tickets away and season ticket holders were not renewing in droves. They were losing millions! They had to find a way to get season ticket holders interested enough to open up a letter with new offers for the Nets upcoming season. Problem was, most fans were so disgusted with the team they just threw out the letters whenever they arrived in the mail. What to do? This consultant said, “I know, rubber chickens!” He sent full size rubber chickens via Fed-Ex to all season ticket holders and wrapped the season ticket offers around the leg of the chicken. Was that insane? YES. Was that outrageous? YES Did it work? YES. They were certainly curious and opened up the letters. Mission accomplished. 80% renewed for the season.

What is the moral of this story? You have to find your rubber chicken. What can you do that is crazy, outrageous and nuts in regards to marketing your services? Something that will get potential patients to take notice of you. Maybe you can have a Chiropractic Weenie Roast inviting families to attend. Sponsor a Hot Dog eating contest. Host a roller skating rink party-Skate for Your Spine. Sounds nuts? Good. Then it will probably work. Beats a newspaper ad anyday of the week. Get creative. If you don’t your competition will.

Dr. Perry Nickelston                                                                                           

VP Practice Development for K-LaserUSA

www.k-laserusa.com

1-866-595-7749 Ext. 102

www.painlasercenter.com

Marketing Tactics That Work

What do you do for a living? What is your profession? Most people will answer with the name of their job title; “I am a Chiropractor, I am an Accountant, I am a Painter.” Wrong! Wrong! Wrong!. You are a MARKETER first. You can’t BE a chiropractor unless you have a patient to care for. They have to be in your office for you to do that, get it? So stop trying to become a better doctor, that’s easy. Become a better marketing professional. That takes time, commitment and LOTS of failures. Here is a list of some of the marketing essentials you need to know and implement for lifeling practice and business success. So do it already…

 Create Your Marketing Plan:

You cannot reach a destination you’ve never been to before without a map. Your marketing plan is your map. It is a PROVEN principle that those who take the time to think, strategize, set goals and plan – in writing – are immensely more successful than those who do not. If you fail to plan, you plan to fail.

Goal Achievement:

Use a DO-DOING-DONE storyboard divided into three vertical sections. New marketing  projects go in the DO section with approximate completion date. When you begin the project, move it to the DOING section and attach a hard deadline. When it’s completed, move to the DONE section and leave it up for 1-3 months to reinforce the positive feeling. This gives you visual accountability of your projects.

Unique Selling Proposition (USP):

Your USP answers the question, “why should I do business with you versus any or all of your competitors, or doing nothing at all?” A classic USP for you to consider is Domino’s “Fresh, hot pizza in 30 minutes of less, guaranteed.”  Your USP is the central theme of all your marketing.

Sampling:

Have you heard of the puppy dog close? That’s when you give the prospect the puppy to take home for a week and fall in love with it. After the week you go and collect payment. Nine times out of ten, the prospect will not be willing to part with the puppy. Providing a sample of a free chiropractic session or my favorite (laser therapy tx) is a variation of the puppy dog close. As long as you deliver value, it will work 90% of the time.

Back End:

As your business and marketing mature, you will find that your biggest windfall profits will come from your back end: the additional products and services you sell to your existing clients. You MUST have a back end if you want to grow a thriving business and stop being at the mercy of your clients. In most cases, your chiropractic services will be your primary back-end, but they should not be your only back-end.  Your goal is to continually locate or create additional products and services you can sell to your existing clients. Your market’s ability to consume far exceeds your ab ility to create, so look for Joint Venture products/services you can offer (e.g. nutritional consulting, massage therapy, rehab supplies/equipment, information products, etc.).

Think outside the box. Have fun and enjoy.

Dr. Perry Nickelston, DC

1-866-595-7749 Ext. #102

www.k-laserusa.com

www.painlasercenter.com

 

Patient Must Knows

Patient Education! It can mean the difference between practice success and failure. Making money or starving. Before your patient leaves the office after your Report of Findings and during their care plan, they MUST know and understand the following 12 points. These are in no paticular order, but each one is an integral part of the success formula. Practice. Practice. Practice. Everyday.

1. Chiropractic care is SAFE!

2. The condition they have

3. They should get rid of the problem

4. Condition is caused or related to ‘subluxation’

5. Chiropractic CAN HELP!

6. As treated, symptoms will disappear

7. Symptoms gone-Still have an underlying condition

8. Drop out of care too soon-Symtoms WILL return

9. Differnce between Relief Care vs. Corrective Care. (Which do THEY want?)

10. Status of Progress Reported during care. They need objective feedback

11. Treatment Plan-They need a roadmap and a plan to follow. Commitment required.

12. Insurance and Financial responsibilties-No surprises!

If you fail to educate you fail to retain! You have failed to deliver value for the patient’s investment. No one turns down a ‘Good Investment!” You never get a second chance to make a first impression.  Keep your attitude in check. An attitude can be more important than facts. It can make or break a doctor. You can’t change many things in life, but you can always change your attitude! Invest your time and effort into learning more about education and communication. Have a plan and follow it! Until next time…

Dr. Perry Nickelston, DC

VP of PRactice Development for K-laser, USA and Clinical Director of The Pain Laser Center, LLC in Ramsey, NJ.

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. 102

Carnegie Had It Right!

Here is a secret! Not many people know it, and it is the key to success. Read carefully and soak up this knowledge. Dale Carnegie had it right when he wrote “How To Win Friends And Influence People.” He knew that the best way to become successful is to MASTER communication skills. If you have not read this book, get off your butt and buy it, read it, and live it! Neglect this skill at your own business and personal peril. Here are 30 quick snippets from the book to get you started. Enjoy!

1. Don’t critisize, condemn or complain.

2. Give honest, sincere appreciation.

3. Arouse in the other person an eager want.

4. Become genuinely interested in other people.

5. SMILE (This is a big one!)

6. Remember that a person’s name is the sweetest and most importatn sound in any language.

7. Be a good listener. Encourage others to talk about themselves.

8. Talk in terms of the other person’s interests.

9. Make the other person feel important-and do it sincerely.

10. The only way to get the best of an argument is to avoid it.

11. Show respect for the other person’s opinion. Never say, “you’re wrong.”

12. If you are wrong, admit it quickly and emphatically.

13. Begin in a friendly way.

14. Get the other person saying, “yes, yes” immediately.

15. Let the other persaon do a great deal of the talking.

16. Let the other person feel that the idea is his or hers.

17.Try honestly to see things from the others person’s point of view.

18. Be sympathetic with the other person’s ideas and desires.

19. Appeal to the nobler motives.

20. Dramatize your ideas. (Tell stories and give testimonials)

21. Throw down a challenge.

22. Begin with praise and honest appreciation.

23. Call attention to people’s mistakes indirectly.

24. Talk about your own mistakes before critisizing the other person.

25. Ask questions instead of giving direct orders.

26. Let the other person save face.

27. Praise the slightest improvement and praise every improvement. Be ‘hearty in your approbation and lavish in your praise.”

28. Gi ve the other persona a fine reputation to live up to. Compliment them in front of other people.

29. Use encouragement. make a fault seem easy to correct.

30. make the other person happy about doing the thing you suggest.

Americans are far more likely to turn to friends, family and others for advice than to rely on advertising. Communication skills is what you and your staff can do well that makes patient’s want to tell others how good you are! Study communication everyday! Read and learn. Your financial statement will reflect the effort.

Perry Nickelston, DC

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. 102

Want Wealth? Use Lasers!

“I’m already busy, why do I need to add a Class 4 Laser to my practice?” First let me say how absolutely stupid this statement is! Yet I hear it all the time when trying to convince doctors to become progressive and add laser therapy technology to their practice. When you get busier, hire an Associate or a laser therapy technician. Case closed!

The mistake most doctors make is not looking at their business from the point of view of the patient (customer). If you try to think from their point of view, what can you see about your business that is fascinating, helpful, unique, or different? You’re looking for a WOW factor that sets you apart. Class 4 Laser therapy offers a Unique Competitive Advantage in the marketplace. When a patient is looking to buy your kind of service they are facing certain risks; It might not work. They might look bad. They might lose and nobody wants to lose. What you want to do is find a way to reverse the risk to the client. You remove risk with quality laser equipment that is guaranteed to deliver results. After all, helping more people is what it’s all about! Help people and you make money. Simple really. 

Money is the instrument of exchange for valued production (i.e. results). Money is earned only by the producer. The accumulation of wealth is accomplished only by applied effort and discipline. Money tends to flow toward those people who can use it in the most productive ways to produce valuable goods and services.  To succeed, you have to do something, buy something, or start something. What you focus on expands. Your field of focus determines what you find in life. Take responsibility for the results in your life. Poor doctors hesitate on purchasing/leasing a laser because they believe they “can’t afford it.” This is classic either/or thinking. “I can’t afford to buy a laser and operate my clinic; the overhead will be too high.” Rich doctors know they can’t afford NOT to purchase a Class IV laser. The return on investment will be astronomical in the long run. Until you can show you can handle what you’ve got, you won’t get any more! 

Dr. Perry Nickelston, Dc www.painlasercenter.comwww.k-laserusa.com

1-866-595-7749 Ext. 102

Kinetic Chain Dysfunction

COMMON KINETIC DYSFUNCTIONS

There are three common kinetic chain dysfunctions you must be aware of to treat a patient effectively. These include the Lower Crossed Syndrome, Upper Crossed Syndrome, Pronation Distortion Syndrome.

LOWER CROSSED SYNDROME

A patient with lower crossed syndrome shows increased lumbar lordosis and an anterior pelvic tilt. There are muscles that are too tight and others that are too weak. The muscles that are too tight include gastrocnemius, soleus, hamstring complex, adductor complex, hip flexor complex (psoas, rectus femoris, tensor fascia latae), and the erector spinae. The muscles that are commonly weak or inhibited include posterior tibialis, anterior tibialis, gluteus maximus, gluteus medius, transverse abdominus, internal oblique, multifidus, and deep erector spinae. This pattern of tightness and weakness causes predictable patterns of joint dysfunctions, movement imbalances, and injury patterns.

Joint dysfunctions include:

• Subtalar joint • Proximal tibio-fibular joint

• Tibio-femoral joint • Iliofemoral joint

• Iliosacral joint • Sacroiliac joint

• Lumbar facet joint

Common movement dysfunctions include decreased stabilization of the lumbar spine characterized by excessive lumbar lordosis. This is caused by tightness in the hip flexors and lumbar extensors as well as weakness in the lower abdominals and lumbar stabilizers. Common injuries include hamstring strains, anterior knee pain, low back pain, sacroiliac pain, and hip pain.

Dr. Perry Nickelston, DC

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. 102