All of the patients that I see here at Monmouth Spine and Rehabilitation are looking for health solutions. Many have pain. Most want to feel better, they want to make a change, and they want a better life. During my private consultation with my patients, I often discuss this “want” factor and how important it really is. I feel out my patient. I may ask, “Are you willing to do what it takes to get the results you are looking for?”
After several thousands of these consultations during a period of more than twelve years I have found one common denominator that leads to the success in over 99% of the cases that I treat. This common denominator is the individual’s commitment to getting better. I may want to help the patient. However, if they are not committed to getting well, then breakdowns will occur.
I have found a direct correlation between one’s willingness to commit to doing what it takes to get well and the results they realize. When someone looks me directly in the eyes and tells me they want to get well and that they are willing to do what it takes to get there, then amazing things begin to happen. These are the patients that most commonly feel better very quickly. More importantly, these are the patients that get better and realize complete health. During the course of treatment, these are the patients that do not miss appointments, they are always on time, and they participate attentively in their treatment plan.
On the other hand, there are those patients that come to me with the same level of pain, but perhaps not the same level of commitment. During the consultation when I ask them what they are looking for they may start talking about how their significant other insisted that they see me or that they have had this chronic pain condition for twenty years but, “It’s really nothing doc.”
In both of the preceding examples of the different types of patients, the important point to understand is that they both presented with the same level of pain or the same condition. One is clearly looking to get better. The other patient is not quite clear with what they want.
I found this to be an interesting phenomenon and I investigated further. Most research in rehabilitative medicine suggests that the best results are obtained when the patient is compliant with their doctor’s recommended care plan. Let’s look at the example of back pain and neck pain. If the back pain or neck pain is caused by a problem with a spinal disc or nerve then a standard rehabilitation program to correct this problem takes a minimum of two months. This two month program is relatively standard involving a combination of various modalities which may include chiropractic, physical therapy, acupuncture, and involve the use of decompression traction or other corrective tools. Treatments last about an hour and the patient is required to be treated a minimum of three times per week.
There is not a great deal of wiggle room with the rehabilitative protocols that are established in the scientific literature. The program is determined by the scientific research in the field of rehabilitation. If the research defines a treatment plan for a specific condition and determines that this plan is the necessary protocol to correct a specific problem, in this example a spinal problem, then it is this protocol that will be followed to accomplish the task.
At this point in my career I will typically know during the initial consultation and examination whether or not a patient will get results. I will consult with them, exam them and review with them their MRIs, X-rays, and any other diagnostic reports they bring to me. I may take new X-rays and perhaps perform a diagnostic test. I will determine at that point whether or not they are a candidate for care in my office.
In most cases, after I have completed my analysis, I will determine that the patient has a condition that I can help them with. However, this does not automatically qualify them for treatment in my rehabilitation center. In order for me to be confident that they will get results and that neither the patient nor I will be wasting our time, I need to know that they are committed to getting well. I need to know that they want to get better. Otherwise, there will be upset. If the patient is not committed, then they may begin missing appointments and then question me or other practitioners about why they do not feel better.
When I first became a licensed physician, I assumed that everyone that came to see me for pain wanted to get out of pain. What I realize now is that some people are not ready to get out of pain. They have not committed to getting well within themselves. Experience has taught me to not only establish whether or not I can help the patient with the condition they present with, but also to establish that the patient is really committed to getting well. Something I like to share with my patients, particularly those that are struggling with a difficult condition is this: there is always a solution to your problem; you simply have to want to find it.
- The following quotation by W.H. Murray during the Scottish Himalayan Expedition during the mid 20th century has always inspired me:
“Until one is committed, there is hesitancy, the chance to draw back, always ineffectiveness.
Concerning all acts of initiative (and creation), there is one elementary truth the ignorance of which kills countless ideas and splendid plans – that the moment one definitely commits oneself, the Providence moves too.
All sorts of things occur to help one that would never otherwise have occurred. A whole stream of events issues from the decision raising in one’s favor, all manner of unforeseen incidents, and meetings, and material assistance which no man could have dreamed would have come his way.”
