Adding a Successful Nutritional Component to Your Chiropractic Practice

I have studied many different patient management systems designed for chiropractors over the past twenty-five years.  But practitioners who try to use chiropractic systems to manage the nutritional aspects of a patient’s case will find themselves falling short of true success.  I had the same problem until I made the discovery that, while a chiropractic patient may benefit from nutritional support, these two aspects of the case need to be managed separately.  If you know this and how to implement it, it takes all the stress off managing the nutritional aspect of a patient’s case and greatly increases compliance to the nutritional program.

Chiropractors in an insurance-based practice can’t normally charge for the nutritional part of a routine chiropractic visit, so they do a regular chiropractic visit and then spend extra time on nutrition.  The patient is not used to paying cash so, quite often, the consultation fee is simply not collected.  And then the patient may or may not buy the nutritional supplements. In other words, there is no system of nutritional patient management for actually getting the patient onto a nutritional program, which is essential to correcting the chronically recurring subluxation complex.

Enter…nutritional patient management.  Why nutritional patient management?  Billions of dollars are spent on health in the United States, yet we have the highest rate of infant mortality of all the so-called civilized or industrialized countries.  And, even more significant, we rank number thirty-seven out of the top thirty-seven industrialized nations in overall health. 

We have national malnutrition as a result of fast foods and foods that are non-perishable.  These “foods” are inadequate to support life.

If malnutrition is at the core of the chronic health problem, the answer is not pharmaceutical medications, which suppress symptoms while the underlying pattern of disease develops.

One vital answer is adding a successful nutritional component to your practice.

There are three key ingredients of a successful nutritional cash practice.

The first one is effective nutritional products that you can count on—using a company with products that have a track record of proven workability and dependability.

Next, you need a workable system of zeroing in on the patient’s needs. We developed Nutrition Response Testing(sm) to give the doctor all the answers needed about the patient’s nutritional requirements in a relatively short visit.  Using Nutrition Response Testing, we can provide a high quality, competently delivered service in a short enough period of time to fit within the economics of a cash practice. If you have a system that accomplishes this, you already have a head start.

The third key ingredient is an effective, standardized system of nutritional patient management, which will increase compliance and results.  The system that you use for finding out what’s wrong with the patients and determining what they need for their program to get well is not what gets compliance and results.  What’s needed is an effective standardized system of nutritional patient and practice management. 

Such a system turns your patients and staff into zealots who build your practice for you. 

There are specific rules for managing a nutritional practice.  However, some rules are so important that I’ve elevated them to the status of maxims. 

Maxim #1: Never start a treatment program or sell a supplement until you know what the patient needs and that the patient understands and has accepted your recommendations, and is committed to doing the program. 

To do otherwise gives the patient the misunderstanding that the product is the program.  The product is not the program.  It is simply one of the tools that enables the patient to complete the program. 

Maxim#2: Never sell more supplements than the patient needs to take him or her to the next scheduled visit. The purpose of the next visit is so that you can verify that the patient needs to continue those supplements.  If the patient “has enough” for a longer period of time, he/she will tend to skip the appointment.  There’s nothing worse than selling the patient a 360-tablet bottle because you think he needs it and, three days into it, he’s got a problem with it for whatever reason.

Maxim #3: A patient needs to be seen as often as it takes until he or she is in full compliance with the recommended program and is responding positively to it.  My clinical experience indicates that, at the start, a patient needs to be seen for a nutritional program approximately once a week (regardless of his current chiropractic schedule). 

I keep seeing patients once a week until they are in full compliance with the recommended program and responding positively to it.  At that point, the “fine-tuning period” is over and I put them on a twelve-week Healing and Observation, where I see them every other week for six more visits over a three-month period and continue to monitor their progress. If they “fall off the wagon,” they go back to once a week until they are again in full compliance to the recommended program and responding positively to it. 

Maxim #4: There is a correct way to handle each and every patient, starting with the initial visit and taking them all the way through to becoming life-long wellness patients who enthusiastically refer new patients for years to come. 

We don’t have to advertise for new patients because we know the right way to handle each and every patient starting with the initial visit.  And the system we use takes them all the way through to becoming life-long wellness patients who enthusiastically refer new patients for years to come. 

Maxim #4 A and B are corollaries of Maxim 4.  The more compliant the patients are and the better they are doing, the less often they need to be seen. 

And the other corollary is: It often takes six to nine months of close monitoring to establish healthful new eating and life style patterns.  We educate our patients and help them develop new healthful lifestyle habits while we support them with supplements. 

Maxim #5: Not knowing or applying these rules (which are based on decades of clinical experience) results in less optimum gains in terms of patient benefits and the overall success of your practice. 

The Initial Visit
The purpose of the initial visit is to establish rapport and to build trust.  The secondary purpose is to determine patient need.  And the last, but most important purpose of the initial visit, is to prepare the patient for the Report of Findings visit.  I no longer examine the patient on the first visit, sell him some product and then hope that he comes back.  When I stopped doing that, my practice became stress-free, my retention rate went up greatly and we became far more successful. 

I don’t sell anyone nutrition on the first visit. Selling nutrition on the first visit would violate Maxim #1 by selling somebody a product before he or she fully agrees with and understands my recommendations and is committed to doing the program. 

The purpose of the Report of Findings visit is to ensure that the patient knows what his/her role is going to be in obtaining maximum possible health restoration.  Patients need to know what we expect of them before we’re willing to accept them.  If the person has any questions or any objections, this is when they are handled.

This visit answers the key question: Is the patient ready to commit to doing the program and following recommendations?  If they are, we start them.  If they’re not, we handle them by giving them more time, more information or we thank them for coming.  We don’t ever start a nutritional program on somebody who is not committed to doing the program and following our recommendations. 

Once we’ve completed the Report of Findings visit, then we set the first therapeutic visit to get the patient started on the program.

Three Phases of Care
We’ve determined that there are three phases of care in a nutritional program.

The first phase of care is “Fine Tuning.” During the fine-tuning period, we ensure the program is correct and the patient is actually doing the program as we recommended. We continue the fine-tuning until the patient’s nutritional program is stabilized and he/she is complying with dietary recommendations and starting to experience results.  All patients fill out seven-day diet records every week and we help them fix what needs attention, in a way that they can actually do.  Once they’ve achieved that, we graduate them to their initial twelve-weeks’ Healing and Observation period. 

Completing a twelve-week healing and observation period enables us to determine their rate of improvement so that longer-term recommendations can be made to enable each one to achieve a more optimal state of health. At the final visit of the healing and observation period, we review each aspect of the program and compare where they are now.  If they’re fifty percent better, they do another twelve-week healing and observation period.  If they’re twenty-five percent better, they do another healing and observation period with expectation of another one after that. 

The Secret to Compliance
After twenty-five years of clinical experience, I finally realized that there is a secret to getting compliance to nutritional programs. It turns out that you—the practitioner—are the most critical ingredient of a successful nutritional cash practice. The fact is, you’ll never have a patient who is more compliant than you.  The reason why most practitioners have trouble getting the patient to comply is found in their own compliance. 

I have expanded these maxims and key points into a three-day workshop so that every practitioner interested in providing their patients with nutrition can easily do so.  It’s an easily do-able program on how to build a highly successful, low stress nutritional practice. 

Our “joyful obligation” as nutritional practitioners is to enable each patient—through education and guidance—to experience life in its fullest. 

Dr. Freddie Ulan, developer of Nutritional Response Testing, has been training health practitioners in the techniques of Nutritional Response Testing for over a decade years and, as an adjunct, provides a monthly workshop on nutritional patient management called Secrets of a Successful Nutritional Cash Practice. For information on the Nutrition Patient Management Workshop or Nutrition Response Testing workshops and DVD’s, call 1-727-442-7101 or visit


Leave a Reply