Dr. Richard E. Busch III, a second-generation chiropractor, has been in practice for almost eleven years. Busch Chiropractic is a cash-based, single practitioner, blended practice of standard quality chiropractic care, personal injury and pain center, focusing on chronic low-back and cervical disc cases that are facing invasive care, such as surgery, or have had previous failed surgeries.
Many of Dr. Busch’s patients have seen two to five other doctors previous to being seen at Busch Chiropractic. They have been treated with heavy steroids and other anti-inflammatories. They are on narcotics, anti-depressants, and anti-seizure medications that are prescribed for back pain. Some have had physical therapy, more have had epidurals and many have failed back surgery syndrome.
Dr. Busch has, based on years of treating successfully with axial decompression and chiropractic care, developed a unique and customized protocol for this type of patient.
Ten years ago, he incorporated one axial decompression system into his treatment protocol, which allowed him to treat severe and chronic low back disc patients. Today, he has a total of six such systems. In an interview with The American Chiropractor (TAC), Dr. Richard Busch III (BUSCH) shares some of the secrets that have helped him develop one of the largest axial decompression clinics in the United States and, perhaps, the world.
TAC: Dr. Busch, give our readers some background information on yourself.
Busch: I attended Indiana University in Bloomington, Indiana, for undergrad work and then Parker College of Chiropractic. I graduated in January 1996 and was married to my beautiful wife, Jennifer, in March. Then, in April of 1996, we opened the Busch Chiropractic Clinic in Fort Wayne, Indiana, just a few miles from where I was raised. It was a great year!
TAC: What inspired you to become a chiropractor?
Busch: My father was a wonderful chiropractor and, from the time I can remember, I was intrigued and I knew I was going to become a chiropractor. I had the opportunity, even as a child, to have met some of chiropractic’s greats.
I have five siblings and we were all treated with regular chiropractic care, almost exclusively. We were the healthiest bunch of kids you could ever have known. We fit the study that indicates children of chiropractors have less illness.
TAC: What are the top conditions patients present with in your office?
Busch: Lumbar herniated or degenerative discs, cervical spine herniated or degenerative discs, headaches, chronic pain patients that have been everywhere, even Mayo or the Cleveland clinic.
TAC: What are your specialties?
Busch: I specialize in the treatment of chronic pain conditions.
Nothing pleases me more than working with difficult and challenging disc conditions and the treatment of the related chronic pain. I have dedicated my life and practice to this. Axial decompression therapy has extended my abilities to treat, with positive outcomes, severe and chronic low back pain and neck pain patients.
I became interested in axial decompression as the result of having the opportunity to speak extensively with Dr. Norman Shealy, a well-known neurologist. Dr. Shealy played a major role in the development of decompression therapy. I also have a great friend, Dr. Jack Ashton, who had a very large and successful decompression practice in Indianapolis.
The technology of decompression made total sense to me, and I had patients that were not responding to standard chiropractic care. I was going to refer them to an orthopedic group. Instead, I went forward with adding a DRS™ axial decompression system. The rest is history. We are now treating patients in my office with six decompression systems from various manufacturers. Over time, I developed a unique and customized low back and cervical protocol and procedure, which employs axial decompression with chiropractic care as the center.
This protocol has greatly enhanced outcomes. We have severe and chronic patients that drive or fly in from other states and stay with family, friends or at a hotel and then go home on weekends. When the chronic patient has positive outcomes, their friends, co-workers and family members also become patients.
My clinic is very strong on protocol and procedures. Even though each patient is unique and is treated with customized care, there are core components and elements that are the foundation of each patient’s care.
TAC: Which techniques do you use and why?
Busch: Diversified, Activator, Thompson.
I believe in being proficient in more than one technique because not all techniques work for all patients. I use Diversified because I just prefer to treat that way and that is the way my father treated. Activator is best for older more delicate patients and patients with extremely chronic pain. Thompson is a good technique to treat low back disc conditions with low-force and no rotation.
The majority of chiropractic patients will respond to the myriad of adjusting techniques; but I saw the real need to incorporate axial decompression for the chronic disc problems that don’t respond to standard chiropractic care.
TAC: What type(s) of diagnostic testing procedures do you use and why?
Busch: The Physical Exam is an extremely important part of every patient’s evaluation. I feel it is almost a lost art and the findings are significant in the patient’s treatment plan of care.
Also, I see a large percentage of patients who have had MRI’s and X-rays in the past, because they are coming from the typical medical low back and neck pain pipeline (i.e., general practitioners, pain medications and anti-inflammatories, physical therapy, ortho/neurosurgeons, epidurals, surgery, pain management). If the films are not current or have not been taken, I require a new set of X-rays. X-rays are imperative, because we want to be certain we can evaluate the patient’s condition completely, so that we have total understanding of exactly what the patient has going on.
I use a computerized analysis of muscle strength and range of motion, predominately in the documentation of personal injury patients, and digital motion X-ray which analyzes for soft tissue injury and ligamentous instability—also very valuable for personal injury documentation.
TAC: Tell us one or two of your most amazing patient success stories.
Busch: It’s difficult to narrow down all the success stories but the following are just a couple good examples of what keeps me inspired!
NH, a 78-year-old female, married, high school graduate, rarely used caffeine, no tobacco and no alcohol. She had a history of heart problems: a current triple bypass and two angioplasty procedures. She had a left hip replacement, right carotid surgery and right shoulder surgery. She came in using a walker and had to lie down during the entire first visit as well as the second visit which is the report of findings. Her diagnoses were intervertebral disc syndrome and degenerative disc disease with radiculitis.
The chief complaint was pain of low back, right pain the right buttocks, hip, and anterior thigh. Pain scale was 6/10 with pain medications and 9/10 without. Symptoms had been for 3-4 months and had increased in the last three weeks. She had flipped a mattress three weeks prior to being seen, and had fallen twice in the prior three weeks. Pain was decreased by pain medications and lying flat and increased when sitting and standing during the day. Previous treatment had been epidurals, pain medications, and steroid injections. She was under the care of an orthopedist who had recommended surgery.
After being treated with the low back protocol with axial decompression and chiropractic as the center of care, she no longer required any walking aid. After a normal series of treatments, she achieved 95 percent sustained improvement and was back to normal daily activities. She has maintained this improvement and is now an active chiropractic patient of ours.
Then there’s JB, a 57-year-old married man with some college education, a business owner who smokes two packs of cigarettes a day, denies using alcohol and drinks nine cups of coffee a day. He had been run over by a car in 1984 and has had three lumbar spine surgeries, over the last twenty years. There had been recurrent problems for twenty years. Recent symptoms were present for three to four weeks. Pain improved with massage, pain meds, lying down and stretching and was exacerbated by most activities such as walking, standing and sitting. Previous diagnosis had been degenerative disc disease. Previous treatment included epidural injections, pain medications, physical therapy and surgery of the lumbar spine and the then-current orthopedic doctor was recommending fusion.
The chief complaint was pain of the lumbar back and the hip. Pain in the right leg and low back had escalated in the last month. His pain level was a 7/10 with pain medications. His diagnosis was degenerative disc disease with radiculitis.
After a series of treatments with the low back protocol of axial decompression and chiropractic care, he achieved a pain-free life style and was even able to resume riding motorcycles, which was an integral part of his business life and personal life.
TAC: What has really impacted your growth as a chiropractor and that of your practice?
Busch: My strong partnership with my wife, Jennifer, and our desire to help the severe and suffering patient; and, also, our shared belief in the integration of chiropractic and axial decompression as a part of the care for chronic low back and cervical patients.
TAC: What marketing strategies do you use to attract new patients, and to keep current patients?
Busch: To attract new patients, from our statistical tracking, now a majority of our new patients have a combination of responses: They know of someone, who is or has been a patient, and they also have seen us (for years) on television or they have been referred by another physician.
Marketing is a complete subject on its own. We write our own news releases, radio and television commercials, print ads, etc. We know our practice the best. We do enlist the help of professionals on the production-side of things—that is filming and interviews. We have one of the best infomercials—I don’t mind saying—that I have ever seen. You can check it out on our website at
To keep current patients, you need to have the highest standards of care, office and employee appearance and procedures and, of course, positive outcomes. We treat our patients as if they are guests at a Five-Star Hotel. We have a patient liaison who does everything for the patient, including filling out paperwork.
TAC: What single piece of advice would you give a new chiropractor just starting out?
Busch: Be aware or beware—the new letters (D.C.) behind your name may have distorted your senses about the reality of what has to be done to generate new patients.
Yes, you are a doctor now. But the reality of that is spelled W-O-R-K and W-O-R-K is outside of your private office door and outside of your clinic.
W-O-R-K means you have to get out and do all hard things that you don’t really want to do, and you may not reap the rewards the same day!
Don’t become dependent on insurance; develop a predominately cash based practice and always be willing to recreate your practice, yourself and your life.
TAC: What general advice would you give an established chiropractor whose practice might be struggling?
Busch: Well, perhaps, just start over with your thinking. Take a critical assessment of your practice from top to bottom. This includes your employees and their thinking. Recheck your business plan and, if you do not have one, create one. Meet with others in business, even if it is uncomfortable; allow them to help you assess your position. You may not be struggling as much as you believe. It may just be a temporary “cash flow” crunch. Go back to the basics of what works to generate new patients. Even though you are an established business, you always need new patients.
Work to regain your inspiration. Listen to inspiring messages: those messages may come from your church, motivational speakers on CD’s and DVD’s, your family—and that includes your parents. Do whatever you can to get rid of “stinking thinking;” regain your love for your patients and, remember, you have the ability to improve their lives. Regain the proper motivation for your professional life: patient well-being first and “Exchange in Abundance.” Again, be willing to recreate yourself, your practice and your life.
TAC: Where do you see the future of chiropractic headed?
Busch: I see more research demonstrating even more the efficacy of chiropractic care.
Because healthcare has become consumer-directed, chiropractic should directly benefit from that. The use of the internet and the ability to research conditions and/or symptoms has empowered the patient.
The internet provides the ability for the public to research, chat and blog about the side-affects reported and/or even unreported of prescribed medications and success rates of medical procedures and surgeries. As public knowledge increases, the public’s opinion will continue to change concerning their role in their own health and their own healthcare—which positions chiropractic well. And referral rates from the medical community will increase as back and cervical pain patients demand to be seen by a chiropractor before they see a surgeon and take addictive medications.
Also, chiropractors will be strongly established in cash practices, as will many medical practices, because of managed care, reduction of fees, reduction of number of visits and the continuing increase of insurance premiums and deductibles.
TAC: Any final words for our readers?
Busch: Continue to provide the highest standards of care, strive for inter-professional relationships, and establish niche practices (do what you believe) within your practice, such as nutrition, axial decompression, personal injury, etc.