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Episode 3: Over 40 Years of Upper Cervical Practice Wisdom with Dr. Robert Brooks
Dr. Davis: Dr. Robert Brooks is a 1970 graduate of Palmer College of Chiropractic. Dr. Brooks has served in numerous capacities in the State of Oklahoma and throughout Chiropractic and Upper Cervical including the NUCCA Board, the Upper Cervical Research Foundation Board, the Upper Cervical Council and more. To list all of Dr. Brook’s accomplishments and accolades would take more than the entire time of this podcast. He truly has been an incredible servant to the Chiropractic profession for more than 40 years. Fifty-six of his patients have become Chiropractors. He has trained and coached 57 interns to prepare them for their own practices, and he has personally cared for more than 25,000 patients from Oklahoma, each of the 50 States, and a number of foreign countries. Dr. Brooks has a seminar company called ‘Taking Care of People’ to teach Upper Cervical chiropractors and students to create non-toxic environments to take care of people, always acting in the patient’s best interest. His life reflects his personal intent to be a student, a healer, and a teacher with dignity, integrity and grace. Welcome Dr. Brooks!
Dr. Brooks: Hi Dr. Davis! Good morning to you.
Dr. Davis: Good morning. Good morning. So Doc, I would, you know, we’ve talked before but I would love to just get a little breakdown of your clinic and Brooks’ Spinal Care is a well-known and legendary clinic within Upper Cervical circles, but just talk about the success of your practice and how that developed and metamorphosized over the past 40 years.
Dr. Brooks: Dr. Davis, the history of Brooks’ Spinal Care is pretty extensive. So, I want to try to give you the shorter run down as I can.
When I graduated from Chiropractic School in 1970, the objective was to open an office and see how many people that we could serve. And, at that time, I wasn’t doing Upper Cervical. I was actually doing what I now called, ‘Segmental Adjusting’ where I would adjust the segments of the spine one at a time. And after three years of doing that I had built a practice up to about 180 to 190 patients visits a day.
Now, I was reading the green books by B.J. Palmer in the evenings and kind of recognized that there may be a way to take care of the spine so that you don’t have to adjust it over and over but it might be able to be corrected and then left alone. And so, I closed the practice in 1975 and spent 18 months taking techniques seminar after techniques seminar and wound up in the Upper Cervical world, going through a number of evolutionary steps from Michael Kilinochi’s to Bill Blair and Blair’s work and into the Orthogonal work through, of course, Pettibone, and eventually Dr. Gregory – and that’s where I wound up, was a NUCCA.
So, when I reopened my practice, obviously in an Upper Cervical practice, I was not able to see the high volume of people that I’ve seen before but the results were more profound that I can give people corrected and have them stay corrected over time. Then, that would have been in the late 1970’s; and then in the early 1980’s, I actually had been able to get away with saying to patients, “What I do is magic.” Because the results were so profound, they let me get me away with it – which is really beautiful. But I decided that what I needed to do, I needed to learn how to communicate what I did to people in a way that they would know how to take care of themselves. And so, I started asking every patient on every encounter, “Are there any questions?”
And as a result of that, by the end of the 1980’s, what I wanted to do at Brooks’ Spinal Care, is I wanted to establish a clinic, Chiropractic practice, that will be a model for the next hundred years. And so, Brooks’ Spinal Care during those 1980’s was seeing – I was practicing basically by myself with the help, every now and then, of an intern or a preceptor. And I was seeing 60 patients, that’s 60 patient’s visits a day. And so, that to me was kind of a nice blend or a segway into what Brooks’ Spinal Care has become today. I have as many as five associates in the practice at the same time. Having a large number of associates became more management than it did patient care for me. So, I trimmed that back, and now I have one associate and Dr. Hanson, Scott Hanson, has been with me since 19 – I’m sorry, since 2001. So, he has been with us for almost 15 years.
Today, our practice has moved from my early beginnings of practicing in a space that was 18 x 24 feet to having 5000 sq. ft. in a landmark building in Tulsa, Oklahoma, basically overlooking the Arkansas River from the 31st floor. So, what our current numbers for patient care are not quite as large as they have been in the past. But, we see anywhere from two to three new patients a day, and we see 40 to 50 patient visits a day.
Now, Bill, I think you know this, but I have currently not been seeing patients myself for the past year. After 42 years of active practice, I’ve stepped more into a teaching role than I have actually a patient care role. But, we’ve created lots of systems to make Brooks’ Spinal Care work through the years. I’ve been one of those people who if it works, we keep it. If it doesn’t work out, I’d throw it away. So, I guess that’s an opening statement for the question you asked. Is that close to the question you asked?
Dr. Davis: Absolutely! It’s difficult to put 40 years into a few minutes, but I think you did very well with that. Thank you. And, you know, I wanted to mention also – because I think it’s just so important to go back to and talk about systems and talk about how, you know, you’ve been able to step away from the practice in the past year, and the practice keeps going. And just talk about the importance of establishing systems from everything that you do in the office and in the way that you’ve trained associates over the years.
Dr. Brooks: Yes. Systems are really important in it and, of course, for us there are more – there’s procedures and then there’s programs and then there’s actually other events that we do that are related but not a part of our everyday process.
So, in terms of systems obviously, having a good office software program, I feel like it’s really important. We we’re unable to find one that work the way we wanted it to. So, my son Douglas and I created what we call a ‘Day Sheet’ and then in the ‘Day Sheet’ what we have is the ability to use it as an appointment scheduler but it has 13 batch functions to actually collect statistics at the end of the day. So, metrics have also been a very important part of the practice, but I’m going to go back to systems for just a moment.
So, in terms of an office, there’s actually greeting people as they come in. There’s getting people comfortable in the waiting room. There’s sitting people to be cared for. There’s caring for the people. Then, there’s actually scheduling appointments, collecting money, and reinforcing the next visit.
So, in terms of a system for patient care, flow is probably one of the most important things that we do. And there are certain things that you can do to move a person through each one of those positions that becomes really significant.
Now, that would be the everyday bulk of the practice. Those are established patients. New patients have a little bit different process than the established patients. So, as you know, the ‘Report of Findings’ becomes really significant, the initial interview, our history becomes really significant, and also then ‘Care Plans’ become really significant. So, what I’d like to do for a moment is spend a couple of minutes talking about how we do ‘Report of Findings’ and ‘Care Plans’ if that would work for you.
Dr. Davis: Yeah! That’d be excellent!
We found that, you know, people want to let us know what they’ve come for before they know what we do. So, in that interview, it then becomes really important to get some background information and a set of context at the end of the – into that interview for how what we do can relate to what the person has.
Now, once that happens we do an exam to determine if the spine is misaligned. If it is, we take X-rays. And on follow-up visit, we’ll have the person come in and actually sit down with the doctor and we go through a little bit of a, ‘This is what a spine misalignment looks like. This is what happens if it’s misaligned over time.’ And then, we go to another person’s X-rays and we do full spine X-rays in Upper Cervical practice. So, we have pictures of what the entire spine looks like, not only from the A-P perspective of misalignment but also from the lateral perspective of degenerative change.
And so, we go through then with that person on their own X-rays showing them their misalignment, matching that with the body distortions, the short legs, the twisting in the body frame that we’ve measured on an anatometer. Then, we make the first correction. Then after the first correction has made, we would take a set of post-X-ray’s, review those obviously. But we have a folder that we give that person, the information and where all we have done as a Report of Findings. We’ve done that just before that first correction and all that is – this is what your misalignment is. This is how it’s affecting you, and we’re going to now get this and to take care of it for you.
Now, once we’ve done that and we read the post X-rays and release the patient, we don’t talk about a care plan until the very first follow-up visit. So, on that very first follow-up visit, then our care plans are designed not on the basis of just simply saying everybody gets the same care plan.
I went with some management firms that had everybody gets the same care plan, and I couldn’t make them work in an Upper Cervical practice. What I learned is the first 90 days is when we have to monitor the stability of a correction.
So, our initial care plan is for 90 days, but we introduced it by saying that “Misalignment can be small and simple, big and simple, small with a complication, big with a complication, or very complicated; and that this will either get corrected and stay really well. It will get corrected and have to be corrected several times before it’ll stay. And the longer it’s corrected, the stronger it’s going to get; the more you’re going to recover.” So, we got a person through what the expectations would be during the care plan.
So, our first care plan of 90 days is monitoring stability, then to go 6-8 months out when the ligaments and tendons got through their first phase of recovery is our maximum – is our strengthening and stabilized part. Then, we go to maximum recovery, which is one month for every year the spine was misaligned, and then eventually into wellness care. And so, it creates then a model for patient care to cure a lifetime patient from exactly what’s going on with him and what we would expect the outcomes to be.
Dr. Davis: That’s excellent! Thank you doc for sharing that. And, I wanted you to repeat that – those different possibilities for a person’s spine. Right? You mentioned them. I know you’ve talked about those before with me or in the taking care of people’s seminar as well. But, can you mention those different options of how the spine would be misaligned?
Dr. Brooks: Yes. So, when we looked at the set of pre-X-rays in an Orthogonal-based Upper Cervical practice, what we have is the ability to determine if this is a simple in NUCCA, which is what my foundation is now; misalignments are type 1, 2, 3 or 4. So, 1, 2, 3 would be simple. A 4 would be a complication. There is one misalignment with another one in on top of it for example. So now, those are either going to be small, or they’re going to be large; and, of course, I would expect a small simple misalignment to be more stable than a large complicated misalignment for example.
So, those five categories of spinal misalignments then would give us a way to establish the case plan – the care plan for the individual for the first 90 days, thinking, “Okay. Well, this one is going to be fairly stable. I can see him a couple of times in the beginning and start to spread them out. Or I have no idea what this misalignment is going to do. I better really take a look – I better stay really right on top of this for a while.”
Then, the second part of the question you’re asking me however. Now, in that period of stability, that first 90 days, you’re going to also have five categories because you’re going to have misalignments you could correct to normal initially that are going to stay really well. Second, you’re going to have misalignments you can correct to normal initially that are going to be unstable, and they’re going to wobble around and come out several times before the body is strong enough to stabilize them. Category 3 will only reduce initially, and then come out and then reduce some more and come out and reduce some more until it eventually corrects and stabilizes. Category 4 – been misalignments I have been able to reduce and not correct completely; and I’ve had 25,047 spines I have not been able to reduce the misalignment at all.
And so, by knowing what I’m working with and being able to be in integrity with the patient when I tell them what their misalignment is and what I’m able to do with it, it actually creates more of a compliance or more of an involvement in the care.
So, those things are simply fundamental to creating care plans based on an individual basis. So that everybody doesn’t get the same. They’re getting care plan based on their misalignment and their pattern of stability.
Dr. Davis: That’s very interesting. I love that. I wanted to shift gears now. I know that you’ve been involved with the organization of the Upper Cervical Experience Event, and I had the opportunity to be involved last year; and it was just a great event and I know it’s coming up again in Orlando, February 11th through the 13th.
And so, I just want you to talk about the Upper Cervical Experience, what people can expect? Why it exists? Why would an Upper Cervical doctor or student want to come to this event?
Dr. Brooks: Well, there is multiple reasons why someone would want to attend this event.
One of those, as you’ve mentioned when you opened this with some of my background. I’m a student as well as a healer and a teacher. And, you know, we can never stop learning. We can never stop looking at different perspectives; and just because I have, you know, I got a lot of years of experience. I’m one of those people that I believe you can be right or you can be in relationship, but you can’t be both.
And I’ve learned tremendously from other approaches to Upper Cervical Care. I think the diplomate program, honestly, is one of the places now where the Upper Cervical world is actually going to be a lot bigger and a lot more successful than it ever has been because we’re sharing information. Well I can say, you know, in the Orthogonal world, this is how I see it. How to do you see it in the Blair world?
And so, we’re looking at the same thing. We’re just looking it from a different perspective. So, the first thing I would say, is it’s an introduction to different perspectives. So, that’s foundation for me.
The second thing is, the Upper Cervical people in Chiropractic to me, not only are some of the highest integrity people in chiropractic, but they’re also the people that get this notion of life is expressing itself and the spinal misalignment interferes with it. And if you correct the misalignment, life returns. And in chiropractic, there’s a lot of stuff out there. But this community is a community in my opinion that actually gets that to its highest level.
And so, I saw chiropractic as a way to remove interference to life manifesting itself. Whatever your context is. Whether it’s divine, whether it’s universal intelligence, innate intelligence – but this community, the Upper Cervical Experience is where you’re going to be shoulder to shoulder with other people who share that same philosophical understanding of how the world works. So that is a community personally that I want to be a part of. And that I would encourage other people to be a part of.
Now, the other part of that is it’s fun. I mean we’ve come… if you came to the Experience last year, and I don’t believe you did this; but we ended the Upper Cervical Experience last year with a parade down Bourbon Street. Now, it’s one thing for us to sit in a hotel room and be our group and be our community, but when we did that parade on Bourbon Street, we had beads to throw to crowds. We had a minstrel band leading us down Bourbon Street in the middle of Saturday afternoon. The police were there. They had the street closed off. That was us taking Upper Cervical out into the world. And that experience alone was a phenomenal experience for a lot of people.
And so, in Orlando, I’m not going to tell you what it is yet. But I’ve got a little surprise coming for Saturday night where again I’m going to create an outing for us to take our group, our Upper Cervical philosophical group, out into the world.
So, I’m very excited about that.
Now, those are just some of the things that I can tell you that I’m happy about. I have to tell you I have the privilege of looking at the curriculum, of seeing who’s going to be there as presenters, of seeing what is going to be available. This year, there’s a specific track for the chiropractic team members. So, you’re front desk person. You’re business person. You’re person that’s actually your patient advocate in your practice, whatever people you have – there are support people, for what you do as an Upper Cervical doctor. There’s going to be specific tracts for people sharing some of the business practices in the Upper Cervical world.
So, that alone is something that I would encourage people to do. Even if you’re choosing to come, please choose either to bring one or all of your team members.
The next thing is there’s some cutting edge research. Each year, we try to have the people that are presenting at the Diplomate Program the latest information. Like cerebellar tonsillar ectopia. Like different compliance from the systole and diastole when there is jugular vein impingement from the Upper Cervical misalignment. I mean, to just be able to see that and to know that it exists, gives us strength in our understanding of what we do. We have, for one of the first times in my opinion in chiropractic, neurological and vascular evidence that is supporting what we’ve known all along. We just didn’t have any way to prove it.
And so, that would be there, so there will be good business practices. There’s going to be a certain amount of inspiration. There’s going to be tracts for your team members. And there’s going to be a sense of community and camaraderie that the Upper Cervical world is going to, in my opinion, this is going to be a foundation for the future of Upper Cervical Chiropractic.
So, come to Orlando, February 11th to the 13th. It’s going to be at the Orlando Hyatt and it’s just – it’s going to be fun, inspiring, and hopefully you’ll find some people that will share some perspectives with you that will broaden and expand your view of the world and your ability to serve.
Dr. Davis: Well, I’m thrilled. I can’t wait for the event. I think it’s going to be another incredible event and hopefully even bigger than last time. I know there is continuing education credits available this time, which hopefully will bring even more people out. And so, just a great event. We will have the information for that event and everything we talked about on the show notes, so you can go to www.uppercervicalmarketing.com/episode3 and get the show notes, and get all the links and everything that we talked about today.
So, lastly doc, I want to talk about The Taking Care of People Seminars. And you know, I’m a big fan of your seminars, and I took it myself when I was in practice many years ago and… So, I just want to talk about, you know, the seminars themselves. What can people expect? How is this different in other things that they may have experienced, and when it is available this coming year?
Dr. Brooks: It’s interesting, you know. The Taking Care of People Experience, it’s fascinating to me to have students go through this because usually about the third year in Chiropractic School, they’ve kind of almost forgotten that what they came to school to do was actually take care of people. And so, there’s so much information and so much clutter that students have tremendous breakthroughs in this program. The Taking Care of People was created as a way of I guess sharing my years of experience in practice with other students and practitioners.
And today, we have over a thousand Upper Cervical Chiropractors who have attended this class. But the foundation of Taking Care of People is – I mentioned earlier that in 1984, I started asking virtually every patient on every encounter, “Are there any questions?” And what I learned over the next five years is I learned that the very same questions arise in everyone’s mind as they try to integrate or learn how to take care of their spine from the perspective of chiropractic and misaligned spine.
And so, what we have in taking care of people, essentially, is eight contexts; and the context is kind of a picture of how the world works. But in each of these contexts, there are answers in each one of those questions are going to arise in people’s minds. And you can build them into your procedure, and you can have those ideas available to communicate chiropractic in a way that the person will actually get it and then continue as a lifetime patient.
So, the foundation of Taking Care of People is communication and relationship skills and again, always acting in the patient’s best interest which frankly the patients already knows. It’s not what I think is best for them, but it’s what they think is best for them that really counts.
So, we have, in Taking Care of People we discuss office practices. We discuss business practices. We discuss the economics of practice. So, it’s communication relationship skills. It’s business practices, and then how to create the practice of your dreams, how can you be truly yourself and truly be who you are and yet serve people in a way that actually allows life to evolve and continue forward.
So, we do have a six Taking Care of People classes coming up between January and the end of April in 2016. I’m just going to run some locations for you. Thank you for asking.
We’re going to be in Minneapolis in January, middle of January. What was I thinking? Oh! Students at Northwestern. Then we’re going to be in San Francisco in the end of January. Next, we’re going to be in Daytona in February before the Experience. And then from there, we’re going to go back to Los Angeles. Then, we go to Davenport, Iowa and wind up in Atlanta, Georgia. So, those are going to be our locations. www.tcopseminar.com is the website, and if you’re an Upper Cervical practitioner and you haven’t checked us out. We do invite you to do that. But what I hear from practitioners is the models that we’ve created and, you know, at our 42 years of experience about using what works, we’ll absolutely smooth out your practice. It will make you more money. It will save you time, and what I’m saying these days, this is going to give you not only professional but also a great deal of personal satisfaction.
Dr. Davis: I know I can speak from personal experience. After I took this ‘The Taking Care of People Seminar’, I was able to use the information immediately. And I still use it today. You know, I think I took it about five or six years ago, and I still use many of the concepts and the way of explaining the misaligned spine.
And so, it’s an absolutely foundational course I think for all Upper Cervical students and chiropractors to go through and really understand how to communicate Upper Cervical more effectively.