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CHIROPRACTIC HELP #49: Consulting a locum
February 06, 2017

Consulting a locum

Consulting a locum can be problematic; it's important to apply some common sense, as the letter lower down will reveal.

All doctors have to take a break from the daily grind, and that includes chiropractors obviously; our work is stressful and many of our patients are in severe pain; inevitably some of it rubs off on us.

Welcome again to this newsletter from Chiropractic Help, and I wish you a happy and healthier 2017. That is the focus of our site; enabling you to take control of your own health to as great an extent as possible.

Functional medicine teaches that whilst we all have genetic weaknesses, usually it's only expressed when compounded by other factors such as a dietary deficiency, or substance abuse and physical problems such as constipation or, in the case of hip and spinal arthritis, a short leg.

These are factors over which we have control; knowledge is power, and here we try to bring it to you in bite-sized digestible chunks.

Allow me to blow my own trumpet for a moment; there are 170 million websites on the net, and Chiropractic Help is in the top 0.3%. Amazing, eh, but we have been going for more than ten years.

I myself very nearly had a burnout some years ago, so I'm speaking with some knowledge on the subject. However, finding a good locum is almost always difficult but, if you don't find someone, then you crash and burn.

In this letter we'll look at the subject firstly from the view of you the patient, then the home doctor, and thirdly the locum.

Consulting a locum

So, your regular chiropractor has taken a break, and you are consulting a locum. If you have a significant problem, don't put it off and wait until your regular DC returns, but also be a little worldly wise.

Firstly, from the waiting room, was the last patient in and out in five minutes? Then you should be on your guard.

Before treating you, a locum should do three things:

  1. He should listen to your story; it's called taking a history and is a very important part of making the correct diagnosis.
  2. He should spend at least a few moments scanning your own chiropractor's notes.
  3. He should examine you thoroughly; remember he has never seen you before.

If any of these are found wanting, you are perfectly at liberty to excuse yourself, and leave, paying for the consultation, but taking it up with your own chiropractor when he returns from that well-earned break.

Be helpful to the locum; for example, if you have an arthritic hip, ask him not to roll hard on your leg if he places you on your side for an adjustment of the sacroiliac joint; warn him about high blood pressure, and so on.

Listen to your gut feeling; there's no need to be overly anxious, but do be sensible; as we'll see in the letter further down, there may be some red flags that you should be heeding.

There is another plus; when consulting a locum, s/he may spot something that your own chiropractor has missed; frankly we all miss things, and it's like having a second opinion; someone viewing your problem through a different set of eyes.

The chiropractor's viewpoint

It's been a long, hard year and from the chiropractor's viewpoint he is in serious need of a break. Perhaps there are warning signs from his own health or, in my own case, I found I just stopped caring much about my patients' problems. I was beginning to have enough of my own.

All work and no play, makes Tom a dull boy; it's time to go fishing, or perhaps just sit on the beach and look at the middle distance with a blank look on your face for a couple days.

I like to take two kinds of holidays each year. One which is busy and might include a long hike up the mountains, or a trip of sorts, and another which is really about chilling; a sleep every afternoon, plenty of books and perhaps a game of tennis or two, or some trout fishing; a restful time.

Psychologists say that every person in a stressful job should at least periodically, and preferably every year, take three continuous weeks' leave. That should be the norm, and you will be consulting a locum.

The locum's viewpoint

From the locum's viewpoint, this is a stressful time; every patient is a new patient; he has never seen them before and he has perhaps only fifteen or twenty minutes to get on top of his game.

He must examine each patient carefully, take a thorough history of the new complaint and scan his colleague's notes; and a doctor's handwriting is often illegible. He might need to review an x-ray or scan, and he still has to treat you. 

Be considerate if he's running late; consulting a locum is hard on him or her too.

An open day

Chiropractors will often have an open day for the locum before he starts his three weeks at the coalface; the last thing you want is for him to be sitting and twiddling thumbs.

This is both a good thing, and a time of potential problems. It's beneficial, because it gives you, in the safety of a group of others to meet the locum. He will probably deliver a short talk on what chiropractic can, and can't do, and then have an open session for folk to ask questions, and perhaps present their problems. It gives you a chance to suss him or her out.

But consulting a locum can be a time of danger too...

A disturbing letter

A chiropractor went on leave, and ran a promotion to get his locum started; perhaps the initial consultation was half price, or some such. There's nothing intrinsically wrong with that, but it is a time to be a little wary. Does everything seem kosher?

In our letter, as we'll see, all the red flags should have been flying; be worldly wise when consulting a locum.

  1. In order to make an appointment for her husband for one of these reduced price consultations, she herself had to have a treatment, even though she had no complaints.
  2. The locum barely spoke to her.
  3. There was little or no examination.
  4. She was in and out in five minutes.

And left with some serious injuries.

In conclusion

In conclusion, do not be overly anxious when you are about to be treated by an unknown doctor; nevertheless, don't succumb to pressure and do use your common sense. If all's obviously not well in the state of Denmark, just walk away and don't be afraid of offending someone; your health is at stake. Taking a partner or friend with you always gives you some support.

You may have the feeling that I'm being hard on chiropractic because of a once in a million bad experience when consulting a locum; let me tell you, just the same factors are at work in Medicine, and all professions; laziness and greed lie at the heart of it; a quick buck.

It's one of the strengths of a multi-doctor practice; you are less likely to encounter a total stranger and he will be familiar with the routine and practice ethos.

3 steps to better health

There are of course thousands to choose from, and every chiropractor will have his or her own 3 steps to better health. Here are mine:

  1. Start to make hummus once a week; enjoy it on a green salad.
  2. Do our lower back exercises EVERY morning before getting out of bed.
  3. Enjoy eggs Florentine regularly.

Follow that simple regimen and you're far less likely to be consulting a locum, medical or chiropractic.


Hummus is a Mediterranean dish that you can rustle up in only five minutes once you're in the groove of making it regularly. It has many virtues.

  • It's a good protein alternative to red meat.
  • It contains all the essential amino acids needed.
  • It has the lignans needed to control your cholesterol and circulating hormones causing cancer.
  • It turns a boring lettuce salad into a gem.

Here's my quick hummus recipe.

Green salad

Chives and spring onion, rocket also known as arugula, parsley, mint and sweet basil; and of course the tomatoes. There's no lettuce today, which is unusual.

If you want to enjoy better health you need to be eating a green salad virtually every day, whether you enjoy it or not; it's medicine. Part of the secret is to grow your own lettuce and other greens; fresh from the garden or pot makes all the difference. Just add olive oil and freshly squeezed lemon juice, and of course the hummus.

Just type 'dark green leafy vegetables' into Google, and you'll get the drift; eat your green salad if you are tired of being sick and want to step up to better health.

There are six greens on the plate above, but you choose your own favourites, and what's in season. Add the hummus and you've got the mandatory eight colours in one meal that will ensure a 35% lower all cause of death; that's massive.

Lower back pain

There's an epidemic of lower back pain in the Western world; and after heart disease and cancer, it's the third biggest user of your insurance premiums; there are many causes but in my opinion it has largely to do with our sedentary existence. The management of each case is unique making consulting a locum difficult. One patient should be adjusted lying on the right side only, another the left, and a third both sides. A fourth shouldn't be manipulated at all.

Add to that trauma, as in a car accident or slipping on black ice, or hereditary hip conditions like dysplasia or impingement, for example, and you have all the makings of a life time of misery.

A large part of the solution is a serious commitment to spending two minutes every single morning before arising doing a simple set of lower back exercises; on your bed. You'll find ours at lower back exercises, but I'm sure there are many such programmes that would be equally suitable; just do something; EVERY morning.

I'm convinced the only reason this seventy-year old patient has escaped surgery is because she is very active, exercises regularly and her weight is perfect; and she doesn't have a significantly short leg.

And a long time ago she realised that moving grand pianos and deep freezers was not for her.

You can see how the vertebra above, at three levels has slipped forwards; one is traumatic and the other two due to progressive degeneration. It has all the potential to be a nightmare back; it's called a spondylolysthesis.

But one size doesn't fit all when it comes to an exercise program; a granny press-up, putting her lumbar spine into hyperextension is what brought her to me; it caused a severe sciatica. If you have a difficult lower back get the right advice before starting out on an ambitious exercise program.

Couch potato

There is soooooo much research now that confirms that those who get out and about have less of almost every disease on the planet. And those in the couch potato mode, for what ever reason, can expect to suffer from setback after setback.

Personally, I'm not convinced that it matters too much what you do; walking, swimming and cycling are the basics; but perhaps you enjoy gardening, or a skipping rope or tai chi; just do something every day. Three flights of stairs twice a day takes a lot of beating, just hold onto the rail. Most of you reading this are probably too old for ring a ring o' roses!

Eggs Florentine

The virtue of eggs Florentine is the combining of the micronutrients in eggs and spinach; they make up a veritable medicine chest.

  • It will provide all the lutein and zeaxanthin that your eyes need desperately to prevent cataracts and age onset macular degeneration.
  • It's rich in the choline, folate and B12 required to neutralise toxic homocysteine in the liver.
  • It's an excellent source of magnesium, vital to help prevent heart disease and arthritis.
  • It tastes damn good, particularly if you dicky it up with some onion, tomato, chili and garlic.

We enjoy this eggs Florentine recipe virtually every morning for breakfast. It takes no more than five minutes to rustle up once you have the goodies at hand.

Crime and Punishment

I confess I haven't read Crime and Punishment but if you scroll down on Amazon you'll see there's a free Kindle version; you could also pay $9.11 if you're not careful! Dostoevsky is one of the most famous Russian novelists; next on my reading list.

"Above all, do not lie to yourself.
A man who lies to himself and listens to his own lie comes to
a point where he does not discern any truth..."

- Fyodor Dostoevsky

I'm certain we all know of the issues mentioned above. We understand that taking holidays is important for the mind and the spirit; we know that being more active is important for our physical frame, and that healthy food is what's needed by the inner man.

But when we lie to ourselves, and worse listen to the lie... that is the beginning of the downhill health spiral.

New Year's resolution: Never eat a donut or drink a cola again.

That may sound extreme, but they are pure, encapsulated, junk food; rather the extremism of what we eat and drink than the extremes of poor health that such foods bring upon us. Just look around you.

If you insist on a hard copy, then Penguin classics will oblige, for a price!

Whilst you're about it, you could support this site by downloading my latest chiropractic book, Stones in my Clog, for a paltry $2.99. Find it at Amazon.

The beauty of most Kindle books is that, if you don't like it, you haven't wasted much money.

The best book I've read this year is "The invention of Wings", a novel from the deep south by Sue Monk Kidd; alas it's not available on Kindle, but worth every cent.

Site search

Chiropractic Help is a large site with over 450 pages; finding your way around can be difficult. Just type "spondylolysthesis" into the site search function in the navigation bar on any Chiropractic Help page and it'll take you to all the relevant pages.

Till next month, then... yours in better health.

Barrie Lewis DC and Bernard Preston DC!

PS. Feel free to forward this to family and friends, your chiropractor and even your medical doctor! You can support this site by purchasing one of Bernard Preston's chiropractic books. Dirt cheap on your Kindle, tablet or smartphone.

› Hips and the sacroiliac joints

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