chiropractic health care, before consenting to treatment. This is a legal requirement in California. This is called informed consent." Again, I am here in California. In California, there is both state law and board rule regs that require informed consent, and the Board Rule and Regulation says it must be written. Here in California, different from other states that are listening to me right now, in California, one of the requirements for continuing education is two hours of ethics and law. In two hours in ethics and law, we go over both the state laws, as well as the board rules and regs, so these things are kind of getting slowly, but surely ingrained into the psyche of a chiropractor who is practicing here in California, even though there are still glitches in the system, you can get your continuing ed from a lot of different people and sometimes certain things are stressed more than other things. I have opportunity, in my section when I do the ethics and law component of my continuing ed classes down here in California, I like to go over informed consent because I think that anything that can help the patient be sager and help the chiropractor stay out of trouble, it's a win-win. It's a good thing. That was my opening paragraph in my informed consent. Next, "Chiropractic adjustments are the moving of bones with the doctor's hands or with the use of a machine," so stop there for a second. A lot of chiropractors don't use their hands. A lot of chiropractors use a machine, so consequently, to clarify is, I think, important because I've seen cases where that has been an issue. Consequently, I say, "It could be with the use of machine. Frequently, adjustments create a 'pop' or 'click' sound/sensation in the area being treated." Stop again. It's interesting how many people have been to a chiropractor that do a low-force technique, and there's no associated audible. There's no associated sound. Consequently, when they go to a new chiropractor, and they experience that cavitation sound, "click/pop" sensation, whatever we call it, that they immediately think that something is wrong, even that they might have been injured or something like that. We're telling them on the front end what to expect. Again, this is based upon our clinical practice. I am a joint-cavitating chiropractor. I do osteas adjusting. I also use machines, as well, that are not associated with an audible, but I definitely do audibles on nearly 100% of the patients that I deal with. Okay, back into the form, "In this office, we use trained staff personnel to assist the doctor with portions of your consultation, examination, x-ray taking, physical therapy application, traction, massage therapy, exercise instruction, etc. Occasionally, when your doctor is unavailable, another clinic doctor will treat you on that day." Okay, stop for a second. On that particular short paragraph there, these are some key things. I cannot remember the last time I took an x-ray because I'm too busy. Someone will always take an x-ray for me. Often, I will do the consultation and someone else will do the examination for me. When it comes to the application of physical therapy, like laser, traction, muscle work, whatever, it is extremely rare that I would do any of that stuff myself. Someone else in the office would do that. Often, it's always trained staff personnel and very often they are chiropractors in training. We would take students that are in chiropractic college that would
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