Episode 35 – Dr. Steven Heffner, Part 2: The Business Side of Therapy and Lessons From His Career

Steven Heffner

USA | DC, Dip MDT

Episode 35 - Dr. Steven Heffner, Continued
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This episode features part two of my interview with Dr. Steven Heffner.  In this episode he shares a valuable lesson from a patient, an effective analogy used for education of centralization, sound advice for considering the business side of therapy, resources and studies he finds helpful and much more.

 

SHOW NOTES

A Memorable Patient

Steve believes that most, if not all therapists that have used this method very long have had their miracle patient. Those don’t stick in his mind as much as the one’s who’ve taught him a lesson.  He gives the description of a patient and her scenario and what he learned about giving the patient a chance to explain before he corrects.

Patient Analogy

In addition to using the bent knuckle and the cut knuckle, and because there are a lot of farmers in his area, he uses an analogy for centralization and peripheralization.  Steve asks the patient to imagine they’ve got 10 pounds of manure (and depending on his patient he may use more colorful language) and they’re trying to move it up and up the leg with the movements he’s teaching them and stuffing it into a 5 pound bag.  And that is the reason why many times they may experience a little, or even a lot, more pain in the back as they fix the problem. 

Best Advice

With treating a patient, we have two hands.  We have the healing hand and the business hand.  And those two hands need balance.  To help with the business hand, he remembers what Scott Herbowy mentioned which was to do what the surgeons do with a patient that has a broken arm.  They give the patient some timeline that gives them expectation and helps to keep the patient through that episode of care to best improve their outcome.  Doing this with our patients will reduce our no show or cancel rate and help us get to recovery of function much more often.

Doing Differently Now

Steve is not manipulating patients until he’s taken them through the progression of forces.

Another thing he does is flex people a lot more than he used to.

And yet another thing he does is put his patients through a lot more repetitions to get more clear answers as to their subclassification.

Resources

The text books.  Steve rereads the texts about every two years. Auditing C and D MDT courses is very valuable for any credentialed or diplomaed therapist.  He also encourages his students to go back to the conference manuals.  Steve offers to also be a resource.  If you want to ask Dr. Heffner for any help he welcomes our requests.  You can find him at: sheffner@laurelhs.org

Impactful Studies

Werneke et. al. Prevalence of classification methods for patients with lumbar impairments using the McKenzie syndromes, pain pattern, manipulation, and stabilization clinical prediction rules.JMMT 2010

You can read the study in its entirety here.

Laslett, M.  Evidence-based diagnosis and treatment of the painfulsacroiliac joint.  JMMT 2008

This entire study is also available here.

Personal Habit

Patients have told Steve that they feel comfortable with him and they explain that they do because he actually listens to them.

Promoting

Steve wants to announce the 29th chapter that is currently known as the Chiropractic Branch.  Jonathon Soltys is the executive director and they are making significant progress in securing relationships with 5 different chiropractic schools that will include teaching the principles of MDT within their curriculum. Look for more information on this new branch coming soon atmckenziemdt.org

Reach Dr. Heffner at sheffner@laurelhs.org

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Episode 34 – Dr. Steven Heffner, Part 1: Traditional Chiropractor and His Unexpected and Complete Practice Pattern Turnaround

Steven Heffner

USA | DC, Dip MDT

Episode 34 - Dr. Steven Heffner
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Dr. Steven Heffner has been a licensed chiropractic physician for 31 years in Pennsylvania, of which 16 of those years he has been employed by a Health System in Wellsboro, PA.  He received his Doctor of Chiropractic degree from Life Chiropractic College in 1983 and his Bachelor of Science degree at Mansfield University in 1974.  He credentialed in Mechanical Diagnosis & Therapy in 1995 and received his diploma in 1997 becoming only the second chiropractor to do so.  Dr. Heffner had been a member of the McKenzie USA branch Board of Directors from 2002 – 2013 of which the recent four he had served as Chairperson.  He has also written chapters in several medical textbooks on the McKenzie approach.  In 2005 Dr. Heffner became a faculty member of the McKenzie USA branch and in 2009 became the instructor for the recently formed chiropractic branch.

 

SHOW NOTES

Personal Background

Dr. Heffner has been married for 34 years, has two children who are grown and one grandchild.  He enjoys hiking and working out and has recently focused on nutrition and has found some strategies that help even his chronic pain patients.  He spends a good bit of time on the weekends teaching for the McKenzie Insitute USA and MI International.

Professional Background

Dr. Heffner is a chiropractor and has been for 31 years.  He was the first credentialed MDT chiropractor in the institute.  He is one of six senior teaching faculty for the institute. 

Quote

  Steve uses a concise way to teach his patients and students what McKenzie assessment is.  To Steve it’s, “the repetitive movements and positioning of the spine or extremities to see what effect it has on their symptoms.

He also feels another quote illustrates what we do very well.
  “Give a man a fish and you’ll feed him for a day.  Teach a man to fish and you’ll feed him for a lifetime.”

A Time When He Struggled

  Dr. Heffner originally began treating how he was taught to in chiropractor school.  He used manipulation as the main treatment and using modalities to make the manips easier.  There was no education.  Steve was frustrated because he didn’t understand why his patients’ pain kept coming back.

  Steve speaks on the tension between physical therapists and chiropractors.  He explains, the way he worked through that is through looking at the evidence.  Becoming a McKenzie therapist he was able to work through bad habits that weren’t supported within the literature. 

When Things Really Began to Make Sense

  Steve really began to improve his care when he returned from a McKenzie course taught by Gary Jacob.  Things clicked on that very first course and he was impressed how there was a way to help patients without manipulating them.  He quickly proceeded to the cervical course and rapidly moved on to become credentialed.

Challenges

  The greatest obstacle is the business aspect of this method. The insurance companies don’t reward us for saving them tons and tons of money.  The toughest thing to do for us is to build up a strong enough marketing plan to survive until we’re reimbursed appropriately.  Steve thinks that outcome-based payment is on its way.    

Strength

  The greatest strength is, no question, the McKenzie assessment. From the history and through the physical exam you know what you’re dealing with because of patterns. 

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Episode 33 – Dr. Gary Jacob, Part 2: A Number of Resources to Assist in Patient Education

After receiving a BA in Philosophy of Science at SUNY Binghamton in 1974, Dr. Jacob graduated LACC in 1978, the California Acupuncture College in 1981 and obtained a Masters in Public Health form UCLA in 2003 in Community Health Education and Promotion.  In 1991, Dr Jacob became the 1st DC and 12th individual to receive the Diploma in Mechanical Diagnosis and Therapy from the McKenzie Institute International and has since authored multiple textbook chapters regarding his unique perspectives regarding the McKenzie Method.  Dr. Jacob teaches internationally regarding end range loading, rehab, biopsychosocial and med–legal issues.  He maintains a private practice in Pacific Palisades, California.