An Interview with Dr. Dino Pappas
When I was a chiropractic student, I interviewed one hundred chiropractors for the DC2Be Revolution YouTube channel and podcast. This article is about the insights I gained from Dr. Dino Pappas. He is a chiropractic physician, certified athletic trainer, and certified strength and conditioning specialist in Austin, Texas.
- Develop a comprehensive system.
Dr. Pappas: I was fortunate because I worked as an athletic trainer and had a Sports Medicine background with the orthopedic skill set that is commonly found in traditional chiropractic practice. The hardest thing for most chiropractors is that they know a lot of technique, soft tissue, and rehab but they don’t have a comprehensive system. One of the things that helped me create a system and organized toolbox was the McKenzie method. One of the misconceptions about the McKenzie method is that it’s just a set of exercises, that it’s extension, or it’s flexion, but the reality is it’s a system of evaluation for getting the relevant information in a concise format so you can process that and apply the right treatment whether it’s hands-on manual therapy or another approach. It’s the scientific method applied to patient care.
- Know the pain mechanism.
Dr. Pappas: Many chiropractors manipulate first and ask questions later. I use the scientific method. By this I mean that I form a hypothesis and prove it right or wrong in order to classify the pain mechanism. It helps e determine what the pain driver is. Is it tissue nociception? Is it centrally mediated pain? Is it from the peripheral nervous system? Is it from the autonomic nervous system? If you can classify the pain mechanism and if you can classify the condition, you’ll be able to apply the right strategy for treatment.
- Build a professional network.
Dr. Pappas: If you’re thinking about going into an integrative setting then call the primary care physicians, the orthopedists, and the neurosurgeons. Talk to them and tell them you need to grow your professional network and find good people to refer to. They have no clue what a good evidence-based chiropractor does. Educate them on what you do. Build community. Develop a good referral network.
The common mistake that chiropractors make when they set up professional relationships is that they are looking for too many connections. You only need a couple. Quality is more important than quantity. Find the best in the area and send your patients there. Hone that relationship. If you are getting great results with their patients then it is those one or two doctors that are going to build your practice and your reputation.
- Develop the doctor patient relationship.
Dr. Pappas: The patient-doctor relationship is an underappreciated part of being in clinical practice. How the doctor acts can either induce harm or can facilitate healing. What you say as a doctor makes a difference in the prognosis and the outcome for that patient. You have to remember that patients are scared because they don’t know what’s happening to them. Especially if it’s the second or third episode of back pain that they are having. They are afraid that they are going to be crippled. You have to tell them the truth and put a positive spin on it. Read books like “World of Hurt” or “Explain Pain” or other books on the psychosocial aspects of pain to help you learn the clinical art of what you say to the patient and how it makes a huge difference in the patient’s life.
I introduce myself and say to them “I am here for you, there’s only one person in this room I have to get it right for and that person is not speaking right now; so at any point please ask me any questions you have because this could be the first time you’re hearing this.” When up front you show caring, concern, and empathy patients are like, “wow this is somebody that’s going to listen to me and answer all my questions.” At the end of the session I give them my phone number and invite them to get in touch with me if they need because I need to get this right for them. I need to gain their trust. I need to know what their goals are. I see it as a pyramid and the concern is the foundation of everything.
To watch the entire interview, you can go here. https://youtu.be/n4f0ipq1ho8
Noah Volz, DC is the author the The Master Student: Book 1: Mindset: The Ultimate Guide to Success, Enjoyment and Productivity as a Chiropractic College Student.