Quality Control in Upper Cervical: An Interview With Dr. Stan Pierce, Jr.

by The Atlas of Life on July 15, 2009

Dr Stan's picture, advanced orthogonal, upper cervical chiropractic

I got the chance to meet Dr. Stan Pierce, Jr. at Upper Cervical Evolution back in April. He’s a really easy-going laid back guy that you can have a good conversation with.

He also gave one of the better talks, if not arguably the best talk, at Evolution. He spoke about quality control within Upper Cervical Chiropractic. I was really impressed with not only his talk, but his delivery, as if he was talking to a small group of 5-10 people, not 300.

I’m very excited that that Dr. Stan took time out of his busy practice and training schedule to answer some questions for The Atlas of Life.

Brandon: What was it like growing up with your father being an Upper Cervical Chiropractor?

Dr. Stan: “I grew up knowing my Dad fixed people’s power.  That’s what we called it.  I never had a pediatrician, never received vaccines or shots (except Novacaine for dental), was always healthier than the other kids, and if we ever got a little sick we would just ask Dad to “please check my power.”  I didn’t know my Dad was an UPPER CERVICAL CHIROPRACTOR, I just knew he could pretty much fix anybody that needed fixing.  I would often find myself telling my friends and their parents “Just go down and see my dad.  He’ll fix you.”  Life was not complicated.  Health was not complicated.”

Brandon: Have you always known you would be an Upper Cervical Chiropractor?

Dr. Stan: “Actually, I always knew I would NOT be a chiropractor.  I’m a big fan of “independent thinking” and not just following in people’s footsteps just for the sake of following something.  Since, my father and his father and his father’s father and many others in our family were all chiropractors… there was NO WAY I was going that direction.

I went to Life University to play college soccer.  I had been having a lot of right knee pain that was keeping me from being able to kick with my right leg.  4 months of chronic knee pain went away when the team’s chiropractor gave me a posterior tibia adjustment.

I find it hilarious that it took a knee manipulation to remind me of the power of the nervous system, and it caused me to remember all the miracles I had seen in chiropractic growing up.  It was at this point I decided to pursue becoming a chiropractor.”

Brandon: What was your experience like in chiropractic school?

Dr. Stan: “Ups and downs…

When I first entered the DC program, I was AMAZED with what I saw.  In fact, I called my father and in such excitement I told him, “Dad, you aren’t going to believe it.  They don’t just adjust the top bones.  They do ALL of them now!”  You see, I thought my father was old school… antiquated.  I correlated him graduating so long ago and him being so upper neck focused, to meaning that upper cervical care is “old school”.  He was kind and encouraged me to be open-minded and learn everything I could, and that we would talk later on.

So, I was very excited to sit through new technique classes.  Inevitably, on the first or second day of class, I would ask my instructor THE question… “How long do your patients hold their adjustments?”  Now, I had NO idea the extreme emotional responses this question would extract, but I quickly learned that holding the adjustment was NOT the point of most techniques.  Moving bones and adjusting people every visit… the POWER OF THE ADJUSTMENT… was the main focus.  Accuracy of the alignment, stability of the alignment, long-term recovery… these were never terms that were used.  In fact, I even recall one instructor saying, “You can even smack someone upside their head with a shovel and get ‘em better!”  This DEVASTATED me to hear.  The curriculum and many of the instructors taught that a well-intentioned force introduced to the body was all that Innate needed to work with.  The problem with this mindset was that the student is left to conclude:

If the patient adjusts well – Innate did it
If the patient doesn’t adjust well – It’s Innate’s fault
If the patient holds the adjustment – Innate did it
If the patient doesn’t hold the adjustment – It’s Innate’s fault
If the patient recovers – Innate did it
If the patient doesn’t recover – It’s Innate’s fault

This takes ALL accountability away from the quality of care that the chiropractor has.  This concept diminishes the desire to become an “expert” spinal adjuster.

Then students’ drive would be further deteriorated by the unanimously given statement “All techniques in chiropractic work.”  With no one defining what they mean by “work”, this statement implies that they all work the same.  So, since they all work the same, and your quality of care doesn’t really matter because it’s all up to Innate, students would gravitate toward the simplest, easiest, quickest methods/techniques to learn.  Thus, interest and commitment to mastering Upper Cervical specific techniques was being destroyed by the college’s curriculum.

Once I realized what was occurring, I made a commitment to myself to train to become the most expert upper cervical doc I could become.  I also committed to recruit as many of my friends/classmates as I could to get them to seriously evaluate specific upper cervical care.

In 1 year, we grew the Orthogonal club from 3 weekly attendees to 24 weekly attendees.  Clinic results for all of us were phenomenal with quality of care being the focus, and we were obtaining a VERY clear vision of the purpose we would be serving once we were in practice.

To this day, our clinic focus and seminar training is all about accountability, quality of care, and maximizing clinic results.  So, my chiropractic college experience was good to me.”

Brandon: Your father, Dr. Stan Pierce, developed Advanced Orthogonal, and you are one of the main instructors for the technique. Can you tell us a little bit about what makes Advanced Orthogonal different?

Dr. Stan: “The Advanced Orthogonal program is probably the most unifying technique between Blair’s aberrant condyle discussions and all Grostic-based procedures.  We take the degree-specific, nerve-clearing, center of gravity stabilizing concepts of Dr. Grostic’s work and incorporates the additional concepts of measuring for all the genetic anomalies that would negate a person’s ability to be adjusted into Orthogonal.  Basically, we adjust a patient into THEIR measurable normal position.

The Advanced Orthogonal program has also substantially improved the x-ray analysis to give the doctor the ability to confidently obtain the exactly calculated vectors of alignment.  We were the first Upper Cervical technique to completely commit to a digital x-ray analysis, and we have developed at least 10 major advancements in the Grostic/Orthogonal x-ray analysis.  Our methods of analysis have significantly increased our doctors confidence in their procedures.

We have drastically improved the steps and spinal joint presets of placing a patient correctly on the table to control the outcome of the adjustment.  The Advanced Orthogonal program has discovered and eliminated the 2 main errors in aligning the height and rotational instrument settings to the patient.  Without these measurements, ANY instrument-adjusting UC doc would potentially be 5 to 25 degrees inaccurate.

We adjust with a very gentle, percussive sound wave adjustment aimed at the transverse process.  Percussion adjusting therefore allows accurately correcting an Atlas when the mastoid is enlarged and covering the TP or when the TP is very high in the tragus notch and the ear cartilage is in the way of applying the correctly angled adjustment.  These are examples where a direct TP contact adjustment would have complications, but a percussion TP adjustment does not.  I personally LOVE using an instrument to deliver the adjusting force because an instrument does not get tired as the day goes on, it does not get stressed or distracted by circumstances; it provides a consistent, reliable adjusting impulse that removes the potential of human error in the actual delivery.

Of course, we post x-ray the patient immediately after the first adjustment so we can verify the results and observe any modifications to be made from that point forward in the patient’s care.

We’ve clarified concepts to a new level, added stability of relying on a mathematically-based approach, created a more structured method of teaching, and are continuing to seek and search for the next exciting breakthrough.  We’ve even developed an express training course that exposes a doc to EVERY detail of our procedure in a 1-week Boot Camp.”

Brandon: You train interns on a regular basis. What is it like having so many new chiropractors coming in and out of your office so frequently?

Dr. Stan:
“It’s very, very helpful.  We don’t treat our interns like temp work.  We treat them like respected colleagues that are about to enter a life of servant-hood, and we want to give them all the tools to achieve that.

There is a definite benefit to having interns coming through.  They help us keep our “edge”.  Fresh minds ask lots of questions, intricately analyze concepts, and bring new ideas to the table.  Constantly being surrounded by this helps us to keep focused on driving forward to achieve the highest quality care available.  We also love knowing that through them, we can help millions of other people, and there is also the joy of knowing we are investing in our profession.”

Brandon: At Upper Cervical Evolution, you spoke about quality control within the world of Upper Cervical. For those that weren’t there, can you give a brief summary of what you spoke about?

Dr. Stan: “This reflects back to my discussion of the concept of accountability.  I spoke of corrective spinal care (NOT adjusting people all the time)… people staying in alignment… holding the adjustment.  I discussed how we have the responsibility to push the envelope in developing concepts and advancements to get better spinal corrections that hold longer and longer.  We need to learn everything we possibly can from our mentors, and then push further.

I encouraged field docs to attend seminars to stay up with the most recent developments, and students to have 2 perspectives: 1) what is required to graduate and pass boards and 2) what is required to succeed in practice and get optimum patient results.

I tried to motivate docs and students to attend seminars that are dedicated to improving your skills and results as a spinal-aligning TECHNICIAN, and that it is a sign of respect to build on the concepts of your mentor, not a sign of disrespect.  Just be sure to master what they know first, and then work on advancements.  Lastly, maintain a servant’s attitude and realize that your patients employ you.  Practice-building and sustaining volume revolve around results and education… and keeping your boss happy!”

Brandon: In your opinion, what is the single most important thing Upper Cervical Chiropractors can do to further their cause?

Dr. Stan: “Continually strive to maintain the highest standards of quality care within your technique and practices.  Attending seminars, having mentors test you, passing certifications, surrounding yourself with people who are getting the kind of results you want to be getting, and assisting in the teaching of your technique are several ways you can work to maintain high standards.”

Brandon: What is your vision for the future of Upper Cervical Chiropractic?

Dr. Stan: “To envision the future, you have to look at the past and the present.

In the past, strong egos collided, UC techniques fought against each other, and UC practitioners tried to position their technique as the only one that really gets the job done.  Presently, the Upper Cervical Evolution seminars have ignited a platform for UC unity that seemed impossible.  In its 3rd year, the Evolution seminars have received consistent support from all the UC techniques except for one.

This has lead to the initiation of the ICA’s new Council on Upper Cervical Care and the upcoming Diplomate degree in UC care.  Research is being aggressively pursued (though more is needed), public awareness of Upper Cervical care is on the rise, patient advocacy groups are passionately spreading the word, and the heads of the UC techniques are moving strongly in a unified direction.

In the future, I predict the Council on Upper Cervical Care will unite the membership and political voice of the upper cervical community, and will form an entity that can provide judicial backing and strength to each UC practitioner.  I believe the Diplomate degree will bring educational legitimacy to UC chiropractic and will help to gain the respect of other professions.  I see worldwide expansion of UC clinics, and UC care being portrayed as the ELITE approach within chiropractic.


if we become apathetic and uninvolved in this movement,

if we believe we have learned all there is to learn and start losing our edge in quality of care,

if we think someone else will do the research or someone else will make the next discovery,

if we just quietly see our patients and stick our heads in the sand and expect it to just turn out ok,

if we try to stay politically hidden,

if we try not to ruffle any feathers and not challenge the trends in chiropractic curriculum,

if we repeat history with the egos and keep to our separate camps,

our future will be quite different than my vision.

By ourselves we can impact our little communities, but together we can impact the world!”