Q: I am a new doc and basically all I have to work with where I am at is my hands. I am an osseous adjuster and sometimes I notice as a result of my size it is difficult for me to adjust larger people. If it doesn't move, or I feel I just bang on a patient I get a little embarrassed, like oh God He's gonna think I am not getting it. Any advice? A: Thanks for your e-mail and question. My advice is simple. It is always a great idea to have some backup technique. If you feel uncomfortable working with a patient due to their age, size etc. use an Activator (of course learn how to use it first) along with osseous adjusting. I use both. I normally start my new patients with the Activator and move onto hand adjusting within a few adjustments and then mix and match. It is depends on what you tell the patient. The few that are used to pops and crackles may feel that they were not adjusted but they either stay with you or move on. Those that are educated by you will follow you with whatever technique or sound transpires. As times goes on you will become more proficient in the technique and your verbal tone and assurance will reduce any anxiety from you or the patient. Since you are new in practice .. I recommend you consider my Smart Start Book ..it has helped over a thousand DC's get off the ground running. Also .. not quite sure where you practice but if it is near Atlanta .. consider attending the next Fernandez Seminar April 21 and 22 .. as my guest for free. If interested call them at 1-800- 882-4476 .. it'll be worth it