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Dear Bill

Dear Bill,

I see that one extreme end of the spectrum of your Law of Fair Exchange below is the annual care plans. My fiancé and I are newer chiropractors, and we were suggested the annual care plan by our mentor. We do not force it on every new practice member, but do offer it.

I've had some reservation about it, but we've found that a few members wait to choose it until after they start to see result (clearly, our ROF is not where it needs to be yet).

Could you elaborate on why the annual plans are not a fair exchange? Maybe this is at the root of my hesitation.


Hesitating in Calgary,

Dear Hesitating in Calgary,

There is nothing intrinsically wrong with annual care plans. Patients who “get” that chiropractic care can be an adjunct to a healthy life, rather than only a short-term “diet” for pain relief will usually appreciate the savings and convenience of an annual care plan. As such, if I were in practice, I would offer an annual care plan, but patients wouldn’t be eligible for it until 60-90 days out, or if they understood the lifestyle implications because they had been under chiropractic care previously, and they were nonsymptomatic, they could start immediately.

My angst about annual care plans is the heavy-handed “selling” of them in an attempt to get the patient to do the “right” thing—at least in the eyes of an enlightened chiropractor who plans to get adjusted for the rest of his or her life. Since most patients enter a chiropractic practice after a lifetime of symptom treating at the hands of medical doctors, the sales overtures amount to talking about kids and marriage on the first date. Or, patients are seduced by what they see as a lower-cost-per-visit, ignore the fine print and begin care with little or no interest in embracing a chiropractic lifestyle.

And not sure what you mean by “our ROF is not where it needs to be yet.” When you report your findings to the patient and offer them choices for acting on what you’ve found, where does your report need to get? You probably want to be careful about turning your report into a sales session. In fact, mixing your clinical findings with overt or covert attempts at getting the patient to do one thing or another, starts to take on the odor of manipulation.

Comments (3)

I smell what you're cooking Bill but I find it hard to present choices in an objective way when I obviously want them to choose the healthiest path. I sometimes feel my ROF comes across as "here's a choice or if you are a total idoit you can choose this" So I get alot of acceptance at the ROF but then I have a drop-out rate the same as others. How would you suggest making patients feel comfortable choosing short term relief or corrective care or lifetime care for that matter?

Tony Russo:

You said it perfectly, Bill. I attended one of your Seminars where you gave a senerio of a person calling our Office and saying that they are asymptomatic, but wanted to consult your office for long term health care to see how they could increase their over-all health potential. The room filled with smirks and looks of indignation. Yet, you mentioned, that is what we ultimately want for all petients who walk into our offices. How can you expect that drastic of an attitude change in the first to fiftieth visit? And you want to convert them in your ROF? If your hearrt is in the right place, your practice will be too.

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From July 6, 2009 11:19 AM

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