Is it possible to rehabilitate and retrain the supporting muscles and soft tissues of the spine in patients over the age of 30 with the dozen visits or so doled out by an insurance company?
Symptomatic improvement? Probably. Lasting soft tissue changes? Unlikely.
This means their symptoms are almost certain to resurface months or years after discontinuing their care. Usually from some new physical, emotional or chemical stressor. When it happens, will they return to your practice for follow up care? Or cozy up to the new chiropractor in town? Or give up on chiropractic all together?
It depends upon several issues that many chiropractors have overlooked.
If you don’t see many patients return to your practice for another round of care after months or years of dormancy, it would be only natural to assume that your intervention permanently “fixes” patients. However, consider the possibility of an alternative explanation. Maybe one of these:
Guilt about letting you down. Many chiropractors become so invested in the patient’s recovery that patients feel like they’re disappointing the doctor when they’ve had enough. Returning, invites what they imagine as a smug and condescending, “Didn’t I tell you that you needed more adjustments?” Instead, it’s easier to consult a different chiropractor. Since there are so many of them around these days. Problem solved.
Chiropractic doesn’t work. When their symptoms return, many patients reach the conclusion that chiropractic is just a temporary, stopgap solution. An elaborate massage. This is when many proceed down the pecking order to the next untried practitioner, maybe choosing acupuncture or something else that seems promising.
Patients think you dislike them. After almost daily recall contact when trying to end their relationship, months and even years pass without even a postcard from you. Many patients assume you’ve disowned them. And return the favor. Cultivating patient relationships, especially during the dormant phase of their care, is essential if you have any hope of seeing future reactivations.
Most of these barriers could be avoided by acknowledging that without purposeful communications around this subject, most chiropractic patients, especially first timers, believe you “fixed them” and that their problem is permanently resolved. If you do discuss the lifestyle implications of periodic checkups, many patients aren’t inclined to believe you until they actually experience a relapse. In both cases, proof of your assertion arrives when your influence has waned. What they do about their relapse is often dictated by the taste left in their mouth when trying to extricate themselves from your practice. In other words, make it easier for patients to leave your practice if you have any hope of seeing them return.
Since virtually every patient has heard that once you see a chiropractor “you have to go for the rest of your life,” this issue can’t be ignored. And it’s better done at the beginning of the relationship, than later when they’re trying to find the door.
At the consultation: “Finally, have you heard the chiropractic myth that once you go to a chiropractor you have to go for the rest of your life? Well, I want you to know that it’s not true. You don’t have to do anything. But let me explain how that got started. Many patients are inclined to stop their chiropractic care as soon as they feel better. Which is before the supporting muscles and soft tissues have been retrained to lasting, healthier patterns. So what happens? A month or two later, or even years later, when they experience some form of stress, their symptoms return. ‘Chiropractic doesn’t work!’ they think. Not true. It’s just that they discontinued their care before the healing was complete. I know that continuing to see us when your symptoms are gone may seem a bit strange. No problem. When you’ve had enough, just let us know. We’ll celebrate your progress and remind you that should your symptoms return, your records will be here, along with our genuine concern for you and that we’d love to have you back and give it another go.”
Many chiropractors, especially those with thousands of inactive file folders (but a chronic need for more new patients), are tempted to conclude that their intervention permanently resolved the patient’s problem. After all, few patients ever return for a second helping.