Patient Media

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Dear Bill

(This one comes from a new patient who happens to be a subscriber to Monday Morning Motivation.)

Q: “After going for a complimentary exam/consultation at a chiropractic office, when I returned the next day the doctor tells me I have to come back to his clinic for three times a week for six weeks, then two times a week for four weeks, and then once a week until a review is made. Is this a legit chiropractor or is he just wanting my money?”

A: Tragically, this is an all-too common treatment plan among chiropractors who are lazy, lack critical thinking skills or think they can use their limited social authority to get patients to do their bidding. (This is addressed in more detail in a March 2010 blog post entitled “Take Two and Call Me in the Morning.”)

While the three times a week sounds legitimate, I’d be suspicious of a chiropractor who claims crystal ball skills sufficient to predict the number of weekly visits required a month or more into the future. Seems reasonable to expect a progress evaluation to be performed 10-12 visits into your care. You might want to get a second opinion.

Comments (2)

To paraphrase a Patient Media poster " How far you take your care is always up to you." Was this a recommendation for relief care, corrective care, preventive maintenance or some combination of all three? Were x-rays taken? If this patient has radiographic evidence of a difficult vertebral subluxation pattern to stabilize or correct such as a reversed cervical curve with degenerative changes then a corrective care recommendation of 26 visits in 10 weeks is unlikely to be excessive. And yes, progress exams every 12 visits are important. This Beverly Hills chiropractor is committed to quality care and accountability.

Chris Kane, D.C.:

Bill, I respectfully disagree with this approach for several reasons.

First, it's not difficult to have a good idea of what a patient will require to at least correct a subluxation based on the exam findings, the patients overall health, the doctor's personal experience and what is documented in the literature. So, if we know this (or at least have an educated idea) and fail to share it with the patient, up front, then we have done them a disservice. We are withholding vital information. This doesn't mean a cookie cutter approach to care is valid. Each person should receive recommendations that are individualized according to their health status and their stated goals. Also, the treatment plan is a template. We should be re-evaluating on an appropriate basis and tweaking the plan if necessary. My personal policy is to overestimate care, and hopefully be able to cut treatment frequency/duration. But I feel it is my duty to prepare a person "for the worst".

Second, finances are usually a factor in a person's decision making process. If I don't prepare a person for what I think in my best judgment will be their financial responsibility, then I have failed that person. Imagine going to an orthodontist and they don't prepare you for the entire cost of care. I would walk.

Third, many people walk in the door with unrealistic expectations. They know the medical model, want us to "fix" them in one or two quick visits and so on... We might tell a person that we'll see them for 10-12 visits then re-evaluate, but many will hear 10-12 visits then I'm done. It's just human nature. Here we are, back in the pain model. Are we really doing this person a service here?

There are other reasons why being up front is important, and no I don't own an crystal ball. But I can do my best to estimate and share that information.

Again Bill, I share this with respect for you and all that you do for this profession!

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From June 20, 2011 9:56 AM

This page contains a single entry from the blog posted on June 20, 2011 9:56 AM.

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