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Is The Two-Visit New Patient Procedure Dead?

Two visit procedure doomed?For over three decades I’ve been an advocate of a two-visit new patient intake procedure. I’m sure it's familiar.

On the first visit the new patient completes the chiropractic intake form, watches an orientation video, has a consultation with the chiropractor, followed by an examination, instruction on some home care procedures and then dismissed.

The second visit consists of still another video to prepare patients for their report of findings, followed by the report and then their first adjustment. There are variations, but that’s the general idea. In fact, this two-visit protocol is taught by many of the management and chiropractic coaching organizations.

Is it time to rethink this procedure? Might it be no longer necessary? Or worse, could it be creating needless new patient friction?

But first, a confession.

Since I’m not a chiropractor with personal experience to test the outcome of either procedure, I’m only left with anecdotal data. Among other things, what I’ve discovered over the years is that chiropractors who use a two-visit procedure tend to have higher patient visit averages (PVAs) than those who use a one-visit procedure. In other words, chiropractors who adjusted patients on the second visit tended to see patients for a greater number of visits than those who adjusted on the first visit.

That was enough for me. Then, two-visits it is!

But it got me thinking recently. Was it the procedure that produced the greater PVA? Or was it the confidence and drop-dead certainty necessary to implement a two-visit procedure that produced the longer patient relationships? Perhaps the difference was just one more example of it being “the who, not the do.”

It seems that in many patient encounters, withholding the adjustment to a subsequent visit not only disappoints patients, but it’s, well, manipulative; almost a way of teasing patients and displaying a chiropractor’s power. (So much for creating a collaborative relationship.)

Getting adjusted shouldn’t require a waiting period like buying a gun!

I know. The two-visit procedure is often sold as a way to avoid overloading a new patient with too much information. But that doesn’t hold much water these days with the proliferation of the Internet and the public’s voracious appetite for consuming content demonstrated by the popularity of the iPad. Maybe you had to “protect” patients from information overload 10 years ago, but that seems unlikely today.

And it’s not as though chiropractors need a day or two to ponder the case or consult with colleagues to determine how they’re going to approach each new case!

Even more profound, how about accepting the fact that most patients drag their allopathic mindset with them as they begin chiropractic care. Withholding the adjustment in the hopes that they won’t think you’re treating their symptoms is absurd. Postponing the adjustment does NOT alter their worldview. If only it were that easy! Instead, it simply delays their recovery and annoys the patient.

Last time I checked, practices using a two-visit new patient procedure have about as many inactive patient file folders as those using a one-visit new patient procedure.

But before I officially abandon the two-visit model, maybe I’ve overlooked something. Is it time to rethink the two-visit procedure? Has it outlived whatever usefulness it originally had? Is it merely a vestige from another era? Please share your insights!

Comments (36)

One or Two-visit New Patient procedures has always been a big question for me. I know what's been taught, and I have seen how it's been received by new patients.

In my view it's a fluid thing. Experience has taught me to pick up on the patient's expectations (what they are and their strength); I am also one of those who does often like the time to think about the case before making recommendations and starting to adjust things.

I prep new patients with the explanation that DEPENDING ON A NUMBER OF THINGS, they may or may not (usually do) get adjusted on the first visit. I do that over the phone when they schedule and again, if needed, at the beginning of that first visit. Time is a big one and I make it clear that if they have a big story and/or the exam is unusually long, etc. (fill in a million clinical detail possibilities), then it will be on the next visit that they get adjusted. A patient who has never been to a chiropractor, for example, and doesn't know what's going on, needs to at least read the brochure, and hopefully see the video.

If it's simpler and more straight forward, and we can get it all done in the alloted time, no big deal, I adjust and they go about their business, happy that they got what they wanted and it was so straight forward and easy. Is there a risk that they might under-appreciate the nature of their condition or my care is there of course.

Thanks Bill for the opportunity to share,

Dennis

Ty:

At Palmer in the mid 70's, Dr. Strang taught a course to seniors on the reality of a chiropractic practice. I still have those notes and look at them every now and them. He was a very successful DC by any measure. He said people came to DC's to get adjusted.

A few years ago, I went to a new dentist who broke up exams and cleanings into 2 separate visits. One of his assistants came to my office and I asked about it. She told me he had been to a weekend seminar on making more $$.

How would you like to be treated?

Chris Wilkerson, DC:

The two visit model promotes the premise that Chiros are Doctors of Sales Care.

Jeff:

Personally, I've always adjusted on the first visit and I have plenty of wellness members and I also have inactive people. I don't believe any of us are that compelling at motivating people that we're going to change their ideas about health in one or two visits. If you adjust them on the first visit and they get well, and never come back, what a great gift you have given them. If they seek you out on a wellness basis, then what a great relationship you have.

I think the question that should be asked is...why? If you feel good about yourself and your coming from a place of what's in the person's best interest than what does it matter if you do a one or two visit procedure. If your comfortable about your procedures then so will the person that seeks your care.

Ryan:

Dear Bill,

I believe we are in transition right now. I have seen both those people whom want it now and those whom appreciate that I am not going to rush into adjusting them without explaining what is going on. I decide on a 2 visit plan if 1. I think there is a possible problem I need to be sure of before I adjust them (like a spondy), or 2. If the patient appears nervous about being in my office. If they are nervous they almost always appreciate me taking the time to lay out what is best for them. Also most malpractice suits come from improper exam, not taking xrays when indicated and adjusting before taking everything into consideration. Occasionally on the second day I will have follow up questions.

When someone has been seeing chiropractors all their life and is in town for a few days. Adjusting on the first day can be just fine.

Thanks for bringing this to the light.

I have recently abandoned the two visit model. Patients always show up for the right reason...Theirs! I feel the two visit model was imposing my own agenda. The reality is that most new patients are showing up expecting to get adjusted. I think a simple question to ask in the initial meeting with the patient is "What would you like me to do for you today?" Often times the answer will be "fix me" and then you can follow up with a dialogue that makes them the boss and you as just the facilitator for their body to do the healing. My feeling is there is nothing special about waiting for visit number two to perform the adjustment. Do a meaningful exam and ALWAYS do a meaningful relating of the patients findings and make recommendations that are authentic. At the initial visit we are just starting a relationship and building trust. In time the education will take place when the patient is ready. We need to focus on being present and not making it about us. Belief systems take time to change!

Don Handly:

I have used both ways. I believe if it really take 2 days to process a new patient then use 2 days. However, if your are using the 2nd day adjustment to control and manipulate the patient then I think waiting is wrong. I know if I went to a chiropractor to be adjusted and had to wait a 2nd day to be adjusted. There would be no second day.

Nick Laurie :

I think that your proceedures will be determined by your patients. If you are confident enough to adjust on the first visit then your patients will sense this. Likewise if you choose a 2nd visit adjustment.
However if you are adjusting for an inauthentic reason, your visit numbers will reveal this. Patients don't return when you are not genuine.
If you are doing what you believe is genuinely in the best interest of your patient then it's a no brainier.
It all comes down to faith, confidence and belief.

I have learned from another chiropractor a blend of the two. I am a Network Spinal Analysis doctor. In the consult and history taking I explain exactly what is going to happen step by step on day one and day two, which they really appreciate and puts them at ease. During that time I explain to them that I consider the first and second adjustment part of the evaluation. I want to see how their body responds to my adjustment so that I can accurately tell them at the end of day two how I will be able to help them. Also, I adjust them at the beginning of day two before we go over exam findings, treatment plans and finances. This takes them out of the mindset of being "on guard" to you "selling" them and puts them in a relaxed and receptive state to better listen to what you have to tell them.

I too have been pondering this situation for a long time. After 25 years in practice I believe I have a instinct that tells me a new patient needs to absorb some of what we have talked about on their first visit. I use a technique that is strange to many new patients and I need time to explain some of the therapies and procedures. If they are looking overwhelmed by the amount of information I will wait to their second visit to go through a slide show/ROF that explains their particular situation and even include some digital pics and or videos of them that illustrate their condition. They need to know that their are being treated by someone that understands THEIR unique condition and has a plan to address it. Today's patients seem to feel the cookie cutter care approach and avoid it.
It helps me to understand that healing is an art form. No two patients are exactly the same. Each one may need to hear things a little differently. It is up to me, the artist, to figure out how to best approach the canvas/patient. Be aware that art is not easily scalable and is not always predictable. Over the years I have found little consistency in how patients psychologically understand chiropractic and healing.
Besides what is an adjustment? When we say we will not adjust them on the first visit, the patient has almost no concept of an "adjustment". "Is that when you crack me Doc?"
For reference in a city close to me there is a orthopedic "prompt care" clinic. I send my referrals there because they may get an exam, diagnostic ultrasound, and prolotherapy injection all in the same visit.
In conclusion I am less inclined to follow rules after 25 years of practice and more likely to do my best to understand what the patient needs emotionally, psychologically and intellectually to make a rational decision about their health. It may not always be the decision I or my PVA would wish them to make, but it's ultimately the patient's decision. I can only do my best to help them feel cared for.

Tim Goulart:

Every state requires a good history and exam. So that's the law. Holding an X-ray up to a light in the darkroom and rushing out to " adjust" someone is not only setting yourself up for a liability, but cheapens the experience for the patient. Of course, like most things in life, there are justifiable exceptions to second day report of findings. If a Doctor has been in practice for while he/she soon realizes that what sometimes comes out of a patients mouth in a consultation and what we find in a good exam are not always the same thing. Taking a little time to review the patients history and exam is in both people's best interest. In this short attention span, smart phone world I understand why we want it NOW. My experience (in most cases) is patients want to know we took the time to listen to them and think about them personally before we answered the question: " What's the problem?" Most of these type of questions come down to intent. My intent in day 1 and 2 is to be an authentic coach. Love to hear back from you Bill. Tim

I think you make a good argument for adjusting on the first visit, but it depends on your procedures sometimes.
An upper cervical practice should wait until the x-rays have been thoroughly analyzed and corroborated with the evidence found in the exam and history taking. This makes not only for a better case report for the patient, but for a better outcome.
There are also cases where a patient comes from a very long distance in which case, adjusting on the first visit just makes common sense.
I say that unless there are concerns about which you need to consult another physician, then go ahead and adjust on the first visit. The patient thinks you are wasting their time and their money if you put it off for another day.

Lowell Keppel:

I am sure depending on the technique used may dictate the 1-2 day procedure. The feed back I get is patients want something done asap if they are in pain. Granted they have waited weeks till they decide to TRY this Chiropractic thing.
I personally adjust on the first visit. After years of experience I have an idea of what is going on with the patient in the consult and I allow the examination to rule it in or out. Most people want action now! They have tried most everything else already.

The most freeing moment in my practice was when I realized I CAN'T MAKE A PATIENT DO ANYTHING!

Also my type of practice Whole Health Nutrition chiropractic...there really are no videos for patient education.. I do give them a video on NET but other than that I have to educate them why they need nutrition and how the nutrition relates to their subluxation complex.

Personally I have fun every day in the office! And patients like the results.

Marcy:

It fits with my practice style to adjust the first day -- with exceptions or unless they are over 65, in which case I really want to see xrays and with the large amount of info we're now required to document electronically on Medicare, I just don't have time to do it in one session. But do agree with the other thoughts - I live in a college community where it is very NOW - if I came in for an adjustment and didn't get one, I wouldn't go back.I have a pretty high PVA after being in practice here quite awhile -- probably from giving people the opportunity to continue on a maintenance type plan or do the cycling pain visit schedule - totally up to them (thanks Bill!)

In our office we practice a specific upper cervical technique and need x-rays to get our listings to adjust patients. We use the two visit model so that we have enough time to go over the patients x-rays in detail. We work very hard to make sure that we always have the correct listing and rushing to get a person adjusted right then and there may compromise this. We do, however, make exceptions. If a patient comes in and are in acute pain or having a severe neurological issue then we will take the x-rays and have them come back later that day for their adjustment.

I can understand how some people would think that because we live in a NOW society we should adjust them on the same day. But, if they went to a medical doctor for blood work would they expect to get the results right away? Or if they went to a dentist for a consultation for braces would they expect to have them put on right away? Now we are not like MDs or dentists, but I think that sometimes we make excuses for the patient. If you are confident in your process and you relay that confidence and authority to the patient they won't mind waiting.

Anonymous:

One size does not fit all. 80% of the time in my office the two day model works beautifully. Also, when we consider that most people we see have ongoing problems that have lasted in most cases months or even years and have not "gone away" I get very little friction about waiting another day. For the other 20% since most of the time I take x-rays we generally schedule a second visit later that same day, or they get adjusted the next day. If you take an x-ray and then adjust without looking at it first-why take the x-ray? In my experience, people discontinue care not because they had to wait an extra day to begin care-but because they got what they came for, or didn't.

dr beau:

Well Bill, I use a 3-visit approach, which means NO adjusting until the 3rd visit. Doesn't mean i don't adjust on the first day ... it simply means, if i don't get to the 3rd step of a new patient approach ... we don't adjust. We ask the patient to answer these questions;
1. What IS chiropractic?
2. How long will it take?
3. How much will it cost?
4. When would you like to start?

What about office flow & developing x-rays- unless you're digital. I've been thinking of this but would be keen on video to outline it all.

I currently use the 2 day visit. I don't think about that aspect of it as my affecting their allopathic model or manipulating control. I do think it helps in most cases to change an image of Chiropractors not being thorough and just randomly "cracking" someone's back blindly. I carefully make exceptions to my 2-day rule; if someone has gone to a chiropractor before, fairly regularly or for a long period of time, then I will adjust them, if possible, according to my schedule. At this point for me, it's not about the 2-day necessity, but it is about the time do exams/tests, look over findings, then a ROF and properly educate them...that's a long visit. So Bill, show me the next video to do it all in one day, I'm listening...

When I take x-rays I have the patient come back that same day in the afternoon or the next day if the x-rays are taken in the afternoon. I think if patients come to see you they want to get started. Especially if they have strong symptoms. If they have seen a chiropractor before, I see them that day right then and there.

Vincent:

I generally adjust same day if I have time and feel like I have a handle on the problem. I have more interest in the patient immediately after the case history than 24 hrs later, so why not translate that interest and energy into a report of findings that may be better than if I wait for visit #2?

Ron Dellanno DC:

I could never let a patient wait to receive an adjustment when it was in my power to help them now. If you believe that we are working with the power that created all existence than it never resonated with me to let a patient suffer because someone thought it was a better way to control them.
Better to tell them about the great power that resides within and show them what is necessary to fully reconnect with that healing force.
No tricks. Just truth.
Dr Ron Dellanno

Thresa Young DC:

I used to do that in practice some 15 years ago. I have decided that there was really no reason to do that. I know how to handle a case on the first visit........so why not do it then!!! I also think it works better for office flow. Plus, the fact that people are hurting and want to be cared for as soon as possible.

Dear Bill,
You raise a very good point!! I have noticed that our society has become a NOW society. We need to connect to the internet NOW, get our fast food NOW, rent movies online NOW, etc. So why would people not be annoyed with having to wait for their adjustments and care?!?!
I think the key to this problem lies with how each office and doctor handles the situation. Here is why my office still maintains the 2 visit style of yesterday:

When my new patients make an appointment, they are told about our 2 visit set up. They are carefully, and fully informed that "the doctor will perform a vast number of exams in order to diagnose any underlying condition, and then the doctor needs time, to closely look at your results, and to put together a care package that is specifically all about you!"

The patient is also informed that they will receive some care on their first visit, "so you don't leave without getting some relief" which in my office is in the form of a Mechanical Traction Table along with heat.

At the beginning of the first appointment I inform my new patients that "So here is our game plan for today, First you will start off filling out some paperwork, and then you will be able watch a short video, which gives me time to review what you wrote in your history forms. After the video we will sit down together and go through your history so I have a good understanding of where you have been, where you are, and where you would like to be. Then I will perform some exams, and after that I am going to get you some relief. I will not be adjusting you today, but that is because your health is very important to me, and I want to make sure you're a good candidate for chiropractic care. I am go to review all the findings from today, and put together a package with all your results, and a care plan, which we will review together at your next visit. And on that visit if you would like to get started on your care plan, we can go right into it that very same day!"

And then at the end of the first visit, I once again reiterate the importance of their health, my time of reviewing it, and putting it into a care package for them.

So my patients hear the same reason THREE times as to why it is so important to wait for the adjustment. At this point they feel so greatful that I as the Doctor take their health so seriously. And because I use the mechanical traction table, which EVERYONE loves, they do get some relief, and can't wait to come in again to get back on the table, and also hear their results for that visit.

And that is how, and why I still use the 2 visit set up. I have had the patients who walk in and want an adjustment NOW, but i have also learned those patients hardly ever return. Why? because they know nothing of me, my dedication to their health, and they do not understand the responsibility they have to their own health. And those qualities of understanding take time to learn.

Yes, I too have inactive patients, but they also dropped out of care before they understood chiropractic care and why it is so vital. (typically drop out after 3 adjustments because they feel better)

All in all, I think it comes down to what kind of Doctor you want to be, what kind of patients you are looking to have, and what kind of clinic you are running.

IT IS ABOUT COMMUNICATION!!! LET YOUR PATIENT KNOW WHY YOU ARE NOT A "NOW" DOCTOR AND GIVE THEM SOME SORT OF THERAPY FIRST VISIT, THIS IS THE KEY TO BUILDING THE KIND OF RELATIONSHIP I HOPE TO HAVE WITH EACH AND EVERY ONE OF MY PATIENTS!

Mark Taylor:

I think we need to treat each person on their individual merits. If they are a complex case maybe the two visit procedure is needed, if we have the confidence to adjust on the first visit then do so accordingly. Lets not throw blanket rules over our patient care in the name of practice growth and PVA's, that's not why we're chiropractors. Neurologically, lacking flexibility and rigidness is unhealthy, I think it's the same if our practices are run the same way.

Bill,
As always I greatly appreciate the breath of fresh air. We have been struggling with this recently and have seen a major shift. I have tracked those that request an adjustment on the first visit or "need it" based on my leverage of "how bad" their condition is (talk about manipulative) and those that we make wait to the second visit. The greater "retention" exists with those that are treated on day one. I appreciate your foresight from a patient's perspective but I agree the "now" era may be frustrated at the delay... I know I would be agitated to get my teeth worked on my next visit.

I only question how this demand for "now" may perpetuate into other office procedures.

Thanks for all you do and watching our "6".

Leah:

Most of the time I adjust on the first visit if there is time. I do a REALLY thorough exam and spend a long time with a new patient, educating them as much as I can at the consultation. About 10% of the time I simply run out of time and it is not appropriate to adjust at the first visit, but I do most of the time.

I think patient education is and must be ONGOING, and whether or not you adjust them at the first visit, if at the second visit the chiropractor forgets it's still a long term process, then how can we expect the patient to remember it's a long term process if we think manipulating them by withholding the first adjustment until the second visit is some magic recipe?

I agree, it's manipulation. However there are cases which are more complicated for various reasons and require waiting. Also, as you, Bill, have said numerous times, some patients get it quickly and some don't and I think my long term commitment to teaching people the fundamentals of the power of repeated adjustments OVER TIME has to be just that - a long term commitment to teaching, not a simple formula at first, as each person requires bespoke education, to be reached and connect with them where they are coming from, not making them fit to my agenda. After all the patient is only going to do what is on their agenda anyway and only by teaching them from within, will their agenda maybe change anyway, not by manipulation. We don't give people enough credit sometimes, and then there are some people who don't deserve much credit for their eyes glaze over and they don't WANT to get it, and nothing you do is going to change that. Just my humble, small-time chiropractor, opinion.

I still believe the two visit procedure is very important for the patient who has never visited a chiropractor before. I believe they actually appreciate the fact that you are taking extra time and care with their case. I do agree that a two visit approach is incorrect and even harmful in a relationship where the patient has been to a chiropractor recently or several chiropractors over the years. These patients would be very annoyed at the idea of having to wait. So, therefore I see no reason why we couldn't have 2 different approaches for the 2 different types of patients. I believe having 2 different options isn't that difficult. Ultimately it would be the doctors decision whether this patient should be adjusted today or until the next visit.

Mithra Green:

For me it's a simple; what would I want if I sought a chiropractor? This question has caused me to drop year-long care plans, skipping the thinly veiled new patient beg-a-thon I called a "Workshop," and basically treating people like adults. It also meant helping people as best I could, as soon as I could. Bill, if you were seeking a new chiropractor how would it feel to wait another day for no real reason other than to bump up their PVA?

Michael:

I used to adjust on the 2nd visit, but been in practice for 25 yrs I am now comfortable adjusting on the 1st visit. You can still take x-rays, or do a scan on the 1st visit and do a decent ROF on the 2nd visit. I think that is what I would want if I was a patient. Previously adjusting 2nd visit was strictly a practice management strategy, and had no clinical significance.

Dr. Joe Labbadia:

I believe this is one of those situations that shouldn't be written in stone. If you know that you can adjust the patient then do so. If you are waiting for a clinical reason such as x-rays or other diagnostics, patients will understand. However if you are only withholding for reasons unrelated to patient care, I think they will sniff you out! Do what is right for the patient!

Hey Bill,

There are exceptions to any rules but for the most part the 2-visit approach works for me because it gives me time to evaluate, review the x-rays/reports and make a better informed decision concerning my patients. Making quick, hurried judgements on patients is what the medical profession does on a daily basis. Most patients present (unfortunately) to chiropractors as a "last resort". The last thing they want is the same approach that they arready had! Being "different" is part of who we are. If patients have waited this long to see us, waiting one more day to get their life back is not going to delay their recovery or annoy them. Instead, maybe it will finally give them hope.

Leigh:

I have always adjusted on the first visit (unless time runs out after the consult & exam). I've never thot I needed to play the power game. If we teach that health is important then getting the process that leads back to health ASAP seems more congruent than waiting.

My technique does not require X-rays but I can understand that if the doc needs to read the films then from a logistical standpoint it might be more time-efficient to read all x-rays at a designated time which might then mean not adjusting on visit 1.

TA:

Bill,

I've been in practice nearly 10 years, and here's my two cents on the issue...

I use an off-site imaging center to shoot my patients' x-rays. During my consultations, I explain how today's visit will play out. The exam may require the need for x-rays before adjusting - if that's that case, I give them some home care recommendations to follow until they're able to schedule an x-ray appointment.

Very rarely does a patient find this intolerable or unreasonable. I find that most medical offices handle imaging and lab studies in the very same manner, so patients are accustomed to "waiting" a few days for treatment or results.

Furthermore, at the end of my exam I ask patients if today's visit was what they were expecting. While on some occasions a person will say they'd hoped to get adjusted, more often than not I hear some version of: "This was a lot more detailed exam than I've had at other chiropractic offices. I appreciate you being this thorough."

So I consider a two-visit approach to be more impacting than one.

Nick Grande:

Bill,
I wonder if practices that adjust on the first day have a higher rate of patients returning for the day 2 visit?

It's not only manipulative to withold treatment, it is inhumane and intellectually dishonest. The patient is thinking, "I can't live another hour with this nagging pain", while the doctor is thinking, but not saying, "let's delay your pain relief another 24 hours so I can start repositioning you to the subluxation model of thinking". In that scenario I think the answer to your question is clear.
Dr. G

John Dowling, DC:

We use the 2 visit procedure and we feel that it does, in fact, create a better patient experience over both the short and long run. Unless they are a seasoned chiropractic patient already, (in which case we *may* adjust them first visit), a patient's expectations for the power of a chiropractic adjustment is often greater than what that first adjustment may deliver: usually because of processes outside our control, like inflammation.

A few caveats. If they are a Wellness new patient, not in pain, we will adjust them first visit and ROF on the second, same as usual.

But, for a "pain" new patient, we almost *always* send the patient home with instructions and a rationale for waiting until there second visit before adjusting them. This is usually icing frequently to reduce inflammation. We tell them that this will also provide them some immediate relief and, prepare their soft tissue and spine better so that their adjustment will be more effective. (Which we believe is often the case.) If they are in extreme pain, or with severely restricted motion, we may bring them back later the same day. (We still ROF second visit).

It has nothing to do with a power play on our part. Patients need to understand that healing and recovery is a process. And that process starts with their first visit. If we tell them one thing, and then do another that speaks to their sense of "I want it now", then we are catering to the aspirin mentality.

A tai chi teacher once told me: when the arrow leaves the bow is what determines whether it hits the target, not after. Their first visit is when the arrow is leaving the bow. We want them understanding that *they* need to be involved in their care, that the adjustment facilitates their healing and, that the process takes time. Shooting the arrow, then trying to demonstrate this is like trying to change the arrow's flight after it leaves the bow! I suspect that what is behind the different in PVA's related to first visit adjustments or not. (And, btw, we *have* deviated from this procedure many times over the last 20 years and...are convinced that, if possible, the 2 visit new patient is the way to go.)

There are many offices, I'm sure that adjust first visit without seeing patient adopt an "adjustment for pain" mentality, but for our part, we feel that if at all possible that is the way to go for a better, more engaged patient.

(PS: I also believe that subconsciously people accept the two part visit as making more sense. Whenever people have something *serious* wrong with them...something that they really should *pay attention* to, with the rest of their health care experiences, it's a two part event: gather data. Get a game plan. And, that's also how we posture it with our patients: today we gather data. They get their instructions to start addressing their problem. Then, second visit, we evaluate how their actions have or have not helped and then we sit down together and go over the results of our examination and xrays. We explain where their decision points will be, and get started. We believe that patients value chiropractic more that way because it fits the pattern that most use for every *other* major purchasing decision in their lives, healthcare and otherwise.)

Just my longish 2c!
:)

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From June 24, 2012 11:03 AM

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