How much care will I need?

       THE RIGHT AMOUNT OF CARE

 

Care Recommendations should make sense

The discussion with patients concerning how much care they really need should be straightforward but can be tricky depending on which type of chiropractic office you visit.  I also believe that the answer to this question speaks volumes on what type of practitioner you are dealing with.

What troubles me is if a patient presents to 3 medical doctors with symptoms of a common cold, most likely there will be 3 treatment recommendations that mirror one another.  Conversely, if someone presents to 3 chiropractic doctors with simple non-complicated, (i.e., not coming from a fall or accident) neck or lower back discomfort, the recommendations can vary considerably far too often.

 

Follow Guidelines that are already standard

In chiropractic school, young budding chiropractors learn to ply their trade and follow guidelines on how to treat a particular condition based on recommendations that were given years ago.  Most recommendations come from 3-4 sources and have not changed much in the last decade or more.  Examples include the Mercy Guidelines and the North American Spine Society recommendations, but there are others.

A practitioner using guidelines such as these has a good start to managing a patient’s care, but the guidelines were not meant to be one size fits all for every person. Just because the Guidelines recommend 20 visits over a certain time for a certain condition, does not mean every patient who comes in needs all 20 visits!  Every person is different, and one person may need only 10 visits, not 20, and this is due to the fact that everyone responds differently to manual adjustments to the spine or any physical work to the body. 

There are many factors that can affect how many visits a patient may need. Examples include but are not limited to: a patient’s response to care, age of the patient, occupation, prior injuries, or arthritic changes in the areas treated.   I could go on and on, but I will not suffice to say each doctor has to take many items into consideration when making a patient’s course of treatment.

Experience and Trust are Invaluable

The decision on how many visits to recommend to a patient should always be based on clinical judgment/experience, and on evidence that can be validated through research.   This decision unfortunately with some practitioners is based on how many visits your insurance company allows you per year, or in plain terms how much money the doctor will make in the course of treatment.

I can think of nothing more harmful to the profession I love than the idea in a current or prospective patients’ mind that their doctor is not recommending care based on what is right for them. This also sours relationships that Chiropractors have with medical doctors, physical/occupational therapists/ and Orthopedic doctors/Neurosurgeons.  Unfortunately, these allied health practitioners have heard too many stories about Chiropractors recommending a year of care or more, and wanting thousands of dollars paid in full prior to treatment commencing.   

 

Always do the next right thing

This is the tragedy, patients come in more than they should, and payout more for care they may not need.  Many studies have indicated that chiropractic adjustments are an effective non-invasive treatment for acute and chronic spine issues.  It is the application of this therapy guided by research and evidence-based approaches that need to be adhered to, not what is best for the doctor’s wallet.  An initial visit to a chiropractor should not be like you are buying a car, and the recommendations given by the practitioner concerning treatment length should make sense to your medical doctor, neighbor, or friend.  If it does not sound or feel right, then maybe get a second opinion.