Who Invented Cookie-Cutter Care Plans?

The term “cookie-cutter care plan” applies to chiropractic offices that require all new patients to follow the same predetermined schedule of visits. An example might be something like this: 3X/week for the first 3-weeks, 2X/week for the next 6-weeks, then once per week for an additional 17-weeks. I’ve seen other offices insist that patients commit to 1-2 year’s worth of care! Who comes up with this stuff?

Does every patient really need the same exact number of visits?  I remember asking my chiropractic school instructors these types of questions, hoping to better understand this logic. Sadly, I never got an acceptable answer. If I had to guess, I’d say that sometimes people just do things because that’s what other people are doing. The old adage “Monkey-see, monkey-do” comes to mind…

Here are some case studies from my practice to help demonstrate why I don’t use these cookie-cutter care plans:

  • Patient A: 51 y/o male held his first adjustment for 3-weeks.
  • Patient B: 37 y/o female held her first adjustment 2-weeks.
  • Patient C: 47 y/o female held her first adjustment 1-week.
  • Patient D: 41 y/o female held her first adjustment 8-weeks.
  • Patient E: 43 y/o male held his first adjustment 5-days.
  • Patient F: 62 y/o female held her first adjustment 12-weeks.

Simply put, I’ve never met two people who were exactly the same. These six examples show how responses vary between patients. So unless you find a doctor with a fully functioning crystal ball, I’d say it’s impossible to predict how long patients will hold their initial adjustments.

Care plans – large and small – should be based on each patient’s specific needs. If you meet a chiropractor who wants to see you the same number of times as every other patient, perhaps a second opinion is in order?

2 Comments

I agree with you that while some plans seem excessive, for othes they’re exactly what is needed for that patient. Hindsight is always 20/20, but w/o a crystal ball (yeah, like we don’t have enough trouble with some in the health world thinking we’re all just smoke and mirrors) we need a starting point. I’m not a big fan of keeping to plan if they’re holding great, and I do tend to space out the visits if they’re holding great. But there needs to be a caveat that a patient needs to understand that at some point, if they’re not holding as well, they’ll need to come in more often. Best news on that though is the fact that we can use objective measures to determine that need (i.e. thermography, leg checks, postural checks etc).

    Thanks for the comment, Dr. Schurger. I’m not disparaging care plans altogether – I’m simply opposed to “universal” treatment recommendations.

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