Suppose you visit a chiropractor who recommends a year long course of treatment. You might be wondering if this is common in the chiropractic profession. It’s reasonable and prudent to ask if this is a necessary and truly beneficial treatment plan. So let’s discuss it.
To clarify, it’s not my purpose or place to tell you what you need or don’t need. By all means, listen to your doctor’s recommendations and then do whatever you feel is best for your situation. I’m simply an advocate for making well-informed decisions, especially when it comes to health matters.
Now, let’s investigate where the concept of year-long care plans originated.
You might be tempted to think it begins in chiropractic school… but it doesn’t. In fact, not once during my chiropractic training can I recall any of my instructors encouraging this protocol. If anything, it was quite the opposite.
In a nutshell, chiropractic students learn to assess a patient’s chief complaint, perform diagnostic procedures, determine the most likely cause of the problem, provide short-term treatment, and then re-evaluate the patient to determine if what they did worked. They also learn to spot red flags and identify conditions that need immediate medical referral.
The most important part of this process was re-evaluation. Is the patient responding to care as expected? If not, change treatment or refer out.
So if chiropractors didn’t learn about this practice in school, where does it come from…
The answer, sadly, is that the business side of chiropractic is learned from “practice management” companies. Self-proclaimed “coaches” impart anecdotal business advice upon impressionable chiropractors. Anyone, proven or unproven, can be a coach. Some of these individuals have only been in practice for a few years themselves, and are up to their eyeballs in debt. Others are veterans who drive Bentleys and own private jets… some have gone to jail.
This murky advice comes at a hefty price, costing anywhere from a few hundreds dollars per month to upwards of $60,000 per year. I personally know doctors who have spent hundreds of thousands of dollars throughout their career on coaching.
While not all coaching programs teach the same procedures, a pervasive theme amongst many of them involves year-long care plans.
But why? What is it about 12-month commitments that makes this concept so ubiquitous within the chiropractic profession?
I wish I could tell you that the person who benefited from this the most was you – the patient. Unfortunately, this approach caters more to the doctor.
See, running a chiropractic office isn’t much different than operating any other kind of business. Rent, utilities, insurance, inventory, employees, etc… all need to be paid before profits are generated. There’s a certain dollar amount that needs to be collected each month just to keep the doors open.
Having a predictable or pre-determined patient load makes the chiropractic business owner’s job considerably easier. If a chiropractor has to see 200 patient visits per month to break even, the first way to insure that happens is to get new patients to “sign up” or commit to long-term care plans.
From there, it helps to devise a cookie-cutter schedule of treatments for all new patients to follow. Why see patients “as needed” when you can instruct them to come in one, two, or even three times per week… for a year! Cha-ching!
Instead of growing the business by creating value for the patient, doctors are trained by practice management companies to place a value on the patient.
This business model infected the profession more than 35 years ago. It has become so common that new graduates who have never even spoken to a practice management company often think that scheduling patients “three times per week for 12 weeks” is the standard of care (monkey see, monkey do).
To this day, I cannot logically wrap my head around such an intense frequency of care. Maybe that’s just me… I’m sure there are thousands of patients out there who’ve happily paid for and completed year long care plans with much success. I’m not disparaging their decision, their doctor, or their results.
But I’ll leave you with this… If you find yourself having to decide whether or not you should sign on the dotted line, I want you to know that patients can get outstanding results without ever committing to 12-months of care.