The Patient’s Choice Practice
RehabCare: The Link between AcuteCare & WellnessCare, and the Link between Insurance and a Chiropractic LifeHabit
Steven P. Weiniger, DC / Founder, BodyZone.com
Chiropractic adjustments help people. Millions of people have walked into a chiropractors office bent over in pain, and walked out feeling tremendously better. This is the sole reason our profession has survived, and prospered, despite myriad political enemies and some grossly unfair practices of the medical and insurance industries. In the eyes of much of the public, and some of the media, chiropractors help people get out of pain. In a Patient Choice Practice (as well as many others) this portion of treatment, from pain to relief, is called AcuteCare.
The chiropractor’s image in the eyes of the public, and the media, begins to suffer once our patients are out of pain. Many chiropractors preach that it is beneficial to get adjusted in the absence of symptoms. Many patients are taught that they need either a program of identical visits lasting for months, or a lifetime of such passive care visits. This not only creates a “red flag” for insurance and other third party payers, it also reduces the value of care in the eyes of our patients. “If each office visit to your practice is identical, why do I have to keep coming back?” patients ask themselves. The reason, or philosophy, for the care may differ from chiropractor to chiropractor, but, for many patients, the bottom line point of view is that “chiropractors keep you coming back forever”. And the philosophy they are taught by much chiropractic patient education, true or not, is frequently not in agreement with what they learn from all the other sources of information in their lives.
We live in a time of information overload. People are deluged with media messages from television, radio, billboards, newspapers, and, most recently, the Internet. People make their decisions based on:
1. Where the information came from, and
2. How many times the information has been received.
Our professional image problem begins after AcuteCare. When people are feeling better, they add the information they receive from a chiropractor with the rest of the information they receive in their lives. In 1990, in addition to marketing directly to medical doctors, there was 48 million dollars spent advertising prescription drugs directly to consumers, in addition to billions spent advertising over the counter medication. In 2000, there was 2 and a quarter BILLION spent. Vioxx spent more money advertising their anti-inflammatory drug in 2000 than Pepsi spent in the cola war. It’s true; $160 million was spent on Vioxx, compared to $125 million for Pepsi. Vioxx also outspent Nike, which used $78 million that year. The chiropractor, and his message, is a lone voice in most patient’s lives.
So what happens in many practices is the patient feels better after treatment and, once out of pain, drops by the office again when the pain returns. This is widely perceived as a problem. One solution is selling the patient a treatment plan for thousands of dollars, covering many visits (with easy payments available on your credit card). This can provide cash flow for the chiropractor, but referrals and renewals suffer as patients doubt their need for care vs. the doctors need for cash. Also, the doctors stress level and malpractice exposure suffers from dissatisfied patients who believed, despite the legal fine print, that the doctor promised to cure their pain.
There is another way.
The Patient’s Choice Practice suggests using RehabCare as the bridge to WellnessCare. Empower patients to choose to be aware of their posture. By aligning the message they hear in our office to what they hear in other parts of their lives, more people will choose to adopt a LifeHabit of daily Posture Exercise and regular chiropractic “tune-ups” to keep the body moving fully and symmetrically as they age.
RehabCare helps patients integrate a message of Move Naturally, Feel Good, and Be Well into their lives by creating a personalized daily Posture Exercise Program. The concept of daily Posture Exercise dovetails with the classic chiropractic idea of “maintenance” adjustments. The patient who does daily posture exercises is more conscious of their posture, understands and can “feel” the improvement in balance and range of motion from regular WellnessCare adjustments.
Initially, in AcuteCare, the spinal adjustment restores motion on the deepest levels of motion, thereby allowing for the possibility to change the body’s patterns of motion. In RehabCare, focused motion exercises retrain the body’s motion patterns to reset old, adaptive motion programs. These programs are embedded in the network of the motion system, which is composed of the muscles, nerves, and fascia. Focused motion Posture exercises break the Pain Cycle and, in so doing, dramatically increase the holding power of the adjustment.
The two elements of a Posture Exercise LifeHabit are first, basic Posture Awareness, and then, Daily Posture Exercises. The first element, basic posture awareness, may, or may not, be covered by insurance. Once they are out of pain, and insurance, many patients will choose to continue a program of continued care that includes creating a daily Posture Exercise Program as they become more conscious of their posture and motion. Tracking their progress, and celebrating their improvements provide continued encouragement. And since people equate being stiff with feeling old, many are willing to adopt daily Posture Exercises as an anti-aging LifeHabit to keep moving, feeling, and being well.
The patient should be past the initial passive AcuteCare phase and before they are ready for active rehabilitation in RehabCare. Posture exercises usually work best after an adjustment. However, having a patient do their exercises before, and then after, an adjustment is a great way to show the increased motion as a result of the adjustment.
A trained staff member such as a massage therapist, physical trainer, or physical therapist can assist you in teaching focused motion posture exercises. Focused motion posture exercises help re-train posture, motion, balance and coordination for pain free ease of movement. In addition, other equipment, such as wobble boards, rocker boards, rocker sandals, foam rollers, and other low tech tools provide additional options available to those trained in functional rehab.
A Progressive Posture Exercise Protocol can challenge patients, and keep their interest. Patients love being able to reach their goals, and their perception of the value you offer continues as they progressively improve in performance, feeling stable and confident in their posture and body motion. The net effect is a healthier patient with less chance of relapse, who continues the LifeHabit of posture exercise and Chiropractic as they Move, Feel and Stay Well.
Read Patient Choice Practice, Part I
Click for more articles for Doctors of Chiropractic
This article is the next in a series on integrating Managed Care, insurance, and personal pay in a practice treating patients for AcuteCare, RehabCare and WellnessCare. If you agree with the Patient Choice philosophy of care, and believe this is the intelligent path for our profession, I’d like to hear from you. Direct your email to DrWeiniger@BodyZone.com.