Often when a family's schedule becomes busy and their child's symptoms appear resolved, parents begin to alter the schedule. The parent may attempt to facilitate the necessary care based on their child's symptom, but parents don't have the skills to determine if the underlying vertebral subluxation complex has been stabilized or if a lordotic curve has been re-established.
With a lighter family schedule, summertime is a great time to establish a re-education and recommitment to a wellness or reconstruction program. Begin with your staff pulling all your current and inactive children files for the past year. The doctor should then review them and separate the files for the staff with specific instructions.
During the reviewing of the files, consider the following questions:
• Did the child complete initial intensive care?
• Did the child's chiropractic care begin to accomplish your original objective?
• Did your ongoing evaluations indicate expected or slow improvement?
• Did the child receive post-chiropractic evaluations and/or re-exam?
• Were these findings shared with the parent?
• Does the child require reconstruction/rehabilitation care?
• Were the parents informed, and did they understand what a wellness care program is all about?
• Why do you and/or your staff believe that the child dropped out of the program?
• Did they understand your recommendation for care?
• Did they get the expected results?
• Did they have transportation, family or financial problems?
Once the doctor/staff determine the status of each case, the following re-education or reactivation process may be selected.
At the next visit with the child and/or parent, get to the point: "Why was the child's care altered?" Discuss with the parents that you would like to take some extra time at the next visit to perform an in-depth examination for their child. Have your staff schedule the necessary time.
At the following visit, perform a more extensive examination than your routine chiropractic evaluation. After the examination, the doctor may choose two options: a mini-report of findings right after the examination; or inform the parents that you would like to schedule a brief report of findings for the next visit.
Both visits should review the current findings and past evaluations. This may include showing previous radiographs (if available). Review the original purpose of the parent's contact with your office for a chiropractic evaluation for their child. Also review your report of findings' original recommendation of care. At this time, clarify with the parent the importance of reconstruction or wellness care. Take time to address any questions, concerns, and resolve scheduling problems (i.e., financial, transportation, etc.). Suggest to the family that they start a summer program, and at the end of summer, consider a post-examination when you can make your suggestions for a fall schedule.
Inform your staff of the agreed upon summer schedule with any other arrangements that need to be addressed. Your staff should schedule the following 8-12 weeks and include an examination date in August. The staff should inquire for the best day, time, and any expected absences (i.e., vacations, camps or extended visits).
For those patient files that are "inactive," the doctor should request that staff call the parent to attempt to determine the reason (see above suggestions) for discontinuing care. If possible, the best scenario is to see if staff can schedule a post-evaluation visit and a brief report of findings.
Click here for previous articles by Claudia Anrig, DC.