As we enter the era of upcoming changes in health care, many are questioning the fate of their future and the fate of chiropractic.
It seems as though many of us are failing to look at where chiropractic started: how far we have come; what we have accomplished; the mountains of struggle we have climbed successfully, and where our persistence can lead us. We cannot and must not falter now!
We are not done yet! It is evident that we are about to face one of our biggest battles yet. So what else is new? Isn't this par for the course for chiropractic since the beginning? You betcha.
Our successes in life are and will be determined by the changes and the choices we make, and by our response to challenges. We cannot change the past. We can only work at controlling our future which, at this point, is spotless.
With fewer exceptions, my greatest concern with this profession is lack of chiropractic "managed care" by NOT having:
- careful, methodical evaluation and diagnosis of every new patients' health problems;
- outlined treatment plans for each patient;
- lack of continuous, ongoing visit by visit planned education for all patients: MM, WC, PI, private pay and others;
- outlined follow up -- check up care for maintaining health.
Education is a critical part of managed care in any area of illness regardless of the insurance coverage or non-coverage. The plans for managed care will definitely be limited care. My definition of chiropractic managed care is:
- after the initial corrective care, following a treatment plan plus continuous education, and sometimes really pushing a patient toward making major lifestyle habit changes for better health;
- regular checkup visits: bi-monthly, monthly or quarterly, depending on the patient's initial health problem;
I had the pleasure of working with a doctor in one of the New England states. We had a nose-to-nose confrontation to convince him to eliminate his words to patients as he finished treating them: "Mr. Patient, come back as needed." That is a killer statement.
These patients had completed the treatment plan with great success. They were very pleased with their care and their recovery. This doctor had brought them from illness and despair to wellness and better health. Even though these patients had completed their initial care with excellent recovery, they may not know if and when to return for checkups. He finally agreed to set up regular checkup appointments at the end of corrective care.
For two days he told his patients, "Come back in two weeks or next month or three months or next week," depending on the patient's condition after completing their treatment plan. It worked! There was no resistance.
And, he has continued to use this approach since for the patient's long term continued health. This is an example of chiropractic managed care.
Let us evaluate other health practitioners. A skilled vascular surgeon removes plaque from the patient's clogged arteries using a technique known as angioplasty. A good doctor would insist that the patient take steps to "manage" their own health care by simply telling the patient:
- no foods containing fat or cholesterol
- no smoking
- regular exercise
- proper rest
- come back in a week, month or whenever and let's check to make sure all is well
"Managed care" for this patient would be an outlined educational, programmed lifestyle change immediately and forever.
Cirrhosis of the liver demands the patient manage their care under the guidance of a competent physician.
- no drinking
- no smoking
- no whatever
Without the patient and doctor working as a team to manage their care, many patients will die prematurely. In all areas of health care, education is a critical part of "managed care" in any kind of illness. If we educate our patients, the majority of them will:
- continue care
- regain health
- maintain their health
- come back to you if and when new conditions develop
- refer others
- stay with you as long as they live No Set Treatment Plan No Education No Follow through on a Program of Continued Checkup Care
All Killers!!
Of course, we have some chiropractors who focus on the killers, which will kill their practices:
a. "I am just not up to doing all of this now."
b. "If only ..."
c. Yes, but ..."
d. Someday I'll ..."
e. "I wish ..."
f. "There is not enough hours in the day ..."
Please consider:
a. If you aren't up to doing it now, I hope you will be if and when your practice begins to decline (or, has it already started?) ... I hope not.
b. If only ... If only is living in the past or the future. Live now. Do it now. Recognize that we are faced with a big bend in the road but it is not an end to the road. The me you see now is the me you will be tomorrow. It is your choice.
c. Yes, but ... it won't work in my practice. Yes, but I don't want to change. Yes, but I don't have the time. Don't "yes, but ..." yourself out of practice.
d. Someday, I'll ... Your greatest enemy and killer is procrastination. Your most dangerous temptation is delaying or postponing.
e. I wish ... It is okay to wish as long as you put "steam behind your dream." Most problems are not problems at all. They are decisions waiting to be made and followed through on. Don't waste time wishing -- just do it.
f. There aren't enough hours in the day ... A classic killer is inertia and a defeated attitude. As you and your staff begin making changes, get your priorities straight - follow through and get geared up for success. Practices that are on the go ... are also on the grow.
Doctor, you and your staff consider eliminating the killers from your thoughts, dialogues, and your actions. Remember, where your concentration goes your energy flows and manifests itself in physical form.
Resolve to start on your journey to a bigger practice now -- today.
Deanna Warren
Roswell, Georgia
(770) 448-1799