When I first heard this saying years ago, I took it to be a blessing. I later learned it was also reputed to be an ancient curse. Considering today’s health care environment for chiropractors, these times are most definitely “interesting”! Whether or not, these times ultimately turn out to be a curse or blessing for chiropractic remains to be seen, but one thing is absolutely certain. The profession is facing very real and unique changes which will affect the way we all practice and challenge our ability to remain profitable. Consider the following:
- Drastic cutbacks in major medical coverage for chiropractic continuing across the board.
- An aging population becoming ever more dependent upon Medicare with it’s drastically limited chiropractic coverage.
- The Affordable Care Act may well move toward a single-payer system in the future… a situation which is likely to see ACA’s current coverage morphing toward a more Medicare-like model.
- An ever shrinking middle class, traditionally the most ardent users of chiropractic.
Of course many doctors are still getting paid, but it’s definitely getting tougher . Many DCs are switching over to cash practices and focusing almost exclusively on offering “relief care” (symptom based chiropractic) only, convinced that patients won’t pay for any sort of ongoing “corrective care programs”. That’s not totally correct but to some extent it is understandable. Today’s new patient, often presents with previous exposure to chiropractic. Many have been previously roped into the old “3 X weekly” series of adjustments which used to masquerade as real corrective care and have no desire to do so again. Their guard is up and we are challenged to find innovative ways to better serve them from what chiropractors have done in the past.
Today’s DC who hopes to survive and thrive without compromising quality of care faces unique obstacles.
- It’s difficult for patients to relate to anything beyond their own pain.
- It’s doubly difficult to “educate” patients while they are in pain.
- Both of these first two items have always been true actually.
- There’s now ample evidence that adjusting patients till the cows come home does little to actually correct the spine.
- Cash strapped patients are increasingly reluctant to pay for long term care beyond the resolution of their symptoms.
- Real corrective chiropractic is accomplished, just like all other types of rehab, with active care programs (stretching, traction, exercise, etc. )
But Here's The Good News....
The Obstacles Are The Way
Rather than just giving up on delivering high level corrective care, consider that each of these “obstacles” actually presents us with a unique opportunity. So your patient is hyper focused on their pain? Well maybe we should be too instead of trying to sell them a corrective care plan on the front end! Difficult to educate patients while they are in pain? Maybe we shouldn’t even try until we’ve first met their most pressing needs and they KNOW we can really help them! Problems trying to correct spines using adjustments only? Well then , stop trying to press patients into some lengthy, 1980s type corrective care programs. Insurance won’t pay and patients are too cash strapped for long term, IN-Office rehab programs? Maybe we need to move away from being providers only and become teachers, coaches, and mentors who care enough to deliver great outcomes by incorporating HOME rehab.
Look I get it., a lot of this change just sucks right now. But despite that, it’s imperative that we don’t give up on delivering great chiropractic care. Change is always hard, but chiropractors were competing successfully for decades before ever we had any insurance coverage. Patients have always known when their doctors truly have their best interests at heart. As much as we hate to be going through this period, our obstacles are presenting us with real opportunities to outwork and out serve our competition by delivering corrective care outcomes that are uniquely chiropractic in nature., yet still affordable for the folks who need our care.