Dr. Tanase's Thoughts on Year-Long Chiropractic Care Plans

(Editor's Note:  Today's post comes to us from Dr. Adam Tanase and I think he brings up a very good point.  Enjoy!)

By Dr. Adam Tanase

Suppose you visit a chiropractor who recommends a year long course of treatment. It’s reasonable and prudent to ask if this is a necessary and truly beneficial treatment plan. So you might be wondering if this is common in the chiropractic profession. 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 themselves for a few years 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 among 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.

The Greatest Healthcare The World Has Never Considered

Upper Cervical Care Vision On Healthcare
Author c1c2care@gmail.com

Since Upper Cervical care came along, countless lives have been turned completely upside down. As Upper Cervical care continues to be the most researched form of Chiropractic, the media will continue to pay increasingly more attention. As this happens, several groups of people will seek out this thing called Upper Cervical.

Primarily, people who are suffering will notice there may be another option. Not an alternative, something better. Something they have never tried. These people will be able to embrace a new concept, find a principled Upper Cervical doctor, challenge their old belief system, and give up who they are for who they can now become. Prospective patients will want to know about Upper Cervical care, and that it is extremely safe, precise, reproducible, sustainable, and effective. They will walk away realizing this is the missing link in the current disease-focused, intervention based sick care model, and will be looking for someone who can take care of their friends and family without drugs or surgery.

Patrons in the second group are physicians and other providers who have their patients’ best interest at heart. These providers will want more information on what this amazing work is about, including referral capabilities, research, white papers, and the steps necessary to make an accurate and efficient referral to an Upper Cervical doctor with ease, every time.

The third group of people who will pay particular attention to this type of revolutionary health care are people who believe in furthering a cause. The people who know and understand that a lack of health leads to a downward spiral in virtually every area of our lives and society. They are constantly looking for passionate causes to support. Upper Cervical care is that cause. This group will know in a lasting way, merely by being brushed by our first impression, that this is quite simply the greatest healthcare the world has never considered. And as such, they will support it financially, and will make Upper Cervical care a global phenomenon.

There will be people who want to learn to provide Upper Cervical care (current and future doctors), and there will be appropriate resources for them. These are people who believe in something bigger than themselves and their own individual clinics, and are willing to carry the torch without counting the cost. They will do whatever it takes to become a part of something that is literally impacting the course of history.

Finally, businesses who want to provide products and services to Upper Cervical doctors and patients will be overwhelmed by their good fortune of finding a world-changing vision of which to be a part.

When To Call In The Upper Cervical Doctor

I received a comment on recent post basically asking, "When should a general/full-spine Chiropractor refer a patient to an Upper Cervical Doctor?" What indicators should they look for in a patient to know when they should perhaps be evaluated by an Upper Cervical Doctor?

I listed some of these in a post back in December called Signs And Symptoms Of An Upper Cervical Injury.

Here they are again:

1. Is your posture poor? Do you have rounded shoulders &/or forward head posture? Does your head feel heavy to hold?

2. Is your head tilted to one side and/or your head rotated to one side when you look in a mirror? This can be very subtle.

3. Does your nose or nasal septum deviate to one side? If so, you may find that it deviates towards the side to which your atlas has moved forward (e.g. nose deviates to the left; then atlas is forward on the left)

4. Is one of your shoulders lower than the other? Pull your shoulders back and down and look carefully for one lower than the other. Again it can be subtle.

5. Press firmly but gently with your thumb into the impression just below your skull at the top of your neck on both sides of the back of the neck. This is known as the sub-occipital area. Find the base of your skull and press the soft flesh around that area. Is this tender or painful for you?

6. Do you have some shoulder and/or neck pain/aches, which don't seem to go away?

7. Does your jaw click when you open your mouth? Further check on this; Put your pinkies (little fingers) into your ear canals and chew normally. Do you feel a bumpy dislocation like feeling? This should be a smooth action in your joints.

8. Do you have any lower back pain or mid back pain (under the shoulder blades)?

9. Can you move your head from side to side without pain or restriction? Is there a loss of Range of Motion (ROM)?

10. Do you have any sand paper, clicking or crunching sounds when moving your head from side to side in a 'NO' action?

11. Is your hearing a problem or do you have other ear symptoms (e.g. tinnitus, watery sounds, blockages, vertigo, Meniere’s Disease, otalgia, recurrent ear infections)?

12. Do you often get headaches or migraines?

13. Can you remember any trauma (even minor) to the head, neck or shoulders?
14. Was your birth difficult?

15. How’s your vision? – Sensitive to light, especially at dusk, floaters?

16. Do you experience any dizziness, vertigo or movement sensations? Does the ground seem to move away from you?

17. Do you experience any tingling and burning sensations especially in fingers and toes?

18. Do you have confirmed Scoliosis of the spine, from x-rays? Do you have one leg shorter than the other or is your pelvis higher on one side?

19. Have you had any x-rays, CT scans or MRIs taken of your neck? Do these reveal loss of normal neck curve), even a small amount?

Most of these can be and often are indicators of a person's need for general Chiropractic care. The only thing that I would add is that if a general Chiropractor is seeing a patient and noting minimal, short term or no changes in the indicators on this list, that their patient is presenting with, then an Upper Cervical evaluation is probably a good idea. An Upper Cervical evaluation may also be in order if they have wide spread symptoms/pain that just doesn't seem to really go away.

I hope this helps provide some guidance to aid in patients getting the care they need and the results they are looking for.