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July 2006, Vol. 16, No. 3
Table of Contents
Autism and Glutathione • CBP® Nonprofit has 24 publications in 12 months • CBP® Research Presented at the International Spine Conference in Norway • CBP® to File Lawsuit Against Quackwatch • CCE Weathers the Storm • Chiropractic Culture • Dr Don Harrison is ICA's Chiropractor of the Year • Dr Jim Gudgel to Co-Instruct With Neuromechanical Innovations • Dr Deed Harrison Speaks at Palmer West • Experimental or Medical Necessity • Fine Tune Patient Communication • From Screening to the Value of Proper Posture • ICA at the Table • ICA's Newly Elected Board Members • Instrument Adjusting's Mechanical Advantage • It's Don's Opinion • Letters to the Editor • My New Whiplash Text is Available • Patient Expectation and Retention • Principles, Ethics and Other Bygone Ideals • Problematic Decision Spectrum • Research Corner • Triano and CCGPP's Will Give You Six Visits
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Principles, Ethics and Other Bygone Ideals
by R. J. Hammett, DC
Dr. Hammett is a chiropractor in private practice in Kenosha, Wisconsin. After graduating from Life College in 1979, he completed several post-graduate programs in Physical Impairments, Diagnostic Imaging and Rehabilitation. He completed his Juris Doctor in 1995. He has written articles for several Journals and has lectured to numerous Chiropractic groups on the topics of Practice Management and Risk Prevention.
Many of you have had the displeasure of belonging to an HMO or PPO. Many of you have gone through the indignity of having a nurse or eighteen year old send a letter to your patient saying that your care was not medically necessary, or cost too much, wasn’t reasonable or some other condescending crap. Many of you have watched your practice patient volumes decline, your profit margin shrink every year. Many of you have been asked to refund large amounts of money back to ever-greedier insurance companies. Many of you have been accused by boards of examiners of practicing unethically because your records do not substantiate the level of care you had provided based on practice guidelines no one has agreed upon.
Those of you in practice more than fifteen years remember a time when your only thought was to provide quality care to as many people in your community as possible and being rewarded with a good living for the knowledge and talent of giving patients great service and outstanding results.
Today, chiropractic does not matter. The principles of finding, analyzing and correcting nerve interference have become a lost ideal. Today has become about how many visits you will receive from the insurance company, how your notes and exams look and how many reports you can send back to “prove” to third parties your care is worth the two dollar and fifty cent profit per visit you’ll get. Combating the patients not about wonders and advantages of lifetime chiropractic care, but how few visits it will take before they “feel” better and never mind correcting nerve interference for the cause of and prevention of dis-ease, that isn’t important.
Yes, ladies and gentlemen, the principles and ethics of chiropractic have changed. We’ve gotten what we asked for - respectability and public knowledge that we’re good back doctors. Our national and local associations have done us proud by taking us into mainstream healthcare. Boy, don’t you feel good about the thousand of hours and dollars you’ve spent on your “higher” education so that you can help your fellow man for that two-fifty you are earning. In fact, it’s great to see that your staff is taking home more than you or driving a better car or taking better vacations. Isn’t it worth the sleepless nights worrying about patients’ health and to find your care was approved for twelve visits at fifteen dollars a visit when you paid three dollars for a gallon of gasoline this morning? Isn’t it funny that your patients are paying one to two hundred dollars per prescription to poison their bodies, but won’t spend twenty-five dollars in your office, because their insurance company says your care is only worth fifteen bucks?
Some facts:
You can’t rely on associations, colleges or boards to protect chiropractic’s future or yours. Your future in practice is in your hands and your hands alone. Consultants and advisors, while meaning well, can only provide some of the answers for your survival in practice. Only you can determine your future.
Some thoughts:
1. Tell the truth. The truth about the thirty-three principles of chiropractic. Tell the public, the boards, the insurance companies - “This is chiropractic - not back-cracking school.” Tell your patient the truth about the status of their neurological health. Tell them the truth of what will happen to them if they do not address all of their subluxations. Tell the insurance companies IME’s the truth about the necessity of chiropractic care, not the medical necessity of chiropractic care (oxymoron).
2. Place your fees correctly. Set your fees so that you can earn a good living and your patients can afford to see you when they need to.
3. Fight the battles you can win. Meaning your only fight is correcting subluxation and educating your patients about the chiropractic alternative to drugs and surgery. Make this your focus in practice. Not insurance, HMO’s or PPO’s.
Till next time........
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