Not Your Typical Chiropractic Practice
Updated: Jul 2
By Dr. Chris Tupper, at Chiro.Studio
Having been in practice for over 20 years, I’ve helped build rehabilitation programs for several medical offices. I’ve also covered for chiropractic practices with various types of management styles. Which One's the Best?
One office would concentrate on personal injury cases. They would see almost 100 patients a day, with several doctors working at each location. Each visit did not necessarily consist of an adjustment. Sometimes, the doctor would just talk with the patient. The passive therapy area had various types of equipment such as ultrasound, e-stim, hot packs, and roller tables. Three staff members attended to the patients, and tables were spaced about 2 feet apart, so that about 18 people could be seen in a room of about 350 square feet. It was a literal "can of sardines". The lights were turned low in the attempt to make a relaxing environment.
It is not what I would call “relaxing”.
Another office followed a maintenance care model. This office charged a very low rate per visit. A patient would be adjusted almost as much as they wanted. There was nothing else offered in the office, outside of an adjustment. This was purely a volume-based practice. Patients could take advantage of higher availability, without the need for an appointment. It was not unusual for a single doctor to treat 50 people in one day. It was very labor-intensive, and physically demanding practice. If you had a condition, such as a disk issue, there was little that could be done in this office, outside of an adjustment. Oftentimes, a patient would not know which doctor they would be seeing, leading to inconsistent patient care. This office often employees new graduates.
"They have to start somewhere!"
In one of the medical offices I worked, I had a team of 4 techs, and 2 at the front desk. We would see up to 70 people a day, mostly under a managed care system. There, we would perform exercises with the patient to help improve their condition. It was not often that we would perform adjustments on patients. This was mostly for strengthening and coordination. We would also perform passive therapy for our patients. It was a very repetitive process. The goal of the medical office was to keep the patient from going in for surgery, no matter how many times we needed to see them.
Overall, most offices work to maximize insurance, by using all the benefits available.
I do not want to say that there is anything inherently wrong with these types of offices. Each one is fulfilling a role, or function to improve a person's condition.
There is, however, an underlying drive to follow the corporate model, the attorney, or the insurance company.
Someone comes in with a lumbar strain to the physical therapy office.
How many visits will be requested for the care of this patient?
All physicians know the number will be 12. In auto accidents, 16 visits.
Over thirty visits in some offices, many times without changing the treatment throughout the patient's care.
What is your time worth?
Is it really going to take 12 visits to help a person improve? Can it be done more quickly with the right kind of care? Who is going to care for you? Is the majority of the care coming from a person with little qualifications, such as a tech?
Offices can oftentimes be driven by insurance plans, an attorney case, or a corporate model. Remember, when you go to the doctor, you are paying to see a doctor.
In many cases, the doctor is the one you will see the least.
In my practice, I am caring for you. I perform the procedures, I am training you on self-care. I am spending the entire time with you. Availability extends to weeknights and weekends. You will not be over-treated. I want you to have a high level of personal care, and the tools to make the improvement you are looking for.