Maintenance Care
Just how often should you see your patients?
Ogi Ressel
Let's talk about the issue of "maintenance care" or plain old "maintenance."
This issue seems to be extolled to the level of a chiropractic sacrament by many. What is it exactly?
The vast majority of chiropractors across the globe schedule their patients (adults and children) for their once-a-month "maintenance" adjustment (visit). So pabents are sold on the idea that this monthly maintenance visit will then help prevent and alleviate many problems pabents could be saddled with if they did not buy into this preventabve measure.
And pabents look joyously to the end of their "correcbve" care and the start of their "maintenance care." They have graduated. They have paid their dues. Their subluxabons are corrected. They are no more! Now, life begins!
So pabents are seen on a monthly basis because it's good for them—that is the mantra. Most chiropractors are adamant about their pabents following this protocol. It makes total sense, not only for the benebt of the pabent, but also for the benebt of the doctor. Right? Of course!
I mean, there is a bnancial benebt for the doctor in that he or she can count on a steady income stream from "maintenance" pabents. There are other benebts to the doctor as well, though. We all like to see our pabents return and be happy to see us. It is like a party. The ego boost is amazing. The office is busy, there is energy and
“The vast majority of chiropractors across the globe schedule their patients (adults and children) for their once-a-month ", "
adjustment (visit). ”
excitement, the sun is shining, the sky is blue, and everything is wonderful! Fabulous! But what about the benebt to the pabents?
Well, that is a little more difficult to quanbfy, isn't it? I mean, they are getting great care from you, aren't they? And you are prevenbng all these future "nasbes" from rearing up their ugly heads, aren't you?
Well, aren't you?
Hmmm, all of a sudden, your certainty has dropped a few notches, hasn't it?
Alright, let me ask you this: Are you really delivering what you promised?
Are you really able to prevent or alleviate a pabent's future health problems with your monthly maintenance program? Are you?
Not so certain anymore?
I totally understand. I want you to know that I absolutely am not against maintenance care, although from the tone of this article you probably felt that I was. Not so.
Here is the reality of maintenance from my perspective. Most of us recommend to our patients that our monthly maintenance program is of great benefit and that it will then prevent this and that from happening to them in the future. Before I retired to teach my program, I also recommended that my patients have a regularly timed "wellness" visit.
OK, this is very difficult for me, but I am very committed to the growth of our profession, so I must confront you with this reality. In essence, when most chiropractors place patients on a monthly maintenance schedule, they are simply maintaining their problems, but their symptoms are gone! That is the reality.
OK, OK, so I've just pushed a gazillion buttons. However, any way you slice and dice it, that is the reality.
Here is my reasoning:
1. First of all, research done by Tapio Vidman a number of years ago tells us that a subluxation, once formed, will cause an inescapable degenerative progression if it is allowed to remain for any longer than two weeks. This means that a monthly maintenance visit
to your office will absolutely ensure that your patient will get worse over time.
They will. Then they will confront you at some point in the future to ask why you have allowed them to get worse when they have paid you all of their money for years to prevent this problem and keep them healthy. And you will begin to babble something about limitation of matter, which is just what your patient wants to hear. I can smell a lawsuit and a board complaint already!
2. Most doctors do not see their patients on an appropriate schedule of care in order to be able to really correct their subluxation pattern, and it is a pattern. It is a neurological habit the body becomes accustomed to, and it most often starts in children. (If you'd like more information on this, you are very welcome to write or call me.)
Most doctors see a patient on a schedule, which they feel a patient will accept, and it is one that is "reasonable," whatever that means. This translates into patients being placed on monthly maintenance once their symptoms are relieved —nothing more— although they are often told otherwise.
I can't tell you how many patients I've had in my office who were on a monthly maintenance schedule with their former doctor, when their examination revealed many problems they thought they no longer had. This is not good fortheir health oryour reputation. Patients often need to be placed on a schedule of care that will actually cause their subluxation pattern to be broken. For example, the schedule many doctors use is 3x/week for 3 weeks, then 2x/weekfor4 weeks, and lx/weekfor6 weeks absolutely will not do it.
So I recommend that you see your patients on "wellness" care, or every two weeks at the very maximum, especially children, but only after their subluxation patterning is changed. The correction of subluxation patterning is most important in children.
Also, tell your patients the truth—tell them what you are doing and the reasons it is so important. They will totally be with you and money will never be an issue.
Now, get out there and be the CA's you were meant to be.
Warmest wishes,
HDr. Ogi is a Practice Coach and teaches the Practice Evolution Program. He is an international lecturer, a pediatric and x-ray specialist, researcher and clinician. It was Dr. Ogi and Dr. Larry Webster who started the whole pediatric awareness and movement on the planet - when it comes to kids, he has no equal. He can be reached at : drogi@practiceevolution. com or www.practiceevolution. com
