Dear Anonymous: I hope this reply finds you in the best of health. Thank you for your reply to my article in The American Chiropractor. I understand that you feel that, when you measure treatment from a patient ! visit average, this leads to over utilization of care. I totally agree with you on that point. Being in practice for 25 years, I continue to see patients that I have seen over the last 25 years-for many conditions and health problems. Children that I once treated are now adults and bringing in their children. This is what I mean about patient visit average. It is your ability to educate, treat, educate AND treat, so patients become lifetime chiropractic patients, which dramatically increases patient visit indexes. Not so that you treat the patient more for each condition, but they come to you during their lifetime for maintenance, as well as other health problems, which most people would not even think chiropractic can handle. When you, or IF you, utilize rehab in your treatment protocol, you will automatically increase a patient visit average, since rehab is usually started sometimes weeks after initial care begins. Therefore, patients will continue their rehab programs well after treatment ends. I should, also, interject that, through the use of exercise, patient adjustments hold longer, patients are in better health, and they respond better than do patients that do not exercise. So, in reality, I do everything in my power to keep care to a minimum, educate my patients about the benefits of what I do, treat them like family, and have lifetime patients that have high P.V.A.s-not because I am someone interested in stats or financial gains, but because I appreciate and respect my patients. I hope you can say the same thing about your practice in the next quarter century. Sincerely, James Cima, D.C.
