That was the comment this afternoon from a patient with low back pain. I had just told her that I am supposed to give her a “treatment plan” with short and long term goals and recommend a number of visits over a certain period of time… (She had just been subjected to 15 minutes of paperwork – she is 74 years old so not too fast – and another 15-20 minutes of examination procedures, before getting adjusted.)
Almost all of that was done because she wants her insurance company to pay the bill.
We’ve tried for 30 years to shield patients from the effects of changes within health care insurance coverage, and explain those changes a little. But there are two very significant realities: (1) the list of conditions which must be met (by me and the patient) before treatment is “medically necessary”, and therefore covered, has increased steadily over the years; and (2) there may never be a condition under which chiropractic care is “medically” necessary. Something to think about.
Anyway, the recent change in coding requirements has caused a significant shift – over the cliff: since deductibles are sky high and co-pays are just about at the same level as our office visit fee without insurance, it no longer makes much sense for a patient to pay several co-pays (and several trips to the office!) and do paperwork – and watch me do paperwork – just to get one adjustment. (All that time focused their file takes away from time spent on their backs:-).
It’s square peg – round hole stuff in the end: this patient hadn’t been in for almost two years and will likely not be back again anytime soon. This month it will be 50 years that this lady has been a patient of this office. So I guess our relationship with her is either a terrible failure (She’s still not well, huh? – or more importantly, we haven’t broken her of judging her health by her symptoms!) or a great success (given all the recent research on the importance of chiropractic care in keeping the elderly active – and how active and healthy she is at 74).
What do you think?
P.S. – When patients pay on the way out the door for their care the visit is $43, FYI.