Sometimes life doesn’t go as planned.
While what we expect and what happens is often very different, if we are willing to adapt, we will see results, and in many cases, find success. This ideal is something I have always kept at the forefront of my practice and in my work with patients. Why? Well, because my life didn’t go exactly as I planned, but I ended up doing something I love instead.
The truth is I never intended to be a chiropractor. In fact, I was supposed to become a plumbing manufacturer like my father and work in the family business – which had roots as a far back as my great-grandfather. So, you can imagine, that from day one, I was expected to be the next generation of the business.
But, Life Had Something Else Planned
Joining the family business was my intended path and all well and good until a fateful day when I was in a motorcycle accident at the age of 15. Truth be told, I wasn’t allowed to be riding a motorcycle, but that’s neither here nor there. The accident that left me with a broken neck and several years of excruciating neck pain.
My neck pain lasted into college, and my situation degraded significantly until it was so bad that I was not able to move my neck normally.
At the time, I met a chiropractic intern who encouraged me to get a chiropractic adjustment. So, I did, and that adjustment was the beginning of the end of my neck pain and the beginning of the beginning of my career as a chiropractor.
From Patient to Patient-Focused
While in chiropractic college, I not only learned the ins and outs of what it took to become a chiropractor, how to adjust patients, and the theories of chiropractic medicine, I also was introduced to patient-focused medicine in the school’s chiropractic clinic.
Patient-focused medicine is a facet of medicine that puts the patient at the forefront of treatment. This includes assessing patient needs, developing individualized treatment plans, and providing the highest quality of care to get patients the results they need, and improving quality of life.
I kept the premise of patient-focused care at the forefront of everything I did when I first started practicing chiropractic medicine. At the time it was easy, health insurance was prolific for chiropractic treatments, and most people had very good health insurance policies that allowed me to put the patient first. Reimbursement was equitable for time spent and getting patients what they needed was pretty easy.
This situation gave me the time to really listen to each and every patient, analyze their exam and imaging findings, relate and research how their lifestyle choices and daily influences were contributing to their discomfort, and really get to the bottom of their pain to effectively solve their problems.
But, in the mid-90s, insurance companies changed how they did business with the introduction of managed care and HMOs. With this change, the insurance companies that were once very pro-patient became vastly different and began to dictate what treatment options were the best for my patients. At the same time, they also significantly decreased reimbursement rates. The new mandate became “see as many patients as possible” to make money.
A 1999 study published in the Journal of the American Medical Association (JAMA) found that this new model changed physician behavior in the exam room. Instead of listening, doctors tended to redirect their patient’s opening statements after just 23 seconds. The study also reported that only 25 percent of patients felt they were allowed to finish what they had to say.
Some research reports that doctors were required to see one patient every 11 minutes. The Atlantic reports that, on average, most doctors only spend 12 to 17 percent of their day with their patients. What made up the rest of the day? A large chunk of it was spent on insurance paperwork.
This entire situation went against the core values that I learned during my time in chiropractic college, and it also just did not sit well with me at all in general. At a professional, intellectual, and spiritual crossroads, I had to ask myself if I was willing to give up my desire to help people to make more money?
The answer was no; I was not.
Instead, I took a leap of faith and began to develop a cash-based model.
I wasn’t alone; many physicians from a wide range of disciplines were beginning to say no and walk away from insurance models and insurance company mandates on how to manage and care for patients.
So, What Changed When I Stopped Taking Insurance?
- Instantly, I was able to return to focusing strictly on the needs of my patients.
- I could spend more time with them, really listening to their situation and their experiences.
- I was able to create personalized treatment options that went beyond just stopping the pain, traced their pain back to a root cause (often unrelated to the area of pain).
- I could offer insight directly to my patients in understanding their pain or condition, such as mechanical dysfunction and how the body compensates for changes.
- My patients went from being classified as diagnostic and billing codes back to being real people, with real pain and real needs.
- I was no longer subject the whims of insurance companies about who should be treated, how they should be treated, and how much they would pay, what they would pay for, and when they would pay.
- The proverbial hoops my patients and I had to jump through were eliminated; I did not have to wait for approvals, mandatory steps, and unnecessary steps to navigate to begin treating patients.
- I had the freedom to use and integrate cutting-edge technologies (previously snubbed by insurance companies) into my practice and patient treatment plans to enhance results. This is especially important in patient-focused care because it allows me to use combinations of treatment to take care of the patient as a whole, versus only being able to make chiropractic adjustments.
- My patients saw results and relief in a timelier manner than under insurance models.
- I earned the reputation of being different, innovative, willing to try new approaches. I was recognized as results-oriented rather than just another doctor who wanted to get paid.
- I was able to manage payment arrangements with patients directly, cutting out costly red tape.
- I became a better doctor.
So, What Does This Mean for Patients?
In addition to better care, it means a simplified process for payment. In our pricing model, the fee for the first visit is higher because of the extra time required to do a thorough assessment. Subsequent visits cost less but paying less does not mean that you are rushed out of the office. Each visit is at least 30 minutes – which is long enough to listen to patients and learn about their needs. It also gives me enough time for treatments in the office.
It also allows me to develop and deepen my relationships with my patients, too. This is critical in developing a complete understanding of their condition or conditions. By giving my patients more time and more attention, I am earning their trust. This allows them to become a partner in their care and allows us to work together to find the best resolutions.
How Do Patients Really Feel About Their Experience?
They love it! One of the most common complaints across all disciplines of medicine is that most patients do not feel like they have enough time with their doctors. Most people experience difficulty squeezing in appointments into their doctor’s already-jammed schedules, long wait times waiting to see their doctor, and barely enough time to talk about what they are experiencing before their doctor is on to the next patient.
The result? Increased numbers of prescriptions, very little explanation of what was going on or how to change it, and increased frustration on the part of the patient. Even when patients got to see their physician, they often reported feeling as if their doctor was not listening to them, but instead typing in information into a computer or a tablet. The reason for the disconnect? Insurance companies demand “meaningful use” requirements and information to assess patient claims.
Not focusing on the patient can mean the potential for missing important information, increased risk of misdiagnosis, and overall reduced quality of care.
Are you tired of feeling rushed or like you are simply a diagnosis or co-pay? Try something different. Call Physical Evidence Chiropractic today at 561-674-1217 for more information and just more.