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“Now
is not the end. It is not even the beginning of the end.
But it is, perhaps, the end of the beginning.”
Winston Churchill
The
Patient's Choice Practice - Part I
Steven
P. Weiniger, DC / Founder,
BodyZone.com
There
is a different set of rules for successful practice in the 21st century. On one
hand, HMOs, PPOs, and managed care companies have trained patients to go to the
doctor on their list. On the other hand, today's consumer wants to make informed
choices and decisions about their care. Plus,
the internet is revolutionizing health information by satisfying patient’s
increasing demand for information, empowerment, and convenience.
Ageing
Baby Boomers Create a Chiropractic Opportunity
Every
8 seconds a baby boomer turns 50. The
loss of flexibility and the inability to move freely means baby boomers will
become less active, and have to stop doing what they enjoy. However, I believe
many boomers will not want to stop "doing" as they age, and will do
everything possible to maintain an active lifestyle. The demand for services and
products that can keep ageing bodies moving will soar.
This
bodes well for chiropractors with biomechanical practices providing the services
people want, such as, massage, yoga and other posture exercise, as well as
LifeHabit advice. Those practices successfully integrating managed care with
personal pay will prosper most of all. The
Chiropractic Opportunity is in creating a practice where patients choose
RehabCare and WellnessCare, even after their HMO/PPO has paid for the doctor to
successfully treat the patient in AcuteCare.
The
Phases of Care
A
Patient Choice practice initially evaluates and appropriately treats an
AcuteCare patient for a short term of care. The goal in AcuteCare is to get the
person out of pain (or significantly reduce the pain) and back to more normal
activities of daily living. Patients are asked to sign an Informed Consent form,
and are advised that they will be re-evaluated at the end of the initial trial
of care. The concepts of AcuteCare,
RehabCare and WellnessCare are introduced.
Insurance reimbursement is explained as covering AcuteCare.
Additionally, the patient is assured that they will be advised when
insurance limitations mean they are financially responsible for continued
RehabCare or WellnessCare.
The
insurance company is billed and all patient co-pays are made at the time of
visits. Keeping patients current
with co-pays is easy with a front desk sign stating
"To maintain our fees, we charge a $20.00 billing fee for
co-payments not made at the time of the visit".*
View/Download
Sign During the two to four weeks
of AcuteCare, the patient is taught basic self-care for their problem and basic
posture stretches.
After
the AcuteCare trial, the patient fills out a self-assessment questionnaire and
is evaluated.
-
If
the patient is unchanged, they are referred as appropriate.
-
If
a patient is improving but still symptomatic, care may be continued under
AcuteCare for another short term, as appropriate.
-
If
the patient is asymptomatic, they are given the option of being dismissed
from care, or continuing care in RehabCare (or WellnessCare, if
appropriate). The patient's financial responsibility for RehabCare,
progressive posture exercises, massage, or other treatments is clearly
explained. If the patient
chooses to discontinue care, they are advised to call if/when their symptoms
return for AcuteCare under their insurance. A Consent for Continued
Treatment or Dismissal form is given to the patient to sign.
Many
patients will opt only for AcuteCare and then decide to be dismissed.
All are more likely to refer to the practice where they were not
pressured, but allowed to choose the care they felt was right for them.
Many will successfully manage slight pain recurrences with the self-care
and basic posture stretches they were taught.
However, if the patient’s symptoms return, they will return to the
physician who treated them with respect and attempted to intelligently educate
them on how to care for their problem. And
since biomechanically based back problems tend to recur if there is no change in
behavior, when the next AcuteCare episode occurs, patients are much more likely
to consider the benefits of keeping their body moving, feeling, and being well
with RehabCare and WellnessCare.
*Note: Consult with your attorney to verify if this is applicable in your state.
Read
Patient
Choice Practice, Part 2
Click for more articles for Doctors of Chiropractic
This
is the first of a series of articles on integrating Managed Care, insurance, and
personal pay in a practice treating patients for AcuteCare, RehabCare and
WellnessCare. If you agree with the Patient Choice philosophy of care, and
believe this is the intelligent path for our profession, I’d like to hear from
you. Direct your email to DrWeiniger@BodyZone.com.
Email this article to a colleague. 
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 Quote of
the Day
"Look to today. Procrastination is the art of keeping up with yesterday." Don Marquis
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Stress
and Aging
Our
bodies were designed for short-term stress responses. The longer the stress
response, the greater the risk to our health.
Balance
and Exercise
Just as we exercise a muscle to strengthen it, we
can strengthen our sense of balance.
Don't
Sit So Much!
Did you exercise today? There is one truth for
everyone with a body, man or woman, "Use it or lose it."
You
Are What You Eat
Getting the nutrients you need makes a difference
in how you feel now, and how your body wears for tomorrow.
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