Patients Will Choose the Path of Least Financial Resistance
Editor's note: The following letter to the editor was submitted online as commentary regarding our Jan. 1, 2013 ChiroPoll, which inquired: "In your opinion, what is the primary factor inhibiting patients from seeking chiropractic care?"
Yes, lack of exposure to or misinformation about chiropractic is and always has been a leading factor discouraging prospective patients from seeking chiropractic services. However, we live in a society where the masses are more and more reliant on third-party-pay systems to assist with financially obtaining health care. So, the question must be asked: If financial issues, i.e., lack of insurance coverage vs. lack of reliable information, is more important, well, just how many Medicaid-covered patients seek and are willing to personally pay for chiropractic?
The answer is woefully few, good information or not. My office alone gets at least five calls per week from patients asking if Medicaid covers chiropractic if they come in. Just how many appointments does anyone think are made by the Medicaid caller once we tell them there is no viable coverage? The reality is that the masses of society are now and increasingly following the money trail. Simply put, as has been stated to me many times by patients or prospective patients, "If insurance won't pay for it, then I can't (or won't) afford it."
The money trail is further evidenced by worker's compensation. When worker's comp insurance carriers incentivize employers to select "their" approved medical facility for injured workers by offering premium discounts (albeit small), thus removing choice from both the employer and the employee, what happens to chiropractic's worker's compensation patient base? That one doesn't take a genius – it simply dries up.
What happens when managed care plans "require" a referral from the patient's medical provider for chiropractic services? Well, you may get some referrals or authorizations, but more often than not, the average chiropractic office will see a definite reduction in that particular patient resource. What happens when a local business, say "ABC Widgits," changes its plan, which previously had a low deductible and low copay for chiropractic care, to a high deductible and high copay? There is a nearly-instant reduction in chiropractic utilization.
Certainly there have always been and will always be those who, for various reasons, are willing to pay for chiropractic services out of their pocket. However, just try and educate someone with all the good and well-intentioned chiropractic information, and then offer them this scenario: If you go to your medical doctor for your headaches, you will pay $15. However, if you go to the chiropractic doctor you will pay $45.
Given that the prospective patient is also having to make decisions about paying for high gasoline prices, escalating food costs, increasing health insurance premiums, mortgages and insurance, I submit that more often than not, quality information or not, most people will do everything in their power to choose the path of least financial resistance. Even if it means just getting by one more day with yet one more pain prescription.
Steven Mooring, DC
Keep Demanding Excellence
Editor's note: This letter was directed to DC columnist Dr. Doug Andersen in response to his most recent column, "Food for Thought 2013: Good and Bad News About Professional Trust" (March 1 issue).
Dear Dr. Andersen:
I very much appreciated your article in Dynamic Chiropractic. The most common comments I hear from my new patients regarding my practice are the following:
Can't you call yourself something other than a chiropractor, because every other one we have been to doesn't have your knowledge? (I am huge on myofascial and exercise rehab, and short treatment protocols.)
Chiropractors just keep people coming forever; everyone says that once you get treated, you never get released, but we hear you are different.
My doctor (friend, mother, etc.) told me not to go to a chiropractor because they will cause a stroke. I hear great things about you, but I don't want to be manipulated.
I feel that the profession is at a true crossroads, and if we don't turn the profession around as a whole, we won't survive. Please keep writing your articles and demanding excellence. It is a message that is sorely needed.
Cynthia Butler, DC
Rolling Hills Estates, Calif.
Dynamic Chiropractic encourages letters to the editor to discuss issues relevant to the profession and/or to respond to a previously published article. Submission is acknowledgment that your letter may be published in a future issue of the publication. Submit your letter to ; include your full name, relevant degree(s) obtained, as well as the city and state in which you practice.