"Every patient is not 'worth' a certain dollar amount"
I was less appalled to read about a 24-visit cap in California [www.chiroweb.com/archives/21/22/17.html] than to read the reference to the LA Times article about Safeway's analysis on overutilization in California, compared to other states. Here in Washington, we have a 20-visit "soft cap," but my visit average falls way below that, with patients returned to work without sequelae.
I used to practice in California, and was amazed at the amount of care (60-plus visits) being paid for in workers' comp for lumbar strain injuries, with no repeat examinations, and no referrals for second opinions. This was theft, pure and simple. It was no different than the brochures I saw in Mexican restaurants that explained in Spanish how to obtain disability in California.
If we want to gain respect in the health care arena, we would do well to review all the studies that show how effective chiropractic care is and how many visits it takes, on average, to get a given condition asymptomatic, and strive to make this our average utilization. When care starts to exceed this, refer for a second opinion. Every patient is not "worth" a certain dollar amount. If a practice consultant suggests this, throw him/her out of the office and the profession.
For those of you who feel everyone needs a chiropractic visit a week for life, remember: Health insurance providers and workers' compensation payors assume you are submitting claims for care related to an ongoing injury they can document and validate. Moral behavior needs to be a part of all our practices. Set it aside, and we will all be sidelined from the health care arena.
Les Peterson, DC
Arlington, Washington
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
