Somebody Just Give Me an Adjustment!

By John Hanks, DC
I was off to see the Wizard ... Wizard Chiropractic Centers, that is, on the West Coast. I'd read about its "integrated patient health management" for some time. Since I was visiting relatives in the area anyway, I figured, "Why not drop in for a look?" I needed a dose of chiropractic enthusiasm, and this group sounded like a good source.

When my cab rolled up to the main clinic, I noticed that the sign outside simply said, "Wizard Health," with no mention of chiropractic. Dr. Wizard, the clinic's owner, director and inspiration, explained it to me.

"You see, John, we are an integrated clinic. We offer the full array of complementary and alternative therapies, so we don't want our customers to get confused."

I was a little confused. "You call your patients 'customers'?" I asked.

"Of course!" he replied. "But not to their faces. We follow the latest continuous quality-improvement standards, which means we are all each other's customers. They're my customers; I'm their customer; the insurance companies are my customers; and I'm one of their customers; my staff are all customers; and I am their chief customer. In the Great Plan of Universal Intelligence, we all must be each other's customer. Got it?"

I got it. However, I couldn't help but notice how Dr. Wizard was dressed. He looked comfortable in his khakis and golf shirt, but he also had two cell phones on his belt, a pager, a Palm Pilot, and a wireless microphone connecting his head to his mouth. "I must be in constant contact with my staff, especially the billing department," he said. "Now, let's take a tour."

The clinic was huge, with rooms reserved for acupuncture, massage, body-mind stress management, and other therapeutic endeavors. "We've combined our aromatherapy and crystal-therapy rooms, and give a discount to our customers if we do both treatments at once. I'm considering adding colonic irrigation to the mix and making it a package deal."

"Dr. W," as his staff called him, was obviously a businessman. I met his risk-management officer; compliance officer; marketing director; senior administrative assistant; and a few MDs. "They're doing a fellowship in alternative medicine with us, which means they basically work for bread and water," Dr. W explained, looking quite content with himself: "There are a lot of MDs who want to learn to be 'healers,' so we let them hang around. Real naturopathic physicians are too expensive."

Finally, we got to the chiropractic department. It was a big gymnasium-style room, much like many physical-therapy departments. Several flat, inexpensive adjustment tables were lined up, and the two DCs who were treating patients in the room seemed to be moving along quite quickly.

"We advertise for customers who don't mind fast service," said Dr. W. "Some even keep their cars running in the parking lot. We must have high volume because of the low reimbursement rates we get from the managed-care companies, and we are providers for many of them. Here - look at our list of payer customers."

The list was long. I recognized many of the payer networks. I learned that Dr. W did not want any of his employee chiropractors to see more than 750 patients a week. "You have to draw the line somewhere," he explained, as we had a lunch of compost soup and artichoke-leaf salad. "Otherwise, these docs start to pose a risk for occupational injury."

Somehow, I found all this depressing. I had hoped to visit a clinic with real chiropractic energy, but found this hodgepodge of therapies thrown together for the sole purpose of enriching the owner. I'm a big supporter of complementary and alternative medicine, but what is chiropractic doing in this category, anyway? It seems we have one foot in mainstream physical medicine, and another in the "grey area" of therapeutics.

As I flew home that night, I kept burping up the compost soup, and my neck was locked in a fight with the headrest of the airplane. I couldn't wait to call a colleague and get a simple, effective, appreciated chiropractic adjustment - no colonic irrigation necessary.

John Hanks, DC
Denver, Colorado

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