Have you been to a chiropractic clinic where they would not treat you on the first visit? Have you had a three-minute visit? Whether fortunately or unfortunately for the general public, not all chiropractors are the same. The vast difference in adjustment techniques and treatment offerings from one clinic to the next can often be confusing. Part of this is due to the very nature of the manual therapy approach to care. There will also be differences between individual physical therapists or massage therapists, however, the differences between individual chiropractors can often seem greater. Please remember, with any profession there is the good, the bad, and, unfortunately, the ugly. Here are five questions you should ask before choosing a doctor of chiropractic to avoid “the ugly.”
#1. I’m in pain! Will the doctor treat me on the first visit?
Question to ask: Will I be treated on my first visit to this chiropractic clinic?
There are some practice management groups that actually coach doctors to wait until the second visit to treat a new patient. This may seem unbelievable, but it’s true! It is simply a practice-building tool to allow the doctor to see more patients in a day. While there are circumstances when a patient should not be treated with joint manipulation/adjustments right away, this would be when the history includes such things as a recent accident, trauma, cardiovascular issues, etc, or if the examination raises “red flag” findings.
Even when there is a recent accident or trauma, a chiropractor can still treat without using manipulation/adjustments. The goal would be to decrease pain and inflammation in order to make the patient feel more comfortable.
A doctor should perform a detailed examination to identify the cause of your pain and determine whether there are any contraindications to chiropractic care. If your pain or chief complaint will respond well to a conservative manual therapy approach, the doctor should proceed with treatment on the first visit to get you better as soon as possible.
Take away: Rarely is it unsafe to treat on the first visit. Look for a different chiropractic clinic if they cannot justify it.
#2. Are you listening?! I don’t want to be rushed through the appointment.
Question to ask: How long will the appointment last? How much of this is actual “face time” with the chiropractor?
Regardless of the type of doctor you are seeing, three minutes is not enough time! It takes time to develop a healthy doctor-patient relationship. If each visit is only three minutes long, you have yourself a bad relationship. It takes much longer than a couple minutes to connect with a person, listen to them, and address their questions and concerns.
Some chiropractors will put a machine (usually therapeutic ultrasound, muscle stim, or laser therapy) on you to help with pain or inflammation and leave the room or leave you with an assistant to tend to other patients. This can be great as long as there is more than this involved in that treatment session. We take more of a “hands-on” approach, offering a range of manual therapy and exercise therapy techniques in addition to chiropractic care in addition to physiotherapy modalities that Dr. Jamie administers herself. Our appointments last 20-30 minutes, with that entire time is spent “face-to-face” with the doctor.
Take Away: Many chiropractors spend at least 10-15 minutes with a patient. Just be sure to avoid the 3-minute appointment!
#3. I’ve heard once you go to a chiropractor you need to go FOREVER!
Question to ask: Will I need to come back for continued maintenance care? Do I have a choice to stop treatments whenever I want?
Your health and health care should always be your decision! You rely on the expertise and counsel of your doctor, but ultimately it is your choice. Generally, you should expect to see a noticeable change in symptoms after four to six visits. Some conditions may only require one or two visits, while others, often chronic conditions, may require more treatment to obtain the same results. For most conditions, a treatment plan should not involve 3 visits per week indefinitely or a 3-4 month treatment plan.
Once we’ve reached your goals for recovery, any continued treatment is once again your decision. There is mounting evidence supporting continued maintenance care for spinal health (1). Based on the findings of this research, we may recommend continued maintenance care for your ongoing physical health, but ultimately it is always your decision. Additionally, we will give you exercises for you to perform on your own which will help maintain your health and well-being.
Take away: Your health care should be your choice! Chiropractic maintenance care is no different! If it’s not optional, you should look elsewhere.
#4. I think I just tweaked a muscle, why do I need an X-ray?
Question to ask: Will I need any diagnostic imaging, such as x-ray or MRI?
There are clinical criteria for determining whether an x-ray is necessary. If you don’t fit the criteria below ask the chiropractor to justify why they want to take an x-ray.
As a general guideline, X-rays are necessary in the following cases:
Some doctors of chiropractic choose to take x-rays as standard procedure, either as a defensive practice to rule out pathology and/or to aid in determining where to adjust the spine. For this reason, many chiropractors have x-ray units in the clinic. If this is the case, you should ask if a chiropractic or medical radiologist (a diagnostic imaging specialist) will be reading the x-rays or if only the chiropractor will.
However, many other chiropractors do not have x-ray in the clinic. These doctors have chosen to refer to a hospital or imaging center for these services.
At Full Motion, if the examination raises the need for diagnostic imaging or you fail to respond to conservative care, you will be referred to the Center for Diagnostic Imaging (CDI) - they have multiple treatment locations. We do this for a couple reasons. First, CDI possesses the latest in diagnostic imaging equipment with digital x-ray and open bay MRI for our patients that require these services. Secondly, CDI has medical radiologists who review every image to ensure that our patients’ imaging is interpreted and diagnosed properly.
Take Away: Not everyone requires an x-ray. If you don’t meet the criteria listed above, ask the doctor to justify why they want to take an x-ray.
#5. I want an active role in my health care, what can I do at home?
Question to ask: Will I get a few exercises or an exercise program tailored to my condition?
Research heavily supports a combination of chiropractic care and exercise therapy for faster, lasting results (2, 3, 4, 5). You should be given exercises to perform on your own to reduce pain, speed your recovery, and limit the risk of the same condition or injury reoccurring. The key lies in taking the time to complete the prescribed exercises.
Take Away: Exercise therapy should be a vital part of any treatment plan. If a chiropractor doesn’t include it in their treatment, then you’re not receiving the best care available.
Jamie Mabeus, DC