5 Signs You’re Being Scammed

 

I'll never forget one morning during my first year of practice I got an urgent visit from a young man.  He said that he was in big trouble because he had a serious back problem.  He had already been to see another chiropractor in town and it was all bad news.  This doctor told him that without roughly $20,000 in care which would take about a year he would probably end up in a wheelchair within 10 years.  Remember, this was my first year. I paniced trying to think of any conditions that sounded like they need that level of care.  There was no need for panic.  There isn't one.

I did an examination, reviewed cryptically scrawled chart notes and some very non-specific x-rays.  I wanted to be thorough because I didn't want to mess up and have this guy in a wheelchair within 9 years instead.  In the end I had to be honest…. his case, while painful, was pretty simple.  A few adjustments and some muscle work and he would probably be just fine.  He was shocked.  How could he receive to totally different responses to his problem?  He didn't become a patient for about a month but after 3 visits he was pain free.  He is still a patient today but only comes in every 6 weeks because adjustments feel great, not because he's afraid of being crippled.

So what happened?  Well, it's embarassing to admit but I'm pretty sure my colleague was scamming him.  What I'll share with you here is purely my opinion but I think you should know about my 5 signs you might be getting scammed.

1. Scare Tactics – Typically we aren't dealing with life and death in a chiropractic clinic.  That is not to say that there aren't serious things that we encounter from time to time.  In my practice I have seen signs of what ended up being fractures, dislocations and even terminal cancer.  However, unless you have some sort of degenerative disease you probably aren't going to end up in a wheelchair.  If you get the sense that the doc is trying to scare you into coming back, I think that is cause to be suspiscious.

2. Many, many… many visits – Chiropractic care is more visit intensive than seeing your MD.  When you have a trauma it's reasonable to see a patient several times a week for a few weeks.  It is rare but sometimes necessary (such as with a motor vehicle injury) that this may even extend to a few months.  However, seemingly endless treatment plans are typically more benficial for the doc than the patient.  As a reference point, on a Worker's Comp case in Oregon we are limited to 18 visits or 60 days of treatment (whichever comes first).  While this isn't always enough it is often plenty to get somebody back in working condition.  There are few good studies done on dosage when it comes to chiropractic and opinions vary but you shouldn't feel shy about asking your doc about how many visits it will take to reach your goals.  Chiropractic works!  So I hate it when docs pretend it will take forever to get you feeling good again.

3. No Plan – At the other extreme you may have a doc who seems to have no plan for getting you better.  They don't tell you what to expect, how long to expect it to take, or sometimes even why they are treating you.  There is no re-evaluation.  There is no change to the plan if you respond poorly to care or recover more quickly than expected.  Your doc should be talking to you about how care is expected to play out.  What are the signs you are improving?  How can you know if you are getting worse?  What happens after the symptoms are gone?  Has the doc explained what is wrong or why chiropractic will help?  If you are left wondering what the plan is then there is a chance that there isn't one.

4. Pop, Crack… NEXT! – There are many types of practices out there.  Some are called high-volume clinics.  A single doctor may see between 40-50 patients a day.  Then there are some that we in the business call "mills" where the doc may adjust as many as 100 patients in a day!  It gets that name because it is high-speed, high-efficiency, go! go! go!  Patients roll though the clinic like logs through a lumber mill.  (or a LUMBAR mill!  HAHA nerdy anatomy joke!).  Again… great for the doctor but not necessarily the best for you.  A doctor who sees 100 patients in an 8 hour day is spending about 3-5 minutes with you.  I don't want to imply that every busy doctor is trying to scam you.  It is possible that he or she is fantastic and in really high demand.  But I also know that you have to cut corners when the volume gets too high and for some that may compromise the quality of care.  If you feel like a log chances are you very well may be.

5. The One Man Show – Chiropractic adjustments are so much fun for this simple reason: You get the coolest unexpected positive outcomes.  I have adjusted people for low back pain and their stomach cramps went away.  Or there was the time I gave an upper neck adjustment that caused the numbness in a young man's tongue to go away.  It is really, really cool and exciting.  That being said beware of the one man show or the doc who claims to fix everything with a single adjustment.  This doc may try to convince you that you don't need your MD, PT, Psychologist or OBGYN because they can do it all for you.  Good doctors (of all disciplines) know their limits and are happy to work as part of an integrated team.  I personally have a Chiropractor, a Dentist, an MD, an Acupuncturist and a Massage Therapist.  I would be suspiscious of any practitioner who told me that they could fill all of those roles for me.  There are many types of chiropractors out there who specialize in things beyond adjusting backs.  For example, I have extensive nutrition and sports medicine training.  But when a doc tries to isolate you from other practitioners sometimes they may actually be trying to avoid scrutiny of other providers.  Good doctors cooperate, they don't isolate.

So there they are my 5 signs you may be getting scammed.  Fortunately, this doesn't happen often but this isn't just about your pocket book it's about your well being.  It's important to know the warning signs so that you can partner with providers who have the same goals as you when it comes to care.  If you think you're being scammed then you should follow the example of the young man I mentioned earlier.  Getting a second opinion will give you peace of mind and the confidence to move forward and not just feel your best, but actually be your best!

This Post Has 5 Comments

  1. Dr. Shawn Allen

    Jason, just read your post on Scams in chiropractic offices and I have to say I have a problem with a couple of your points. If I read your post STRICTLY from an insurance based POV, then I would say most of your points are right on. But the practice that I am involved in you would categorize as a 'high volume' practice. There are some things you should know that don't apply to such a practice. We are not an insurance based practice and as such our focus is on the Chiropractic maintenance visit.  The same weekly chiropractic adjustment that you and I received and provided when we were in school. The same weekly chiropractic adjustment that we both provide to our family and friends. To find and fix a specific problem and treating that specific problem until it is resolved should not take unless adjustments. BUT as a part of the wellness plan for your patients, weekly adjustments are a part of the routine that includes eating healthy and going to the gym 5xs a week. As such a weekly adjustment IS a good idea. And should not cost an arm and a leg. Our payment plan includes an option that would allow that patient a weekly adjustment for less than $600 per year. Not paying off any boats with that option. Insurance won't pay for the treatment anyway. When we discuss how long the visit should take I would ask you to be honest with yourself, how long do you spend with the patient face to face JUST providing the adjustment. When you eliminate the 'extra' treatments of STIM and ice/heat and massage and stretching and teaching exercises; how long do you spend JUST adjusting the patients. I don't need to spend more than 5 to 10 minutes with the patient when I am JUST adjusting them. And all of those extra modalities are not necessary when you are providing a maintenance visit.  So your post is really just talking about insurance / symptom based chiropractic care; which you don't make clear. Not the type of care that we are providing. A good quality maintenance chiropractic adjustment. When you consider this type of practice, though it has some of the characteristics that you describe in the post as scams, really are not a scam. Have a great week.  Go DUCKS!! 

  2. Jason Young, DC

    Dr. Allen,

    I respect your input.  I offer these signs as red flags not necessarily as proof.  I think that if you have a good rationale, patients are well informed as to the plan and buy in then that is an honest way to do business. 

    As for the time element… adjusting is only a part of what I do.  It is a powerful tool but not the only important tool I use.  The only tools more valuable than my hands,l in my practice, are my ears.  Listening to a patient takes time.  So yes, adjusting doesn’t take much time at all but in my opinion patient care does.

    And really all of this is my opinion and I recognize and respect that not all of my colleagues share it.  That’s ok.  None of us are really wrong for having an opinion.  I will say that I know that you are not that type of guy I described in the begining of the post.  Keep getting people well doc!

    -Dr. Young. 

  3. Dr. Shawn Allen

    Dr. Jason,

    The reason that I wanted to bring up these points was that your original post stated your five points that indicate that your patients are being scammed. I just wanted to point out that some of those points don't necessarily indicate 'scam'. They may, but they may not. I too have seen a few patients that were 'over sold' on a treatment plan for a condition that didn't indicate it. Unfortuneately there are some in our profession who feel it necessary to use such tactics. 

    That said, some of your 'fav five' may not indicate 'scam'. But the way you put it, you were saying that these are the signs that indicate scam. As a doctor, your opinion (and mine) carries a lot of weight. And just like our 'shaddy' colleages who would scare patients into a questionable treatment plan. We can also scare our patients away from a perfectly rational and reasonable clinic because they share some of the characteristics that you deem 'red flags'. 

    I think that the most important points you made were 1. that if it feels like a scam, it probably is; and 2. that quality patient care is about the patient and listening to them. Which we emphasize with all our clinics. I don't want to turn this into a commercial for my employer, but I want to point out that quality chiropractic care doesn't have to include lengthy office visits or elaborate and expensive treatment plans. We can provide a quality chiropractic visit and still recommend regular (weekly) chiropractic treatments that will enhance the quality of life. 

    Have a great week. 

  4. Scott

    Dr. J,
    After almost steaming and losing sleep, I’ve decided that I might be able to provide a constructive criticism POV as opposed to brash and unproductive. All chiro’s are different. Sadly, one of the reasons we as a profession can’t get any legislative action is because we all disagree on so many things. Some of your points make sense if you run a mechanistic practice, which sounds like you , considering your adjustments are just a “tool” in your office. That being said, I woudl venture to guess that Shawn is right about how often you check your family and get checked yourself. The thing I have found is that we don’t recommend the same care we put on ourselves to our patients i.e. I get adjusted every week to BE MY BEST (NOT ELIMANTE PAIN) but if I tell my patient to come back when it hurts, there is a contradiction. Dr. Dan Murphy and Dr. James Chestnut have the most cutting edge research on the wellness model of chiropractic that actually proves subluxation to be real and not a unicorn that we all were taught by our one sided professors. I am also considered high volume and don’t spend a lot of time with my patients because I am not there to treat symptoms. It’s not what chiropractors do- that’s why we’re different. I feel the more we try and fit into the medical model (prescribe drugs, use modalities) we get away from our very nature as doctors of cause. You ask any of my patients about their quality of care and they know I am fully present and there to turn on their body’s power by removing interference. The cool thing is, when I recommend extended CARE (not treatment) plans for my patients, I explain that chiropractic should be a lifteime habit, just like brushng your teeth and going to the gym. One of my biggest frustrations is when a patient comes in to say that chiropractic doesn’t work because there last chiro “treated” visit by visit and it didn’t get better by 6 visits. So many people have chronic stress in there life and it takes time just like any other process. My point in all this, whicle I respect that this is your opinion, is that it tells your patients that subluxations are no big deal, and that chiro’s who recommend ongoing care are quacks. Be careful my friend. We’re all supposed to be in this together.
    Dr. Scott

  5. Jason Young, DC

    Thanks for the comment Dr. Scott. I worry that you and Dr. Allen may be reading too much into this. I’m not trying to attack wellness care. I’m also not saying that we should only be treating pain. If you re-read the article I’m sure you won’t find a statement like that.

    I am saying that there are some unethical elements in our profession (just like any profession) and trying to give some clues as to how people may avoid them.

    I think that we could agree that patients deserve to be treated by a doc with a plan which the patient can understand and accept. Doctors should be honest about the consequences and alternatives to receiving care. Patients are deserving of respect, time and care according to their needs and not the doctors goals. Right?

    That’s all this article is about. I don’t think high volume practices are bad. I think treating people like logs in a lumber mill is bad. I don’t think many visits are bad. (I get adjusted at least every two weeks) I think excessive care centered on the chiropractors needs is bad. I don’t think giving patients information and education about real conditions (such as subluxation) is bad. I think being so insecure about your diagnosis that you have to exaggerate to get people to receive care is bad.

    The purpose of this post is to answer a question I get often, “How do I know if I’m getting scammed?”. It’s not to call out doctors. I don’t think you should feel defensive. At least I hope you don’t.

    Keep on keeping folks well.

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