I regularly stand in front of chiropractic crowds and in the course of the conversation I ask, ‘What do you get paid for?’. The usual answers fly back. 

 ‘Adjustments’     ‘Time spent’        ‘Outcomes’  

All are partially correct but the real answer is that ‘you get paid to manage a care plan’

Care Planning focuses on outcomes. Adjustments are part of the service and it takes time to observe and measure results. However, what we get paid for is our skill in creating and managing a patient’s specific care plan. That’s why it is so critically important that you get this right and adopt the latest and best proven strategies in planning the care for your patients. 

I refer to this as the Paradigm Lost concept where there were two paths that could be taken with respect to care planning and neither of them are as relevant today:

  • Bait and Switch: This people-pleasing approach focuses on developing a short term plan to address symptoms and along the way your intention is to tell them the bigger story about chiropractic being useful in their overall health. This usually ends up with a preventative check-in plan which can be referred to as a maintenance plan; sort of like scheduling an oil change.
  • Sheeple: This pre-programmed and no fuss approach could also be referred to as the ‘3-2-1 and out the door’ plan.  Somewhere along your journey, a coach or trusted advisor has offered a standardised plan that is to be delivered at the time of the Day 2 Report. It’s usually well scripted and is similar, if not the same, for all adult patients and slightly modified to a lesser number of visits for paediatric care. The goal is usually to get them into a ‘wellness program’ on a 1 x month frequency. The wellness portion isn’t based on real-time objective data and the front desk staff are constantly recalling missed appointments since there is no ongoing strategic plan being followed.

In these paradigms, re-exams, if done regularly, are usually limited to palpation, range of motion (ROM) testing and asking the question, ‘How do you feel?’ or ‘Does that still hurt?’ questions. In most cases, the outcome of updated reporting is for the patient to be offered a less frequent care plan as some sort of reward for making it this far and everyone seems happy … until the problem arises again, and again.

The neuroAGE of Chiropractic care planning has arrived 

Care Planning, along with the timing and frequency of care delivery, need to be vastly different in today’s world. A paradigm shift has occurred as a result of the evolution of and increased use of instrument-based, functional neurological testing. These easy-to-use, objective tests create a new level of certainty for both the clinician and the patient. They force the communication and planning from symptom-based, feeling outcomes towards functional transformations. The shift has opened up the neuroAGE of chiropractic!

On the leading edge of this dynamic shift are the INSiGHT scanning technologies. These precision, neurological scanning devices are used exclusively to evaluate the impact of chiropractic adjustments as they are administered in a care plan. For over 30 years this technology has evolved within the profession so that the DNA of millions of chiropractic outcomes are built into the logic and engineering of every INSiGHT. This means that every exam and report in a monitored care plan brings to life the importance of remaining under watchful care while celebrating the amazing improvements in the functioning nervous system.

How does INSIGHT scanning make a difference in care planning?

The magic of chiropractic outcomes is based on adjusting the tone and tension within the spinal nervous system. Scanning the spine detects hidden patterns of autonomic and motor neurological distress when vertebral subluxations are present. Scanning the heart rate and rhythms provides a window into a patient’s adaptive response. The scope and relevance of these scans means that you can access neuroscience at your fingertips! Without looking deeply into the function of the central nervous system, chiropractors default to managing spinal and postural problems when the real issue lies deeper. You can’t get this data from X-rays and you can’t measure tension accurately by simply palpating, measuring Range Of Motion (ROM) or observing postures. 

Scanning creates the ‘RRTB’: the Real Reason to Believe 

Scanning backs up with hard data. Scanning also creates a journey map that forms the basis of any care plan. It’s only logical that when a scan is performed on an initial exam, subsequent re-exams can be compared at any stage of the ongoing care. 

Here are 5 ways you’ll get paid for leveraging today’s technologies in care-planning

1. Branding and Marketing: When you shift from Feeling to Functional care planning, you are known as the brand that delivers long term results instead of being the one-off miracle worker. Sure, it feels great to make such a dramatic difference in just a couple of visits but the real goal is to KNOW that the nervous system is returning to its functional state and that this process takes time and dedication. INSiGHT scanning also adds a wow-factor to care planning. Patients love to know that they are improving and also love to know that you know what is going on in their spine and neurological health at all times. You will soon be regarded as the expert in your community.

2. Watchful and Progressive Clinical Excellence: Care plans that are designed with an exam-exam sequence keeps the clinical presence at the forefront of all decisions.  CLA clients have adopted the mantra of ‘Test don’t Guess’. This means that regularly scheduled re-exams and reports are added into the total value of services being delivered when calculating the financial plan. You’ll be surprised at how multiple re-exams will improve your bottom line!

3. Built-in Retention: Functional, neuroAGE styled care plans generally span weeks and months. Part 2 of this care planning eBook teaches how the ‘Rule of 12’ organises your exam and reporting procedures around ethically delivering a care plan that follows a neuroplastic approach. Be sure to download it as well. Let’s face it:  Anytime a person sees the value in ongoing care and commits to change, they are motivated to show up. That’s retention! Scan-based exams emphasise the value of chiropractic and confirm that the care plan is working as planned. That’s why it’s called a CARE PLAN! 

4. Attracting families and their friends: Once the results of a properly presented care plan become obvious, patients are motivated to have their families and friends checked out neurologically. Not everyone has a back and neck problem but everyone needs a neurological performance check! The INSiGHT reporting methodology creates a CORESCORE for both adults and children which grades the level of performance in their neural processing. It’s never been easier to attract the right mix in a practice and get them on care plans that last a lifetime. If you are attracting well informed and inspired new patients, your practice will expand exponentially.

5. Reactivating patients that have lost their way: We all know that in every practice there is a graveyard of existing patient files. With best intentions they started care but dropped off for any number of reasons. INSiGHT scans can be used to invite them back for a neurological review. Offering them an opportunity to get an updated ‘stress score’ is perhaps the easiest way to stimulate growth in any practice. Once reconnected, a new or updated care plan can easily be organised.   

There are many more ways that care planning creates new levels of certainty and growth in any practice. I know from my own experience that once I mastered the art of care planning EVERYTHING fit into place. It was as if the care plan became the Magna Carta of my office. It represented my dedication to clinical excellence; my love of helping others; my passion for ethical relevance and my insatiable desire to showcase chiropractic, as it was always meant to be. Along the way, I developed the INSiGHT scanning technologies that you see today.  They represent the epitome of objective analysis and reporting which allow chiropractors to gain a newfound confidence for creating and delivering care plans. 

In Part 2 of this Blog series, we will explore the mechanics of creating an individualised care plan while introducing the neuroplastic rationale that makes function-based care planning the best option for your patients and your practice.   

– Dr. David   

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Dr. David Fletcher is actively involved in all aspects of innovation teaching and research connected to the INSiGHT™ scanning technologies. He is widely recognized for his ability to share his expertise in compelling and easy to understand ways.

Dr David is a renowned chiropractor who practiced for many years with his associates in a scan-centric thriving principled family-based practice in Toronto. He is a sought-after teacher mentor and keynote speaker who takes every opportunity to share the wisdom and the power of chiropractic as it is meant to be.

Dr. David Fletcher
DC FRCCSS(C) – Founder & CEO CLA Inc.

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