In the past year we have seen many clients from Poole who had previously been to a local clinic offering a consultation package which included “a thorough exam, report of findings and x-rays if clinically necessary” the consultation did not include treatment on that day but did cover a long report of findings when the clinic explained what the problem was and how they were going to address it.
In all of these cases, the patients were then told that they needed extensive corrective care treatment 3x a week for a minimum of 6 weeks then less frequently. Obviously this level of care can get pricey but if they signed up and paid upfront they would get it a discount price of £800, for another it was £1349. We now look at whether that type of package is necessary.
Case 1:
The first case is a young gentleman who had neck and upper back stiffness and an ache of only 3 weeks duration; he had no previous trauma and was only 30 years old. Therefore extremely unlikely in the absence of trauma to have any degenerative change of significance and yet he was still x-rayed as he was told at the consultation that he needed x-rays. Let’s be clear here, therfe was no clinical justification to take the X-rays which are basically a radiation dose and therefore should only be taken when certain criteria are met.They were not met in this case. The X-ray films found he had a “straight neck,” ie, loss of the normal curve. This is common if you have pain, it is a temporary phenomenon caused by muscle tension around an irritated joint.
He was then told he would need many treatments to correct this, and when he paid £800 up front, his “care” could begin. However, he saw through the hard sales technique and declined, deciding to attend Back In Form Chiropractic clinic in Ashley Cross Poole instead.
We gave him a 1 hour consultation that assessed him neurologically and mechanically and after a chat about his simple common very treatable problem we started his treatment there and then which is our clinic policy as we feel if you come for treatment we should give it. This other clinic stated that he wouldn’t get any treatment unless he paid a large sum up front therefore tying him into a package that could be argued suited the clinic and not the patient. At the next visit he was already feeling a lot better and after just 2 visits he was completely pain free. His cost to get pain free was £120 with no unnecessary exposure to radiation. He reported this at his 3rd visit and will see us again in a month to check there has been no reversal of this rapid but expected improvement. His total cost £220 not the £800 the other clinic wanted to charge him.
Case 2:
Our second case is a lady in her early fifties who consulted the same local clinic with neck pain again. In this case she had pain for 4-5 years with some minor strain but not traumatic. As is the case with the clinic she attended initially she was x-rayed and some minor degenerative changes were found at levels of the neck consistent with being a 50+ year old, ie normal for age. This in itself is not a reason to expose someone to ionising radiation. She was given the usual lengthy report of findings and told she needed to have extensive treatment for at least a year to correct her problem. This was to be paid for as she went, for a cost of £1560, or in one go for £1397, or in 3 installments of £494 for £1482. Quite staggering really, as I don’t know any clinician in the world dealing with musculo-skeletal problems who can accurately predict the number of treatments needed to improve a condition. She declined the service suggested and came to see Back In Form Chiropractic Clinic.
Pricey!
After a thorough exam encompassing assessment of musculo-skeletal and functional neurological assessment of the central nervous system (brain and cord), we found some deeper reasons why she may have a persistent problem. We started treatment and gave her some tools to both rehab the body AND the Central nervous system.
So far, after just 3 visits her headaches have improved dramatically and her neck pain is significantly less, however due to the length of time she has had her problem she will require around 6 more visits over the 12 month period suggested by her first consultation at the other clinic. Therefore her total cost of care at Back In Form will be around £470 a saving of £1000 compared to her previous recommendation at the other local clinic.
Here are the IMRI Guidelines for x-raying
For the majority of patients with non-traumatic, non-specific neck pain, X-rays are not recommended.
Reasons:
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Poor diagnostic yield for soft-tissue or degenerative causes.
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Common findings (disc space narrowing, osteophytes) often do not correlate with symptoms.
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Does not change management in most cases.
No imaging is indicated if:
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Pain is mechanical/non-specific.
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No history of trauma.
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No red flags.
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No progressive neurological symptoms.
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Patient is under 65 and symptoms <6 weeks.
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Suspected whiplash without red flags (X-ray not helpful; MRI only if neurological deficits).
So the upshot is this. In Musculo-skeletal care most clients DO NOT need to be X-rayed. In fact I would argue an MRI is far better, safer as it doesn’t give you a dose of radiation and gives a lot more information for not a lot more in cost. . I understand why some clinics hook people into long expensive care plans, it can help with patient compliance as they will want to see the package through and that could be argued to be giving patient centred care, it also clearly helps with the cash flow of the clinic too, but is it patient centred care (as expected and regulated by the General Chiropractic Council) if the client does not need that amount of treatment or X-rays to become pain-free and functioning well?
All I can say is that at Back In Form Chiropractic Clinic treatments are 20 minutes long and you are the only person we pay attention to at that time. You won’t be in a room with many others and given just an adjustment and that’s it. A system that clients who have experienced it likened to a production line. Come to Back In Form Chiropractic Clinic and you will get treated in the same way as I would treat myself, we look at you as someone we care about, we care about your health and spend the time using all the tools we have to get you right, focusing just on you and not exposing you to harm from ionising radiation that generally is not necessary. If you need imaging we recommend MRI, it’s far better and safer.
To your health.
