The Myth of the Bargain Adjustment

While most of my patients are referrals from other patients (or doctors), some patients find me through internet searches. When people are just looking for a chiropractor based on internet searches (without a personal referral or idea of what kind of care awaits them), one of the first questions they ask is, "How much is a treatment?"  It seems like a simple question, and it seems like a reasonable one. However, in chiropractic -- especially in chiropractic -- the answer can be quite misleading. If you call around to all of the chiropractic offices in town and ask the question, you'll get a range of answers. Thinking about my neighborhood in San Francisco, I know that the range would be from about $40 on the lowest end to around $250 on the high end. (I haven't been in Sacramento long enough to know the range!) But based on price alone, I can tell you that the cheaper chiropractors - the $40 guys - are almost certainly practicing old school "back cracking" style chiropractic. This method works, and for some people, it works great! However... due to the purely spinal mechanical approach, the method requires a lot of reinforcement. Patients need to come in very frequently, particularly in the beginning of care. One local $40 chiropractor I know (who sometimes discounts his care to as low as $20 a visit) recommends that new patients come in *daily* for the first month! From a dollars-per-treatment point of view, this sounds great! $20 x 20 visits in a month = $400, which is the cost of just 2 visits at the $200 chiropractor's office. But are treatment dollars the only calculation? If you're coming in to the city from anywhere but south, there are bridge tolls to pay. Parking, etc. or perhaps you're taking BART or MUNI and have to figure in those costs. What about your most precious asset of all, which is your time? How much time does it take to go to the chiropractor? The $20-$40 guy's visit may take only 3-5 minutes, but unless you live down the block, it probably took 1-2 hours out of your day! Multiply these factors by the frequent visits, and now, the bargain price does not seem like such a bargain at all. Back when I was a pre-chiropractic student, I was receiving free chiropractic care from a very generous local doctor. While I very much appreciated the free care, I eventually came to resent the time that it took from my day. I eventually dropped out of care because I could no longer handle the cost in time! Time is our most precious asset, no matter who we are. I always knew in my gut that there had to be a better way to get people well and to stabilize their spines than simply "popping" it back into place over and over again! Now, in my 21st year of practice, I am confident that I've found the best methods to achieve the greatest stability in the fewest visits. Healing still takes time, of course. Most cases still take about 3 months to achieve good stability. But those 3 months now take about 1/3 (or less!) of the visits than they used to.  In the long run, this probably saves some money, but most of all, it saves quite a lot of time. I can't remember ever running into someone who has complained about all the free time they've got on their hands! We all have the same limited amount. So, when shopping around, while it's reasonable and fair to want to know what the cost of a treatment may be, the better question might be, "How much time can you save me?" :-)  And that is all I have to say about that. Be well! -DK