To Exam or Not to Exam..
A strange thing happened at the office a couple of weeks ago. I had a consultation with a young lady who had been having some health issues lately which had not been resolving, in spite of her having been to a number of doctors (including at least one other chiropractor). The consultation went well (or so I thought) and I recommended that the next step be to get some x-rays and schedule a more thorough exam so that we could really get to the bottom of her problem. Just as she was about to schedule the exam, her boyfriend stopped her, looked at her, and said, "Do you REALLY think you need ANOTHER exam?" She paused, thinking about the other exams she'd recently had, which had led to no help, and then decided against it, and left. After all, she had come in the hopes of simply jumping straight to a treatment - without any exam - so that she could "try it out." This is not an uncommon mindset, and even some of my own friends have occasionally texted me and asked things like, "Do you know a good chiropractor I could see who won't make me do an exam?" This question baffles me! But I can see where people are coming from. After all, I am a patient as well as a doctor, and I have had some incredibly shoddy "exams" in my life. The worst which comes to mind was a $600 "exam" I was billed for which consisted of a technician taking my blood pressure, pulse, temperature and weight and then a doctor asking me if I'd been in the woods recently ("No") and then shrugging, listening to my heart and lungs for 15 seconds, and then stating "You're fine." !?!?!? Needless to say, I've never been back to that doctor. I could have taken my own vital signs and declared I was fine for free! With "exams" like that - which seem to be done just for the sake of bilking insurance companies - it's no wonder that patients perceive them as a money-making waste of time.
And yet, an exam is critical if you're expecting some kind of treatment from a doctor - particularly if you've never seen them before! A lot of people come to chiropractic thinking that it's all about "popping bones." "I just need to be cracked right here! I couldn't get it myself this morning, and my wife is out of town!" After almost 20 years in chiropractic, I know that it's a whole lot more complicated than "popping" bones, even if it doesn't look like it. There is absolutely an art as well as a science to it, and I know from personal experience (as well as that of my friends and mentors) that things are not always as they seem, and that to skip a good exam is a disservice to the patient and a very risky proposition to the doctor.
I don't accept insurance in this office. As such, I am not tempted to bill for big worthless exams just for the money. I do a detailed and honest exam that gives me the information I need to assess a case on all 4 bases of health: structure, nutrition, toxicity and emotional. In our exam, not only do we check the spinal alignment, but we also do a number of neurological tests that you are unlikely to ever have performed on you outside of a neurologist's office! Why? Because we are concerned about FUNCTIONAL neurology and FUNCTIONAL health. Symptoms alone are misleading. We need to dig below the surface. That means doing an exam. And then, if and when you start treatment? We have to do periodic RE-exams, in order to monitor the progress. Exams are kind of like an airplane pilot looking at the controls. Even though MOST of what happens on a plane is on autopilot, would you really feel good to know that the pilot rarely, if ever, put his eye on those numbers and controls? Of course not! That's your life in their hands there! Same thing with your nervous system. This is your life we are talking about here.
So, yes, you DO need an exam before even considering treatment with a doctor. I would not feel good sending my kid to a chiropractor - or any doctor - who was willing to treat him without an appropriate exam. That's just sloppy practice. And that, is pretty much all I have to say about that!
-DK