Maintenance Care by Dr. Ogi Ressel

Sunday, April 26th 2009

Warm hellos to everyone!

Ok..........I've had this on my mind for some time and after some months of deliberation
I've decided to let it rip!

Let's talk about the issue of "maintenance care" or plain old "maintenance."

What is this exactly?

The vast majority of chiropractors across the globe schedule their patients (adults &
kids) for their once-a-month "maintenance" adjustment (visit). And patients are sold on
the idea that this monthly maintenance visit will then help prevent and allay many problems
a patient would be saddled with if they did not buy into this preventative measure.
And patients look joyously to the end of their "corrective" care and the start of their
"maintenance care." They have graduated. They have paid their dues. Their subluxations
are corrected. They are no more!
Now life begins!

So patients are seen on a monthly basis because it's good for them - that is the mantra.
And most chiros are adamant about their patients following this protocol. It makes total
sense not only for the benefit of the patient, but also for the benefit of the doctor.

Right?
Of course!

I mean, there is a financial benefit for the doctor in that he/she can count on and be
certain of a steady income stream from "maintenance" patients. There are other benefits
to the doctor: we all like to see our patients return and happy to see us. It is like a party!
The ego boost is amazing! The office is busy, there is energy, excitement, the sun is shining,
the skies are blue, and everything is wonderful!
Fabulous!

What about the benefit to the patient?

Well........that is a little more difficult to quantify, isn't it? I mean, they are getting great care
from you, aren't they? And you are preventing all these future "nasties" from rearing up their
ugly heads, aren't you?
Well.......aren't you?

Hmmmmm......all of a sudden, your certainty has dropped a few notches, hasn't it?

Alright.......let me ask you this: Are you really delivering what you promised?
Are you really able to prevent/allay a patient's future health problems with your monthly
maintenance program?
Are you?
Not so certain anymore?
I totally understand.

I want you to absolutely know that I am not against maintenance care - although from the tone
of this THOT you probably felt that I was. Not so.

But.......here is the reality of maintenance from my perspective:

Most of us recommend to our patients that our monthly maintenance program is of great
benefit and that it will then prevent this and that from happening to them in the future (when
I graduated from college, I also did this).

Ok....this is very difficult for me, but I am very committed to the growth of our profession and
so I must confront you with this reality. In essence, when most chiropractors place a patient on
a monthly maintenance schedule, they are simply maintaining their problem - but their
symptoms are gone!
That is the reality.

Ok, Ok....I've just pushed a gazillion buttons. However, any way you slice and dice this, that
is the reality.

Here is my reasoning:

1.    First of all, research done by Tapio Vidman, a number of years ago, tells us that a
Subluxation, once formed, will cause an inescapable degenerative progression if it is
allowed to remain for any longer than 2 weeks. This means that a monthly maintenance
visit to your office will absolutely ensure your patient will get worse over time.
And they will. And they will confront you at some point in the future and ask you point
blank why you have allowed them to get worse when they have paid you all their money
over the last few years to prevent this problem and keep them healthy. And you begin
to blabber something about Limitation of Matter - just what your patient wants to hear.
I can smell a lawsuit already!

2.    Most doctors do not see their patients on an appropriate schedule of care in order to
be able to really correct their Subluxation pattern - and it is a pattern.
It is a neurological habit the body becomes accustomed to. And it most often starts in
children. (If you'd like more info on this, you are very welcome to write to me)
Most doctors see a patient on a schedule which they feel a patient will accept.
One that is "reasonable" - whatever that means. This translates into a patient being
placed on monthly maintenance once their symptoms are relieved -nothing more -
although they are told otherwise.
I can't tell you how many patients I've had in my office over my practice lifetime who
were on a monthly maintenance schedule with their former doctor, when their
examination revealed many problems they thought they no longer had. This is not good
for their health and your reputation.

So....I recommend you see your patients on "Wellness" care - every two weeks at the very
maximum, especially children. The correction of their Subluxation patterning is most
important. To me, there is no such thing as "maintenance."

And tell your patie4nts the truth. This is what you are doing, and here is why. They will
totally be with you. And money will not be an issue.

Now, get out there and be the doctor you were meant to be.

Warmest wishes,
Dr. Ogi Ressel