Open Area Adjustment
What is it and why do we do it?
Short answer: You get adjusted in an open area, its come to be awesome!!! and…. insurance.
When I first started my clinic I had no idea how difficult insurance was and how difficult some patients can be. I would practice my heart out and it was quite a journey learning about all the insurance problems. For one, they don’t pay up to 90 days and anyone who pays a bill 90 days later isn’t happy to pay. Also, insurance makes the doctors sign a contract stating they will only pay them half their fees–yet we have to fill out 5 additional forms.
When digital scheduling and billing came to be popular in 2000 we got paid as early as 30 days later so most clinics would bill every 30 days just so patients wouldn’t yell at them anymore. 99% of patients had no idea I had to pay rent for rooms, 4 employees, a computer program . I then had to wait until payment with a 60% denial rate.
Billing insurance is complicated. After 2010, insurance got even worse with pre-authorizations. You couldn’t see us anymore without an MD referral or the insurance approving our visits, which rarely happens. To counter the 60% hit and added expenses the insurance companies make with their insistent procedures, I asked patients if they wanted to pay more for rooms or have one large check up room which allowed us to use 4 times less machinery, have more space for traffic, and lowered the rent in the equation. What do you think the patients choose?
90% of patients just wanted to pay less and appreciated efficiency.
Now we actually had unexpected benefits and surprises from open adjusting. We had people laying on tables doing their exercises and reading education posters on posture and talking together having a great time. We had families that would fit better in the room being treated together. We had acupuncture and Naturopathic b shots while they were waiting. We had patients who were inappropriate or hitting on my staff behave now that others could see what they were doing. We had people less frustrated if there was a wait because they could see that the doc was working hard and so they didn’t take it personally and knew it was a medical emergency. Some patients who were new and really nervous about their adjustments watched people feel better and walk out, so it eliminated their stress.
We had kids play together instead of stressing the parents out when coming to their appointment. Patients were able to see the treatment they were receiving as well from an outside perspective, which helped them understand how and why we are doing what we are doing together to make them better.
Another great benefit is that as a doctor, if 75% of my patients slouch and I can tell many people at once the details behind staying up straight and having better posture–I’m not repeating myself all day so i’m more fresh and can see more patients which again keeps our prices down. Open adjusting has really been a beautiful thing but I haven’t told you the biggest benefit yet.
12 years in practice and I started noticing that emotional stress is a big part of peoples posture and joint problems. Just think of a teenager starting to accept adult responsibility and trying to be their own person while everyone is telling them what to do. They have a lot of challenge and we all know teenagers slouch. In open adjusting, there are a few people who refuse to be among others. They insist on privacy and telling their stories about why they are the way they are. These people are insisting on healing alone and want to be in a room so others don’t know whats going on. This stops the healing process emotionally and prevents comradery. We all are together in this, some people are overly independent and suffer feeling alone all alone to look good in front of others and I see a lot of stress and tension created by this in the body. So open adjusting has allowed others to heal together and learn from one another. It’s really a beautiful thing.
As a doctor, I’ve been able to create 15 min appointments with less than a 5 min wait, 45 adjustments, rehabilitation, k tape, and traction. This therapy somewhere else would take an hour and a clinic would charge you around $350. In my office we can charge a lot less because I can see 4 patients at the same time, going back and forth setting traction, and setting cold laser frequencies.
Now of course privacy is important and we provide rooms for patients who need to show us bruising in private areas (like their sacrum and so fourth). We also do room visits for re-exams so we can do a thorough exam and ask personal questions, but check ups in open area allow for us to get more done which has boosted our completed successful treatment plan rates to 95%. See, if a treatment plan is inefficient such as having long waiting times, extra cost for rehab and education materials, and long treatment times–this makes the probability of patients sticking to their plan very low. You see and hear people saying all the time “chiropractic doesn’t work, its just a waste of money”. These are that patients who didn’t show up to their appointments, do the exercises, or stick to their treatment plan.
Open adjusting is a beautiful thing, why wouldn’t we do this?
-Dr. Cara Olsen