6 Things You Should Look For In A Chiropractic Clinic: Chiropractic Clinic Best Practices

By Dr Ken Nakamura+

Have you ever heard that once you see a chiropractor you need to see them forever?

Have you been to a chiropractic clinic where they would not treat you on the first visit?

 

Have you been told, at a certain chiropractic clinic, you need to sign-up for 60 or 80 visits to get better?

 

Have you had the three-minute chiropractic visit?

 

Yes, all of these things and more happen everyday in your town and certainly here in downtown Toronto.

 

As a chiropractor for over 18 years, I love the profession because I love what I do.

 

At the same time, there is more than one chiropractic clinic that still has very unethical practices from my point of view. 

 

In this article, I will address these issues and reveal to you the best practices, and the direct questions to ask when going to a chiropractic clinic anywhere. Remember, with any profession there is the good, the bad, and some that I admit are down right UGLY.

#1: Why Can’t I Be Treated On My First Visit at This Chiropractic Clinic? I’m In Pain!

 

Question to ask:  Will you treat my on my first visit to this chiropractic clinic?

 

When I was an intern in Chiropractic College, we treated on the second visit so we could look up what had to treat as we were still learning.

 

After graduating, I did what was natural and treated the person in pain right away, to get them better as soon as possible.

 

I then went to a “Practice Building Seminar.” They told me I was doing it all wrong. I was told, “You never treat the person on the first visit.” This was a SHAM! It’s simply a practice-building tool in order to have more time to treat more patients.

 

See Also:  Guide For Finding The Best Chiropractor In Your City

 

There are circumstances when you should not treat a person right away with chiropractic adjustments. This would be when the history includes such things as a recent accident, trauma, cardiovascular issues etc…

 

Even when there is trauma, a chiropractor can still treat without using chiropractic adjustments. The goal would be to decrease inflammation or to decrease pain in order to make the person feel more comfortable.

 

Bottom line: Rarely is it unsafe to treat on the first visit. Look for a different chiropractic clinic if they cannot justify it.

#2: Killer Subluxations? What is that?

 

Question to ask: Do you explain what a subluxation is?

Downtown Toronto Chiropractic Clinic

Chiropractic Subluxaton:  Two vertebrae  where one is slightly out of place causing a pinching of the nerve.

 

 

You sit down for your second session at chiropractor called a “Report of Finding” and a chiropractor explains to you that if you don’t get your subluxation fixed you will be in a wheel chair or that you will be in terrible health if you don’t get it fixed.

 

At this point, you should run out the door or leave as soon as possible. There is no such thing as the killer subluxation.

 

What is a subluxation?  A subluxation of the spine is a vertebra that is out of place.

 

A medical subluxation is a “significant structural displacement, and therefore visible on X-rays”, whereas chiropractic subluxations are more subtle and usually only palpable with the skilled hands of a chiropractor.

 

The World Health Organization defines chiropractic subluxations as separate and different from medical subluxations.

 

Simply put, if a chiropractor tells you will have dire health because of subluxations you should leave. If they are telling you that subluxations pinch the nerves that go to various organs and can affect the way they function, that is being honest and true.

 

The difference is fear mongering versus simply giving the facts.

#3: Will I Need To Go See A Chiropractor Forever?

 

Question to ask:  Do I have a choice if I want maintenance treatments? Can I stop treatments whenever I want?

 

Three phases of treatment are involved with most treatment plans.

 

  • Acute Phase or Initial Intensive Care: The idea is to eliminate pain and swelling.
  • Sub-acute Phase also called Rehabilitative Care: Here you are strengthening muscles and improving spinal function. This is great except that many chiropractors are just giving chiropractic adjustments and giving very few exercises or none at all. Giving you the “Big Three” rehab exercises is not a rehabilitation program.
  • Maintenance/Wellness Care:  This phase should be Your Choice. If not needed, move on.

 

Bottom line:  You don’t need to be treated on a maintenance or wellness plan forever. It should be your choice. If not, move on.

#4:  Why Is The Treatment Only Three-Minutes.

 

Question to ask:  How much time will the chiropractor spend with me? Does this include the use of modalities (machines, to help with pain, healing, or inflammation?

 

Three-minutes are not enough! Whether you are seeing a medical doctor or getting a chiropractic adjustment, you have yourself a bad relationship if each encounter is only three-minutes long.

 

Why? It takes more than three-minutes to connect with a person to find out how things are.

 

“But I’ve been told it needs to be quick.” Don’t be fooled!

 

Many chiropractors will put a machine on you to help with pain or inflammation and leave the room to tend to other patients. This is great as long as there is more than this involved in that treatment session.

 

Bottom Line: Many chiropractors spend about 10 minutes. Just avoid the quickies.

#5: How Much Will It Cost At My Local Chiropractic Clinic?

 

Question to ask:  What is the cost of the initial visit and of subsequent visits?

 

Chiropractic is not like buying a car or house where there can be many accessories. You really only have the initial visit and subsequent visits.

 

Some clinics do charge packages where you get a discount for buying a block of treatments.

 

Alarm bells should be ringing in your head though, if they are trying to sell you 60-80 or more visits per year.

 

In my 18 years of practice, I have never needed 80 visits to help someone in a one-year period, no matter how bad their condition. NEVER!

 

I personally would not buy a package of more than 10-12. Then again, I am a chiropractor.

 

Chiropractic clinics also offer separate services. For example, they may charge $40 for an adjustment and $50 for acupuncture, but combined they are $80 giving you a $10 discount.

 

Just get this clarified before proceeding with any treatment.

 

Bottom line, if they can’t answer the question “how much” over the phone/email then you should just find another chiropractor.

#6: Will I Need X-rays? Will This Chiropractic Clinic Make Me Get X-Rays?

 

Question to ask: Will I need an X-ray? If you don’t fit the criteria below ask the chiropractor to justify why they are taking an X-ray.

 

 

Chiropractic Clinic Neck X-rays Downtown Toronto

Chiropractic Clinic Neck X-rays Downtown Toronto

 

Not everyone requires an X-ray, but some doctors of chiropractic take them as standard procedure, either as a defensive practice to rule out pathology and/or to aid in determining where to adjust the spine.

 

Unfortunately, in this litigious society I cannot blame any chiropractor for taking an X-ray of each patient. While I personally don’t X-ray every patient, it can be helpful in many cases

 

As a general guideline, X-rays are necessary in the following cases:

 

  • If the patient has sustained a significant traumatic injury at any age
  • If the patient has experienced any type of trauma (even a minor one) if over age 50
  • For most patients over 70 years of age, especially if the patient’s history and examination suggests a possible bone disease (such as arthritis)
  • If the patient has had long-standing pain that has not responded or been resolved with previous chiropractic health care.

 

 

SEE ALSO:  MRI, CT Scans X-rays:  Which One For My Pain?

 

 

Tell us in the comments if this article was helpful to you.  Remember to share this article with your friends.

 

Here is the list of questions to ask over the phone or by email. If they won’t answer, go on to the next chiropractor.

 

  1. Can I be treated on the first visit?
  2. Can you explain what a subluxation is?
  3. Do I have a choice if I want maintenance treatments? Can I stop treatments whenever I want to stop?
  4. How much time will the chiropractor spend with me? Does this include the use of modalities (machines, to help with pain, healing, or inflammation?)
  5. How much is the initial visit and what are the costs for subsequent visits?
  6. Will I need X-rays? If you don’t fit the criteria, ask the chiropractor to justify why they are taking X-rays.
  7. Bonus Question:  Will I get a few exercises or an exercise program tailored to my condition? If they have to ask the chiropractor, chances are they will not give you the exercises needed to be as independent as possible.

 

Doing all these things won’t guarantee you will find the best chiropractor or best chiropractic clinic but it will filter out the mediocre and business first clinics

 

Tell us what you think in the comments below and like us on Facebook. This Toronto Downtown Chiropractor will answer all questions in the comments section.


Author

Dr Ken Nakamura


20 Responses to 6 Things You Should Look For In A Chiropractic Clinic: Chiropractic Clinic Best Practices
  • Mohi says:
    April 25, 2017 at 12:08 am

    Hi..
    I am seeing a chiro in GTA. Dont see many patients there but what amuses me is that she charges me 40CAD for just few seconds of ‘adjustment’. Dont see much gain after 1 initial and 2 adjustment visits. She keeps claiming that 4-5 visits will get pain out.
    Sometimes I feel I am being ripped off. The adjustment is just lying on a bench and 4 bends and twists of my back and neck and thats it..

    • Dr Ken Nakamura says:
      April 25, 2017 at 11:20 am

      Thanks for your comment Mohi. If the chiropractor spends a few minutes with you, it seems that you have two concerns. The value the chiropractor is providing you in terms of time, and the quality of the treatment as you are not getting any better. I believe a guideline for chiropractors is supposed to be a 10-minute visit, which I read a while ago but I cannot find the source. It is difficult to give a quality treatment if the session is so brief. The two problems of value and quality are linked from my point of view.

      You may also have a problem with what I do. I charge $65 Canadian for one session but I spend twenty minutes with the person. You may think that is not much value as I am charging a lot more. For a downtown Toronto chiropractor, this is average. Some charge a little less and some charge a lot more. As for time, spending 20 minutes allows me plenty of time to say hi and do the mini-examinations that I always perform on everybody on every single visit. Sometimes it’s just a quick check of your range of motion of your lower back, sometimes more extensive depending on the status of the patient and their needs. Then I continually re-check these tests so I know if the treatment is working and by using what works customise a treatment plan for that particular individual.

      Usually, it takes time to get someone better. I cannot say if you should have gotten better already as I don’t know your case and I haven’t examined you. Each case is different. You have to make a decision based on what is comfortable for you. It sounds like you are not getting what you want out of it. Neither value or improvement but I don’t think you have given it enough time.

      Hope that helps you make your own decision.

  • Annette Bussiere says:
    April 22, 2017 at 5:43 am

    Hi ,I recently met a chiropractor at a home show i went and seen her twice,the second time she gave her assesments then her secretary came in with the price information after i signed it i knew i made a mistake and i told the chiropractor i couldnt follow through as i couldnt afford it i have rent and car payments she wants me to do 33 sessions which would be fine if i had the money but i dont unfortunately my insurance doesnt cover a whole lot Blue cross and i dont want to be treated about what my insurance will pay…Its my foot nerve pain on the top of the foot and she explained all of it ,but i told her i couldnt afford it.. i called and cancelled all appointments and told her again i couldnt afford to go at her prices as it would make mye finicially burdened she still calls me every day wanting to know when i m going to start sessions up and ignores that fact i say i cannot pay that amount for her services.. I am beside myself legally what I can do too make her listen or am i obligated since i sgned her program payment before i thought about it it says on the legal form if i change my mind they will return all monies….I feel very pressure from her and her secretary even though i repeated i couldnt afford to come back as i dont have the money even the secretary made more appointments than i was comfortable with and like i told them i couldnt start up this week as payment is due for my rent and car ..What is my legal obligation as All i want to do is run ….

    • Dr Ken Nakamura says:
      April 22, 2017 at 10:13 pm

      Thanks for your comments Annette. I believe this problem is unique to Canada and the US. It depends on the state (USA) or province (Canada). I don’t believe you are obligated to pay if you did not have any of her services. In fact, I believe you say you can get all your money back if you change your mind. Well, you changed your mind, and since you haven’t paid you have no obligation. You will have to check the laws in your jurisdiction but, I believe you are free and clear. I would personally write a note or letter saying you changed your mind so you are no longer obligated to make a payment as it says on the form.

      I am not a lawyer and every jurisdiction is different so you will have to check. Keep in mind this is an opinion and not a recommendation.

      As an example of a typical treatment plan, I personally have treatment plans that range from 2-8 visits. Some people need more especially chronic cases.

      Hope that helps you find a chiropractor that practices according to the standards or a clinic that makes use of best practices.

  • Dianne Adie says:
    September 27, 2016 at 9:18 pm

    Thank you so much for this info. My husband and I were told we need, 90 visits over a year, and that, without treatment, in five years, he would not be able to help my husband at all. He did not have any symptoms, but decided to have a consult, since he was asked to come with me to my “doctors report”” as spousal support. He was told his X-ray showed his vertebrae was “almost fused together”. He could not understand why he wasn’t having symptoms, so probably something else is happening inside of his body. I was told my neck was in bad shape. We were also given a presentation about the “silent killer subluxations”. Some of our acquaintances rave about him, so we decided to give it a chance.. The treatments are no more than 3 minutes long and he does not encourage conversation. The treatment is done and out the door. We also have to take a number as he goes back and forth between 2 tables in a semi private area adjacent to the waiting room. The adjustments are the same for everyone, as his focus is on “correcting” the spine, back to where ” God wants it to be.” All of this has not felt right though, from the beginning, as he wanted money up front, however he does refund if treatment is terminated. This we found out from talking to one of his former patients.
    I am used to having 2 adjustments per month, and have been going to chiropractors all my life, but after one month at 3 visits per week, most of the time, I feel worse. When I try to tell him this, his response is “It’s just going to take time”. He says I am in stage 2 going into stage 3 and my husband is in stage 3. He rarely sees stage 4 because most of them are dead.
    After much discussion, getting over scare tactics, our plan was to end this “program” today. When I saw your article, I cannot tell you how grateful I was, because it just confirmed our decision.
    Thank you so much for putting these red flags out there, to help others.

    • Dr Ken Nakamura says:
      October 6, 2016 at 11:37 pm

      Thanks for your comments Diane. Unfortunately, you went to a terrible chiropractor that is really focussed on money. You need to find a much better chiropractor.

    • Annette Bussiere says:
      April 22, 2017 at 5:53 am

      Oh and yes my chiropractor wants money up front also or payments 1860.00 to be exact i certainly dont have that kind of money..

      • Dr Ken Nakamura says:
        April 22, 2017 at 10:14 pm

        I don’t think she is your chiropractor anymore.

  • Carlos says:
    May 11, 2016 at 4:33 am

    My insurance covers my chiropractic visit but my chiropractor charges me $20 every visit for “exercises” that he says they do not cover. These lying on my stomach and doing one set of alternating leg lifts and then one set of squeezing my shoulder blades together, for a total of about 40 seconds. I can get a gym membership for that money, so I’m feeling a bit dubious about the value of his exercises. Should I not feel that way?

  • SK says:
    April 4, 2016 at 7:50 am

    thanks for your information, that was really helpful for me, cause I have a problem in my neck but I’m still a little hesitate about the clinics and which one I have to choose.

    • Dr Ken Nakamura says:
      April 7, 2016 at 9:49 pm

      Thanks for your question SK. Why don’t you look at the reviews of someone with a good reputation.

      Hope that helps your neck.

  • Candy says:
    February 29, 2016 at 12:28 pm

    I recently came across a chiro who did my xray at his own clinic, something along the lines of he preferred having the xrays done when patient is standing upright. (I’m assuming they do xrays laying down at the radiologist) However that meant I was out of pocket quiet a fair bit. Why do some Chiros do xrays at their own clinic?

    • Dr Ken Nakamura says:
      March 1, 2016 at 11:40 pm

      Thanks for your question Candy. Doing X-rays standing up tells takes into account how you stand and your posture with your pain. If you are lying down you can’t tell you have a scoliosis (curvature of the spine) for example if it mild. Some chiropractors do X-rays at their own clinic as they feel it helps control the set-up of the x-rays. Others will simply X-ray everyone as a business tool. My opinion is that is not right but that’s just my opinion.

      I personally don’t send many people for X-rays for various reasons but that’s just me.

      Hope that helps you pick the right chiropractor.

  • Jeffery says:
    February 20, 2016 at 9:46 am

    Let me know where u do chiropractic work. I’d like to get it done ASAP! And no worrie about ripoff’s.

    • Dr Ken Nakamura says:
      February 20, 2016 at 11:53 am

      Thanks for your question Jeff. I am in Toronto at 110 Yonge Street, Toronto, Ontario, Canada M5C 1T4, Tel: 416-777-9999

      Hope that helps.

  • Vijay says:
    January 23, 2016 at 10:33 pm

    This article is very important and extremely helpful. Thank you so much for considering the patients point of view on lack knowledge and fears of being misled.

    • Dr Ken Nakamura says:
      January 25, 2016 at 7:32 am

      You are welcome Vijay. Hope you find a great clinic and great chiropractor.

  • Dr Ken Nakamura says:
    September 26, 2013 at 9:51 am

    I am very happy you found the information helpful. I have written a different article for when you actually meet the chiropractor. Use the information in the following link to see if they fit the criteria I have outlined. Ask for a free consultation (5-10 minutes). If they fit the criteria great, if they don’t think about moving on. The chiropractor doesn’t have to be perfect but you should use both articles as a guideline.

  • William Robin says:
    September 25, 2013 at 5:37 am

    The things which is told by the author for going to chiropractic clinic is great. This information is very helpful for the people while go to clinic…
    thanks for sharing with us

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