One of the smartest things you can do in practice is institute patient guidelines. This establishes parameters for patients to adhere to before they've even gotten their first adjustment. More importantly, this provides something to fall back on if the patient begins to miss appointments or prematurely drops care.

When patients have guidelines they become more committed. It's like the difference between talking about a goal and writing it down. Better patients mean our practice life becomes easier.

People bring their families for corrective and maintenance care and retention is higher. Guidelines should be based on your particular practice system and should be given to the patient at the Report of Findings, both verbally and in writing. Review the patient's x-rays and corrective care outline and get the patient's commitment to start care before you give him or her the guidelines.

Here are the patient guidelines I've used for years for maximum patient commitment and retention.

1. Start with the end in mind

Finish what you start! Understand the benefits of finishing the program and the consequences of stopping prematurely. Know your time commitment and investment before you begin. Don't start unless you are going to finish. Stopping corrective care before you finish is a loss of both time and money, i.e. an expense NOT an investment.

2. Maintain your spine

Once maximum correction of your spine is achieved it needs to be maintained throughout your lifetime. Protect your investment. If you are not going to maintain your spine, don't fix it! You wouldn't neglect maintaining your car, teeth, or anything else you invest in fixing. Don't neglect your spine either. Spinal maintenance requires periodic adjustments for stability and alignment.

3. Consistency for best results

Stay consistent with your adjustments. If the doctor recommends 3-4 adjustments per week, please follow this recommendation. Nerve and muscle memory needs to be retrained through repetitive inputs in order for there to be enough change to correct your spine. This takes consistent repetition similar to learning piano, gymnastics, etc.

4. Missed appointment guidelines:

a) If you miss an adjustment, make it up within one week if possible. You need around 18-24 adjustments in six weeks in order to change nerve and muscle memory resulting in spinal changes. Missing adjustments will slow your progress. If you miss too many adjustments and do not make them up, we will have to stop your care to protect your investment until you can do the program correctly.

b) You MUST call to reschedule an appointment. Being consistently late or missing appointments without calling is unacceptable. A simple call to change or miss an appointment would reflect the same courtesy and respect to us that we deliver to you. This will help us help you and others with the most efficiency.

5. Chiropractic orientation class appointment

Patient education is the key to your success. You are required to attend an orientation class within your first week of care, to understand the philosophy and uniqueness of the Nikitow System of Spinal Correction and better understand your care program.

6. Family policy

We make it a policy to check your family within the first week of your care, and we allow you to do this at no charge. Since spinal alignment is for WELLNESS, we feel it is necessary to check family members for spinal misalignment (subluxations) regardless if you/they decide to treat or not. Imagine if your child or spouse went to the doctor for a supposed medical problem, yet it was coming from their spine. Wouldn't you like to know before it was treated with unnecessary drugs or surgery?

7. Communicate

Communicate if you have any questions or problems. All problems or concerns can be worked out. We are here to help you, but you must communicate.

8. Payment policies

We've worked very hard to create payment plans that are extremely affordable for you and your family. If you are committed to getting chiropractic care and are financially challenged, we will help you even if we have to tailor a special payment plan to fit your budget. This way there is no excuse not to get the care you need to be healthy. Do not be embarrassed, just be honest. We will help you.

9. Helping others

Help others by educating them about how spinal alignment (subluxations) affect wellness and the importance of maintaining their spines. Take them literature, invite them to an orientation class and encourage them to get examined for spinal misalignment (subluxations). It could change their lives!

Have the patient sign the guidelines sheet for acknowledgement. Using this system will increase higher retention, increase compliance, and mean less stress for you.