March 2004

Up‑front fees: Another way to 'get' subluxation‑centered chiropractors

by Dr. Matthew McCoy

I am presently acting as an expert on three cases involving Boards going after chiropractors in part because they collected fees up front from the patient for a course of care or a pre‑determined time frame.

The situation is not unique to the United Sates and it is happening in the UK, Australia and Canada as well. Discussing the absurdity of Boards going after chiropractors for this is a waste of time ‑‑ it's crazy. Rational people know it's crazy. Dentists have been doing prepaid plans for years.

The fact of the matter is that certain individuals and groups in the profession don't like it and use it as a way to "get" subluxation‑centered chiropractors.

They see it as a way for the chiropractor to bilk money out of unsuspecting patients for corrective or wellness care, which they don't believe in. You see, they think chiropractic is for neck and back pain; patients don't need more than 10 or 12 visits, so selling them a year of care is ludicrous to them.

The scary thing is that this attitude has support from "prominent" figures in the profession.

In a publication edited by the "Secretary General" of the World Federation of Chiropractic, David Chapman‑Smith, it was stated:

"There is a public and medical perception that chiropractic treatment is endless...[T]he perception is fueled by and is consistent with some practices and practice management schemes that boast lifetime care, promote unreasonable frequency of care, and press patients for large advance payments for future treatments. As has been the case in Australia recently, licensing boards need to deal aggressively with unprofessional behavior in these areas." (The Chiropractic Report. March 2003. Vol. 17, No. 2. Pages 7‑8.)

The seriousness of this statement and admonition cannot be overstressed. Should you be the next victim of a Board who heeds this recommendation, you might be asked if you are a member of an association that is affiliated with or supports the WFC. If so, you will have some explaining to do.

Take some action on this today: Find out if the state or national association that you pay dues to supports such statements and check with your state board before instituting prepay arrangements.

(Dr. Matt McCoy is one of the founding members of the Council on Chiropractic Practice (CCP), and has been instrumental in the development of the most widely accepted set of chiropractic guidelines. He's also editor of the Journal of Vertebral Subluxation Research and has extensive practice, research and educational experience. As chairman of the Council on Chiropractic Advocacy, he helps doctors of chiropractic facing board complaints, lawsuits, or other challenges. For more information, visit the Advocacy at www.worldchiropracticalliance.org and click on Councils or e‑mail Dr. McCoy at advocate@worldchiropracticalliance.org.)