March 2006

see also: World Chiropractic Alliance Policy on Pre‑Payment of Chiropractic Services

WCA supports DCs' right to offer pre‑paid services

The World Chiropractic Alliance has issued a position paper supporting the right of doctors of chiropractic to offer a variety of payment alternatives for patients, including annual retention fees or pre‑payment programs. Pre‑pay arrangements have sometimes been categorized as "insurance" or criticized as unethical by chiropractic detractors such as Stephen Barrett, MD.

According to the WCA paper, the use of pre‑pay arrangements is commonly accepted in many other professions, including orthodontics, obstetrics, and law. The arrangement is particularly useful for people who intend to use the professional services on a regular basis over time, and can help by saving these individuals substantial amounts of money.

In recent years there has been an increase in the number of chiropractors who have been brought before their state licensing boards for offering such prepaid plans. According Matthew McCoy, DC, a member of the WCA Board of Directors, cases have been reported in the US, Britain, Canada and Australia. The complaints are frequently directed at doctors of chiropractic who focus on subluxation‑correction and wellness care rather than limited treatment of specific diseases or conditions.

According to the position paper, which was crafted and unanimously approved by the WCA Board of Directors, "Case fees, paying for professional services in advance, paying for care over fixed time periods, family case fees and discounts for fees paid in advance are mechanisms that doctors of chiropractic utilize in order to assist patients in managing their health care finances. Such efforts are an inherent part of the ethical responsibility of health care providers to lessen the financial barriers to needed care."

The position paper also specifies that doctors wishing to offer pre‑paid services carefully explain the program to their patients and consider establishing trust funds for payments in advance of the receipt of services.

In issuing the paper, the WCA urged chiropractic regulatory bodies to consider such practices to be in compliance with the laws, rules, and regulations of the jurisdictions where chiropractors practice.