2008 Scholarship entrants must respond to the following:

Essay Assignment:  You are ready to open your own chiropractic office.  As a straight chiropractor, the 33 Principles of chiropractic will be the purpose behind your practice.  

PART I: List the “pros and cons” of utilizing the following three methods of payment as a means to practice based upon your purpose:  1) You will accept 3rd-party payment for the duration of your career.  2) You will accept 3rd-party payment until your student loans are paid, and then transition to a “cash practice”.  3) You will run a “cash practice” for the duration of your career.

PART II: Which payment method do you believe has the easiest 'cons' to overcome, and how would you do it? 

Congratulations to Jason W. Blackketter, DC2B ~  Palmer College of Chiropractic, 7th Trimester.

His essay follows:

I am almost ready to open my own chiropractic office. As a straight Chiropractor, the 33 Principles of chiropractic will be the guiding purpose behind my practice. Everything I think, say, and do for my patients will be founded on these 33 Principles. During the planning phase for opening my office, I have wrestled with the looming financial burden ahead of me. I often think about my student loans, future bills, providing for my family, and which means of payment will best match my purpose. Will I accept 3^rd party payments from insurance or cash only or both? Here are the “pros and cons” of utilizing the following three methods of payment:

1)      Accept 3rd-party “insurance and government” payment for the duration of my career.

PROS

-More affordable in the minds of patients

-Advertising and referral benefits available for becoming a provider in a network

-Most people are familiar with insurance co-payments and billing 3^rd parties

-D.C.s may be participants in a federally run health care system soon

-Medicare, and Medicaid where available, pays for adjustments of the spine

CONS

-3^rd parties are in business to make money, not pay claims to Chiropractors

-Partial reimbursement of my fees will reduce my net income

-My patients deserve the best care, not just billable services or ancillary procedures

-Insurance is allopathic, so they only pay to treat pain, symptoms, disease, and outcomes

-This limited view of health is inconsistent with chiropractic’s goal of subluxation removal so the nervous system and innate intelligence can function at peak potential

2)      Accept 3rd-party pay until my loans are paid. Then transition to a “cash practice.”

PROS

-This will give me a perceived safety net of income during the “starving years” because reduced income is better than no income

-I can accept all methods of payment yet educate my patients into cash along the way

-The good patients who get the Big Idea will stick with me for the long haul

CONS

-The incongruent nature of my philosophy and practice will be obvious to the public

-Convincing people to keep coming after their symptoms are gone may be challenging

-Reduced income from partial reimbursements and limited number of visits

-There may be many temptations to stray from the fundamentals, compromise my principles, stay with the 3^rd party system, and keep playing their game by their rules

3)      Run a “cash practice” for the duration of my career.

PROS

-Authentic ADIO chiropractic without worrying about Outside-In-Below-Up regulations

-No fear about whether or not I’ll get paid back for x-rays or instrumentation exams

-“Cash on the barrel” is easy to explain once people understand that their insurance company and the government are not really interested in their health

-Communication and patient education is simplified

-Freedom to set my fee schedule as I see fit, not based on what a 3^rd party will pay

CONS

-Fear of failure and self-doubt

-Many experts say cash only practices cannot succeed in this modern world

-Some patients will not pay for chiropractic because they are dependent on insurance

Now that I’ve listed three payment methods and the “pros and cons” for each, the final step is making a decision. I believe options 1) and 2) present many perks and remove some initial fears of failure, but they both leave me feeling dissatisfied. Neither of these plans will produce long-term relationships with my patients unless they become convinced to pay out of their own pockets for their healthcare. I also have a feeling that chiropractic will be eventually become relegated to mere musculoskeletal pain relief. This disturbing trend in the schools and the profession at large is enough reason to shun any association with 3^rd party payment systems altogether.

Starting out accepting cash from day one has the easiest “cons” to overcome. Option 3) appears overly optimistic to the majority of my peers at school, but I think cash only patients will make superior members of my practice. They will bring more referrals because they are committed and see long term benefits of a healthy adaptive nervous system. I will be on the same page as my patients from the outset. I won’t have the guilt of the “bait and switch tactics” required in option 2) and I will have successfully avoided the inconsistent philosophy present in option 1).

My plan for starting out and continuing with only cash payments is simple. My expenses will be managed conservatively and my overhead will remain low. I will work hard. Talk about the principle daily. Train my assistants and office staff. I will meet people everywhere and tell them about the benefits of the chiropractic lifestyle. I will be devoted to developing my skills in the science, art, and philosophy of specific chiropractic. I will focus all my time and energy with patients on detecting and removing vertebral subluxation. I will depend on x-rays and instrumentation first and foremost. My patients deserve truth and reality in their lives, not just an alternative to the societal norm. Authenticity and reliable results will be a hallmark of my practice. I will measure success by how long patients remain free of subluxation. This passion will drive me to excellence. They will learn to trust their innate intelligence. We will live, work, and play without fear. Honest compassion will be matched with objective analysis. It is as simple as that.