Dear Bill | Patch or Fix?
Posted by Bill Esteb on Mar 3rd 2020
Dear Bill
I have always used your model of "patch" verses "fix" in my reports to allow the patient to make choices regarding their health. This has worked well. But I still get the patient who I thought "got it" but then drops out after 12 to 15 visits.
Perhaps the most obvious possibility is that with their pain gone, maybe they think they
are fixed!
The patch or fix model is a handy way to explain symptomatic care versus rehabilitative care. It's used extensively throughout the profession.
However, many chiropractors misuse it.
When patients, especially if it is there first time in a chiropractic setting, are given the choice "Do you want to just patch this or really fix it?" they know that the "correct" answer is to fix their problem. So that's what they say. It doesn't mean they intend to fix it, but it's how you score an A on the test and get an "Atta boy!" from the teacher.
This little white lie is especially helpful if it is asked early on before they have received the relief that prompted them to seek care in the first place.
In this way patients are much like politicians—you can't trust what they say; only what they do. This is especially true when discussing anything beyond relief care with a chiropractic virgin. It's a question far more meaningful to ask someone who is on his or her third or fourth episode of chiropractic care.
It's probably best to explain the two strategies without pressing for a choice—especially since you can't really trust their answer anyway.
Most patients (and many chiropractors) believe that a patient's spinal problem is permanently correctable. (Read
Are You Actually Fixing Patients?)
Still others are quite satisfied by the promise of relief. They have little interest in curve restoration, postural improvements or other spinal enhancements "under the hood" represented by the "fix" strategy.
You might want to consider why it's so important for you to know what their plan is. Is it a loyalty test? Is it a gauge (albeit a poor one) of how well you've made your case? Since their answer is unlikely to change your clinical routine, maybe don't ask so they aren't later caught in a lie?
Thanks for the question!