I have been having bad back and neck pain recently. It has interfered with work and sleep, restricted my range of motion, and left me very uncomfortable. It feels like certain joints need to have pressure relieved (i.e., it feels like my back and neck need to ‘pop’.) Unfortunately I could not trigger this on my own.
One day last week it got very bad, and out of desperation I decided to call a chiropractor, something I had never done before. I first called my insurance company (I have the Aetna EPO plan) and asked if chiropractic care was covered. “Yes,” they responded, “with a $40 copay.” That struck me as rather steep, but hey, I was hurting. I asked how to go about seeing a chiropractor, and was told to choose a name from an online list of in-network providers, and was told that eligibility was based on “medical necessity.” I asked how necessity was determined, and was told that it was based on the report of the chiropractor.
I chose Jean M. Duffy from their list (I’ll also write “Jean Duffy” here in case someone is using a search engine looking for her) and made an appointment for later that day. I had, in short, probably the worst clinical visit in my entire life. The receptionist was unprofessional, the office was severely over-heated, Duffy insisted on teasing me about word choices even though I was in obvious pain. She struck me as unintelligent and unresponsive. She was fairly dismissive when I voiced concern about the use of high-velocity popping, which is widely regarded as unnecessary and quite dangerous. I got a challenge to “define that precisely” for her, then was told in a doctor-knows-best tone that she did “what she decided was necessary”. At the end of a long questioning process she performed some perfunctory stretching of my neck and back, proceeded to perform exactly two manual manipulations (one in my neck and one in my mid-back), and told me I was done. When I expressed surprise at this (not the least of which because I was still in pain) I was given a lecture about chiropractic not being a “pill” that “fixes something immediately”. Sorry, Jean, but the prospect of immediate relief is the only thing that took me to a chiropractor in the first place. If I wanted slow-but-sure recovery I’d do physical therapy, something with which I had great success a year ago after an injury. She then iced my back and neck for under five minutes, a quarter of the time that I was iced at physical therapy.
I was asked to make a follow-up appointment two days hence. I was hesitant to do so because I was unsure I would be coming back, so I asked if I could call tomorrow and make a follow-up appointment. “No,” Jean said, “It would be better for you to make an appointment and cancel it if you need to.” (“Sure,” I thought, “that way you could charge me for the missed visit if the notification period is less than 24 hours.”) I went up to the receptionist without Jean. She asked me to make an appointment and I repeated my desire to call tomorrow to re-schedule. The receptionist agreed and I left.
My neck was still in pain and still had limited range of motion. When I got out to my car I simply turned my neck to the right and it ‘popped’ again, and instantly felt better. A simple turn of the neck, not a forced turn, and yet Jean did not perform this. I suppose it’s possible that her work on my neck allowed the later pop, and that that pop could not have occurred otherwise, but I’m skeptical. I was annoyed leaving the office, and thought to myself that the only thing left would be to find out she was a crook as well, that she’d find a way to charge me more money than she had said.
The next day she called me and told me that she had contacted my insurance company and they refused to pay, saying I needed a referral for chiropractic care, the exact opposite of what I had been told on the phone.
“All I can say is I hope you got someone’s name,” she said. “We’ll just have to send you a bill.” I asked how much. “$50,” she said. “Just $10 more than your copay.”
I’ll just pay it. It’s not worth fighting for $10. And it may be true. But I won’t be surprised if I find that Aetna has also paid that $10 after all.
I had never gone to a chiropractor before for a couple of reasons. One, the theoretical basis of their medicine is absurd and discounted by the traditional medical community. Two, after my father injured his neck some ten years ago he considered going to a chiropractor but went to a specialist and got an x-ray instead. He was told by the specialist that with his condition, had he gone to a chiropractor he would have ended up a quadriplegic. So why did I go? Good question. All I can claim in my defense was extreme pain, and the anecdotal evidence of friends who have received immediate relief from chiropractic care. But one is again reminded, in this story, that even pain is no excuse to abandon reason and logic.
Devotees of chiropractic will rightly point out that this is one sample point, one practitioner, and should not be used to make a judgment on the whole discipline. But next time, if I ever go to a chiropractor again, I will do so strictly based on a referral from a friend. But will I go again at all? Probably not.
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