|Posted by firstname.lastname@example.org on March 26, 2020 at 7:55 AM|
Early on in my clinical career, I remember seeing some repeat patients. I wondered why, especially given that it was not injury related, or at least I did not consider the reoccurring conditions as injuries, but more so something that should have been managed. I know, I know, I was young and naïve. I am referring to reoccurring non specific low back pain in middle aged individuals. I asked one of our patients, “so what happened, why have you returned for the same conditioned we treated you for just less than a year ago?” He sort of just shrugged his shoulders to which I responded, “you know, we are just going to do the same things we did before and if you don’t want to come back for this again, I suggest you continue doing this when you leave.” A that moment, I developed the “once a low back pain patient, always a low back pain patient.” Meaning that, you will probably always have to do something to manage this. That concept sort of narrowed to NSLBP, or and later to really any chronic condition or unmanaged condition/injury (more on this later, see What Happens When we Ignore: Most Acute LBP will reside on its own, so why should we treat?) This was over 25 years ago, but I don’t think I lay claim to this concept but I should investigate This was also at a time with little (like $5.00) or no copay, low premiums (if) and reimbursement was open and essentially not contested or capped (remember those days???). A runner with bilateral knee pathology was worth about $300/visit????
I like posing this questions to future practitioners: What would happen if we eliminated all reoccurring conditions and chronic problems? Well first off, we would save global healthcare an obscene amount of money given that chronic conditions consume some of the highest % of healthcare/GDP in both developed and undeveloped countries. We would be without patients? I don’t think this would happen completely, but there might be a shift, in some of the industry in what is keeping people healthier as well as the conditions in which we treat. I was once told be a salesperson I should buy their product because its great for acute injuries or at least the acute phase……………..I said, “that is not where we struggle as practitioners or in healthcare.”