Dynamic Chiropractic Magazine – A new model of chiropractic care?
The Joint: Addressing the questions and controversy.
Among the hotly debated topics swirling through chiropractic thought circles lately: a national chiropractic franchise called The Joint.
The following interview with two representatives of The Joint was conducted by Dr. Brian Porteous, a longtime practice consultant for many doctors of chiropractic across the country. After hearing many rumors and receiving many inquires, Dr. Porteous decided to do his own investigation into what The Joint was all about. Here's what he discovered. The Joint has more than 400 locations currently open and in development in the U.S. in 27 states, and a plan to bring the concept to more than a thousand locations over the next decade. I sat down this summer with Shawn Allen, DC, who serves in an educational capacity as chiropractor and trainer at The Joint Corp., and Dr. Stephen Harkins, the designated PC for numerous California locations of The Joint. Both address the many inquiries and misconceptions I believe are industry-wide about The Joint and what the franchise is all about.
What was the inspiration for The Joint? The Joint was founded by a DC in Tucson, Ariz., in 1999, predicated on the vision of making routine chiropractic care accessible to everyone with as few barricades to care as possible, and without the need for insurance. The Joint continues to deliver on its mission today, restoring the doctor-patient relationship where it belongs - between doctor and patient without interference or restrictions typical of a third-party system.
What is the greatest misunderstanding about The Joint? There's this belief that we are a discount, full-service chiropractic clinic. The Joint has a very specific model of providing only chiropractic maintenance care. Our mission statement is "to improve quality of life through routine and affordable chiropractic care." We are filling a need for patients to receive ongoing, routine chiropractic care without the need for insurance.
Because we do not take appointments, our patients can stop in anytime and be seen by their doctor, and our membership model means there are never additional fees for additional services. We provide only routine chiropractic maintenance care. Once DCs learn about our focus - that we are a subluxation-based practice - they realize there's plenty of room for everyone at the table.
You say "subluxation-based" practice; can you tell me more about this focus of your model? A subluxation-based practice is a practice where the focus of care is the subluxation. We do not diagnose or treat any condition other than a subluxation. This is also the reason for our uncomplicated, lower-cost pricing model.
So, can you explain the pricing model for routine care at The Joint in some detail? Certainly. Our prices always cover the entire visit. There are never any extra charges for additional services, because we're providing routine chiropractic maintenance care. The base price for a visit is $29, but a patient's first visit is only $19. That initial visit includes the history, consultation, exam and adjustment, and generally takes longer than follow-up visits. The Joint offers a maintenance plan price for a membership fee of $49 per month, [which] includes up to four office visits. We also offer discounted family plans and visit packages to meet a variety of needs.
Again, the membership plan is intended to make routine care affordable and convenient, and members can also receive any additional visits during the month at a discounted visit rate of $19. We want our patients to benefit from routine care, and our pricing model was created to encourage patients to make that commitment to their health as easy as possible. You talk a lot about routine care, but what about patients with acute care problems? How does The Joint handle those patients ... or does it? Many patients present with acute problems, and those patients are referred to providers who are best equipped to treat those conditions. We also believe that patients with acute problems will benefit from maintenance chiropractic care concurrently and are able to provide that care at our clinics.
What about the idea that The Joint is attempting to eliminate the need for broad-scope chiropractors? That's not at all the case. We feel that there is a place and a need for a variety of different providers, including those who provide maintenance chiropractic care. Patients will always have a need for an insurance-based chiropractor or other medical provider, and when that happens we are pleased that those providers are available. Our focus is very intentional, as is our desire to be part of a holistic approach to a patient's care.
Doesn't a high-volume practice mean the quality of the visit suffers? We don't believe so, and with our large patient and membership base, we don't think it's a concern our patients have, either. We feel that a quality chiropractic adjustment can be provided in just a couple of minutes. While the initial visit is longer, subsequent visits that do not require an exam can be completed in about five minutes. D.D. Palmer is quoted as saying if an adjustment takes longer than a minute and a half, you are wasting your patient's time.
I've noticed The Joint's marketing is focused a great deal on the convenience of care at its locations. Can you explain why this is the case? Yes. We're simply committed to making chiropractic care accessible to everyone, and that means our hours and locations need to be as convenient as possible so receiving routine chiropractic fits into people's daily ... well, routines. Our locations are open weeknights and all offer weekend hours on Saturdays, with some even open Sundays. People need to see their doctor when they are in pain. Schedules are hectic, and people rarely make their health a priority, so we're placed where they live, eat and shop, and we take walk-ins, so no one needs an appointment. Our shortened visits also make it easy. At the end of the day, our focus is our patients, so we feel convenience is a vital component of our practice.
Is an exam performed on every patient? Oh yes, absolutely. Our chiropractors are held to the same standards as all licensed chiropractors in their respective states. We do not perform the medical exam that many insurance companies require, since we do not accept insurance. Instead, our chiropractors perform a "chiropractic-focused" exam. All our chiropractors are to use the PART exam to identify a subluxation.
It is rumored the Joint doesn't take X-rays. Is that true, and if so, what if the case requires imaging? This is probably the most misunderstood of all ideas surrounding what The Joint does and does not offer its patients. At The Joint, we ascribe to the industry-standard guidelines that X-rays or other special imaging may be necessary to diagnose specific conditions. When a patient has indications that deem X-rays or other imaging is necessary, our chiropractors will refer those patients to the appropriate facility for those procedures. Again, this is a great opportunity for The Joint to become a strong referral source for other DCs in their area and work together to provide the most comprehensive care for our patients.
Let's just speak frankly here: All this talk about how low The Joint's prices are leaves one to wonder, how can clinics afford to pay their chiropractors properly? The Joint clinics are independently owned and operated franchises, so compensation is at the discretion of each clinic owner. We find that our chiropractors typically receive a salary commensurate with an associate position, based on experience. Additionally, most clinics provide an added bonus structure based on clinic performance, which makes it possible for the chiropractor's salary to increase as the clinic grows.
Keep in mind: The Joint removes many of the tasks and responsibilities associated with insurance, paperwork and billing, making it possible for chiropractors to focus on patient care - what brought us all to this profession in the first place.
Who pays the malpractice insurance for The Joint's doctors? To ensure suitable insurance coverage is in place with the appropriate liability for the chiropractor, business owner and the local corporation, The Joint expects that the malpractice insurance is paid for by the business owner with a required insurance provider. We find the majority of locations follow this recommendation.
To learn more about The Joint and its model of chiropractic care, visit www.thejoint.com.