The maintenance myth and a bad business model
True story:
A client tells me she has been seeing a chiropractor, every 4 weeks, for the last 10 years.
Me: Does it work? Is it helping?
Client: …I don’t know.
Me: Have you thought of easing off, or taking a break from it?
Client: I asked the receptionist if I could leave it 6 weeks [financial reasons], she said it would be a bad idea, that I might find I end up needing another one 2 weeks after that. So I asked for 5 weeks, she gave me a date 4 weeks later.
“If a therapy takes years with no improvement – it does not work”
We call this creating dependency, and it’s easy money, but more importantly this is harmful to the client. She believed her spine was unstable and needed resetting every 4 weeks otherwise she would be at risk of pain and injury. She had given up weightlifting, which she loved. These beliefs stopped from exercising, the very thing that would most probably helped her with pain, but also would have been so good for her general health. Strange as it may sound, these kinds of negative or fear beliefs are associated with a higher risk of experiencing pain. Bad information is that serious. This is not unique to chiropractors, I know really great chiropractors who do not work this way, but many therapists do follow this business model. It is a business model.
The word maintenance is not appropriate for people. It is appropriate for cars – if you do not pay a professional to service your car, it will eventually fail. Human bodies are not the same. You can move, eat well, sleep well and generally look after yourself. You do not need a professional to maintain you.
Maintenance is not getting better.
People see me for on-going, sometimes regular massage, this is fine. It is always under the explicit understanding that the client likes it, values it, feels benefit from it, and absolutely does not need it. This is the same reason I have a massage every month and have done for years. I love it, feels great.
Exceptions. There are some conditions that cause the person to experience pain and for which there is no cure. For example, fibromyalgia where the person experiences pain in seemingly random body parts. For people with such conditions, massage can be of great value in providing some pain relief and is worth exploring.
When an injury requires rehabilitation, there’s an end point, it’s done, go enjoy and call me if there’s a problem. When I see clients with chronic pain we work together to come up with the best strategies for that individual based on what matters to them. It just doesn’t take that long to see improvement. Perhaps not as good a business model as, ‘see me every two weeks for years’.
A therapy that takes years with no improvement, does not work.
Tris