I'm no politician and for the most part I'm pretty unclear about the whole health care reform thing and who, what, where, when or why it will affect me or my practice, but this is what I do know.

I started practicing in October 1996. In the first 2 years, reimbursement for Chiropractic and Physiotherapy codes went up. Almost 13 years later I've taken huge pay and income cuts to the point that moving to Scottsdale was partially due just to increase business volume in a larger metropolitian city to try keep up.

Here is what I mean. In 1996 ultrasound $25, traction $15, heat $10, exercise and rehab $48-52, manipulation $40-50, muscle stim $25, soft tisue $25, X-rays $100, exam $90 Visits were based on medical necessity about 20-60 visits.

Now? In 2009 ultrasound $5-10, traction $0-5, heat $0, exercise and rehab $10-18,
manipulation $17-24, stim $10, soft tissue $14, x-ray $0, exam $30. Forget about orthotics, re-exams and medical supplies, it's dried up. Oh yeah, I almost forgot, higher deductables $250-$1000, co-pays $25-55, visit limits and excluding covering many of these therapies completely or only 2-3 per visit.

In the meantime my healthy family's premiums with a $1000 deductable for each of us is now over $800.

So, to summarize. Premiums way up, reimbursement way down. Show me the money. It made no difference under Clinton or Bush. The results were the same. I forsee the day of cash only, high volume, extreme competition. I see small offices or huge groups to lower overhead with either horrible 2 minute I don't care service or give it away all inclusive value service just to survive. But that is just my observation and experience.

Stay tuned for Health Care Reform Part Deux, "O Canada".