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A Disturbing Conversation with a Patient: Part 2

This article is a continuation of a previous article about why more doctors aren’t well versed in the diagnosis and treatment of adhesion and it’s massive role in musculoskeletal injuries. If you missed Part 1 Click here to catch up.


Now, onto  “A disturbing conversation with a patient: Part 2”

This patient continued to ask me:

“I’ve seen incredible results that have lasted a long time.  Why don’t more doctors like yourself do this? Why don’t more doctors diagnose and treat adhesion?”

Another fantastic question!

And again, I can’t speak for other doctors but I can give some insight into what I hear whenever I recommend a colleague look into and complete the training we have done and continue to do.

The most common response that I’ve received from colleagues is:

“That sounds like a lot of work.”


“Insurance doesn’t pay me for that treatment.”


“The training doesn’t count towards my CEU’s (continuing education units).”

You’ll notice that none of the excuses I just listed have anything to do with what’s best for the patient, which is extremely unfortunate.

“That sounds like a lot of work.”

Yes, the training and resulting implementation and daily practice of the things we do in our office IS a lot of work. The majority of what we do in our office has been learned in numerous postdoctoral training seminars, small group training, and self study. If your doctor doesn’t have the drive to always be learning, they would be less likely to come across this information let alone learn the importance of it and how it affects numerous musculoskeletal conditions/injuries. It’s disturbing to think about, but not all doctors have the same education level.

Over the last 11 years, I myself have spent well over $150k and 600+ hours of my personal time on continuing my education and hands-on training in the diagnosis and treatment of musculoskeletal injuries. This isn’t a brag, this is just me stating the facts about what it takes to be able to deliver high quality services. Some of my colleagues do far more training than I do, and I’ve seen how incredibly good at their profession they have gotten, making the solution to the most difficult cases seem easy. And I want nothing less than that for my patients.

“Insurance doesn’t pay me for that treatment.”

In regards to insurance, doctors in our community are right. Insurance companies do not reimburse for the specific treatment we use to fix people, they only reimburse for the traditional chiropractic “crack” adjustment. They do not reimburse (any longer) for the billing code that best describes our treatments. Actually, that is currently an incorrect statement. Your insurance company by THEIR definition does pay for the treatments we do. They just decided that it’s all now grouped together under the traditional adjustment code. When this happened a few years ago, the reimbursement rate for the adjustment code did not increase, they simply stopped paying for the extra code for the soft tissue work. Their way of decreasing reimbursement and putting more money in their pockets.

So as a doctor, I can see how one would look at the huge training and time commitment to learn these new methods as being a huge burden that just doesn’t appear worth it to them. Why wouldn’t a doctor just keep doing what they’re doing if there is zero incentive to switch, right? Especially if one relies on insurance companies to fill their practice instead of clinical excellence.

Another problem when dealing with insurance is that there is no way for the insurance company to differentiate between the treatment that we do in our office (high quality) from another doctor that simply rubs a few sore muscles (low quality) before they deliver an adjustment. Both treatments would require the same numeric code being billed to your insurance company which tells them what treatment the doctor performed in the office.

So, from the insurance companies standpoint there is no way for them to differentiate between high quality treatment and low quality treatment. Both treatments get billed using the same code. The problem is our treatments took a tremendous investment in training, post-doctorate education, and implementation, whereas the other very simple treatment takes zero brain work or doctoring to deliver. Our treatments deliver sustained, long term changes in the tissues of the body, reducing the rate of degeneration, and allows the body to heal, where the other low quality treatment only provides temporary (few minutes) relief of pain.

“The training doesn’t count towards my CEU’s (continuing education units).”

Lastly, the topic of continuing education units.  Yes we all as Chiropractors have to earn 12 credits per year that are “OK’d” by a local governing body.  And no, this particular advanced training does not count towards those required CEU’s for too many reasons to list here but mostly have to do with regulations and politics.  My thoughts on this are:

“But, it’s going to make you a better doctor and you will be able to help truly fix far more people.”

Which I typically receive a response like:

“Yea, maybe, but I’ll just stick to the traditional adjustments. It all works the same.”

But that is the is problem, it DOESN’T all work the same.  If it did, we wouldn’t be investing so much time, energy, and money learning this type of diagnosis and treatment!
Side note here…… I typically complete my required 12 hours of CEU’s per year in a 1 day seminar that costs me roughly $150 and 1 day away from the office. So, tell me again how this is even part of the conversation. Yeaaaa, let’s carry on…..
We don’t enjoy traveling several (10-12 times per year on average for me) times every year, trading our weekends with family and friends for hours of hands on training in a hotel conference room.  Actually, that’s a lie, most of us thoroughly enjoy our training time together and have grown tremendously not only as professionals but as humans as well.  But, I guarantee every person, if given the choice, would much rather be spending time with their significant other, playing with their kids, or be out skiing or hiking for the day, taking a break from their careers.

So to wrap this up.  Yes, this style of diagnosis and treating patients is a lot of work.  And no, insurance companies don’t respect it, know enough about it, or have a way to differentiate it from less quality treatment in order to justify paying for it.  And, no this training does not count towards CEU’s in New York. (new this year, CEU’s are offered in other states)

So why do we do it?

Because it allows us to sleep at night.  It’s what it takes for us to be able to take pride in what we do.  It’s what it takes to be able to provide the best care possible.  Our care is always focused on the best interest of your future health.  Because if your diagnosis is wrong, nothing good can follow.  It’s not fair to you to receive anything less than a solution to your injury.  You deserve expert diagnosis and treatment so that you can stay active, avoid surgery, and not just survive, but thrive into your 80’s and 90’s.


Our system of evaluation and non-surgical treatment is massively different and will help you solve your problem in a matter of weeks.  Stop ignoring your body and give us a call today, 716-677-5525. 


Dr. Brian A. Zelasko
Non-Surgical Neck and Back Specialist
Board Certified Doctor of Chiropractic

Zelasko Soft Tissue & Spine
3075 Southwestern Blvd., STE 200
Orchard Park, NY 14127

Certified in Advanced Chiropractic Care

5 things ART got wrong
Brian A Zelasko, DC
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