Q:

Dr. Margolies,
Thanks for your emails, they have been right on.
I have been reviewing your smart start book and have
enjoyed it thoroughly. There is one area in
particular, the ROF where I am confused. In pages 51
trough 53, after the first exam you say to let the
patient feel assured that you know what the problem
is. Then on the folowing visit you say to reconfirm
that you have found the cause of their problems. I
understand that part.But when, I think on p.53 you say
let's see you for three days to see if we can help
you? I am confused and this is an important area of
practice. Are the three days stalling a bitor come off
as you don't know exactly what to expect. I know you
are busy if you could reply I would appreciate it.

A:

Thanks for your e-mail  .. I don't have a Smart Start Book in front of me but I remember 
what you reference. When I wrote this book as a text for my class and I was able to 
embellish and explain every aspect of the text .. I used the context found within the ROF of 
a number of consultants. There are some out there that wish to convey to the new patient an 
impression that recommendations will be made collectively ..the doctor will determine how 
the patient is responding and therefore may benefit from care and the patient has the ability 
to determine if this is what they wish to include in the health care regime and place a value 
on chiropractic. The goal is to "correct" or at least offer enough care to remove or manage 
the subluxation complex that may take an unknown quantity of adjustments and time. 
Therefore .. prior to offering a schedule of care for any length of time it would be only fair 
to both parties that the doctor has educated the patient to the reality of the problem and the 
partient decide based on the new knowledge. You have to agree that any complex decision 
that may require a new patient to partake funds and time will be made with more reality and 
committment when the process of understanding is clear.

"Therefore .. Mrs. Smith, prior to me giving you my recommendation and a schedule of 
care, I feel it is important that you decide if you wish to patch the problem .. what I call 
relief care .. or correct the problem which I call comprehensive care. During the following 
few days, I will know more about how your body has adapted to your condition and 
specifically what it will take to correct the subluxation omplex which I have determined by 
my findings is at the root of your condition. After a few days, you will know more about 
the comprehensive and relief aspects of care and can choose which care you wish. I can at 
that point outline my recommendations including time and fees. Does this sound okay?"

Although providing an answer now is not the best way towards answering your e-mail .. I 
just want you to realize that honesty is always the best. Ethics dictate that you tell the story 
to the patient and therefore utilize the skills you learn at school and in the field to render an 
opinion. If it takes a few days to fill in the blanks then so be it. I think it is too difficult for 
a patient to decide on long term comprehensive and maintenance care without knowing why 
.. this takes time. If you can do it in one day .. then this is your ROF and will be powerful 
and successful for you

I hope this answers your question. If not .. please keep e-mailing me