August 2011: Micro-practice Article

A chiropractic micro-what?? Several of you have asked me why I changed the structure of my practice late last year. That probably means a great many more of you have the same question, but haven’t asked. I hope to answer that question by giving you all an overview of my practice philosophy here.


Over the last many years micro-practices have been growing in the conventional medical community. This style of practice addresses patient desires for more personalized healthcare and it allows doctors to focus more on providing high quality care to their patients. A micro-practice is set-up to intentionally slow down the practice pace from the more common “break-neck” speed of many clinics these days. Doctors are deliberately taking a step back in time to a place where they have the time to really listen, hear patient concerns, and determine the best course of action for each patient’s optimum health.


This “new” micro-practice practice style is really just "old-style" medicine, which interestingly has remained fairly common in alternative healthcare practices. Many studies have shown that “old-style" medicine is one of the larger draws to alternative healthcare for patients. Patients want to know that their healthcare provider will take the necessary time to hear them. Very simply, they want to feel cared for.


Everyone is familiar with the very common and ubiquitous high-paced clinics that shuffle patients in and out. Somewhere along the way we all have allowed the development of a situation in our greater healthcare system where the “care” in healthcare has been relegated to a place somewhere below the “volume of patients seen.” 


This is not to say that individually every healthcare practitioner doesn’t strive to provide high quality care in their practice, even in high volume clinics. I believe most do. Nor am I implying that every patient visit needs to be long to be able to provide quality care, but that some do. Patients and doctors often desire more time for the compassionate art of healthcare, not just a rote, analytical, algorhithmic approach of working through a checklist to fix to a given problem.    


Even in the alternative healthcare community however, not many chiropractic practices have embraced the micro-practice concept. Many, if not most, chiropractic practices move at a rapid or very rapid pace, pushing patients in and out of the clinic as fast as possible. The tongue in cheek term for that style of chiropractic is colloquially known as a, “Rack ‘em and Crack ‘em” type of practice.  As any of you who have seen me know, that simply is not how I personally like to practice chiropractic healthcare. Still, the idea of intentionally slowing down a chiropractic practice is definitely out of the norm.


When I started doing deep tissue bodywork in the early 90’s, my mentors taught me to frequently spend from 1- 2 ½ hours per session, per client. Over the last 10 years as a chiropractor, the doctors I have had as mentors also have had a similar approach, where a chiropractic visit may range from 15 minutes to 1 ½ hours if necessary. While the “length of visit” time frames differ significantly between deep tissue bodywork and a typical chiropractic visit, the concept is the same. Quality, compassionate care often demands more time and more individualized attention on the part of the provider. I have worked hard to emulate that style of practice throughout my career.


So for me, intentionally slowing my practice somewhat makes sense. It has allowed me to do more doctoring, less administrating, and refocus my practice on doing the work I love. I find it deeply gratifying to be able to spend more time providing the best quality care I can, so that you can be as pain-free as possible and get back to leading the life you want.


In Health,


Dr. Michael Neely


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