Value Driven Healthcare

On March 21, 2016, in Uncategorized, by Dr. Dino Pappas

There are somethings that elicit very strong, visceral reactions in people. One of those topics is health and healthcare. Let me paint a picture for you.

3 Restaurant Scenarios

Gibson's: One of Chicago's Finest Steakhouses - Your Wife REALLY Wants to Go Here

Gibson’s: One of Chicago’s Finest Steakhouses – Your Wife REALLY Wants to Go Here!!!

Scenario #1: You work hard day in and day in out grinding away for your family. Your wife does the same. You finally get a night to relax. You get a babysitter for the kids. You want to show your wife how much you appreciate her and her sacrifice for your family. You decide to take her to a nice dinner. Her favorite restaurant is a nice steakhouse. She really, really wants to go. You realize the cost for the dinner and evening on the town and decide that “you know it’s worth it” because you want the best for your wife. You realize that you don’t go out often, but when it’s a special occasion you both want to enjoy it.

Outback: A steakhouse, but not what your wife envisioned!

Outback: A steakhouse, but not what your wife envisioned!

Scenario #2: Same scenario EXCEPT you realize the cost for the nice dinner and evening on the town.  You gulp and say to her, “Let’s go to the Outback Steakhouse instead.”  You decide in this scenario to compromise and someway, somehow that leaves a mark on the relationship.

Beef Is Beef Right?

Beef Is Beef Right?

Scenario #3:  Same scenario EXCEPT you realize the cost for the dinner and evening on the town. You gulp and say to her “Beef is beef so let’s grab a burger at McDonald’s.” You decide in this scenario that steak is just glorified beef and want to skimp out on your wife. That decision negatively impacts your relationship. Your wife is NOT happy!

3 Health & Health Care Scenarios

Let’s transpose this to your health and your health care. Your health and your healthcare is a VERY personal experience kind of like your wife’s connection to going to a nice restaurant and your initial willingness to recognize her sacrifices by taking her to that restaurant. Your health and healthcare creates a strong sentimental connection and visceral reaction. Your health should matter most to one person and that is YOU!

You can look at it in one of 3 ways:

Scenario 1: You work hard day in and day out. Unfortunately, one day you hurt your _______ (insert body part here – back, knee, shoulder, ankle, hip, neck, etc.). You want the best because you realize your health is EXTREMELY VALUABLE and without it not too much else matters. You are willing to pay for an excellent product and service because getting rid of pain, restoring function and missing out on the quality of life things you do (sports, playing with the kids, riding a bike, swimming, going on vacation, etc.) with the people you enjoy matters too much. This means you select treatment from providers willing to give you exceptional treatment and service. These are providers that have additional specialized training, do not routinely overbook patients, do not over treat or under treat patients by providing too many or too little visits and services, are willing to spend quality 1:1 time with you, are willing to answer questions and can routinely deliver outstanding results. These providers are typically out of network or in network but have a strong commitment to excellence. The relationship with your wife is great and she’s extremely happy! Likewise, the relationship you have with the injured body part is now great and you’re extremely happy you chose them!  You’ve accomplished and maybe even exceeded your therapeutic goals.

Scenario #2: Same scenario EXCEPT the hang up is that you want to sacrifice quality for price. On the surface you are eating a steak, but beneath the surface the quality isn’t there. You could be sacrificing the chance for an outstanding long term outcome meaning you could be increasing the chance for future episodes of pain, lingering loss of function and chances for inability to do the quality of life things you enjoy. These are providers that have some skill, occasionally overbook patients, have limited face to face interaction and are less likely to deliver outstanding results. These providers are typically in network and may not fully be committed to excellence on each and every case, but generally speaking they care about patients. The relationship with your wife is strained for a bit and she’ll remember this day later on. Likewise, the relationship you have with the injured body part is strained and it’ll remember that in the future. You may have reached several of your therapeutic goals, but not all of them.

Scenario #3: Same scenario EXCEPT you find the costs to be prohibitive. You want to eat out, but you select the most affordable and least quality option. You are eating beef, not steak. You eat at McDonald’s, not the Outback nor your wife’s favorite steakhouse for your rare night out. You sacrifice quite a bit of quality for price. You ARE sacrificing the chance for an outstanding long term outcome, ARE increasing the chance for lingering loss of function and ARE increasing the chance for inability to do the quality of life things you enjoy with the people you want to do them with. These are typically providers that have baseline level skills, routinely overbook, have extremely limited face to face time with patients with techs or assistants doing much of the work and deliver average or sub-par results. Everyone gets the same treatment. They plug you in like an assembly line. These providers are in network with every insurance company and use volume (# of patients) rather than quality of interaction and results to make a profit. They are not committed to excellence, rather to profit. The relationship with your wife has taken a turn for the worse and may not recover. Likewise, your relationship with the injured body part is harmed and it is possible you may never make a full recovery. You do not reach any of your therapeutic goals.

The Health & Healthcare Dilemma

Take a moment and reflect right now…Which one of these scenarios fits you best? This is a very personal decision.  There is no right or no wrong answer. There is just your answer. Your answer has to be right for you.

I think like most Americans you are looking for value. You want to feel good about your purchase. You want to feel like you got a lot for what you have paid for. Sometimes, you are fully aware of the trade off between quality vs. quantity and quality vs. price. Sometimes you aren’t aware of the trade offs. Sometimes you aren’t aware that all health care providers aren’t created equal nor trained equally.

Sometimes you aren’t aware that providers of similar degrees within a specific field (example: MD vs. MD, DO vs. DO, DC vs. DC, PT vs. PT, etc.) aren’t created equal nor trained equally. In my field of chiropractic, you may see it as a commodity rather than a specialty. You may erroneously think that you can drive up and the down the major streets in your area and get the same thing from any chiropractor. You may mistakenly fail to recognize that there are specialist chiropractors within the specialty of chiropractic as there are chiropractors with advanced training in sports medicine, radiology, neurology, internal medicine, nutrition, rehabilitation, orthopedics, occupational health, acupuncture and more (Post Graduate Chiropractic Training).

Months after your treatment is completed you may come to the harsh reality that your health care benefits are exhausted, your out of pocket expense is higher than what you thought, you were plugged into a cookie cutter treatment program where everyone gets the same thing, you paid for images (X-rays, MRI’s, etc.) and lab tests that you didn’t need, and you still don’t have the answers you were looking for nor the outcome you want. You are still in pain. You still can’t do the things you want to with the people that matter most to you. You wanted steak, but choose a hamburger instead. Your wife is not happy. You sacrificed quality and value. Your injured part is still injured.

The best value in the medical and allied health fields is typically not the cheapest priced nor the most expensive. The best value in health care are the providers that deliver specialty care, outstanding results, extended 1:1 interaction, and outstanding service at a reasonable price for your local market. In some cases, these providers may not be in network. This shouldn’t scare you! You don’t use them very often just as you don’t go out for a nice steak dinner routinely. These are special occasion decisions. I’m going to Gibson’s steakhouse because it’s a special occasion. I’m going to a skilled professional (chiropractor, physical therapist, medical doctor, osteopath, etc.) because it’s a special occasion and I need to get my _________ (body part) examined and “fixed.” When selecting a health care professional you must make a VERY PERSONAL choice and ask yourself the tough question, “Is it really worth it to go with the cheapest available?”

About The Author

Dr. Pappas is a chiropractic physician, certified athletic trainer and certified strength and conditioning specialist. Dr.

Dr. Dino Pappas

               Dr. Dino Pappas

Pappas blends the best of physical medicine with the best of integrated medicine to help patients and athletes of all shapes and sizes. He practices out of The Center for Integrated Medicine in Tinley Park, IL. The practice serves the South and Southwest Suburbs of Chicago, IL including Tinley Park, Orland Park, Orland Hills, Mokena, Frankfort, New Lenox, Homer Glen, Lemont, Palos Park, Palos Heights and Oak Forest. He utilizes tools such as chiropractic manipulation, soft tissue work (IASTM, Graston, myofascial release, neural mobilization and joint mobilization), biomedical acupuncture, functional movement based assessment, the McKenzie Method, strength training and conditioning, kinesiology taping, customized nutrition and specialty laboratory testing (blood, saliva, urine, and stool) when needed. Dr. Pappas’ clinical focus is sports medicine, conservative orthopedics, rehabilitation and integrated medicine. His sports medicine interests are endurance athletes, overhead athletes (pitchers, throwers, volleyball players and tennis players), contact sports athletes (football, rugby, lacrosse, field hockey, soccer and basketball) and Crossfit athletes. He has worked with athletes at all levels from professional to amateur. He reads and interprets the medical literature daily to stay abreast of cutting edge advances in his field. The doctor is currently the team chiropractor for the Windy City Thunderbolts minor league baseball team and a sports medicine volunteer for Andrew High School in Tinley Park, IL. He is an avid runner and aspiring triathlete having completed 5 marathons, 3 half marathons and numerous 5 and 10k races. The doctor is also active in the local, suburban Chicago running scene. He is currently training for the Pikes Peak Ascent Half Marathon. He has goals of qualifying and competing in the Boston and New York Marathons, the Ironman in Kona, Hawaii, and climbing Mt. Kiliminjaro in Kenya, Africa. One day he hopes to serve his country as a team chiropractor for the United States Olympic teams and serve as a team chiropractor for one of the professional teams in Chicago. His mantra is “Why Put Off Feeling Good?” He can be reached by email at or at 708-532-2346. ***

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