Over a decade of high-volume clinical practice teaches you things a quieter setting might not. One of them is this: fee for service care, regardless of the practitioner’s intentions, is structured around the intervention — not the outcome.

That’s not an accusation. It’s a description of what the model produces. When a session of acupuncture, a chiropractic adjustment, or a physical therapy visit carries a fixed value independent of what it produces, the intervention becomes the unit of care. Not the treatment plan. Not the trajectory. Not the outcome. The session. continue reading »