Suite 17, Milford House - 7 Queen Ann St.
(off Harley St.), London, W1G 9HN
Consultation
by Mr. B.M. Luklinski
MSc Medical Rehabilitation; MSc Physical Education; Dip Home Med.
A consultation and examination normally last for one hour. This enables us to determine the cause of your spinal disorder and to determine the correct treatment procedures. We rely primarily on precise physical tests rather than scans to arrive at a diagnosis.
INITIAL TREATMENT
1st REVIEW
FINAL REVIEW
PAYMENT
INITIAL TREATMENT
If the patient decides to begin a course of treatment, a payment on account is required to cover the initial cost of treatment. This initial period of treatment allows the patient to appraise the results without having to pay for a whole course of treatment in advance.
It may not be possible however to obtain an improvement during the initial treatment phase because in many chronic cases an increase in pain or discomfort is experienced following the mobilisation of spinal joints and the consequent irritation of nerve roots. If there is a strong reaction to treatment however, this is usually a good sign that the treatment is working. For example, in regard to cervical nerve root impingement affecting the arm and hand/fingers (radiculopathy), the treatment may initially exacerbate the symptoms. In many acute cases however, a significant reduction in symptoms can be achieved after only a few sessions.
1st REVIEW
A determination is made following the initial treatment period. The full cost of treatment with an estimate of the number of sessions required to successfully treat the disorder is then given. It is important to appreciate that although the cost for the whole course is determined at this review, the estimate for the number of sessions required to successfully treat the disorder may turn out to be inaccurate.
If the patient's disorder is satisfactorily resolved within the estimated number of sessions, the patient will be discharged, and no refund will be given for 'unused' sessions. If the patient however requires more sessions than was originally estimated, appropriate advice will be given and additional charges may apply.
It is important to appreciate that although our aim is to 'cure' a disorder, the most we can undertake is to reduce the patient's symptoms as much as possible by treating the cause of any diagnosed disorder. We can never guarantee to cure a patient because some factors are beyond our control, such as the patient's own lifestyle (the patient may enjoy skiing down mountains!). If we express an opinion that we can effect a cure, this must only be regarded as an opinion which can turn out to be wrong.
FINAL REVIEW
A course of treatment will be concluded and the patient discharged when the practitioner believes no further improvement can be gained, or that the disorder has been resolved as best as possible in the existing circumstances. There would be little point in continuing treatment if no improvement can be obtained in the patient's condition.
If a disorder has been resolved, so that for example no further pain or numbness is felt in a leg, the patient may still require additional treatment for another part of the spine and for other symptoms, such as pain or numbness in an arm.
This treatment cost will be quoted in the same way as described above and the same review structure will apply. Obviously if one set of symptoms have been satisfactorily resolved, the patient would have the necessary confidence to begin treatment on the second category of symptoms.
When patients are discharged we may ask the patient to provide a written confirmation that they feel as comfortable as possible with no symptoms. The patient is usually given a programme of specific floor-based movements to carry out to prevent any recurrence of the disorder and so we usually do not need to see the same patient twice.
PAYMENT
Any appointments for treatment not kept or cancelled will be charged £250, or if at least 24 hours notice of cancellation is given, a cancellation fee of £100 will be retained or charged. The cost of treatment can be paid for in instalments. The patient may withdraw from treatment at any time although any money paid on account will not be refunded.
The practitioners are busy and like any other professional, time is chargeable and a missed appointment cannot always be filled by booking another patient.
Our fees are not calculated in terms of an hourly or session rate but according to the condition that needs to be treated and the degree of experience and skill that needs to be applied. In some cases for example a mobilisation, manipulation, distraction, or manual traction procedure may be required in the course of treatment which if it were not applied would never cure a condition. The procedure may only take a few seconds to apply and so if we were merely charging an hourly or session rate then our fee might not come to more than £5!
An hourly or "per-session" rate is therefore not an appropriate basis on which to charge treatment fees, which are based upon the condition to be treated.
The Consent Forms that you will be required to sign before any examination or treatment is conducted are set out below. These consent forms are designed to enable a patient to give informed consent to being examined and treated and to provide legal support for the practice.