Usually, the information you provide us suggests that you have allocated a significant amount of your valuable time and financial resources to this health problem. We would prefer that we fully explain our costs and treatment processes to ensure you are completely satisfied that you are making the best use of these resources by attending my clinic. 

If you reach the end of this email and decide our clinic is not for you, we will feel satisfied that you are moving on to a more suitable healthcare destination. We are sure that if you could have made such a decision with previous practitioners you could have saved much time and money. 

Don’t be put off! Your problem is not simple, and neither is our treatment!!

We have two chiropractors with post-graduate qualifications who are experienced in complex neurorehabilitative care and one administrative assistant, all who are involved in the management of complex care disorders such as yours:

• Dr. Paul Noone PhD, B.App.Sc (chiro) DACNB- (Registered Chiropractor) click here for more about Paul
• Dr. Tony Cassis, B.Sc (Health Sci), M.Sc (chiro) DANCB- (Registered Chiropractor) click here for more about Tony
• Joan Noone (Clinic Manager)

INITIAL CONSULTATION AND TESTING

We conduct the initial consultation for complex cases such as yours over ONE INITIAL session. 

This session duration is 60 minutes,  at a cost of $350.  

Here is a brief background on the Initial Consultation session.

Firstly, we may have asked you to complete some questionnaires or send us a detailed history prior to you arriving at the Initial Consultation. We will have spent time reviewing this information before you arrive, and will review it again during the consultation. Depending on this information, we may assess you using different equipment we have in our clinic.  

We might use Our Vision Testing equipment called RightEye (to see a youtube video of RightEye equipment click here).

You will sit in front of a special screen that has infrared cameras that can track your eye movements. This allows us to measure various complex eye movements that are controlled by different parts of your central nervous system. Results from this testing may provide us with information on how various areas within your nervous system are functioning.

The second assessment is a full computerized balance assessment (Balance Track by Vestibular Technologies).

You will be standing on a stationary force platform (it is still and does not move), and we will be measuring a range of aspects of your balance by the use of complex computer software. Balance is a very sensitive indicator of nervous system health, and the complex data provided by this testing provides us with sensitive clinical information about your condition. 

We will perform other tests during our examination that are specific to the problem you have outlined in your email history to us. 

We will then use this information to prepare an in-office treatment program (we rarely administer treatment during the initial consultation, as your nervous system can be quite fatigued after the testing) and a set of  “tailored” home-based rehabilitation exercises for you to perform for at least 5 minutes, twice daily. We will thoroughly guide you through a full demonstration of all exercises, and determine how much of each exercise you will perform on a daily basis. 

We often record the exercises on your phone, so you have an accurate record of how to perform them. Believe it or not, one of the most common excuses for not doing these exercises (and there are plenty.. more about that later) is “forgetting how to do them”. 

Most patients need to commence at a very light level of home exercises, and slowly build up the number of exercises over a 6-week period. Even though we attempt to make the exercises as easy to perform as possible, they are quite complex and take significant concentration on the patient’s behalf. 

FIRST 6 WEEKS OF REHABILITATION – THE MOST IMPORTANT TIME!!

Our treatment philosophy is home-centred. Unlike many clinics, we don’t ask people to undertake costly programs consisting of daily clinic visits for a week, month, or even 2-3 times per week. 

It is our rehabilitation philosophy that the patient restores their own health, we are just facilitators. We place great emphasis on our patient’s personal health responsibility, thus doing daily home exercises to build neuroplasticity is very important. We place great emphasis on patients taking control of their own health. 

But, we know, as does the scientific evidence, (READ THIS CAREFULLY!!) that less than 30% of patients who start home-based rehabilitation programs are still doing them to an optimum level after 6 weeks. We also know that the greater the contact with the clinic in the first 6 weeks the greater the compliance. 

Message from Paul Noone: 

“After 40 (2023) years in practice, and over 26 years of managing complex cases such as yours, I believe that the first 6 weeks is crucial. I am going to be bluntly honest here…. poor compliance continually frustrates your and our efforts. 

If you are to have the best chance of success, daily home-based exercises (tailored to your condition) combined with 6 weekly visits (to gradually and subtly change the exercises, and sensitively encourage your exercise compliance) will provide the most cost-effective improvement in your condition. 

My vast clinical experience in complex case management informs me that if you are not significantly improved (not necessarily cured, but improved) at the end of this time, and you have been 100% compliant with weekly visits and daily exercises, you are most likely not going to improve with my treatment program. “

But…we cannot do the Neurorehabilitation exercises for the patient. The patient must find the time in their lives to do 5-15 minutes daily for 6 weeks (the crucial first phase for neuroplasticity). 

So we insist that our complex patients attend our clinic weekly (or have weekly Zoom consults if the distance is an issue) for the first 6 weeks, (at a cost of $80 per 15 minute session). 

We will ask that you book these 6 weekly appointments in advance, this will allow you to access the times that are most suitable for you. 

PLEASE NOTE:

We do not take pre-payments for future appointments. 

We feel that it is your decision to continue with us. If you feel after a session or two that we are not for you, feel free to inform us and cease your program. There are no penalties or fees for doing so. We feel that this is the only fair way for our therapeutic relationship to proceed. 

Payment is only made at the time of the consultation. If you give us 24 hours’ notice there are no cancellation fees. 

However, a full cancellation fee is charged if you cancel on the day, or do not show up for your appointment.

I am sure you agree that this, too, is only fair. 

Here are a few other issues that we feel you should be aware of. 

• If you are unable to attend weekly appointments for these initial 6 weeks (for example, you might be going away, or have family issues you need to address), then we recommend you do not start with us until you can commit to seeing us weekly (either in the clinic or by Zoom) for a clear 6 week period. 
• If for some unexpected reason (e.g. family illness) you have to break your schedule, we will insist that you do not waste your time and financial resources. We will cancel all future appointments, wait until you have a clear space to commit to your program, and we will start again. 
• If it becomes apparent that the time is not right for you to commit to our program, we will strongly recommend you do not continue with us until you are ready.

We place great importance on these first 6 weeks, as this is the period when patients will demonstrate important changes in their condition. We meet on a weekly basis to discuss the progress of all our complex cases, and modify the home and in-office rehabilitation. We take our treatment of you very seriously and dedicate significant time outside of your consultation to your case. 

Each Regular Rehabilitation Session usually lasts 15 minutes ($80). 

We will discuss with you if your condition requires an Extended Rehabilitation Session of 30 minutes ($150)

We ask all patients contemplating a Complex Care Initial Consultation with us to ensure that they are prepared and able to attend weekly for this initial 6-week period. If you have to travel some distance (e.g. over an hour away, interstate or from overseas), we are able to accommodate you with Zoom consultations on a weekly basis (Zoom consults are at a cost of $80 per 15-minute session, and do not qualify for health insurance rebates).

We usually expect to see at least a 50% improvement in symptoms in 6 weeks, if patients have been 100% compliant with our program. It is important for you to know that a significant percentage of our “failures” are due to patients who are not compliant with our exercise program in the first 6 weeks or miss or cancel appointments during this time. 

We are going to repeat his message here!!

“If you are unable or unwilling to do the 5-10 minutes of simple, home exercises on a daily basis for 6 weeks, we strongly recommend you do not commence with our program. You will be wasting your valuable time and financial resources. It is also important to know that we only have the resources to consult with a limited number of complex cases such as yours. If you continually cancel appointments or are not engaging with your rehabilitation program, you will also be denying another patient the opportunity of attending our clinic”.

If you start with good intentions for good compliance, but we find you are not being compliant over the ensuing weeks, we will recommend you suspend your program and recommence when you feel you can be fully compliant for a 6-week period.

What happens after the first 6 week period?

After 6 weeks, we usually reduce our contact with patients to once every 2-4 weeks and hopefully move the patient to more complex rehabilitation routines. After the first 6 weeks, we normally see our patients, on average, about 4 occasions over the next 4 months. Our patients’ clinical responses vary during the next 4 months. We find those who have been naturally compliant are happy to continue their home exercise routines and are more likely to continue to see sustained improvement over the next 4 months. Those who struggled with compliance in the first 6 weeks often drop off exercise maintenance and do not see expected improvement over the following 4 months. 

We know this has been a lot of information. However, we hope you have enough information to make an informed decision about attending our clinic. We have consulted with many, many hundreds of patients with your type of condition. What we have outlined above is the best way we can possibly help you, if we can help you.