Complex Care Chiropractic Services

We manage complex cases at the Small Street Clinic.

You will be unable to make a new patient appointment for a COMPLEX CONDITION online. Please call us to discuss your appointment.

It is important that you read this information if you are considering undergoing complex care management at the Small Street Clinic.

Paul Noone and Tony Cassis are registered chiropractors in Australia, each having successfully completed an accredited postgraduate chiropractic clinical neuroscience training program. While they are not medical doctors or neurologists, they are committed to providing extensive, tailored, and nuanced chiropractic examination and treatment frameworks for individuals grappling with complex neurological conditions.

At Small Street Clinic, we prioritize ensuring that our patients with complex cases are well-informed about the costs and processes involved in our treatment program. If, after reviewing this information, you find that you are unable to commit to an initial one-hour consultation followed by six weekly 30-minute follow-up treatment sessions, we may not consider the Small Street Clinic suitable for your specific condition.

Complex neurological conditions often result in a variety of functional impairments, including spine-body pain and postural control dysfunction, significantly affecting the everyday activities of those affected.
While chiropractors do not promise a cure for these conditions, our approach involves examining patients and delivering treatment within a framework that acknowledges the unique and often delicate intricacies of each patient’s nervous system. We utilize a range of gentle yet advanced chiropractic treatment and rehabilitation strategies aimed at addressing pain, enhancing postural control, and improving overall body movement. By integrating chiropractic care with evidence-based clinical neuroscience principles, we strive to notably enhance the quality of life for individuals navigating these complex neurological challenges

INITIAL CONSULTATION

Our initial consultation for complex cases spans a one-hour session, emphasizing the thorough assessment required for complex neurological conditions. It’s essential to understand that addressing complex neurological cases necessitates more time and commitment compared to straightforward spinal pain cases.

Our assessment process begins before your visit. We request that you complete detailed questionnaires or provide us with a comprehensive history beforehand. This allows us to review your information thoroughly prior to your arrival and discuss it further during the consultation. Your pre-visit information guides us in utilizing various diagnostic testing equipment available in our clinic effectively. This includes RightEye Vision Testing and Computerised Dynamic Posturography (force plate assessment using BalanceTRAK software). These tests provide valuable insights, enabling us to tailor a treatment program that targets specific areas in your nervous system that may require attention.

  • Duration: 60 minutes
  • Cost: $350

Follow-up Treatment and Rehabilitation Sessions

The initial phase of our Treatment and Rehabilitation program involves weekly 30-minute sessions for 6 weeks. Additionally, you will be required to dedicate 10 minutes daily to tailored home-based exercises.

After completing the initial assessment session, we will schedule a follow-up session within a week. Prior to this session, we meticulously review all the information gathered during your initial consultation. Subsequently, we prepare an in-office treatment program and a set of personalized home-based rehabilitation exercises aimed at activating specific areas of your nervous system.

During your first follow-up session, we administer the initial in-office treatment. Subsequently, we integrate your daily exercise program with our weekly treatments over the course of 6 weeks. During this period, we closely monitor your progress. To ensure convenience for both you and us, we recommend booking these weekly treatments in advance to align with our mutual availability.

  • Duration: 30 minutes
  • Cost: $150

COSTS & PROCESSES WHEN VISITING SMALL STREET CLINIC AS A COMPLEX CARE PATIENT

Complex Case – Initial Consultation : Duration (1 Hour)
Fee – $350
Complex Case – Follow-up Consultation: Duration (15 mins)
Fee – $80
Complex Case – Extended Follow-up Consultation: Duration (30 mins)
Fee – $150

You have been directed here as you are someone who is contemplating seeing one of our Chiropractors as a complex care patient. You would have received an email reply to your inquiry. We did not include the nuts of bolts in the email reply, as some people just aren’t interested. However, we are required to provide full disclosure on all our costs. So please continue reading.

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. 

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. 

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. “

Meet our Team

Paul Noone

PhD, B.App.Sc (chiro) DACNB

Tony Cassis

B.SC, M.SC, DACNB, ICCSP

Joan Noone

Clinic Manager

Contacts

For any inquiries please contact us

Paul Noone Hours: 

Monday 9 am-12.30pm, 2pm-7pm,
Thursday 9 am-12.30pm, 2pm-7pm
Friday 8am-12pm

Tony Cassis Hours:

Tuesday 9 am-12.30pm, 2pm-7pm
Wednesday 9 am-12.30pm, 2pm-7pm,

Call Us: 0395987787
Email Us: smallstreetchiro@gmail.com