DC's "Person of the Year"

At this time each year, we look back on the events in chiropractic the 12 previous months and present our annual achievement award to a deserving DC, person or organization.

We were particularly impressed with news coming out of Illinois toward the end of 1999. In the December 1, 1999 issue of Dynamic Chiropractic, our main front-page story was "DCs as Primary Physicians with Blue Cross/Blue Shield of Illinois." We reported how Alternative Medicine, Inc. (AMI) had contracted with Blue Cross/Blue Shield of Illinois, the state's largest managed care plan, to give its more than 700,000 enrolled members the option of having one of AMI's chiropractors as their primary care physician. It is for this reason that we have named AMI CEO James Zechman our "Person of the Year."

The bugaboo of managed care has been the advent of the "gatekeeper," a primary physician who orchestrates patient care. That role has traditionally been the domain of the MD. The debate in chiropractic over the last few years has been whether DCs should be primary physicians. AMI thinks they should and is doing something about it.

James Zechman and Richard Sarnat,MD, founded AMI in 1997. Mr. Zechman is the CEO/chairman and Dr. Sarnat, is the company president. AMI's goal, in the words Mr. Zechman and Dr. Sarnat, "is to integrate alternative care with mainstream medicine to produce a health care model that utilizes the best each system has to offer." Their model has achieved "significant savings while maintaining a high level of patient care and satisfaction." Dr. Sarnat believes that chiropractic "will prove at least equal to, if not better than, any entry point (gatekeeper) to the health care system."

James Zechman graduated with honors in music from Drake University and received his MA (also with honors) from the University of Denver. Before joining AMI, Mr. Zechman was the founder of Apwel, Inc., an international trade finance and import-export company. He also served as a managing vice president for Merrill Lynch on global derivative markets.

What is the AMI philosophy? "We are always focused on the patient and keeping them healthy," explains Mr. Zechman. "Everything else falls into place as long as that's first." The company has started a massive radio marketing campaign in Chicago to get the word out about their complimentary health model. Mr. Zechman believes that the AMI program will transfer well to other states.

And his long-term goal? "What we would like to do is say is that we've created not just a great technologically-based delivery system, but that we've created the best integrative model for delivering health care to large segments of populations on a very cost-effective basis. Quality, cost, keeping people healthy, and integrating alternative medicine with the allopathic side of the world is where we believe our long-term mission will take us."

Mr. Zechman confides that the reason behind one very large employer group asking AMI to help them market and educate their wellness program is its employees. "The company knows that we will save them significant dollars in their health care costs, because they're self-funded, and that it will keep their employees in better spirits and on the job, which is also a significant benefit to them. When we start talking about this in their HMO setting, they said they'd also like us to build a highly-credentialed, highly-qualified chiropractic delivery system for their PPO members. That's the first time we have been asked by a large employer group to formulate a PPO product. They then asked us to work with them on developing the same type of program for workers' compensation. So as a company, we've gone from working with managed care organizations on an HMO product to branching out to employer groups who are self-funded to help them across their various benefit programs, be it HMO, PPO, point-of-service program or workers' compensation. That's an exciting new development for us."

We agree that it is an exciting development for chiropractic.

Mr. Zechman points to a large insurer in Illinois that has asked AMI to analyze the feasibility of creating a high quality chiropractic PPO that is not focused on reduced fee schedules but on raising the bar of quality providers in their network. "This is significant," Mr. Zechman explains, "because they are finally coming to the realization that wellness programs and keeping people healthy, even if they end up spending more on alternative medicine on the front end, will achieve significant savings in all their other costs: pharmaceuticals, hospitalizations, referrals to specialists, procedural tests and the like."

AMI is identifying the strategic partners in each state to duplicate what the company has done in Chicago on all levels (HMO, PPO, employer groups, etc.) and to try and make these programs available on a wider basis.

Mr. Zechman and Dr. Sarnat are holding meetings with a MCO in Colorado and a prominent chiropractic network in New Mexico; they've also have been contacted by health organizations in Texas and in the Northeast.

"There are roughly 40 states that recognize and license chiropractors as primary care physicians," notes Mr. Zechman. "The training that they (chiropractors) receive, specifically at National College of Chiropractic in Lombard, Illinois, is focused on primary care, so we are seeing their capabilities and qualifications absolutely up to meeting the tasks at hand."