Because we have received multiple calls from doctors requesting information on how to get started working with industries, we will provide in this article some basic concepts of building industrial alliances for the doctor of chiropractic. We will also provide at the end of the article a brief warning of what has happened to doctors of chiropractic and medical doctors in Michigan who are involved in a federal investigation on unethical interaction with industries in the Detroit region.
Too many times, doctors have placed money as the primary purpose for desiring to work with industries. Many practice consultants provide advice on how to generate new patients from industrial contacts. While we all need to survive in practice, going in with the wrong purpose does a disservice to the profession and the industrial community. Unfortunately, the Michigan scenario provides an example of what can go wrong when your purpose is off.
Our belief and opinion is that the creation of a positive industrial alliance is based upon service and trust. Both require industrial skills and commitment to create long-term relationships with the industries in your city.
There are different levels of industrial alliance building. The best reason to get involved with industry is that you, as a doctor of chiropractic, have something to offer the industrial patient and the industry itself. If your purpose is for service, it will make the entire process of getting involved much easier. If your primary purpose is to enter the market to improve your income, you will struggle with developing a workable plan and the longevity of your relationships will be nonexistent.
You are entering a crowded market with institutions that have a much larger capacity to market themselves than most individual chiropractors. Going in with the purpose of service provides you with the edge you need to succeed. Chiropractic truly has more to offer industries than any other health care field, but it is up to you to do it correctly.
Steps to Industrial Alliance Building:
A. Create and define your purpose for working with industries. What made you decide to work on a higher level with industries? Use your purpose as your guide for developing a plan of action.
B. Define what level you would like to get involved with industries:
I. Patient care;
II. Education and injury prevention;
III. Job evaluation;
IV. Safety committee interaction;
V. Job design;
VI. Ergonomic evaluation and implementation; and
VII. OSHA requirement/consulting.
Patient care and educational programs are natural fits for all doctors of chiropractic due to our training in body mechanics. There are some simple rules to remember at this level of involvement. Evaluate the cause or mechanisms of injury and correlate them to the condition the patient presents in your office with. Make the necessary changes to correct the condition and prevent its reoccurrence.
Use what you have learned at chiropractic college and do not fall into the crisis or triage care model where you only treat the symptoms. Include exercises to rehabilitate the weakness that led to the dysfunction, and change the environment that led to the weakness manifesting into symptoms. In other words, correctly evaluate your industrial injury patients and provide proper care including corrections of the environment that created the condition in the first place.
The next level introduces education on injury prevention and safety. The best way to get comfortable with teaching within the industrial setting is to start by teaching industrial patients in your own office. Videotape your patient working or somebody doing his job, do an analysis of the work, then teach your patient in a private, one-on-one class what s/he needs to do to correct the condition. Cover basic anatomy and body mechanics. Address the important issues of self-responsibility and self-evaluation. Allow the patient to view the videotape and facilitate them to come up with a proper solution.
Remember that in teaching, the best teachers respect their audience's expertise in the knowledge of their jobs and that the doctor is the expert in why the body breaks down or fails. Together you facilitate a solution for the patient. By creating the solution this way, it creates ownership by the patient and implementation will have a higher chance of being completed.
None of us change our health habits unless our health belief system changes. If you teach with that in mind, you'll have good results. After you get comfortable teaching individual patients, you will be able to promote your benefit to industries with confidence.
The remaining levels require additional training or education. We highly recommend the diplomate programs in industrial occupational health provided by the chiropractic colleges.
For an example of getting started working with industries, we will provide the following information to familiarize yourself with the industrial arena. To effectively treat any injury, one needs to be familiar with the activity and mechanism that cause the presenting symptoms. We have used the example in a past article in DC of the pitcher on a baseball team. If you had never seen a baseball pitcher throw, the process of treating and rehabilitating the athlete would be less efficient.
The worker is an athlete in a different environment. The more you understand about the worker's activity and environment, the more efficiently you will be able to treat the patient. Calling the industry to find out more information is an easy step to take. Simple dialog (as follows) allows you to initiate contact with industries to assist them with industrial injuries.
"Hello, this is Doctor Smith. One of your workers has entered my office seeking care for an injury he feels was caused at work. Who would be the appropriate person that I should talk with about this injury?"
After connection with the proper personnel: "Hello, this is Dr. Smith. Sam, who works in your finishing department, has reported a work-related injury to me at my office. Could I ask you a few questions to help me with the care of your employee? What hours does he work? How many hours per day? Is there job rotation? If yes, how often?
"In the type of work he performs, do you feel there are specific areas of stress on the body? He has a shoulder condition. How often does he have to reach above his head during a normal hour of his job? What kind of weight does he have to lift? Can he do his job sitting or standing? What posture is he mainly in while performing his job? How long has he been on this job and with the company? Has he been working overtime, or has anything changed recently in his work environment?
"What are your return to work policies? Do you offer in-house rehabilitation such as ice and stretching? Is there anything else that you feel would assist me with the treatment of this patient? If I have any further questions, would you be the person that I should contact? Could you send a job description to my office to assist me with further questions? Do you have educational programs on safety for your workers? If yes, could you send them to me so that I can review them with Sam to reinforce the work that you are doing in your company?
"I would also like to review videotapes of the worker's job with them to see if there are preventative measures we can take and also to improve my treatment of Sam. If possible, I also would like to take a tour of your facility to better familiarize myself with what your workers do. I dress in a white shirt and tie in my office; do you feel that would be appropriate in your company or do you have any suggestions for me?"
Industries are looking for individuals to play a role in the treatment and prevention of injuries. By finding their needs and addressing them, you will be invited to become part of their team. Nobody is better equipped than the doctor of chiropractic to fill the needs of industries.
As promised in the beginning, the U.S. Department of Justice has charged doctors in Michigan with mail fraud for providing false or phony disability reports to employers of General Motors and Chrysler. Unfortunately, the doctors knew that the patient did not have a disability or sickness to be off work, yet provided the patient with a note to take them off work for the day or week. The doctors knew that the patient wanted personal time off for such things as deer hunting or visiting family in Florida, but still wrote the note for the patient. This Robin Hood syndrome of assisting the patient at the expense of the company is an example of poor judgment - and now, potential fraud. By creating working relationships with industries, this type of action is not an option for you. Remember to keep your ethics high.
