Editor's note: This is part of our series on multidisciplinary practices which began in the June 15 issue with C. Jacob Ladenheim, JD. Dr. Ladenheim's article, "MD/DC Practices: Not to Worry, Just Hide Your Assets," contended: "Every doctor who is in an MD/DC practice, regardless of who set it up, is potentially at risk."
In the June 29 issue, Ron Halstead, DC, responded with "The Multidisciplinary Practice: The Patient Sees the Best of Both Worlds." He asserted that the multidisciplinary approach was "very beneficial to the practitioners," but that such a practice is "much more difficult to operate."
There are 83 serious pending investigations on multidisciplinary centers using MD/DC/PT combinations in the U.S. today. Of these, I have represented 33 as an expert witness: 31 were for the defense. My position as an expert witness has been established from years of experience in the field of integrated centers. I've developed and practiced for 10 years in one of the southwest's largest MD/DC/PTs centers, billing in excess of four million dollars and a yearly collection rate of $3.5 million.
As a consultant, I have taught over 4,700 doctors and integrated more than 770 officer in 45 states. Practice Perfect offers to our doctors 136 modules in seven locations taught by the most adept experts in the industry. Our billing and coding specialists are the best in the nation. I have written and published 36 educational multidisciplinary pamphlets, and I have created the only multistate database in the country which contains rules, regulations and billing particularities of 45 states for HI, PI and WC.
I have worked closely with federal investigators and agencies and fraud-investigation units. I write weekly article to all our clients and speak to hundreds of doctors daily. I still own my clinic and attend multiple insurance seminars, meeting with officials to embrace every aspect of the MD/DC situation. As president of Practice Perfect, the nation's largest and most prolific MD/DC consulting firm, I have spoken to numerous state associations and have as clients some of the nation's largest and most influential doctors. We teach DCs and MDs to develop their clinics in aspects of management.
Four years ago my father was ill and given three months to live by his doctors in France, his country of residence. After he had spent weeks in a hospital, I had him flown to the U.S. With the help of my clinic doctors we not only stabilized his health, but also kept him alive and medication free for two and one-half years. There is no greater reward in the world to know that the center which I created as a young, dedicated, ambitious doctor could one day save my father from harmful treatments and elongate his life by several wonderful years. There lies the real truth and beauty of a multidisciplinary center: that a few doctors get together and practice as a team to render genuine, 100 percent unadulterated care. And what better clinic leader/director than a chiropractor. Imagine the knowledge, compassion and natural approach chiropractic has to offer to anyone. Now add to that the expertise of medicine and you have the best of all worlds.
Patients don't care who will cure their aliments, or necessarily how it will be done. A patient just wants to be healthy. chiropractors use their hands to heal patients and have been very successful at it. Why deny these facts? Why limit our treatment to a few patients who may see our ads or believe in chiropractic because of the media? Why not treat everyone? You must agree that not all patients are candidates for only chiropractic care: some need medical attention as well, as did my father. There is, however, nothing wrong with having several doctors practice together in one center, providing the best health care with all the combined expertise of chiropractic and medicine for the sake of the health of all patients.
I am appalled and disgusted that so many consultants represent multidisciplinary centers as "money makers," and have attorneys say, "Here come the rip-off doctors." I'm upset that these consultants for the greatest part have either never practiced in a multidisciplinary center or are not doctors themselves. How can anyone trust a chiropractic consultant who is not a chiropractor in such complex issues as multidisciplinary centers? Knowledge of a practice is not acquired through osmosis or reading up on the subject.
Attorneys cannot tell you the particularities of billing, and insurance investigators only understand their own limited insurance company. Doctors in practice know that a successful practice demands constant attention to all details, from marketing to development, including and not limited to hiring key employees, billing strategies, developing effective reports of findings, and the use of proper forms.
If you are truly serious abut your practice you must worry about all these points and many more. But let us not ever forget the real people who lie on our exam tables: the 52-year-old mother with severe neck pain; a 26-year-old engineer with numbness in his fingers; and the 7-month-old child with bilateral otitis media. All real people indeed. That is the real reason why doctors need to expand their services to include multiple doctors, and for the sake of all these real people who are the reason we decided to practice. It is indeed a doctor's raison d'etre.
The fact that I employ several doctors in my clinic and have tripled my income is very nice indeed but totally unrelated and certainly not a requirement. It is just a long deserved blessing. One of the doctors I represented as an expert witness shared with me his fear of going to jail. Even though he had pleaded not guilty and faced a tough battle, he regretted not hiring our services earlier to do it the proper way. This is definitely not a game. The regulating bodies which govern state and federal agencies are not amused at the recent wave of so-called "expert consultants" who help integrate multidisciplinary centers.
MDs have been working together since the beginning of that profession. Chiropractic is here to stay. The multidisciplinary center is the wave of the future. The only portion which must go is the untrained consultant with the attorney who writes misquoted and out of context articles to scare legitimate chiropractors into developing the most wonderful concept in health care: the group practice of specialists led by DCs and MDs.
If you are truly interested in an MD/DC practice and genuinely concerned about the future of health care, do your homework. Research your consultant's background and experience. Demand multiple references in numerous states of doctors who are happy practicing and successfully collecting (not just high volume billing) without having increased their overhead beyond 8-12 percent, and not having purchased any machines and/or equipment. Accept to less than the best. Your patients deserve it and so do you. Make this a reality.
Articles are published to increase readership. Do not be swayed by mere words. Demand action, proof and detailed explanation. Let's put our resources and minds to work and get ready to walk into the oval office and say, "Mr. President, we have the solution to health care; we have the answers to all the questions; we have the key to the future of our nation."
Make it happen, doctor. It is only your fear that can stop you.
Daniel Dahan, DC
President
Practice Perfect
Seal Beach, California
