On Jan. 24 1978, the New Zealand governor-general referred to a Commission of Inquiry an investigation to determine the desirability of providing for reimbursement of chiropractic benefits under the New Zealand Social Security Act and the New Zealand Accident Compensation Act. The commision's findings would impact chiropractic worldwide for decades to come.
Turning Vision Into Opportunity
Chiropractic occupational health consultant Dr. Scott Donkin of Lincoln, Neb., is featured in this issue's occupational health forum. Dr. Donkin is an internationally published author, chiropractor, lecturer and business consultant, and the producer of a variety of multimedia educational programs on health and wellness. He regularly consults with government agencies on safety practices, with companies on ergonomic and health issues for employees, and with manufacturers of such products as office furniture, bedding, pillows, airline seats; and was recently chosen to serve as the national spokesperson for the Panasonic line of massage chairs.
Q: How many years have you been serving in this specialty area and how did you get started?
A: I have been continuously involved with occupational health and safety since 1980, beginning with my experiences with you. As I began my private practice, numerous encounters with patients in 1981 and 1982 demonstrated to me that I could provide them with greater service and improved outcomes if I addressed occupational, ergonomic and lifestyle considerations, and implemented solutions to these concerns into patients' treatment plans. I have continued to be dedicated to this discipline and have more opportunities now than ever before. I regularly visit my patients' workplaces to gain better insight regarding their injuries and conditions. I've discovered that patients as well as employers greatly appreciate this extra service and refer co-workers, family and friends to me for care. This is how I built my practice.
Q: Please give our readers a few examples of the wide range of corporate clients you have worked with and some of your experiences in that regard.
A: I have been invited to work with small- and medium-sized family-owned businesses, larger companies employing more than 500 workers, and Fortune 500 companies that have thousands of employees. Some of my contracts have been with the city of Lincoln; the state of Nebraska; the state of South Dakota; United States federal agencies, European governmental agencies, as well as global companies. I have been fortunate to help organizations of all sizes, providing health, safety, ergonomic and lifestyle advice for all types of workers from individuals on the assembly line to managers, CEOs and public officials. I believe the common denominator in initiating successful outcomes for workers is to ask them to consider: "How can I be healthier, safer and more effective at work, not only for myself, but also for my family and my community?"
Q: What kinds of bottom-line outcomes have companies achieved as the result of your involvement with them?
A: One particular example that comes to mind occurred about nine years ago while working with a local manufacturer that employed slightly more than 500 workers. The company had experienced workers' compensation costs of $143,140 the previous year, and was committed to reducing the incidence, as well as the severity, of the injuries and disorders responsible for these claims. I was contracted to develop and implement a prevention-driven strategy that included an entire menu of occupational health-related services. These included post-offer, pre-placement physical screening evaluations, ergonomic assessments, work-station modifications, back safety classes, on-site stretching programs, triage of all occupational injuries, illnesses and disorders with other providers, diagnosis and treatment of all of their neuromusculoskeletal injuries, as well as the provision of independent medical evaluations and functional-capacity evaluations.
Through the successful implementation of this comprehensive intervention program, over the following four years, workers' compensation claim expenses were drastically reduced to $20,951. As stated above, this company was committed to making changes to its processes and its corporate culture, and was willing to support the procedures and strategies I recommended. The company has continued to sustain these outcomes and has been frequently contacted by other employers interested in learning from its success.
Q: Those are very impressive numbers, Dr. Donkin. Can you share with readers how you market yourself within this specialty, and how this work has contributed to the economic stability and success of your practice?
A: I can trace almost all my local occupational health consulting and treating opportunities to my own patient network, and almost all my national and international consulting assignments to my patient and professional networking. A professional's network of genuinely positive relationships is priceless. In addition to technical skill, professional success is all about positive relationships. Once it became known within the community that I was willing to physically go on-site to observe people at their stressful work stations, the process began to take on a life of its own. With perseverance, it gradually gained momentum and acceptance of these offers became common, to the point that invitations were coming from a variety of sources.
A word of caution is in order regarding on-site visits to the employee's workplace; it must always be pre-authorized by managers, supervisors or owners, as applicable. They must approve of your being there, and must also provide you with the necessary protective equipment and safety protocols relevant to their firm. This process of providing a higher level of personalized service for my patients and employers became my primary means of practice building. One exciting benefit is that it attracted exactly the type of patients and employers I most wanted to care for.
Q: You mention the importance of technical skills. Please tell our readers about your training in occupational health and applied ergonomics.
A: My initial training in this specialty was "on the job" working with you in the performance of the post-offer, pre-placement physical screening examinations and the implementation of the biomechanical stress index (BSI), and witnessing the very positive outcomes we achieved. Through being intimately involved in the process, the experience had a profound impact on my professional career, as I recognized the phenomenal benefit chiropractic could have for companies and governmental agencies everywhere. It became crystal clear to me that because of the overwhelming prevalence of neuromusculoskeletal disorders among workers, businesses are in critical need of our services and expertise. The next step in my training, of course, involved participation in the postgraduate diplomate program on occupational health and applied ergonomics offered through the Northwestern Health Sciences University continuing education department. That training provided education as well as confidence to help me move forward with initiatives in my community.
Q: What advice would you offer to doctors who may be interested in working within this specialty?
A: It is important for doctors to create their own vision, establishing a plan with action steps and following through with persistence, taking every opportunity to learn from the moment, even those moments in which they do not succeed. Make corrections in your plan as you proceed. Obtain sufficient education and training to gain competence as well as confidence. Seriously consider involving yourself in a continuing-education program on occupational health and applied ergonomics,. Do not hesitate to seek assistance. Join the nonprofit International Academy of Chiropractic Occupational Health Consultants and utilize its resources as applicable. The organization will help you stay abreast of happenings within the specialty and can serve as a network of like-minded professionals who can be of assistance to each other.
Always keep in mind that just as in patient care, the fulfillment of your client's and their employees' needs and goals will best fulfill your own. Obtain constant feedback from your clients. Listen carefully. Understand that it often takes time, patience, persistent communication, compatible intentions and perseverance to influence the corporate culture toward more proactive/preventive thinking. It is always best to under-promise and over-deliver. Maintain careful records, take careful notes, and collect data to validate your outcomes.
Finally, your opportunities are directly related to the size and shape of your vision, your beliefs, your tenacity for good, and the depth of your humility. You may be surprised to learn that there are likely more viable opportunities within your community than you currently realize, especially during these challenging economic times within the business world.
Q: Any other insights or observations you would like to add?
A: My personal mission is to enhance the expression of life on the planet. That is why I am a chiropractor. It is the reason I so much enjoy consulting for and working closely with local employers and their most valuable assets, their employees. This is also why I am greatly enjoying working with global companies such as Panasonic and Herman Miller, as they are renowned as innovative designers and manufacturers of products of incredible quality, and are also environmentally responsible. I have never regretted for a moment dedicating a major portion of my life and career to chiropractic occupational health and safety. I encourage my chiropractic colleagues to explore this specialty area of professional service to learn whether a sense of congruity exists with their personal mission.