The Healthy Aging Practice (Part 1): Planning for the Health Care Shift

Editor's Note: This is part 1 of a three-part series on creating a healthy aging practice to better serve the aging baby boomer population, which likely will comprise an increasing percentage of your patient base in the coming years.

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I have been in continuous private practice for more than 30 years, but I am still a student. I am happy to be a part of a profession that is ever-growing on a global scale. Corporations, governments, unions, insurance companies, and individuals want what we offer for pain management, injury risk management, and healthy aging innovations.

I recognize the challenges posed by today's health care system. I think the most dominant change we are facing is probably the growing impact of an aging population. Deciding how to deal with (healthy) aging is an ongoing challenge that has never been greater. We're witnessing a tug-of-war between the "Big Pharma" business sector with its strong messages, strong leadership, and government backing, and what people realistically want – which is not "cookie-cutter" health care. The insecurity around growing old and being debilitated needs solutions, and as chiropractors, I think we can really help this situation. After all, let's face it: you only get one chance at growing old.

What We Need to Do

First, we need to surround ourselves with good, like-minded people (MDs, DCs, NDs, PTs, acupuncturists, etc.) and mentor each other. We should constantly use research and attempt to improve what we find to do things better. Sometimes we should drop the stuff that really doesn't work – often a doctor treats patients strictly based on whether the doctor likes a particular treatment. Everyone is different and what is good for one person might be dangerous, or at best, ineffective, for another.

Second, we need to hire good people for our offices and create a team that can help us conduct comprehensive pre-senior and senior health assessments and fitness testing. We will need to teach our patients the fundamentals of therapeutic lifestyle changes (diet, exercise, sleep, spirit, etc.). I think we need to be willing to take risks and purchase new equipment (bio-impedance analysis, bands, balance devices, foam rolls, free weights – all inexpensive) and maintain updated, modern offices. Without new equipment, we freeze into one technique without the opportunity to personalize care.

I don't know what the research says, but the average DC seems to have a pretty long career. I've been around long enough to know that when a chiropractor "builds" a practice and becomes the doctor they have worked years to become, they are then reminded that they have only this very short amount of time to continue enjoying life and the practice. Getting older, I appreciate this even more. It's our job to educate people that early attention to the aging process impacts the common degenerative processes, especially the musculoskeletal system, the cardio-respiratory system and waistlines.

It's easy for patients to say, "I put on weight after I had my kids," and now it's 20 years later and they still have not executed the self-made promise to lose that weight. I meet a lot of people who tell me they want to lose 10-15 pounds (the truth is many need to lose more than that amount). It's my job to tell these people that they need to lose weight.

CommonDegenerative Diseases of Aging Abnormal cholesterol levels Cancer (almost all types of cancer can be caused byaging, but breast, prostate and colon cancer are the most common) Dementia Depression (long term) Early menopause High blood pressure Morbid obesity (30 percent or more above your idealbody weight) Osteoarthritis Osteoporosis Stroke Type 2 diabetes Things We Can Help Control as Patients Age Muscle mass Strength Basal metabolic rate Body-fat percentage Aerobic capacity Blood sugar tolerance Cholesterol Blood pressure Bone density Temperature regulation

These overweight people have an incredible history of "dieting" in their backgrounds. I still tell these patients, "Let's try this together so we can turn your weight loss into a success story." It's my job to do this! The risk of overweight and obesity translating into chronic diseases becomes more apparent as people grow older. Diet success is about consistency, and I'm now using an online program to track my patients' food intake and help everyone, particularly the lifetime dieters, live up to their dreams.

Technology has helped me to be more comprehensive in how I execute dietary changes with my patients. I have found good success using body composition analysis and the Paleo diet principles. People are recognizing how diet is related to chronic disease, particularly as they grow older.

To safely and effectively work with mature adults for healthy aging, we'll need to build confidence by going to postgraduate seminars necessary to generate a current-trend-line education. It doesn't matter if you're a "straight," an SOT'er, AK'er, diversified practitioner, etc. In the next year, take more postgrad education than you are required to do. Patients are increasingly seeking out knowledgeable doctors.

To help patients age healthy, the partnership between doctor and patient is going to be more imperative. In the big picture, it's going to be imperative to work together as chiropractors to create healthy aging for society. We need to have knowledge of guidelines specific to the aging population for lower- and upper-body flexibility, balance, aerobic endurance, lower- and upper-body strength, and agility.

Not only will we need the skill set to assess, treat and re-assess, but as doctors we'll also need consistency of "message" surrounded by identifying what motivates the mature patient to improve diet, nutrition, exercise, sleep, spirit, etc. Having the ability to daily message or quarterly message will be helpful. Having an online system helps me keep track of each patient's biometric data that I enter into a secure, password-protected health record and can be accessed at any time from any Internet-enabled PC. Patients and doctors can easily log into the user-friendly web interface to review results and evaluate progress.

Having a monitoring system for patients creates compliance and strong, precision-guided goals. Presently, I keep track of the patient's exercise log, food diary, Functional Movement Screen (FMS) scores, hydration levels, body fat and lean muscle mass. The consistent message is having a healthy lifestyle.

My patients are asking for help more than ever before. They are asking the same questions all the time: "How should I change my eating habits?" "Which exercises should I do?" "How can I reduce stress?" How will you help them understand these and other issues imperative to healthy aging? It comes down to this consistency around our messaging.

We have to be efficient, provide fair pricing, great service, and be transparent. We have to continue to use our skilled "hands-on procedures," but even more so it is about health information; sharing this information so patients can continue to facilitate positive changes even when they are not with us in the office.

Embracing Healthy Aging

I have a personal approach to this healthy aging practice, but I also use technology. I still study and read something related to our field every day. I'm still a student. I am still learning today as much as I was learning when I started in chiropractic college. Don't forget that your job has to evolve and change all the time, and that what worked in the past may not work in the future. In my view, if you don't believe you're learning, if you're not a student, then you're probably going backward. To be helpful, to be innovative on behalf of your patients, you have to be aware of the health trends and how that translates into a practice-management strategy.

This year, I wish you and yours healthy aging. This year, remember to focus on the fundamentals before adding complexities, such as teaching patients a little about microbreaks and good posture, a little about diet, a little about functional fitness, and a little about stress reduction, since these basics take care of the majority of cases quite nicely. "Cheers" to creating an organized, thoughtful healthy-aging program in your office.