Chiropractors are strategically poised to take advantage of one of the biggest problems facing industries in America: employees with musculoskeletal pain.
Companies pay for the health insurance and workers' compensation insurance that cover this healthcare expense. Whether injuries occur at work or at home, the company pays for treatment of musculoskeletal pain. In addition, the company suffers from lack of production, decreased morale and many other direct and indirect costs that result from employees' pain and absenteeism. We need to be there to fill this need.
Employees all over the U.S. have repetitive motion jobs that cause accumulated trauma injuries. In the past, these were mostly grouped as upper extremity conditions like carpal tunnel syndrome, tennis elbow and rotator cuff. This definition has expanded over the years. Presently, in some states, low back injuries have been defined as accumulated trauma. Numerous programs that have been implemented to prevent these injuries have been successful in reducing the frequency. Unfortunately, these programs will never succeed in totally eliminating the problem. Whatever conditions we don't accumulate at work, we accumulate outside of work. Both cause pain and dysfunction. Both affect a company's bottom line.
The chiropractic profession is the most appropriately licensed and trained profession to deliver services to positively affect the change that corporate America desires. We are able to rapidly and effectively make people feel better and keep them working. They can't make money with injured people who are sitting home or on light duty. If we pay attention and become flexible, we can profit in this challenging and constantly evolving healthcare marketplace.
On-Site Treatment
Over the last two decades, I have seen changes in the workers' compensation system. More and more states are limiting or making access to injured workers difficult for chiropractors. I see the worker-related injury treatment window slowly closing for our profession; however, the window that is opening is on-site treatment.
This type of service is expanding nationwide as companies look for ways to prevent the accumulation of work and home stressors in their employees. Companies want to prevent recordable workplace injuries and light duty. They also want the employee at work, not laid-up with an injury that occurred at home.
An article recently published in the Journal of Occupational & Environmental Medicine showed the cost savings of chiropractic care onsite. This is our expanding niche market.
State and federal laws are constantly changing. Corporate management, company policy and personnel are in frequent turmoil. So, keep in mind that you will have to be prepared to adapt to changing landscapes if you want to enter this field.
Getting Started
I would like to share the evolution of the marketing model that I now use to create more opportunity.
I sat one day and looked at the fact that Blue Cross Blue Shield (BCBS) is more than 75% of my office income. Recent changes in the workers' compensation law in the state of Illinois have made it even more difficult to see patients, much less treat work-related injuries.
This year, BCBS is requiring require pre-certification for all services performed in a chiropractic office in Illinois. Add to that the lack of a yearly cost of living increase, and you have the perfect storm. Adaptation is imperative.
Shortly after I reviewed my office income, a company I periodically worked with called me. They asked if I had a massage therapist who could do seated chair massage at their company two hours per week. They were interested in addressing some of the discomfort expressed by their employees. I furnished the company with one of my massage therapists. I billed for the service hourly at a reasonable fee.
After my therapist had been there for six months, she noted that many of the employees had recurrent complaints that she was not able to help. I called the safety manager and asked to meet with her to help with this problem. I briefly discussed on-site treatment to address these conditions.
It is important to understand the motivations a company has for having on-site treatment: they are only partially based on the prevention of work-related injuries. Companies have rules set up by the Occupational Safety and Health Administration (OSHA) to document work-related injuries. Industry is interested in keeping the number of recordable injuries low to keep under OSHA's radar, as well as for other financial reasons.
I prepared for the meeting by putting together some statistics and a plan for how my proposal would positively impact the company. The financial realities were compelling and I started the next week.
[pb]On average, I work at that company twice per week for two hours at a time. The preferred time is across the shift change; I treat for one hour before and one hour after this time. They pay me hourly to perform fascial manipulation and Graston technique. The employees thank me regularly for the relief they get from the soft tissue work that I do. The management is thrilled with the rapid response to the treatment and with the employees' satisfaction with the benefit.
By adding four hours per week, I have increased my net income by 20%+. I did not add additional overhead. Through my first company, an additional company has also contacted me to provide this service. I still put 36+ hours per week into my office, so the schedule is a bit grueling, but not bad for adding four hours of work per week.
There is competition in this marketplace nationally. One group charges $300 per hour and pays their doctors $200 per hour. Several companies in my area are quite satisfied with this system. This nationally well-known group has a great reputation with the food and automobile industries in which I work. My fees are less than theirs, but remain a profit center for my practice.
When treating work-related discomfort onsite, you should use specific terms. Please note the words in quotations are OSHA's words and have very specific meanings and usages.
This article is not an attempt to explain the rules and regulations of OSHA. I am summarizing my opinion on information pertaining to the meaning and application of OSHA regulations as they relate to musculoskeletal injury and treatment. OSHA allows "massage" to be performed as "first aid" on employees who experience "discomfort" at work. Therefore, massage (soft tissue work) is allowed to be performed on employees with discomfort, and this is not a recordable injury.
I labeled my program Onsite First Aid and Wellness Care and provide all of my services on-site to keep people working no matter what the source of discomfort. I have separated the services into two distinct areas: massage for work-related discomfort and adjusting and giving exercises for anything else that hampers someone's ability to work.
This is essential because adjusting and advising on corrective exercises makes work-related conditions recordable. If employees can't work because they hurt their back at home over the weekend, the company still loses. By making them feel better, employees can stay at work — everyone wins. As part of my program, I also offer free health classes on stretching and strengthening to prevent injuries at work as well as at home.
How to Find the Business
You know the companies who need you already. Their people sit in front of you every day. Tap that resource to offer companies what they need and want. Make yourself into that they need. If they talk about injuries, offer them on-site treatment. If they talk about lack of training in health, stretching, lifting or ergonomics, offer them that. If you need training yourself, I recommend the Occupational Health and Applied Ergonomics Program at Northwestern Health Sciences University.
Two of the companies I work with had done seated chair massage for their employee discomfort prior to working with me. They continue to use seated chair massage as I have added my services. My recommendation is to offer seated massage at an attractive price to your local companies. We call it stress buster massage. Your therapists know what you do, and I'm sure they can talk you up. If you don't work with massage therapists, they can be wonderful profit centers and a great adjunct to your practice. Maintain your marketing after you start. When the employees I am working on tell me of their great relief and satisfaction with treatment, I remind them to thank the people who are in charge of the program. It is important for management to know the success and gratitude of their workers.
In my opinion, our profession has been squeezed out of the work-related injury market place from the over-treatment, misunderstanding and greed of some of our doctors. In meeting with hundreds of companies over the years, I have been asked to leave on more than one occasion when the principles of the meeting found out I was a chiropractor. Don't be one of the spoilers in this or any other system. Provide poignant, professional, effective treatment. Don't take sides between the employee and the company: be the neutral, sane party. Make people feel better, show them how to take care of themselves, save companies money and release the patient. If a patient doesn't get better, refer. That's the way to foster our image. This is your opportunity to use your soft tissue techniques to benefit your income by providing needed and appreciated services to local industry and to foster our professional image in companies throughout our great country.
Resource:
Continuing to impress the advertising and marketing world, The Foundation for Chiropractic Progress (F4CP) has again been recognized by industry organizations for its excellence in educating consumers on the benefits of chiropractic, this time through social media, newsletters, and demonstrating thought leadership by promoting holistic well-being.
Dr. Louis Sportelli received the Lee-Homewood Chiropractic Heritage Award during the annual conference of the Association for the History of Chiropractic (AHC). During his nearly 60-year career, Dr. Sportelli has embodied the spirit of the award, given to “living individuals who have made outstanding contributions to the chiropractic profession.”
Presently there is no consensus on the best treatment for Achilles tendon rupture; and its management is still controversial. The treatment options are conservative treatment and surgical repair. With either treatment, be it conservative or surgical, Achilles tendon tears necessitate prolonged recovery and rehabilitative management.
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