Issue 3 - February 2003

Nutrition: Food for your patients, food for your practice
By Linda Segall

Food, food everywhere, and not a calorie to nourish! Americans are quite possibly the best fed – and worst nourished – people on the earth. Knowing and acting on that fact can open the door to healthier patients, better retention and a bigger bottom line in your chiropractic practice.

“Americans eat terribly!” says Dr. Michael J. Koch, DC, of Breakthrough Coaching. “We consume billions and billions of McDonalds, Burger Kings and french fries…tons of refined sugar and flour and more cancer-causing additives and preservatives than any other country in the world!”

The poor nutrition of Americans is caused by more than just the food they consume, observes Galen O. Ballard, president of Titan Labs. “Food is much less nutritious today than it was 50 years ago. Our soils have been depleted of much of the essential nutrients required by the human body. Irradiation of foods has also reduced their nutritional value…Today’s refining process strips foods of their nutrients.”

And although farmers attempt to replenish nourishment into the soils by heavy fertilization, fertilizers used today only contain the three or four nutrients necessary to grow crops – but not the 20 or 30 required by the human body, says Ballard.

Supplements benefit almost everyone
Since virtually all Americans eat processed food, almost everyone can benefit from a nutritional supplement program. “If they are breathing, they need supplementation,” says Koch. “Our bodies are constantly oxidizing and aging. We are plagued by arthritis, asthma, diabetes, high blood pressure, high cholesterol, ulcers and cancer. Patients who are in one of these sub-sets are nutritionally deficient. Supplementation is the cheapest insurance policy anyone can buy against illness and aging.”

Ballard believes that the basic nutrient requirements for most people are pretty constant. “We all need multiple vitamins, minerals, anti-oxidants, trace elements and essential fatty acids on a daily basis, so nearly all Americans should take a multi-vitamin (anti-oxidant) and a calcium-magnesium based mineral supplement.”

Telling signs of nourishment needs
With that said, patients “tell” you that they need nutrition, according to the problems they relate to you during your work up, says Dr. Frank King, DC, ND, of King Bio Pharmaceuticals, a homeopathic manufacturing company serving chiropractors. “Most everyone has some sort of health problem that is not being corrected by conventional healthcare procedures. Chiropractors have a great opportunity to successfully address these problems, by adding nutrition and homeopathy.”

And when you ask the patient what ails him (or her), you’ll get an earful. “People don’t just come in [to the chiropractor] with musculoskeletal problems,” says Dr. Ward Dean, MD, director of research and development for Vitamin Research Products. “They have hypertension, diabetes, cancer and depression, for example.” All of these can be considered “warning signs” of poor nutrition.

And don’t overlook the obvious, such as obesity and aging. “Obesity is a form of malnutrition,” says Ballard. “The body takes in an over-abundance of so-called foods in an attempt to assimilate the nutrients necessary to sustain life.” But since it doesn’t get the proper nutrients – only fats and simple carbohydrates – people get fat.

Aging is also a sign off supplementation need. “The aging process is one disease that everyone over 30 has caught,” says Dean, whose research has specialized in aging. “All chronic degenerative symptoms are manifestations of the super-disease – aging.” Dean, a medical doctor, states that the medical solution to these degenerative diseases is to treat the pain, such as with nonsteroidal anti-inflammatories. “But these drugs impair the replication of cartilage,” he says, “and make the problem worse. Supplements help to replicate cartilage, relieve inflammation and pain and reverse the problem.

Aside from the “telling” signs that a patient has a nutritional imbalance, a chiropractor can run tests. King says, “Most doctors have a system to determine what people ought to be on. They use lab tests, reflex tests and diagnostic tools that can tell what each patient needs and does not need. DCs have more sophisticated ways to determine what the patient needs and when to change products throughout the healing process. That individualized care allows the chiropractor to take the patient’s health to higher level.”

A simple pH saliva test is one of the best methods for determining if a patent should take nutritional supplements, says Ballard. “A healthy human body is slightly alkaline with a pH of 7.4. If the pH test shows an acid level of 6.8 or below, it is a clear indication that the patient’s nutritional needs are not being met.”

Bottom-line ‘cents’
Adding supplementation to your practice can make sense for your patients. But it can also make “cents” for your bottom line. “Americans are buying billions of dollars of supplements from drug stores, health-food stores and magazines, with little to no competent advice,” says Koch. “Why shouldn’t DCs bring some expertise to the equation? Even a little knowledge can be far more effective than leaving the patient to their own potentially erroneous designs.”

Koch quickly adds, however, that “nutrition shouldn’t be entered into as an ‘ancillary’ business or an after-thought. It should be an integral part of every patient’s diagnostic work up and treatment plan.”

“The practitioner should be aware of his motives before embarking on a supplementation program,” says Ballard. “A chiropractor should never sell nutritional products. Rather, he or she should prescribe nutrition when a patient’s health problem indicates the need for specific supplementation… Practitioners who are in for the money only usually end up making mistakes and losing patients.” Providing supplements can have a dramatic effect on your bottom line, however. “You’ll have better patient retention and referrals,” says Ann Holden vice president of quality for Standard Process. That alone will help the practice’s profitability. Add in mark up and a chiropractor will see an impact. King says that it’s not uncommon for chiropractors to add upwards of $50,000 to $100,000 annually by making homeopathy and supplements an active part of the practice.

Compliance is key
The real key to a profitable nutrition and supplement business, however, is patient compliance. Patients who don’t follow a regimen don’t feel healthier and won’t continue to purchase supplements. According to King, “When you combine the right balance of chiropractic, nutrition and homeopathy, you correct problems more effectively and efficiently and people become more complaint.”

All the experts agree that education is key to compliance. “Most reputable venders offer a wealth of complimentary educational materials for the chiropractor,” says Ballad. “If the practitioner recommends a specific nutritional protocol, he or she should provide the patient with the brochure or research booklet prepared by the vender which will give the patient full explanations.”

Education can’t be “under-done,” says Holden. “The more you educate the patient, the more success you will have. Compliance comes when patients understand what they are taking.”

The education process can be one-on-one, or it can be through workshops. “Chiropractors have an obligation to their patient base and to the public at large to offer nutritional workshops in the office, at health-food stores, workout centers, park districts, PTA groups and to anyone who will listen,” says Koch. And don’t forget your own education. “If you are not already knowledgeable about nutrition, become educated,” says Koch.

Sources: Linda Segall, editor of Chiropractic Economics, interviewed Galen O. Ballard of Titan Laboratories (www.titanlabs.com); Dr. Ward Dean, MD, of Vitamin Research Products (www.vrp.com); Ann Holden of Standard Process (www.standardprocess.com); Dr. Frank King, DC, ND, of King Bio Pharmaceuticals (www.kingbio.com); and Dr. Michael J. Koch, DC, of Breakthrough Coaching (www.mybreakthrough.com) for this article.