Issue 8 - June 2004

Occupational healthcare: Wide open arena for chiropractic
By Joseph J. Sweere, DC, DABCO, DACBOH

Work-related injuries are not the product of the 21st century. As early as the 18th century, Italian physician Bernardino Ramazinni, had identified 50 or more disorders that were directly attributable to workplace exposure.

Today, between 60 percent and 70 percent of all work-related injuries and incidents involve the neuromusculoskeletal system and approximately 90 cents of every workers’ compensation dollar are spent in their management.

In spite of significant advances in healthcare technology, all the indicators suggest that many employers and their workers remain at notable risk for work-related illness and injury, absenteeism, loss of productivity and worker turnover.

Workers and employers who are most vulnerable to a high incidence of spine and related neuro-musculoskeletal disorders are in:

• Trucking and vehicle operations industries;

• Manufacturing; warehousing and manual material-handling occupations, including the building and construction trades;

• Nursing home and healthcare facilities;

• Work activities involving prolonged sitting;

• Work involving repetitive motions; and

• Combinations of these occupations.

From this list, you can appreciate that these jobs involve thousands of employers and as many as 100 million workers. The socioeconomic burden and human suffering associated with these realities is immeasurable.

MANAGED CARE NOT A SOLUTION
In addition to work-related injury costs, employers are also concerned about the cost of non-work-related healthcare. In the early 1990’s managed care expanded dramatically in the United States to serve as a deterrent to escalating costs.

Most employers and organized employer groups now consider this a dismal failure. Healthcare costs have skyrocketed with a 600 percent increase in healthcare premiums during the past 11 years.

Employers and policy makers are facing the reality that no end is in site to the drastic escalation in costs and our nation is facing a healthcare crisis of incredible proportions.

Because employers negotiate and contract the vast majority of healthcare insurance coverage, they will likely remain the single most important force in determining the direction of healthcare well into the future. An exceptional opportunity exists for you to position yourself into positive, win-win working relationships as corporate health and wellness consultants.

CHIROPRACTIC’S CRITICAL ROLE
With appropriate postgraduate training in occupational health and applied ergonomics, chiropractors can work as solo consultants with small to medium-size firms of 25 to 500 employees or larger firms that employ up to 10,000 or more workers.

When employed by very large firms, DCs usually function as members of teams of professionals involved in occupational health and safety. Other team members may include occupational medical physicians, occupational nurses, human resources coordinators and others among the helping community.

Consulting is one avenue in occupational healthcare. Here are additional examples of how some chiropractors work in the occupational arena:

• Onsite services. Dr. H. provides on-site chiropractic services within a variety of corporate settings, serving the health needs of workers. His work with employees on structural care, ergonomic needs, lifestyle and nutritional concerns has resulted in drastic reductions in workers’ compensation premiums, reduced absenteeism and improved productivity, worker morale and employee retention.

•Full-time consultant to industry. Dr. O. has been serving as a full-time occupational health consultant to several dozen major companies, providing chiropractic services and engaging the workers and occupational health nurses in ergonomic workplace modification and on-site care that addresses the neuromusculoskeletal symptoms before they become a workers’ compensation statistic.

This chiropractor has saved workers from significant human suffering and corporate clients millions of dollars by drastically reducing the need for carpal tunnel surgeries and disabling spine related disorders.

• Post-offer physicals. Dr. S. has over a dozen companies that send all post-job offer, prospective work candidates for a chiropractic, structural approach to pre-placement physical screening examination.

Each of these corporate relationships was acquired through the positive word-of-mouth recommendations of satisfied existing clients.

• DOT screenings. Dr. K. has been providing DOT and non- DOT drug screening services and DOT physical examinations for local corporate clients, adding “tens of thousands of dollars” of income to his practice each year.

• Wellness training sessions. Dr. B. provides up to 30 corporate health, safety and wellness educational training sessions every year. His talks have resulted in satisfied employers mandating substantial chiropractic benefits by their managed care providers. In return, many of those employers involve chiropractic services in a broad range of health, wellness and safety prevention strategies.

YOU CAN BECOME INVOLVED
A number of chiropractic colleges have provided specialized training and certification in occupational health and applied ergonomics since 1983. Approximately 2,000 doctors of chiropractic have participated in various aspects of this training, many of whom are now serving as professional consultants to corporate and business clients.

In 1990, the American Chiropractic Association established a Council on Occupational Health (www.acacoh.com ) that provides the framework for the development of a board certification specialty. About 90 doctors of chiropractic have earned the title, Diplomate, American Chiropractic Board of Occupational Health (DACBOH).

The non-profit International Academy of Chiropractic Occupational Health Consultants (IACOHC, www.IACOHC.com) offers additional resources related to occupational health and industrial consulting.

Joseph J. Sweere DC, DABCO, DACBOH, is the director of occupational health at Northwestern Health Sciences University. He can be contacted at: 952-888-4777, ext. 269 or by e-mail: jsweere@nwhealth.edu.