Supplemental income
How to incorporate nutrition into your practice
By John H. Maher, DC

Nutrition offers “the good,” “the bad” and “the profitable” to chiropractic.

First, a look at the good:

People are interested in nutrition and supplements. The growing numbers of baby-boomers want good health and they know good health is directly linked to good nutrition.

At the same time, Americans know they don’t eat properly. They don’t eat enough micronutrients or fiber and they ingest too much high-glycemic carbohydrates and “bad” fats. And all the while, they expose themselves to toxins, germs, allergens, additives, preservatives, pollutants, contaminants, hormones, pesticides, neuro-excitatory chemicals, genetic modification and radiation.

So, what you have is this: Patients who are highly interested in nutrition and supplements, who look to you to be knowledgeable about their health and to guide them in their search for good nutrition.

At the same time, we doctors are also interested in adding nutritional support to our practices, because nutrition helps support our work in chiropractic.

Now, the bad:

Providing nutritional products and guidance is not all roses. We have a few thorns to consider as well. Perhaps the two sharpest thorns are in the areas of patient compliance and practice integration.

Patient compliance is often poor, because patients:

• Are confused about what to eat or not eat; what supplements to take; why, when and how to take them;
• Resist having to swallow a lot of pills or change their dietary habits;
• Are concerned about the cost of a nutritional program versus its perceived benefits; and
• Have a tendency to purchase what they perceive as “better priced” products, especially once they discontinue active care.

• We doctors are concerned about linking our reputation to the companies whose products we recommend;
• We are reluctant to undertake the learning curve associated with multiple products, ingredients, indications, contraindications and uses;
• Offering nutritionals to patients generally means training staff to inventory, price and bill for the products;
• Providing nutritional products means we have to take time to consult with patients. Insurance often does not reimburse for this time; and to incorporate nutrition into the practice, we have to take time away from our main therapeutic practice.

Now, a look at the profitable:

In the United States, Americans spend billions of dollars each year on all types of vitamins, minerals and supplements to get and keep healthy (despite their poor eating habits). And many chiropractors are also interested in augmenting income sources while enhancing the perceived value of chiropractic services.

Giving your patients more of what they need — in a way in which they will take it — presents you with an economic opportunity.

How to do this?

1. Identify appropriate nutritionals. The ideal food for your patients would have a high nutrient-to-calorie ratio and low toxin-to-calorie ration. Nutritional sciences, food-processing technologies and assimilation enhancement technologies have combined to make a number of super foods readily available, including:

• Multi-vitamin and mineral preparations;
• Low-glycemic foods and drinks;
• Legume-, grain- or fruit-based fiber mixes;
• Omega 3 fatty acid oils, pills and powders;
• Whey and soy/legume protein powders; and
• Various phytonutrient concentrates.

Your best bet: Stay with the basics — science-based dietary recommendations almost everyone needs throughout their lives.

2. Utilize technology to demonstrate need. Although you know your patients need balanced nutrition, your say-so may not be enough to convince them. The way to show them what they need is to make an objective evaluation.

A computer, programmed with scientifically validated health risk assessment surveys, can graphically demonstrate the need for lifestyle adjustments, including nutritional changes. Patients can take these assessments in a few minutes in your waiting room and within minutes, you can print the program’s generic recommendations, complete with instructions for inclusion of nutritional supplements.

An additional benefit of software survey programs: They minimize your time involvement and allow you to focus on the primary aspect of your practice — chiropractic.

3. Provide pharmaceutical-grade supplements. Ideally these should be in high-compliance delivery forms (good tasting meals, drinks, bars, sprays, chewable tablets), in order to enhance the likelihood of lifelong brand loyalty.

Providing pharmaceutical-grade supplements manufactured at a facility rated CGMP (Certified Good Manufacturing Practices) gives both you and your patients the peace of mind that they are taking only high quality products, free of toxins.

4. Recommend products available through professionals. By providing these high-quality products, you ensure that you profit from your patients’ lifelong compliance.

5. Consider companies that offer client-direct purchasing. If your patients get their products auto-shipped, the impact on your staff is minimized (little inventory to maintain, no billing, etc.).

John H. Maher, DC, DCCN, FAAIM, maintained an active practice for 25 years and has taught nutrition to health professionals for the past 10 years. He is vice-president of education with BioPharma Scientific Inc. (www.biopharmasci.com). He can be contacted at jmaher@biopharmasci.com.