Just say yes!
How industrial consulting can give your practice an edge
By Linda Segall

It’s not news to you: Chiropractic Economics 9th Annual Fees & Reimbursements Survey showed insurance companies are clamping down on reimbursement rates, and our 10th Annual Salary & Expense Survey indicated median gross billings and collections, as well as your total compensation, have remained flat for several years.

What’s a chiropractor to do? How can you make headway to secure your future? According to Joseph J. Sweere, DC, DABCO, DACBOH, the director of occupational health at Northwestern Health Sciences University, you might want to consider industrial consulting.

“When you consider that between 60 percent and 80 percent of workplace illness and injury involves the neuromusculoskeletal (NMS) system and 90 percent of workers’ compensation dollars are spent in the management of NMS conditions, it is logical and appropriate that chiropractic should be playing a major role in occupation health,” says Sweere.

He emphasizes the appropriateness: “This opportunity is particularly obvious when you consider there are almost eight million businesses operating within the United States, but fewer than 2,000 board-certified occupationally trained medical physicians available to serve their needs.”

Very large companies or manufacturing plants usually have many resources available to them, but about 80 percent of American workers are employed by firms with fewer than 100 employees, says Sweere. “In the majority of cases, smaller employers do not have internal resources to manage their health, wellness, and safety concerns and thereby bear significant workers’ compensation insurance claims and related expenses.”

What this situation amounts to is an opportunity for those chiropractors who are looking to expand their practices in innovative ways.

In addition to Sweere, Chiropractic Economics talked with several DCs who work at least part time in corporate and industrial consulting. They include Drs. Michael Megehee, Bruce Hansbrough, Chad Henriksen, and Marcus E. Vaughn. (See sidebar, “Meet the industrial consultants.”)

We asked them about their consulting practices, how they first got into industrial consulting, and what advice they could offer to colleagues who want to venture into the industrial arena.

SCOPE OF INDUSTRIAL CONSULTING

It would seem that no two chiropractors do industrial consulting the same way.

Solo practitioner Megehee, for example, devotes about 25 percent of his time to consulting, and much of that time is spent in various types of testing. He says that although he provides chiropractic care, he also provides drug and alcohol testing and physical exams for companies. “We specialize in DOT [Department of Transportation] programs, including third-party administration of drug and alcohol programs for the federal government.”

Hansbrough, who has a group practice, devotes about 35 percent of his practice to occupational health. “Industrial consulting includes in-office and on-site workplace assessments, education and training, safety-program development, drug and alcohol screenings, preplace-ment (post-offer) physical exams, and DOT physicals,” he says.

Like Megehee, Vaughn, a solo DC, spends about 25 percent of his four-and-a-half day workweek in industrial consulting. “My primary focus is with the trucking industry,” he explains. “I conduct DOT physical examinations for a number of companies, a local truck-driving school, and a large number of individuals.

“We also conduct DOT-mandated drug and breath-alcohol testing. A second focus [of industrial consulting] is on injury prevention. I conduct workshops for companies to help them meet their Injury Illness Prevention Program (IIPP) requirements, as mandated by the State of California.”

Vaughn says his goal is to meet the employer’s needs. “I find this out by meeting with the safety officer or the person who manages the compliance requirements. Once I know the needs, I tailor my presentation appropriately.”

Henriksen no longer runs a “typical” chiropractic clinic. Rather, since 2001, he has devoted 100 percent of his time on industrial health. He has not abandoned chiropractic, however. In addition to the seminars and workshops, injury-prevention consulting, ergonomics assessment, and occupational health consulting, he provides on-site chiropractic care to employees.

OPPORTUNITY AND BENEFIT

All four of the chiropractors say industrial consulting has had a positive impact on their practices.

Megehee explains the opportunity: “Consulting has opened a new financial market source, which blends into chiropractic treatment of employees and injured workers.”

“I used to look at [industrial consulting] as an adjunct to my practice — a way to make a little extra income. I’m now seeing a much bigger picture, as I have had companies approach me without my soliciting them,” says Vaughn.

He also acknowledges industrial consulting has enhanced his professional and personal life. “When I offer an employer and employee tools to help them in their work by reducing injuries and increasing productivity, it’s win-win. In doing so, I am expanding my professional reputation as a knowledgeable, credible, healthcare provider in my community. I am blessed with many referrals. The exposure I gain from meeting and working with people in the community has been one of the greatest assets to building and growing my practice.”

Hansbrough agrees. “New patients come as a result of doing a good pre-placement or DOT exam. Employers may also send workers’ comp and other cases, including employees on their group plans with other health issues.”

FIRST CLIENTS

Industrial consulting, like any other endeavor, requires thought, planning, and going after clients. Sometimes getting started is almost a fluke, as in Henricksen’s case.

“I was working as an associate in a traditional chiropractic office when we were approached with an invitation to assess some trouble a local company was having with its employees. They asked us to provide some on-site chiropractic care to help restore and maintain the health of the employees,” says Henricksen.

“After wonderful success at this company, I started on-site at a second company. Consulting contracts continued to grow after I completed my occupational health and applied ergonomics diplomate.”

Getting into this area of healthcare also requires taking advantage of a window of opportunity, as Megehee notes. He acquired his first client when a local medical doctor decided to stop offering drug screening. “We were called by three large companies and asked if we could provide the service,” he says.

California law requires companies to have a formal program on injury prevention. Vaughn had a patient who owned a company, so he asked the patient who did the program. “That started it all. Then I began asking my patients who worked for larger companies and those who had [good] chiropractic coverage in their company’s health plans,” he says.

Hansbrough started out by treating workers’ comp cases. The company was impressed with how expeditiously he helped return people to work. “This was so impressive to them, they requested assistance in developing written return-to-work policies and procedures with transitional duties and temporary work assignments (TWA),” he states. “This required over a year and a half of working with safety and HR to develop more than 17 TWAs that could meet the criteria of Title I of the Americans with Disabilities Act.”

ADVICE TO NEWCOMERS

Because you can’t always expect clients to be handed to you, the consultants shared advice on getting into industrial consulting.

• Study your market. Know what you are getting into, says Hansbrough. Identify potential clients and get to know their needs.

• Develop a business plan. “Clearly define your services, benefits to the company, and how you will market,” says Henricksen.

• Know your stuff. “Get training. Get credentials, if possible, from courses such as the diplomate program,” says Megehee. “If you know your material and subject matter, you will have confidence when you deal with companies in person.”

“Spend time with others who have been down the road,” says Henricksen. “My greatest successes have been a result of avoiding the mistakes of others and gaining the wisdom of those who have worked within this field before me.”

• Join a professional organization. “Align yourself with someone or a group, such as the ACACOH [American Chiropractic Association Council on Occupational Health], who has already paved a trail,” says Vaughn.

• Use inside knowledge. “Cold-calling is labor-intensive and has a very low return-on-investment (ROI),” says Hansbrough. “Use your inside knowledge, such as patients who already work for a company you are interested in doing business with. The best way I have found to get HR, risk, or safety professionals to trust you is invite them to a professional club meeting or to lunch.”

• Be persistent. “I’ve heard in sales it can take up to seven times before a sale is closed. Sounds reasonable. I just keep this in mind,” says Vaughn.

Hansbrough adds, “The best relations take at least several months to develop and maintain.”

• Be flexible. “Every company is different,” says Henricksen. “I needed to learn to be flexible, patient, and persistent.”

• Call upon your background. “Many DCs had other occupations before they became doctors  and they can use their experiences to relate to those types of industries,” says Vaughn. “As an example, I was a Teamster warehouseman, a parts- department clerk for a major national truck-trailer manufacturer, an office clerk for a pump manufacturer, and a manager in our family grocery business. These early jobs help me relate to multitudes of people during my presentations.”

• Talk the company’s talk. And that usually means talking ROI, says Henricksen. It also means addressing its concerns about your qualifications, the kinds of results you can achieve, and liability issues it may be worried about.

• Know your role. Don’t try to do the safety manager’s job, says Hansbrough. “The biggest mistake I made was going into a roof-tile manufacturing plant and pointing out all the safety violations to the safety manager on my first plant tour.

“I had just recently taken an OSHA certification course, which made me think I was now an ‘expert’ in OSHA rules. Naturally, this did not make the safety manager feel very good about utilizing my consulting services. … Never give advice or opinions unless asked for them or there is an imminent danger of loss of life or limb.”

Linda Segall is editor-in-chief of Chiropractic Economics. She can be reached at lsegall@chiroeco.com or at 904-567-1537.