Adding nutrition to your practice can pay large dividends, while integrating smoothly with chiropractic.

By Marc H. Sencer, MD

Adding nutritional medicine to your practice can be as simple as giving basic healthy eating advice, or as complex as building a full-blown nutritional medicine practice with a multidisciplinary staff, laboratory workup, and a range of treatment protocols for various conditions.

Find your niche

The first step in adding nutrition to your practice is to decide what services you would like to offer and then do a business analysis on each of them. Although nutrition encompasses a wide field of clinical activities, there are some basic services any nutritional medicine practice typically will offer.

1. Food sensitivity. One of the most interesting areas of nutrition is food sensitivity. Food allergies have been linked to many different conditions so it shouldn't be difficult to market this addition to your practice.

In addition, you may develop a specific niche within the food allergy category, such as food allergy and autism, or food allergy and depression.

Food allergy services consist of testing for food allergies, treatment with elimination diets, and desensitization with allergy injections.

All of these can be profit centers for the nutrition practice. In addition, there are initial evaluations and follow-up visits for ongoing allergy patients. Check with your state's board to determine which of these clinical activities fall under the scope of practice for your state. If there is an MD in your practice, this will not be an issue, as allergy services can be provided in all states by MDs.

2. Weight management. As we all know obesity treatment is a multibillion-dollar business and, as a nutritional specialist, you are perfectly positioned to help overweight patients. Most nutritional practices include obesity treatment as a significant portion of their business.

The profit centers in weight loss practice include doctor visits, the initial evaluation, regular follow-ups, nutritional supplements that support weight-loss, and for integrated practices with medical doctors on staff, the use of HCG and medications to help promote weight loss.

In addition, some practices offer consultations with a dietician, weight support groups, and other ancillary services.

Cutting-edge care

Many common medical conditions have a nutritional component. The most well-known examples are abnormalities of blood glucose: diabetes, hypoglycemia, and metabolic syndrome. But there is also evidence that many other diseases, from irritable bowel syndrome to Parkinson’s disease, can be improved or have their progression slowed with the use of nutritional supplements.

Currently, major teaching centers, including the University of Miami, are studying the effects of Co-enzyme Q-10 and vitamin D on Parkinson’s disease. As a nutritional doctor, you can be a part of this cutting-edge area of practice.

As with most nutritional therapies, the profit centers include diagnostic tests, doctor visits, and nutritional supplements.

In addition, many

patients visit a nutritional specialist for the prevention of medical problems, to support and promote general good health, and to slow down the aging process. These wellness patients typically make up a significant portion of the nutritional practice.

Although most are in good health, your initial evaluation may uncover medical conditions that they are at risk for or that are present in an asymptomatic state. The wellness sector is also easy to market. Competition is often limited and demand is great.

What, you may be asking, is the role of chiropractic in all of this? Because chiropractic is a holistic treatment that promotes general well-being, it should be a part of the treatment regimen for all of your nutrition patients. Even those who do not have a distinct musculoskeletal component can benefit.

Making it work

Nutritional medicine is such an exciting field clinically that it is easy to lose track of the fact that it is still a business and must be run in a profitable way. For each service you add, you must know your cost to provide the service, the reimbursement rate, and how you will market it. You should create protocols for the provision of each service that you add. Although some patients are more challenging than others, you and your staff should not have to reinvent the wheel for every new patient you treat.

Reimbursement for most nutrition services will be direct pay. Although insurance may cover certain procedures and tests, you should have the patient pay and then have them submit the claim for reimbursement. One of the nice things about this type of practice is you do not have to deal with the hassles of third-party payers.

As with many of the services you can add to your practice, nutrition can run on autopilot, with most aspects delegated to associate chiropractors, MDs, and dietitians. Once you have good protocols in place, the rest is automatic.

Interesting clinical work, no hassles with insurance, and a practice that can be delegated. With a nutrition practice you can have it all.

Test yourself

Check your knowledge about how to set up a nutrition practice with this true or false quiz.

[  ] 1. Most nutritional services are covered by private insurance but not by Medicare.

[  ] 2. Only nutrition patients with musculoskeletal problems should receive chiropractic treatment.

[  ] 3. Nutritional supplements may prevent the progression of Parkinson’s and other chronic progressive diseases.

[  ] 4. Food allergies have been linked to many medical conditions.

Nos. 3 and 4 are true.

Nos. 1 and 2 are false. Most nutritional services are not covered by Medicare or private insurance. Because it is a holistic therapy that supports wellness, barring any contraindication all of your nutrition patients will benefit from chiropractic treatment along with their nutritional program.

Marc H. Sencer, MD, is the president of MDs for DCs, which provides intensive one-on-one training, medical staffing, and ongoing practice management support to chiropractic integrated practices. He can be reached at 800-916-1462 or through www.mdsfordcs.com.