DCs face challenges outside the norm, and sometimes outside belief, performing Alaska chiropractic care for patients
It’s probably been a while as a doctor of chiropractic since you’ve loaded a folding adjustment table into a small four-seater Cessna to fly to a small town, or accepted barter instead of a fee for service, or set up your table beside an ice rink in 30-below weather, or driven your snow plow down a frozen river to service the small villages along it.
Chiropractic in some of the rural regions of Alaska can be a different animal.
Being at the start and finish of the Iditarod [dog race] with a folding table, that’s an experience,” says Walter Campbell, DC, and founder of Arctic Chiropractic Rehabilitation and Physical Therapy in Alaska. “To be a chiropractor here you gotta love some of the things that make it difficult. You have to enjoy contending with Mother Nature, or it’s not the place for you.”
Raised in the remote north, “about the farthest north you can be and still be in the U.S.,” Campbell knows rural Alaska. The town he grew up in had no roads.
“It’s kind of inhospitable, even to Alaskans,” he says of his upbringing. But it instilled in him a love and sense of service for seeing to the needs of fellow rural Alaskans.
Coming out of chiropractic college, an associate position he had lined up fell through, so he decided to work mobile.
“I went out to small communities that weren’t large enough for a full-time clinic, a couple days a month each, and became a travel practice,” Campbell says. “I found a few communities that were big enough, far-flung rural places but they were good markets. I went to places people wouldn’t go to and I opened up practices, and because I grew up in rural Alaska I had a credibility with people in those places. Northern Alaskans are pretty skeptical of people down south in Alaska, like down in Anchorage.”
In 2005 Campbell opened his first two Alaska chiropractic offices, which quickly grew to six.
“I put out a call for doctors, and the way Alaska works is you can only license doctors three or four times a year, at least solo doctors,” he says. “I replaced myself at my first three clinics in probably six months. And then within two years of Arctic being Arctic, we had six clinics. Then anytime anyone wanted to sell a practice, a rural practice, they would call me before they wanted to put it on the market. So I was able to acquire several practices that way and the thing started to take on some momentum.”
Today Arctic Chiropractic is just short of 30 clinics across the state, a far cry from Campbell’s beginnings loading equipment in the back of his clinic on wheels.
“When I started in a little town called Healy [population around 1,000], it had a Lions Club building and a hockey rink next to it, and I would just set up my table,” Campbell says. “Folks in Healy will play hockey when it’s 30 below; it’s just crazy. But they had a little changing building they would rent out, they had a nurse practitioner who would come in once a month — so I did a little bit of barter. They have some bed-and-breakfasts up there in that national park area. Especially in the summertime it’s a thriving bed-and-breakfast area up there.”
Doctor perks and perplexities
Attracting good doctors to Alaska, Campbell says, is no easy task. Add to that local difficulties finding housing and transportation, and working as a DC usually comes with some necessary perks.
“I take pretty good care of my doctors,” he says. “I usually provide housing and cars — it’s incredibly difficult to find housing. The housing markets are not your normal housing markets in these small rural towns. Sometimes you crash on people’s couches and wait months for an apartment to open up. One thing we did early on is we would buy the [clinic] building and we would remodel so there was an apartment attached or buy an apartment in town. We would make moves to make sure we always had housing for our people.
“So that’s a challenge, a vehicle is a challenge, and just finding people who want to live in these places. You can offer them anything, and if Alaska is too much for them, it’s too much for them. You have to find people who want to live in Alaska because they want to live in Alaska, not people who have gold dust in their eyes.”
Alaska chiropractic: adding physical therapy and rehab
It was 4-5 years into establishing Arctic Chiropractic that the “Rehabilitation and Physical Therapy” began to integrate into the title. Campbell and his team noticed there were areas of the state with additional benefits for patient options, and patients having a difficult time seeing a physical therapist.
“We had patients coming to us because they were on a four-week wait to see the PT at the hospital,” he says. “So knowing that there were people stacking up, and knowing there were plans with a large or even unlimited number of PT visits, we gave it a 2-4 month trial run, and we gathered enough data to show that it could work.”
Expanding into physical therapy and rehab, Campbell says, provides additional service options for his clients and additional revenue streams for the business. And where there was once friction between chiropractors and physical therapists, he says that has for the most part gone by the wayside in today’s wellness environment.
“What works for us is we find PTs that have a similar mindset,” he says. “You want to find guys and gals that are hands-on just like doctors of chiropractic, but their credentials are different. And you don’t have any of that inter-professional rivalry, which we are seeing less and less as time goes on. I saw a lot of that early on, and I didn’t want to waste my time with that. They have to be team players and ambitious enough to build a practice with you, have the same mindset, and then they get on great with the chiros and it’s a fun place to come to work.”
DCs that put in the years with the Arctic family eventually receive equity in the clinic and free reign to offer modalities that are among their specialties or passions.
Alaska can be a difficult place to live, but also rewarding for doctors of chiropractic seeking the natural beauty and solitude of the most sparsely populated and largest U.S. state by area.
“I think the biggest thing is just when you get to some of these rural places and realize how remote they are, and then you just open up the table and start treating patients just like you would anywhere else, it can be a little surreal,” Campbell says. “Some of these small communities have been left behind. But I’ll tell you this, they’re damn glad to see you.”
Rick Vach is the editor-in-chief of Chiropractic Economics.