Practitioners consistently seek innovative ways to expand their practices and augment their income in the ever-evolving landscape of chiropractic care. Amidst a myriad of supplementary services, Department of Transportation (DOT) medical services emerge as an untapped goldmine, promising DCs not just financial gains but also a streamlined approach to practice development.
This article delves into the unparalleled benefits of incorporating DOT medical services, particularly DOT physical exams for commercial motor vehicle drivers, shedding light on the lucrative prospects, minimal effort involved and broader spectrum of opportunities these services unlock.
Unlocking revenue: The DOT advantage
Doctors of chiropractic are well-aware a new chiropractic patient can potentially generate significant revenue over the course of treatment, ranging from $1,000 to $2,500. However, the challenge lies in attracting these patients to the practice. Over the years, DCs have explored various avenues, from offering orthotics, laser therapy and treatment for neuropathy and thyroid disease to selling supplements or CBD products. While these services contribute to practice growth, none rival the growth potential and simplicity of performing physical exams for drivers of commercial motor vehicles.
One might wonder: What trucker doesn’t need a good adjustment? The beauty of providing physical exams for truckers lies in its ability to draw them through the DC’s door. DOT physical exams are cash-pay services, eliminating the complexities associated with insurance transactions. With a nationwide median fee of $85, initiating this service requires minimal effort, no additional overhead, no inventory management, no upselling and only 15 minutes of the DC’s time, along with about 10 minutes from the staff.
Pandemic resilience
The transportation industry has proven its resilience against pandemics and economic downturns. During the COVID-19 pandemic, DCs offering DOT physicals, categorized as an “essential” service, not only kept their offices open but also added a layer of pandemic protection for chiropractic practices. The essential nature of these exams, aimed at keeping drivers behind the wheel, underscores the stability and reliability of this niche even in challenging times.
Who requires DOT physical exams?
Understanding the demographic in need of DOT physical exams is crucial. Before operating a commercial motor vehicle, drivers must possess a valid medical certificate, a requirement that also extends to drivers attending driving school. While drivers can be certified for up to two years, certain medical conditions mandate more frequent certifications. Medical certification is generally obligatory for drivers operating a commercial motor vehicle (CMV) in interstate commerce.
Interstate commerce, defined as trade, traffic or transportation of goods or services in the U.S. involving crossing state boundaries, encompasses various scenarios. Even a local UPS delivery driver, who may never drive a CMV across state lines, is considered part of interstate commerce, necessitating a current medical examiner’s certificate.
In addition to commercial driver’s license (CDL) holders, numerous other drivers must maintain a current medical certificate through a DOT physical exam every two years. This includes non-CDL drivers of CMVs, such as box trucks for UPS, FedEx and Frito Lay; intrastate drivers; school bus drivers; 16- to 20-year-old drivers of CMVs; Federal Transit Authority (FTA) vehicle drivers (taxis, metro vans and transit buses); ambulance drivers; crane operators; forklift operators and firefighters.
Statistical insights
The most recent statistics from the Federal Motor Carrier Safety Administration (FMCSA) highlight the substantial volume of DOT physical exams performed over a three-year period. For interstate CDL drivers alone, 14.7 million exams were conducted, with 8.4 million receiving a two-year medical certificate and 4.4 million obtaining a one-year certificate. Notably, 3.6 million of these exams were performed by the 3,500 doctors of chiropractic who were medical examiners at the time. Considering the average charge of $85 for a DOT physical, DCs conducting these exams generated an additional average yearly revenue of more than $28,000.
However, it’s essential to recognize the actual number of exams is much higher. The FMCSA data covers only interstate drivers, excluding non-CDL drivers of CMVs, intrastate drivers, school bus drivers and others. The actual number of exams performed is estimated to be twice the amount reported by FMCSA. Taking into account the broader spectrum of drivers requiring these exams, the potential yearly revenue could easily exceed $56,000.
The chiropractic advantage
In the realm of DOT physical exams, DCs possess a distinct advantage. Two primary concerns for drivers seeking these exams are cost and appointment availability. Nationally, the cost of a DOT physical exam varies based on geographic area, competition levels and the medical examiner’s profession.
DCs, operating with lower overhead costs compared to other medical professionals, can offer competitive pricing for DOT physical exams. Moreover, many DCs are known for their efficiency and patient-friendly practices, often providing same-day or next-day appointments. Despite these advantages, only 5.6% of the approximately 80,000 DCs in the country are medical examiners, presenting a vast opportunity for DCs to tap into this niche.
Getting started
Becoming a medical examiner and offering DOT physical exams involves a two-step process. First, the provider must maintain a valid state license and be listed as a medical examiner on the National Registry for Certified Medical Examiner (NRCME) database. Second, the DC must attend an accredited training course, which can be completed online or in person, and pass the certification test.
There are accredited training organizations to help facilitate this process and ensure DCs are well-equipped to seamlessly integrate DOT physical exams into their practices. This straightforward process opens the door to a practice-building opportunity with vast potential.
Beyond DOT physical exams
While DOT physical exams undoubtedly offer a substantial return on investment and serve as a straightforward entry point for practice growth, they represent just the tip of the iceberg. Offering these exams creates opportunities for DCs to provide additional services their staff can perform, such as DOT-required alcohol and drug testing.
In federally regulated industries under the DOT, all safety-sensitive personnel must be enrolled in a federally regulated testing program. Approximately 50% of drivers are randomly selected for drug testing each year, while 10% undergo random alcohol testing. Additional testing instances include pre-employment screening, post-accident assessments and when an individual is suspected of being under the influence of drugs or alcohol.
Interestingly, in the private industry, non-DOT drug testing of employees is estimated to be seven times larger than DOT drug testing, highlighting the broader market for such services. By extending their offerings to include these additional services, DCs can diversify their revenue streams and provide comprehensive healthcare solutions.
Final thoughts
Incorporating DOT medical services, particularly DOT physical exams, stands out as a potent and straightforward strategy for DCs looking to build their practices and enhance revenue. The resilience of the transportation industry, simplicity of implementation and additional service opportunities make this niche an attractive prospect for DCs seeking to position themselves at the forefront of innovation and growth.
JEFFREY CARLSON, DPM, is TeamCME Co-CEO and Chief Medical Officer. DCs interested in delving into the realm of DOT-related medical services can contact TeamCME at 541-276-6032 or via email at contact@teamcme.com.
