New opportunities exist for doctors of chiropractic by acquiring advanced credentials recognized in joint providerships with chiropractic and medical academia.
Although perception drives reality, there is no substitute for knowledge. When knowledge is supported by evidence in scientific literature and validated by well-respected academic institutions, it changes the perception of those in your community and those looking at you as an expert in your field and beyond. Unfortunately, based on decades of reports flooding medical and lawyers’ offices with deficient documentation to the point of being “embarrassing,” the perception of our industry and resultant reputation has been well below that of even physical therapists with a bachelor’s level of education. DCs can change the perception of the practice by obtaining advanced credentials through clinical chiropractic academics.
Despite the evidence in the literature, such as Blanchette, et. al., who stated, “medical care ended spinal related compensation 12% longer than chiropractic, and physical therapy care required 239% more time to end full compensation. Regarding partial compensation, medical care required 20% more time and physical therapy 313% more time.”1 Cifuentes, et. al, reported carpeting had a 32% decrease in cost compared to physical therapy.2 The medical and legal communities commented when confronted with these statistics by responding “a research sound bite does not overcome the evidence we see over and over in chiropractic documentation and no advanced credentials.”
Perception is reality
Although many such as myself are working to increase chiropractic standard of documentation, one of the biggest hurdles are advanced credentials. Our industry decades ago created a level of academics and called it a “Diplomate.” Although the education is real and it helps DCs further their knowledge, the language has created a “disconnect” with the health care and medical legal communities. This is critically important because it’s about perception, and we can never lose sight that perception creates reputation, which drives referrals. DCs can change the perception of the practice by pursuing advanced clinical chiropractic academics.
There are reasons why our profession is trapped in a cycle of utilization between 7% and 10% depending on the source. Moreover, there is a reason why medicine utilization is close to 99%. The chiropractic profession needs to learn from what’s working and focus our efforts on elevating the profession through the pursuit of advanced credentials vs. being outliers.
A partnership between chiropractic and medical academia
Over the last decade, I have led a team to create joint providerships between chiropractic and medical academia. Working with forward thinkers in our industry, such as Carl Cleveland, III, DC and the late Frank Zolli, DC, we have successfully enabled DCs to get credentialed through clinical chiropractic academics with courses, qualifications and fellowships. As a result, this is opening the doors for the best in the medical industry to join forces with the best in the chiropractic industry in teaching advanced subject matter. DCs now have the opportunity to learn, for example, stroke from a double-boarded vascular neurologist from the Albert Einstein College of Medicine who is a current associate professor in medical academia. To learn MRI spine interpretation from a world-renowned medical neuroradiologist from Harvard who teaches at one of the most prestigious medical academic institutions in the world, and many more.
With these advanced credentials, including CV citations, qualifications and fellowships, this new breed of chiropractors educated at this unparalleled level in our industry has broken barriers and opened doors never available before. Beyond the medical-legal implication with the courts (judges) allowing 100% of these doctors to testify, which previously was a growing issue, the biggest hurdle that has been overcome is the collaborative relationships with the medical industry.
Advanced credentials means acceptance by the medical community
As shared with me by countless medical providers, they historically have tolerated our profession because they want our referrals. Almost all prefer to work with physical therapists because they have more control with the “power of the prescription” and more positive feedback with consistently better notes. Since the inception of the “new credentials,” medical specialists now consider us peers and happily refer. To underscore that issue, one doctor in Texas, with his knowledge and new credentials, walked into an orthopedist’s office and spoke for 45 minutes about case management and MRI acquisition. Now, five years later, he has gotten more than 1,500 referrals from the nine-person ortho group. This is not an aberration; I have heard similar stories from coast to coast.
After a presentation to law firms representing the entire state, once they understood the “new breed of chiropractors” based on their credentials and knowledge, all changed their referral patterns instantly away from their current DCs and MD specialists. They realized they were being hurt by those who weren’t prepared to support their clients. True to their word, the volume of immediate referrals was overwhelming as validation of the power of this level of academics.
Final thoughts
Nationally, we are all required to take continuing education, and what you choose matters now more than ever. Your future is at stake, and so is the reputation of the chiropractic industry. You do not have to change how you practice or what you believe. However, you will change how referral sources and patients perceive you, which will change your reputation, which will change how you get referrals if positioned correctly.
References
- Blanchette MA, et. al. Association between the type of first healthcare provider and the duration of financial compensation for occupational back pain. J Occup Rehabil. 2017;27(3), 382-392. PubMed website. https://pubmed.ncbi.nlm.nih.gov/27638518/. Accessed Oct. 24, 2023.
- Cifuentes M, et. al. Health maintenance care in work-related low back pain and its association with disability recurrence. J Occup Environ Med.2011;53(4), 396-404. PubMed website. https://pubmed.ncbi.nlm.nih.gov/21407100/. Accessed Oct. 24, 2023.
