Increase your bottom line by offering wellness care and occupational medicine
Now that you have graduated from chiropractic school, how do you intend to pay off those student loans? Do you go into practice with another established doctor? Do you start your own clinic?
You have been taught how to do a few things in chiropractic school. You can examine sick people, take X–rays, perform basic lab tests, do spinal adjustments along with physical therapy type modalities, and maybe even acupuncture or dry needling. Is that all you can do? Although you were trained as a primary care physician to diagnose and treat sick people, only a small percentage of people will even go to a doctor of chiropractic. In 2023, we still have people who think we are not real doctors and were deterred by someone (MD, family member, internet) from seeking chiropractic care.
How can an individual DC fight this stigma? How can a new doctor create an environment where the public isn’t afraid to go? You can spend a lot of time and money trying to convince the public, but you are working against billion-dollar drug corporation ads, big hospital ads, big medicine ads. Quite frankly, you don’t have enough time or money.
Wellness care
Did you know there are organizations that require their employees to undergo physical exams and other tests, such as drug, alcohol, pulmonary function, respirator mask fit and more, all in an effort to keep them safe and healthy? Wellness care has been a part of the federal rules of working since the 1970s, and here’s the best part. Most of it is mandatory, meaning these employees must have it done to keep their jobs, and the company they work for must pay for it all in cash.
Occupational medicine options
The following discusses the full range of services you can offer as a DC in wellness care or occupational medicine. Some services are the same as chiropractic, such as physical exams and X-rays, although you may be doing slightly different physicals. For example, Department of Transportation (DOT) physicals for truck drivers, Federal Aviation Administration (FAA) flight physicals for private pilots or physical exams for police or firefighters. Hardly different from school physicals for athletic participation, which many DCs already perform.
DOT physicals can be performed in every state except Wash., Mich. and New York. FAA physicals for private pilots can be performed in 28 states where DCs are called physicians. Drug testing and alcohol breathalyzers can be performed by DCs in all 50 states, as can hearing testing, pulmonary function testing and OSHA mandatory respirator questionnaire reviews. You can run lab tests for diabetes, home sleep studies, home heart monitors, wellness programs to lose weight/stop smoking/lower blood pressure/reduce sugar levels, flu tests and COVID tests for companies to try and keep people working without infections coming into the work site.
Case examples
We once had a company call us to come onsite and COVID test 200 people at a plant at $100 each. It took us four hours, and we received a check for $20,000. One of the most easy, rewarding days of my 32-year career. There are DCs who perfect this occupational work and are recruited by companies to work within the company full-time helping keep the employees safe and healthy not only with chiropractic adjustments, but by providing all these services the company must have done to keep the doors open. You can be more of a team player if you help companies with what they are mandated to do, then provide the extra care of chiropractic. Companies can live without chiropractic care, but they cannot survive by neglecting mandated government requirements. So learn how to become part of the intricate industrial healthcare team and you will see part of the $33 billion spent mandatorily every year.
The benefit of organization care
Remember, no insurance pays for occupational medicine. Many DCs like being paid in cash and not having to file insurance and go through all the hassles of collecting after the fact. There is another benefit of patient acquisition and compliance. After 32 years in practice, I have learned it is far easier to convince one person (the company boss) to send me all his employees for exams and testing, and have the company pay the bills. It is much harder trying to convince one patient at a time to spend their hard-earned money with me when their insurance doesn’t want to pay much for my services.
When the company mandates that their employees come to you for an exam, they come. When I send a bill to the company, they pay it. No hassle, no reduction of money, no recoupment of money, no denials. More importantly, the employees getting screened may have neck pain, headaches, back pain, other problems, and because the company sent them to you, patients realize you are a real doctor, and you can get them to come back for needed care. They all have jobs, and most have insurance or money to pay for your care. They are not Medicare or Medicaid. They are working people who need chiropractic care.
So would you rather do complimentary spinal screenings in the mall or earn $75 to do 100 exams ($7,500) to screen people for problems knowing they have a job, insurance and/or money to pay you?
Final thoughts
Most businesses will pay you to take care of their employees’ health needs. Expanding your range of services you offer as a DC into wellness care and occupational medicine, including performing regular screenings for organizations, can help you earn additional income, be financially successful and pay off those student loans.
JAMES RAKER, DC, FADP, CME, CWP, is CEO of OccMed For DCs and has 30 years in private practice, including occupational health for several companies. He has been doing DOT work for more than 20 years, was one of the first doctors in the country to pass the DOT certification and become a Certified Medical Examiner for the U.S. Department of Transportation, and has been teaching occupational medicine services since 2012. He can be contacted at jraker@arklatexhealthclinic.com.