Doctors of Chiropractic and other health professionals agree that a balanced diet is essential to attain good health. So why should a chiropractic clinic offer nutritional services to their patients? Quite simply, nutrition and chiropractic are inextricably linked. How many of your patients would improve their posture if they were able to lose the extra pounds they are carrying?
Although weight loss is an important part of chiropractic care, Doctors of Chiropractic are too often bombarded with promotional materials expounding the virtues of one diet supplement over another. What they really need is a means of obtaining an objective nutritional assessment so that diet and exercise recommendations can be made on the basis of good science. Chiropractors must also be able to demonstrate the dramatic biomechanical improvements in posture that are directly related to weight loss.
In this article, I will substantiate the benefits of computerized posture and nutritional assessments for your patients and highlight biomechanical and nutritional analysis as an important source of revenue for your practice.
The Trend Towards Obesity
In the United States, almost 30% of the population is overweight, while another 25% are considered obese. If these percentages also hold true for your practice, a significant number of your patients require nutritional counseling.
Biomechanics and Weight Loss
I will show you the dramatic effects of weight loss and posture by tuning into the biomechanical effects of obesity. A biomechanical evaluation performed with a computerized system easily demonstrates how important it is for your patients to lose weight. Consider the following case study.
A 35-year-old woman presents to a chiropractic clinic complaining of non-acute lower back pain. A pre-evaluation questionnaire reveals nothing except that the woman has completed two pregnancies in the last two years and has not lost much of the weight associated with child birth. Based on this information, the woman is deemed a good candidate for a postural evaluation.
Lever weight and weight applied to the various centers of mass are evaluated in a computerized postural evaluation. A summary of compression forces calculated according to the laws of physics are presented in Table One. Based on the information in Table One, in addition to a nutritional assessment, an exercise regimen and nutritional recommendations are made and chiropractic adjustments begin.
During the next ten weeks, the patient comes to the office once a week for chiropractic treatment, in addition to performing postural reinforcement exercises at home. At the end of the tenth week, the woman is reevaluated. Table Two summarizes compression data obtained in the second evaluation. Results show her posture has improved and the loss of eleven pounds has decreased the force exerted on her cervical vertebrae by 48 pounds. Furthermore, the force exerted on her dorsal vertebrae has decreased by 185 pounds and the force exerted on her lumbar vertebrae has decreased by an astounding 332 pounds!
The treatment plan continues for another ten weeks at which time a third evaluation is carried out with the results as summarized in Table Three. By losing 20 pounds and following the chiropractor’s treatment planincluding the exercise program and improved dietthe young woman has substantially decreased the compression force on her vertebrae.
Table Four shows the total reduction of compression forces after losing 20 pounds. The weight loss has decreased the force exerted on the woman’s cervical vertebrae by 53 pounds,the force on her dorsal vertebrae by 185 pounds and the force exerted on her lumbar vertebrae by 418 pounds.
Figures One and Two compare pre- and post-treatment evaluations based on comprehensive biomechanical data. The same chiropractic adjustments without nutritional and exercise recommendations-and ensuing weight loss could not have yielded the same benefits to the patient.
This case study demonstrates that nutritional assessment is a fundamental component of chiropractic care. How many of your patients are overweight? The importance of quantifying the impact of being overweight cannot be overstated.
Integrate Nutritional Assessment
Because a complete nutritional evaluation is time consuming, I strongly recommend using a computerized nutritional analysis package to compare nutrient uptake with recommended allowances. A good program presents results in a way that is easy to understand and is compelling to the patient. The report should also explain the results and indicate food sources for each nutrient. The patient should be able to consult the report to guide food choices (Figures Three and Four).
A computerized report will make it easier and faster for you to make your recommendations and motivate your patients. Most importantly, linking posture and nutrition will improve the quality of care you deliver as a chiropractor and ensure the kind of long-lasting results that help build strong relationships with your patients.
W3hat About Dietary Supplements?
If you plan to offer nutritional supplements to your patients, you must consider their needs carefully. This means being aware of your patients’ food intake and their rating compared to the RNI (Recommended Nutrients Intake). You may prevent some nutritional deficiencies by performing a nutritional evaluation of patients you consider to be at risk of developing deficiencies. Different stages of life and specific health conditions also require increased intake of nutrients. A complete nutritional evaluation can help you determine if it is more appropriate for a patient to take nutritional supplements or to increase the intake of specific foods.
Nutritional Assessment as a Source of Revenue
To measure the impact of nutritional assessment on your practice, consider the following example:
- Professional nutritional assessment software packages cost approximately $1,500.
- The current rate for a nutritional assessment is between $80 and $100.
- A nutritional assessment requires about 20 minutes to perform and 10 minutes of consultation time with the patient.
Based on these figures, software expenditures are covered in only 19 evaluations. If a clinic performs 15 nutritional evaluations per week, the total annual revenue will be:
$80 x 15 evaluations x 48 weeks = $57,600
Nutritional Counseling as a Source of Revenue
Patients on a weight loss program are typically seen for one hour during their first appointment and for 30 minutes each subsequent week. By offering additional personalized support, nutritional counseling may climb to 30 billable hours per week. The total annual revenue from nutritional counseling can represent as much as $144,000 (30 hours x $100 x 48 weeks). You can increase your annual income by $201,600 simply by offering these services. If you plan to sell nutritional supplements or already do so, a conservative estimate of revenue may be as high as $50,000 per annum.
Of course, you may need to hire a nutritionist to handle the nutritional evaluations and consultations. A nutritionist typically earns between $40,000 and $50,000 per annum. As illustrated in Table Five, by adding nutritional services to your clinic, you may increase your practice’s annual income by $211,600 (which includes the cost of a nutritionist).
Nutrition and chiropractic are inextricably linked as demonstrated by the science of biomechanics. Nutritional advice can help a significant amount of patients improve posture, relieve ailments and can add value to your practice. By implementing nutritional evaluation and comprehensive biomechanical assessments as an important part of your practice, your patient traffic flow, revenue and patient satisfaction levels will all increase dramatically. As technology evolves, a more comprehensive approach to chiropractic is emerging. Is your practice ready to meet the challenge?