How did you become involved with industry?
I graduated from Northwestern College of Chiropractic in 1986 and set-up practice in Minnesota. During the mid-eighties I wanted to expand and took post-graduate orthopedics training. In 1976, I became board certified as a chiropractic orthopedist. I had an orthopedic practice and consulted here and there with industry if I had an injured worker patient.
I’ve always had an interest in industrial consulting and would visit my injured patients’ place of work. I went wherever it might beif it was a farm or a factoryand watched what they did to help me learn how to prevent future injuries. I then started offering nursing home training in my local area, which is a small farming community near St. Cloud, Minnesota.
What was the result of your working with the local nursing homes?
I was getting a lot of nursing assistants as patients and it occurred to me that nursing homes are generally populated with high school females who do the heavy lifting. Once they get a little older and have sore backs, they graduate into doing more paperwork. After I began training the local nursing homes, their injury incident rates plummeted and insurance MOD rates went way down (a MOD factor is a rating or multiplier).
Can you give an example of the advantages of a lower MOD factor?
One of the first nursing homes I trained had a MOD factor of about 1.46, which is not good. Let’s say a nursing home’s standard insurance rate is $100,000 per year based on the number of employees. Keep in mind, the $100,000 figure is just an example of a typical premium. To calculate the insurance rate with a MOD factor of 1.46, multiply $100,000 by 1.46. In this case, the nursing home’s rate is $146,000. This particular nursing home’s MOD factor went down to .76 or $76,000, which is saving considerable money. This is what’s happening over and over again. Plus, not only did the administration like the training, but the workers liked it, too.
H3ow many companies have you trained?
At this point I’ve trained just under 70 nursing homes, hospitals and so forth in the Midwest. I’ve migrated to industry and we have offered lifting training in more than 360 facilities throughout the United States.
Do you mind dropping some names?
We’ve trained Northwest Airlines, Fingerhut, the United States Postal Service [USPS], National Car Rental and 3M companies.
Please describe your work with 3M.
I’ve worked with twelve 3M facilities, including training their largest facility in the world. This particular plant has 2,000 workers and is located in Hutchinson, Minnesota. More than a year-and-a-half past training, their workers’ compensation injury rate went down 90%. Their comp costs for lifting injuries went down approximately 95% and their lost time went down 100%. These statistics are outstanding, especially for 2,000 workers and I can tell you it got their attention.
H3ow does your work with the USPS compare?
The same type of thing happened with the post office. I started out training the local post office, a processing plant in St. Cloud. Later, I received a letter from the plant manager saying this was the first time they’d ever seen this type of response with any employee training they’d ever done. It was the first time management noticed their workers had positive things to say.
After a year, the local post office had no injuries so we started training some other smaller post offices in the state. All of them did equally as well. Workers liked it and injuries went down.
This brought us to the Minneapolis stationthe state’s major center with approximately 3,000 mail handlers. We trained half of the staff because they wanted to do a pilot, as many companies like to do.
Six months later, the safety officer called and said, “Dr. Schaefer, I’ve been looking at the statistics and we’ve had 24 injuries since you trained our mail handlers. We thought we would see fewer injuries.” Well, I concluded something must be wrong and asked for an audit of the 24 injuries to find out who had the training and who had not. It turns out 22 of the injured workers had not had the training. From there we went national with the postal system.
We’ve since trained for the USPS everywhere, including Alaska, Manhattan and nearly every state inbetween. They have 800,000 workers, so we have a long way to go.
Where did you go from there?
After that we landed our first international account. It was about five years ago and I did a “train the trainer” program for a company called Fairmont Tamper. “Train the trainer” involves licensing a company to train their own personnel.
They had no injuries for two years and it astounded them, so they sent me to their sister plant in South Carolina. Again, after two years, the injury rate was zero or very close. That got the attention of the parent company, so we visited their headquarters in Pennsylvania and did what is called a “global” demonstration class via satellite to all of their holdings. They have steel mills and manufacturing plants throughout the worldit’s a two billion dollar company.
Every one of their holdings said, “Wait a minute, we need to have this training.” Now, they’re arranging for training to begin in England. As a result, we’re getting prepared to go global.
Are you primarily referral-based?
It used to be that we had to make cold calls and all of that. Now, all of our training is by referral. We get referred from one 3M to the next; one post office to the next and from one company to the next. It’s based on the fact that we have a superior product.
What are the different training methods you employ?
There are three methods of delivering the training. The first is “train the trainer.” Some companies have in-house training departments and like to train their own personnel. We deliver “train the trainer” to their core trainers on how to deliver this program. For a typical factory it might be two days to two weeks, depending on how many people we’re training. Once they successfully get through our training format, we license them to use our training program within the facility.
The second format is “live training.” We come in and train everybody ourselves for the simple reason that some companies like to bring in outside consultants and have them do the training because it generates more respect from their personnel.
The third method is a combination of both. We’ll do the “train the trainer” series as well as live training. The purpose is once we leave, new hires will need trained. If the company hasn’t done “train the trainer,” they’ll need to keep bringing us back to train.
What is your target group?
My company concentrates on large corporations. They have the means to fly us out and pay for the training. However, we weren’t tapping the market for the smaller companies, such as the 50-person plant in a typical small town USA because it’s too expensive to pay lodging costs for a week and so forth.
Local DCs are in a perfect position to assist the smaller companies because they have a practice to run and usually aren’t interested in traveling all over the place to train for three months like we do. They want to train in their local area, but need an effective training tool.
I train doctors to negotiate for a live training contract. The goal being to eventually be hired as the ongoing lifting training and ergonomic consultants for the smaller company.
What other benefits appeal to working with smaller companies?
Well, DCs can get their foot in the door with corporations and are actually participating with industry, which is a fun thing to do. Naturally, as a by-product, their practice grows.
You have to consider who the workers are going to see the doctor who comes to their place of work and tries to help them with their job, of course. It creates credibility in the workplace and patients will follow.
Some DCs are a bit idealistic and think if they’re going to consult with industry, they’re not going to even think about getting any patients. Well, you don’t have to even think about it because it’s automatic. If you’re in the same town, these people will visit you.
What is your experience with that?
I had people travel from Alaska to see me before I retired from practice. I told them I practiced in Minnesota, but they said, “We don’t care where you are, we’re going to see you.”
As a result, I gained so much respect and credibility. I don’t want to make it sound like a patient-building device because it’s not, but it will get you into industry and automatically, more patients.
Are there any obstacles to overcome?
There are DCs who have taken some industrial training and find that it’s hard to break into industry as a local chiropractor without holding a degre in industrial safety. However, a good lifting program establishes credibility for the DC to do lifting training, which can lead to doing pre-employment physicals, ongoing ergonomic programs and whatever else is desired in their community.
Is lifting the number one injury in workplaces?
Yes, it is. In 1998 the National Safety Council estimated the employer’s average cost of a disabling injury is $29,000. However, these are direct costs and don’t even include indirect costs, such as lost productivity, worker replacement costs and so forth. The $29,000 figure includes wages paid to the worker, medical bills and disability payments.
What are the hallmarks to look for in an industrial program?
There are three key points. Number one, you have to provide training that is effective and reality-based. For example, workers are accustomed to instructors coming in and showing them squat-lift training in the classroom, but never showing up on the production floor to demonstrate how to lift.
The second component is what we call production floor training. You must be able to take your training to the production floor to work with people one-on-one and actually be able to use the technique. Whether it is your philosophy towards ergonomics, lifting or management-whatever it might be-it must be shown to the workers one-on-one at their work site.
The third component is ongoing training. Whatever training you are offering, there must be an ongoing component. Industry is accustomed to consultants coming in, setting up a program, doing some training and then they disappear and there’s no follow-up.
What type of ongoing program do you have?
We offer reams of support materials and monthly mini-sessions. These are five to fifteen reviews of a given lift or procedure. It could be a home or work-related subject, such as handling pallets at work or lifting your children at home. We’ve created illustrative guides to be used by the employer which are basically lesson plans for five-minute lunch-box safety talks.
Why is ongoing training so critical?
We do it because lifting behaviors are not going to change overnight. Some people catch on instantly and other people might take a year to finally change their old habits. It’s a continual process.
Companies are absolutely impressed when you show them you’ve already thought this out. The first thing they ask is, “What do we do after you leave?” I say, “Let me show you,” and have the whole process mapped out. They’ll reply, “Wow, this is great.”
Should the doctor charge by the hour for the training?
No, they should charge according to the number of people trained.
What are the typical training rates?
The industry average around the country is about $35 per worker for training. This is the average for any type of trainingnot just lifting.
Do you charge for the total number of employees, including office staff?
Yes, when we go in, we train everybody. If you’re going to try to create a lifting safety culture, you can’t have a receptionist not know what it is, for example.
Is it reasonable to expect travel fees?
Yes. We charge mileage if we drive (or airfare) and lodging costs. The only thing we don’t charge for is meals.
Can you give an idea of how your income was affected?
My income was supplemented in a couple different ways. Number one, is the fee to train. Number two is a gain of more patients. Number three, the nursing homes in my area recruited me as their designated chiropractor.
Whenever the nursing homes had an injured worker, if the employee wanted to see a medical doctor, they went to the designated company MD; if they wanted to see a DC, they went to their designated company DC, which was me.
What is an advantage to directly working with the companies?
What really gives credibility is when you go back to the workplace with the injured individual and find an appropriate job for them to do. The general tendency is to just take an injured employee off work for one to two weeks. Companies despise this, although it is often what happenswhether it be a medical doctor, chiropractor or physical therapist. However, lying around the house is not a good way to rehab your back-unless you have a very severe injury, of course. By placing the worker in an appropriate task, it really builds credibility.
What else have you gained?
Another benefit is to use this training as a patient education lecture. It builds credibility in the community and they appreciate it. We used to pack people into my office for lectures. When it became too small, we went to the basement of a bank and had 60 or 70 people attend regularly. Every so often, one of the attendees was a manager from the local factory or somebody with some clout and they’d say, “We need this at our plant.”
How much did your practice grow after you started working with industry?
I had a busy practice to begin with and it grew to the point where I had to add an associate doctor. I think we went from 150 patients a week to 300.
What are the employers’ biggest objections to overcome?
Primarily the costs of training. We have companies look at their costs for sprain/strain injuries for the current year, previous year and the year prior to that. Generally speaking, they’ll come back with large numbers-ranging anywhere from $20,000 to $3 million, which was the cost for one of our companies.
We then compare the injury costs with the costs of training. We use charts that compute the savings if we reduce a company’s injuries over five years by just 25%. We also figure the break-even point and how much the company will make after that. Then we compute the break-even and profit points by reducing injuries 50% and 75%.
You have to help companies understand that they’re going to make money by doing training. American industry is not oriented towards the long-range. They are short-term, profit-oriented and have to be re-educated on spending a dime up-front to save a dollar in the rear.
Do you have any words of advice to those getting started in industry?
Lifting training gives DCs a proven tool to get into industry so they can do the rest of what they’ve been trained to do, such as pre-employment physicals.
It’s difficult to go into a factory and say, “I’m Dr. So-and-so and I would like to do pre-employment physicals for your plant.” It just doesn’t cut it-you haven’t created much credibility for them to take you on. Let’s face it, they’re going to send people to the local hospitals or medical doctor instead.
When you have created credibility, it opens the door for other things. It did for me, and it will for others.