We have the answers from our first managed care survey. An overwhelming 70% of our respondents want to be considered Primary Care Providers (PCPs) rather than specialists, although 76% of you believe the present system views DC’s as specialists.
1. What percentage of your practice will be managed care by the year 2000?
a) >25% b) 25-50% c) 50-75% d) >75%
a) 28% b) 26% c) 19% d) 14%
2. How dependent do you think the success of your practice will be on medical referrals by the year 2000?
a) <25% dependent b) 25-50% dependent c) 50-75% dependent d) >75% dependent
a) 50% b) 24% c) 6% d) 9%
3. If you had a choice under managed care, you would rather be considered a:
a) Primary Care Provider (PCP)
b) Specialist
a) 70% b) 16%
4. How do you think the managed care system presently views chiropractors?
a) PCPs b) Specialists
a) 16% b)76%
5. How do you think the managed care system will view chiropractors by the year 2000?
a) PCPs b) Specialists
a) 26% b) 60%
6. By the year 2000, experts predict the oversupply of specialists will be:
a) <25% b) 25-45% c) 45-65% d) 65% or more a) 2% b) 26% c) 24% d) 24%
7. How knowledgeable do you consider yourself to be about managed care?
a) minimally b) moderately c) highly
a) 30% b) 45% c) 16%
8. How many seminars on managed care did you attend in the past year?
a) none b) one c) two or more
a) 41% b) 29% 23%
9. Would you consider taking a certification program in managed care?
a) yes b) no
a)48% b) 43%
10. Your present practice is:
a) solo b) group c) institutional d) industrial e) multidiscipline
a) 41% b) 47% c) 6% d) 0% e) 0%
11. You view your future practice as:
a) solo b) group c) institutional d) industrial e) multidiscipline
a) 51% b) 31% c) 1% d) 1%
12. Do you feel clinically qualified to practice as a chiropractic specialist in a multidiscipline group?
a) yes b) no
a) 93% b) 4%
13. Do you feel clinically qualified to practice as a PCP in a multidiscipline group?
a) yes b) no
a) 76% b) 17%
14. Are you presently affiliated with a hospital?
a) yes b) no
a) 9% b) 76%
15. Would you apply for hospital privileges if they were available?
a) yes b) no
a) 51% b) 40%
16. You view managed care as:
a) a passing “fad” b) here to stay in one form or another
a) 13% b) 77%
17. You consider managed care to be:
a) an opportunity b) a problem c) both
a) 9% b) 29% c) 56%
18. Your practice income is:
a) increasing b) decreasing c) staying the same
a) 26% b) 40% c) 25%
19. Do you think you can maintain your current level of income if you choose not to participate in managed care?
a) yes b) no
a) 41% b) 52%
20. Is a “cash practice” a viable alternative to managed care?
a) yes b) no
a) 46% b) 48%
21. What do you feel is the profession’s biggest challenge in managed care? Results are ranked numerically in order of importance:
#1 Properly identifying the role of chiropractors in managed care. (PCPs versus specialists)
#2 Acceptance by the employer/ insurance community.
#3 Acceptance by the medical community.
#4 Teaching D.C.s how to access managed care programs.
#5 Teaching D.C.s how to integrate with other disciplines.
#6 Managed care education for chiropractic students.
22. What do you feel is your personal biggest challenge in managed care? Results are ranked numerically in order of importance:
#1 Understanding and accepting the managed care parameters of quality care, positive outcomes and utilization.
# 2 Accessing managed care programs.
# 3 Properly identifying and then preparing for my role in managed care.
# 4 Structuring my physical plant, staff and practice systems to be compatible with managed care.
# 5 Affiliating with a group practice to become more attractive to managed care organizations and medical groups.
# 6 Integrating with other disciplines
# 7 Other In Michigan, we have zero local MCO’s. I would join if feasible, but to-date it is not an option. — Grand Rapids, MI
Patients are willing to pay for superb service and reasonable fees. Practice management groups promoting cash-only practices are promoting a fool’s paradise. –Houston, TX
I hate managed care and I feel an organized multi-disciplinary revolt/boycott is needed ASAP! –Kalamazoo, MI
I am not into managed care and I do not plan to get into it. — Winston-Salem, NC
Chiropractic is not wanted by insurance companies or employees in managed care. — Clarksville, AR
I’m very concerned about other doctors dictating what I can do with my patients. I can’t afford to join all these MCO’s.– Atlanta, GA
Managed care equals three visits at $45 each. Wow. Good patient care. Managed care has developed lots of impurities. It will be modified with time. — Medina, NY
A certification program in managed care is greatly needed. — Millersburg, PA
If we are not PCPs, it’s back to cash basis for us! Chiropractic will become historical if it depends upon MD referrals. — Mt. Sinai, NY
Keep your fingers crossed that DCs will continue to flourish. — Aurora Hills, CA My practice is currently >50% managed care. — Oceanside, CA
I have been a chiropractor for 47 years. The new group is stupid. — Jackson, MO
Chiropractic must become scientific and rid itself of pseudo-science. — Lawrence, KS
Managed care must be stamped out! Managed care is not the answer for the future, wellness is. — Salem, OR
THANK YOU TO ALL WHO PARTICIPATED! The results will be used in various studies and research projects.
This survey was developed by Dr. Gerald Weis, president and Dr. G. Steven Baer, medical director of Chiropractic Choice, Ltd., a physician organization of leading chiropractors in the Cincinnati area. They lecture on managed care throughout the United States and serve as consultants for numerous managed care organizations, medical groups, hospitals, third party administrators and employer groups in the Midwest.
