As the executive director of a non-profit organization for chiropractic health consultants, it has been my pleasure during recent years to become familiar with many various chiropractic industrial networks. For the purpose of this article, let’s define a chiropractic industrial network (CIN) as: a group or system of two or more Doctors of Chiropractic, cooperatively working together to deliver a diverse menu of chiropractic prevention and intervention services to employers for their employees. Solo practitioners may also gain from the material that follows for the purpose of including consulting services to employers through an existing practice.
The purpose in identifying and highlighting CINs assists the advancement of chiropractic into the specialty field of occupational health, informing individual doctors of the processes involved to gain the due respect of employers, insurance companies and managed care networks. Of the groups responding to a recent questionnaire of existing networks, all share common factors establishing themselves as experts in the field. They are:
- A specific vision, mission statement and a set of defined objectives.
- Knowing the importance of investing in the appropriate resources.
- Assessing their external environment.
- Knowing the importance of developing professional relationships.
- Placing specific focus on marketing the unique and individual services a company may need.
- Seeking out specialized postgraduate training.
- Indicating a clear intent to be successful.
This list represents key components of a solid business plan. Another shared trait by these CINs is that regardless of the network’s size in terms of people and/or dollars, each began with individual doctors who had or shared a vision.
Of course it all sounds very exciting, but you may well be asking yourself the ultimate questionhas it been financially rewarding? A very good question that deserves an answer. Let’s take a look at some of the particulars of these groups, highlighting significantly important aspects to bottom line success.
Getting started for these CIN groups has not been as easy as knocking on a particular door of industry, expecting (or hoping) to be warmly welcomed. It can be a very complex and lengthy process to gain the trust, respect and full attention of the employer. This is the same for the hundreds of Doctors of Chiropractic who are flying solo in their industrial consulting practices.
On average, it can be expected to take a period of two years of establishing and maintaining professional relationships with decision-makers before they will exhibit a desire for your services. I’ve heard many doctors refer to this as a time of courtship leading to a meaningful long-term relationship. The importance of relationships is a recurring trait seen throughout this article.
VISION , MISSION AND PLANNING
For those who share a vision for beginning either a solo or group industrial consulting program, the first step is to develop a mission statement. This short, concise (yet flexible) statement becomes the guiding force for fulfilling objectives. It identifies the product(s), the customers or market, the intent of the entity and desired outcomes. As an example, Allied Health of Wisconsin (Wausau, Wisconsin), has a mission statement that reads, “Strive to unify and strengthen chiropractic, become a leader in health care, provide security to our patients and ensure the viability of our profession.”
Although Allied’s mission statement doesn’t necessarily name injury prevention services or wellness services to employers as a product, it does include a broader mission of providing “security” to patients and “viability” to the profession. Interestingly, to know Allied Health of Wis-consin’s Presi-dent, Dr. Scott Bautch and Dr. Steven Conway, CEO, it is clear this CIN is focused according to their set mission statement. Notice the bigger picture they see includes exhibiting leadership within the profession and within the health care marketand equally important, placing value on their patients. Their mission statement leaves room for flexibility for how they might go about fulfilling it.
Generally speaking, developing a solid business plan entails the following steps:
- Establish the objectives to be achieved, considering internal and external environments (environments supply resources).
- Identify strategies for achievement.
- Create budgets that identify resources for investment and income.
- Set policies to ensure and measure outcome.
Industrial Safety Solutions’ (Fayetteville, New York) developers Dr. David Thorpe and Dr. Robert Shane included in their business plan the opening of a multidisciplinary occupational consulting corporation known as Work-Med, offering a wide range of both pre and post-injury services. This part of ISS’ business plan became a reality after ten years of providing other types of services in other formats. Work-Med provides first aid, triage, baseline testing and screening services to client companies. ISS began its existence doing only industrial back schools and now enjoys constant growth and metamorphosis, providing industrial clients an array of services.
To open a multidisciplinary corporation such as this for work-related injuries is not a casual task. Strategic planning and systems to execute the plan were essential to achieving this objective.
INVEST IN PEOPLE AND RESOURCES
Next, identify the resources needed and then invest in them. Usually the list will boil down to three specifics: time, money and people. It will take plenty of each and the order in which they are required will be unique to the operations of each network. However, investing in people will likely be the most important.
Invest in relationships
Through my involvement with chiropractors every day, it is clear that the time commitment needed for establishing professional relationships with decision-makers for employee safety, health and welfare is enormous. It is a major investment in the external environment. Remember, environment supplies resources, and in this case, income or potential income.
Dr. Thorpe of ISS says, “I have found there is an initial period of gaining the companies’ trust and any services that were offered during this time were very limited ones. Once the trust is earned, it is the companies themselves that have many times dictated our expansion.”
Becoming acquainted with the right peopleemployers, safety directors, human resources managers, occupational nurses and so forth, can start this process for you before you lay any cash on the table for marketing or other aspects of the business. Go meet the proper people. Learn the operations of the company and the individual company’s needs. Be genuinely attentive to building a mutually respectable relationship.
Invest in staffing resources
Investing in the right staffing resources is vital to growth and success. There is the challenge of obtaining skilled staff for performing the every day tasks for operations, including marketing, billing, scheduling and so on. Do you use existing staff or hire additional personnel? Do you hire experts for certain aspects or try to do it with your own limited human resource?
At Genesis (Waconia, Minnesota), developers Dr. Dan Neubauer and Dr. Chad Henriksen use the same staff in their clinical practice to complete the tasks for their on-site occupational health treatment facility at a hearing aid manufacturing company. These people are key components to the ongoing success of Genesis.
Consider the saying, “Begin where you are planted.” Getting to know who your patients are, what they do, where they work and the position they hold with their company is very important. Many DCs have found a patient or relative of a patient to be their “foot in the door” person.
Dr. Chuck Sherrod of the California Health Consultants, Inc., (Menlo Park, California) has invested his time and professional care in his existing patients. He shares, “It appeared that my patients who owned or operated businesses began requesting my skills in developing workplace injury prevention programs such as work-site evaluations, task-specific stretching and strengthening protocols and job/task analysis.” Another tip: talk injury-prevention-in-the-workplace to your patients.
Investing in people, whether business associates, office staff or potential industrial clients is the driving force for success. Without people, plans fail. It’s people who get the job done.
Invest in yourself
Investing in yourself can only lend credibility and value to the services you offer to employers in your community. When the CINs highlighted here were asked about start-up costs and investments, Dr. Scott Donkin of Sitting on the Job (Lincoln, Nebraska) said, “I invested in postgraduate (and other specialized) training. The financial return has paid for the training many times over. One contract netted approximately $14,000, another brought $16,000 coupled with inclusion in managed care organizations.” Who says you can’t operate a chiropractic practice under managed care.
Invest in marketing
Investing in the right source for marketing to industry deserves careful attention and of course will be determined by your available budget. Allied Health of Wisconsin invests in a full-time Director of Industrial Resources, Ms. Barbara Thompson. Ms. Thompson ensures that Allied Health shares the same goal of employersthat is, to treat the injured worker and get the employee back on the job as quickly, safely and healthy as possible. She assists with the educational programs delivered to employers throughout the state and serves as an internal case manager for all workers’ compensation cases that result in lost work time or care beyond 12 visits. Ms. Thompson’s background includes education in vocational rehabilitation counseling and facility administration.
ISS hired a full-time marketing expert, Mr. Michael Matteson as Director of Operations. Mr. Matteson exudes a passion for the advancement of chiropractic services to employers. In return for ISS’ investment in Mr. Matteson’s expertise, they have acquired his nearly 17 years experience and knowledge of corporate business sales. His role is to perform the day-to-day sales and marketing of ISS’ services.
Mr. Matteson knows that not every Doctor of Chiropractic can justify investing in a full-time marketing expert, so he offers this advice, “If this is not possible, I recommend utilizing your practice contacts to develop exposure and experience. When appropriate, seek a business partnership that expands your operations.”
The payoff can be rich for hiring marketing and occupational health experts. Optimum Performance, (Torrington, Connecticut) is yet another group that has invested in the professional marketing services of Elin Larsen as Director of Marketing. As a result of a growing business, Optimum Performance is able to cover the entire New England area through those included in the network developed by Dr. Leonard Kocis.
BOTTOM LINE: IS IT WORTH IT?
Will a financial return will be gained on the investment of beginning a solo or group chiropractic industrial practice or network? There isn’t any easy, one-size-fits-all answer. The nature of investing is to become vulnerable to certain levels of risk. Most often, careful calculation of potential risks will either determine commencing with plans or provide the wisdom to pursue other possibilities for a sure return on investment.
The question of financial return has been asked of these three experts who already have chiropractic industrial networks that are experiencing growth. After all, these are the people who have made successful CINs.
According to Dr. Charles Sherrod, “California Health Consultants, Inc.s’ gross income base has risen 320% in the last two years.”
Dr. Lenny Kocis of Optimum Performance says, “The investment in industrial consulting has been very beneficial to our office. We are paid well for our consulting services and through that exposure we have gained entrance into managed care panels and increased our patient numbers.”
Dr. David Thorpe of ISS concludes, “Through continued market penetration, we have been able to cultivate long-term relationships, as well as enhance the delivery of services and programs to our clients. This has enabled us to become the company doctor, providing the whole gamut of services from pre-placement exams to on-site treatment servicesresulting in a 780% increase in sales revenue in the past twelve months.”
1. Reprinted from “Healthy Workers, Healthy Families” newsletter, Volume 2 No. 4, July-August 1998.
2. “Trends in Alternative Medicine in the UnitedStates, 1990-1997,” Journal of the American Medical Association, Nov. 11, 1998.