Considering a growing trend in expanding your chiropractic care
Multidisciplinary practice, once considered a rare phenomenon, is now a marked trend in the health care industry. Market forces and decreases in revenue are driving practice consolidation within chiropractic — a movement already familiar to the medical community, where less than 30% of medical doctors remain in private practice.
Honor your unique professional roles
Chiropractors and physical therapists offer different but complementary approaches to patient care. While chiropractors focus on the spine and nervous system, physical therapists focus on musculoskeletal conditions, rehabilitation and movement. When these two professions work together, they can provide a comprehensive approach to patient care that addresses both physical and physiological aspects of injury and illness.
In addition, chiropractors and physical therapists can share information and collaborate on treatment plans to ensure patients receive the best possible care. By communicating and referring patients to each other when necessary, they can provide a seamless continuum of care and improve patient outcomes. Moreover, working together can also benefit the health care system as a whole. By focusing on preventative and noninvasive treatments, chiropractors and physical therapists can help reduce the burden on hospitals and other medical facilities, and lower overall health care costs.
Is adding a PT to my practice right for me?
“Yes” is not the right answer for everyone.
It’s not the saving grace for a practice that is not financially sound. It’s great for practices that are ready to go to the next level. A chiropractic practice should consistently see at least 100 insurance-reimbursed office visits per week and at least 20 new patients per month before considering adding a PT to the health care team. In addition, your state must have a favorable legal and reimbursement climate for multidisciplinary practices.
Many states allow a chiropractor to hire a physical therapist as an employee. In these cases, consult with a local health care attorney to ensure your current articles of incorporation will allow you to include the service of a physical therapist.
Some states require simple changes to the existing articles of incorporation. Some states do not permit a chiropractor to hire a physical therapist and require a medical doctor as part of the ownership corporate structure. It is essential to work with a knowledgeable health care attorney to ensure your entity complies with all state and federal laws. You should also review these laws annually with an attorney to ensure you comply with any changes.
What can I expect financially?
Many carriers provide for a separate benefit for services provided by a PT. This allows patients to utilize the chiropractic benefit for chiropractic services (exams, adjustments, etc.) and have additional services provided by the PT (exams, rehab, modalities).
Physical therapy coverage may reduce limitations for reimbursement for a DC-only practice. Perform a sampling of insurance verifications for the most common carriers currently represented in your practice. Verify both DC and PT benefits. If there are benefits for services provided by a PT that are not covered when provided by a DC, adding a PT may be right for you.
Isn’t hiring a PT expensive?
Starting salaries for PTs vary per area of the country. A quick search on Indeed.com or Glassdoor.com will provide you with a range for your geographical area.
As with all practice-building activities, your minimal goal should be to realize a 3:1 return on this investment. You should be able to cover four months of increased overhead to allow for the revenue stream to begin. In a post-pandemic world, credentialing of new staff members with insurance payors can be a major roadblock, slowing reimbursement for between three to six months. This gap can be covered out of your current cash flow, cash on hand or a line of credit.
Be sure to figure in the cost of any equipment you may need to purchase to allow your PT to provide quality service to your patients. Starting with “low-tech” rehab equipment is often fine for most practices.
How do I hire a PT?
Physical therapists are in high demand in many markets. It is best to develop a multi-pronged approach.
Cast as wide a net as possible. Do not drop single lines into the water. Having as many channels working as possible will increase your chances of hiring in a shorter period of time. Remember, you do not have to hire the first person you meet. Be sure to find the right fit in terms of volume of patients to be seen, case management goals and practice philosophy.
Consider:
- State board lists
- PT school websites
- APTA website
- State and local association websites
- Ads in your local paper and websites
- Staffing agencies
How can a PT help grow my practice?
Many patients do not have chiropractic as part of their health care paradigm. This includes many medical physicians. An on-staff PT increases the perceived standard of care your practice provides.
It can make your practice a more desirable destination for referrals. One of the most significant yet overlooked aspects of creating a multidisciplinary practice is that you will attract referrals you might not receive as a DC-only practice. While their view is not reality-based, some members of the medical profession view a referral to a chiropractor as a referral to a lesser standard of care. Referrals to a physical therapist are not viewed this way. Marketing your multidisciplinary practice to medical doctors fosters the quality and quantity of referrals that you desire.
Enlist the marketing skills of your PT to help market your practice for referrals. Set aside dedicated practice-building hours for your rehab department. This can be orchestrated by the clinic director and implemented by the physical therapist.
Design referral pads that highlight the physical therapy services your practice provides and deliver them to nearby medical offices. For added impact, offer to provide in-service programs at those offices explaining the services your multidisciplinary practice provides. Learn who actually makes the referrals and build relationships with those individuals. Oftentimes it is not the medical physician but the office manager or front desk personnel who act as referral coordinators.
Maximize health from the inside out
Chiropractors have been attempting to change the health care system from the “outside in” for over a century. When chiropractors and physical therapists work together, they can provide a comprehensive and integrated approach to patient care. They can improve patient outcomes, reduce health care costs and improve quality of life for patients.
By collaborating, they can ensure patients receive the best possible care, avoid unnecessary procedures and treatments, and maximize optimal health and wellness.
MARK SANNA, DC, ACRB LEVEL II, FICC, is the CEO of Breakthrough Coaching. He is a board member of the Foundation for Chiropractic Progress and a member of the Chiropractic Summit. To learn more, visit mybreakthrough.com.
