Every day, about 20 chiropractors send me e-mails asking for advice about their current relationship with their hospital, or wanting to learn more about making inroads into their local hospitals. These e-mails are the foundation for a developing database of chiropractors with hospital affiliations. These letters are also a source for my growing frustration over our profession's lack of communication with regard to hospital practice.
Through these e-mail correspondences, I have learned about the existence of a growing number of hospital chiropractic departments. Amazingly, it is almost impossible to get information about many of these hospitals. I have written to every state board of chiropractic examiners and every state association, inquiring about chiropractors in their state's hospitals. The results have been disappointing at best. Many don't respond. Many of those who do respond don't know the exact names of the hospitals or the names of any of the chiropractors involved. Many of those who do know are not willing to offer any more information than to say, "Yes, there are hospitals with chiropractors in our state." For example, I have been told that there are three major hospitals with chiropractors on staff in the Chicago area. If anyone can name these hospitals or the chiropractors involved, I challenge you to send the names to me via feedback at www.chiroweb.com/columnist/cerf.
The American Chiropractic Association's Hospital Relations Committee, under their leadership of Jon Buriak, DC, made an effort to develop a database of hospitals that offer chiropractic services. Unfortunately, the ACA has so many important projects that it couldn't afford to fund this project. Realistically, developing a database is too time-consuming and expensive for the resources of the ACA's Hospital Relations Committee. It is no fault of the ACA or other chiropractic organizations that their resources are already devoted to other important projects.
The newly formed American Academy of Hospital Chiropractors (AAHC), a nonprofit, nationally based help chiropractors pursue hospital privileges. The AAHC supports our national and state organizations by encouraging membership while not using the funds of these organizations. The AAHC devotes all of its resources to hospital chiropractic. This helps the ACA and other chiropractic organizations retain their resources for ongoing projects.
One of the main goals of the AAHC is to develop and maintain a database of chiropractors both with and seeking hospital affiliations. This database is turning out to be a valuable tool for coordinating the efforts of chiropractors who desire hospital privileges. The database can also be used for chiropractors in a particular hospital, to use the accomplishments of chiropractors in other hospitals as an example of what their own hospital administration should allow as part of their hospital privileges.
Hospital administrators don't want to be the first to try something new. They see liability in not running their hospitals according to standard practices. Administrators are much more open to having chiropractors on staff when made aware of the numerous other hospitals with successful chiropractic programs. Likewise, administrators are hesitant to expand the privileges of their staff chiropractors without proof that there are chiropractors with these same expanded privileges already performing them safely and successfully in other hospitals. When I proposed allowing the chiropractors to perform manipulation under anesthesia (MUA) in my hospital, the first question was, "How many other hospitals in the United States allow chiropractors to perform MUA?" As there was no database at the time, I was unable to find an answer and the proposal was put on hold.
We need as many chiropractors as possible to join the AAHC. We need to demonstrate our profession's interest in hospital chiropractic. We need to develop the database to show which states have chiropractors in hospitals, and in which states and cities chiropractors want to be in hospitals. The membership dues of the AAHC are only $75 for the first year. The potential benefit to our profession is limitless.
The opportunity to work in cooperation with mainstream medicine in the most conservative of medical settings is revolutionary for our profession. If half of the hospitals in the United States wanted chiropractors "on-call" in their emergency departments, there would not be enough of us to fill the positions. As we organize our efforts through the AAHC, hospitals will become aware of our ability to enhance the services they provide, save money for both the hospitals and insurance companies, help relieve the overburdened hospital staffs, and support the hospitals through our referrals.
By coordinating our efforts through the AAHC, chiropractors can find out about other chiropractors in their area who may already have a foot in the door of their local hospital. If 12 chiropractors know one or two medical physicians in a particular hospital, as a group, they can influence a large percentage of the hospital staff. My experience is that hospitals benefit more by having a group of chiropractors with privileges, as it increases referrals to the hospital by a significant amount. We need to approach our local hospitals in small teams of chiropractors from the region surrounding the hospital. By joining the AAHC, the names of other interested chiropractors will be available to help you form your local team.
Another main goal of the AAHC is the maintenance of standards of hospital chiropractic care. Hospital administrators and boards of trustees want to know that chiropractors who are granted privileges will act in a manner consistent with the goals of the hospital. Membership in the AAHC is a testament to the chiropractor's willingness to provide uniform behavior and practice in the hospital setting. Taking an AAHC-approved hospital protocols certification course will help the chiropractor develop a working knowledge of accepted hospital practices and procedures.
The AAHC is an advocate for chiropractors with hospital privileges. The AAHC is committed to educating insurance companies, state boards of chiropractic examiners, state health departments, hospitals, etc., on the benefits of supporting hospital chiropractic practice.
John Cerf, DC
Jersey City, New Jersey
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