In the 1992 movie "Article 99," physicians are faced with fighting a bureaucratic Veterans Administration (VA) in order to provide the proper care for their patients. The title of the movie refers to a VA hospital regulation concerning the withholding of medical benefits if an ailment is not specifically related to military service.
Sometimes I think our chiropractic practices are being subjected to the same form of discrimination from the more traditional fields of medicine. In other words, medical doctors often will not consider sending one of their patients to a chiropractor to gain relief from a variety of ailments. Instead, they will prescribe drugs as the panacea for all of their patients' conditions rather than refer them to us. As I mentioned in the first article in this series ("Chiropractic Care: A Dying Profession?" Available online at www.chiroweb.com/archives/26/09/03.html), chiropractors must take action to expand their services in order to survive the current health care climate.
If we can't quit fighting ourselves, our profession will not advance. If you as a chiropractor can't see how the past has changed what we do and how restrictive our scope is, then the future is going to be even more bleak. If that is your issue and you can't see past your nose, stop reading this and get out of the way of the rest of us trying to be the doctors we were trained to be.
To that end, in the first article, I outlined seven steps to augmenting your practice through the use of integrative medicine. To refresh your memory, these steps included:
- support;
- education;
- nutritional/dietary evaluations;
- supplementation;
- exercise programs;
- laboratory testing and analysis; and
- body-composition testing.
In this article, I will focus on the first two steps, support and education. These two critical "pre-work" steps form the essential building blocks for practice expansion. In order for a chiropractor to successfully integrate alternative forms of patient care into their existing practices, they must seek out those in the know and educate themselves in the major areas of integrative medicine.
Support
As I mentioned in the first article, we are not alone. The American Academy of Anti-Aging Medicine (A4M) has been supporting the integrative medicine movement for the past 15 years. The A4M is a nonprofit medical society dedicated to the advancement of technology to detect, prevent and treat aging-related disease. It also promotes research into methods to slow and optimize the human aging process.
The A4M provides a variety of services, including acting as an information center for the anti-aging movement; educating physicians, scientists and the general public on health and aging issues; providing affiliate organizations to assist doctors; providing a research library of cutting-edge articles and clinical abstracts; providing integrative medicine products; conducting anti-aging seminars worldwide; and providing certification programs, including the American Board of Anti-Aging Health Practitioners Diplomate Certification, the American College of Anti-Aging Sportsmedicine Professionals Certificate, and the A4M Anti-Aging Clinic Accreditation Program.
You can contact the A4M via its Web site at www.worldhealth.net. This organization has been a true blessing for information I have gathered in my practice. With studying, research and marketing techniques, my patients are in better hands.
Education
There is nothing worse than an uninformed medical practitioner (chiropractor). We need to stay abreast of the latest techniques being used not only in chiropractic care, but also in related fields such as nutrition, exercise, fitness and integrative medicine (including anti-aging and hormone therapy). Providing guidance to your patients in these related fields will increase your customer retention by keeping them coming back for more. Besides going for the normal required training necessary to maintain good standing in the chiropractic industry, you should consider taking additional classes and attending conferences that address the following topics:
- vitamin and mineral supplementation;
- nutrition and diet planning;
- general fitness and exercise programs;
- anti-aging and hormone therapy;
- integrative medicine concepts; and
- laboratory testing and body composition training.
Becoming proficient in these topics will allow you to become a more holistic chiropractor; one who can provide complete care to an aging population. Education never goes out of style. Imagine this patient coming into your office: a 50-year-old male complaining of lower back pain. He is 25 pounds overweight. Instead of just adjusting him, you provide a detailed "whole-body" plan that includes diet and nutrition counseling, supplementation recommendations (including a detailed description of exactly what his body needs, based upon laboratory testing of his urine), an exercise program and a body-transformation plan that highlights weight loss, hormonal balance and overall health and wellness. While the patient is coming for his weekly adjustment, you can monitor his progress in all the other areas, making sure he stays on track.
Part of the problem I see is that many of us have made a nice living and have gotten complacent and lazy. Some of our ongoing education should include degrees and credentials that are accepted in the rest of the world, not just by chiropractors. Get a master's degree in nutrition. Credential yourself in exercise physiology. Where are patients going to go? Ask their MD? Medical doctors don't know; they're not trained or understand anything we've been talking about. But rest assured, they are starting to look at these options to enhance their own practices.
My next article will focus on the steps to take to expand your practice by offering integrative medicine services: nutritional counseling and dietary planning. I will outline the educational programs you should attend and provide some thoughts on how to approach this topic with your patients.
So, the next time a physician refuses to refer someone to you for care, call them up and tell them to watch the movie "Article 99." It might change their perspective on how to properly treat patients.
David L. Martin, DC, is a graduate of Palmer College of Chiropractic. He practices in Chino, Calif., specializing in physiotherapy, sports medicine, diet/nutrition and exercise. For questions or comments regarding this article, contact Dr. Martin at (909) 591-2525.