Dr. Pieren previously served on the American Chiropractic Board on Occupational Health and chaired the Wisconsin Chiropractic Association's Industrial Relations Committee; currently, he is active with the ACA Council on Occupational Health and the International Academy of Chiropractic Occupational Health Consultants. Dr. Pieren's industrial experience includes training, coaching and educating people in manufacturing and service industries, as well as businesses employing workers with disabilities.
Wednesday, May 19, 2004 was National Employee Health & Fitness Day. This event, promoted by the nonprofit National Association for Health and Fitness, emphasized the significance of a healthy work force to corporate America. The health of the more than 5.6 million companies in the U.S. is directly connected to the success and well-being of employees through increased job satisfaction, reduced absenteeism and increased productivity. Perhaps the most important benefit directly linked to lowered health care expenses for participating companies is decreased rates of employee injuries and sickness. The total financial impact of work-related injuries alone is estimated to be as much as $240 billion a year (Liberty Mutual, 2002). Health care expenses beyond workers' compensation are also adding financial strain to corporate budgets. The utilization of health care benefits by employees and their families affects their insurance premiums, which have increased by double-digit rates in the past 10 years. According to the U.S. Census Bureau (2003), private employers offer 61.3% of all health benefits. Keeping employees healthy through integrated health and wellness programs has not only been shown to reduce these expenses, but also to improve every other aspect of their working environment.
Comprehensive health promotions, wellness programs, and early interventions have been shown to promote a reduction in health insurance premiums. This outcome helps companies increase profitability and strengthen their competitiveness. Employees and their family members who have been exposed to comprehensive programs become more informed and show increased self-responsibility. They then become active players in their health care, which positively affects themselves and their families. This paradigm shift at a company level has tremendous potential to create a systemic health culture, departing from its past focus on crisis care.
How can a chiropractor play a critical role in promoting health and wellness to the work force? First, become educated. It is critical for the involved doctor to become familiar with the occupational health culture. Become an expert through proper training, such as that offered by Northwestern Health Sciences University (www.nwhsu.edu), and use resources, such as the ACA Council on Occupational Health (www.acacoh.com) or the International Academy of Chiropractic Occupational Health Consultants (www.iacohc.com).
Second, strengthen your communication skills - verbal, written and presentation. You will need to apply your skills to many people at various corporate levels to effectively deliver information between all parties. Also, due to the cross-cultural nature of some companies, be considerate of people who might not be proficient in English. Remember, what you share should be well-understood by all, so they can apply it to themselves.
Third, get involved by joining associations, chambers of commerce, safety councils, or conferences. This will create relationships and provide valuable learning experiences. Businesses often choose consultants they know and trust. Being visible and accessible at places where decision-makers gather will often initiate professional relationships.
Finally, be patient; not every initial contact will lead to a final contract. Be persistent. The competition for industrial consulting is fierce. The chiropractor will benefit from a focus on trusting, long-term relationships with employees and employers.
Chiropractors can get involved at many levels of a company, affecting their employees' health. This can range from crisis care to wellness programs. Chiropractic has often shown positive outcomes within the traditional health care system. These expanded options allow the chiropractor to position himself/herself as a valuable resource for managing occupational injuries and sickness. Bruce Hansbrough, DC, DACBOH, president of the ACA Council on Occupational Health, offers these three main areas for chiropractors getting involved with industries:
- integrating work-related and personal health issues;
- education and training; and
- effects of alcohol and drug use on corporate health.
Even proactive employers have recognized the value of chiropractic involvement and created opportunities for those within our profession. As many of us have centered relationships with companies on workers' compensation cases, others have accepted the employer's invitation and offered services beyond adjustments.
Some of these services are:
- On-site clinics. This option allows employees to get early intervention with minimal loss of work time and increased compliance. In addition, the chiropractor has the advantage of being able to evaluate the worker's job site. The employer benefits with reduced expenses due to the employee's reduced absence.
- Drug testing. Chiropractic has long embraced the notion of drug-free care. This foundation supports the employer's need for healthy and safe workers. Substance abuse testing includes alcohol and illegal drugs.
- Ergonomic assessments. The chiropractic industrial expert will be able to optimize the design of the work site. It has been established that prudent ergonomics play a critical role in reducing cumulative trauma disorders.
- Pre-placement physical examinations and functional capacity evaluations. Evaluating job candidates for their physical ability to perform the required duties is an important first step in preventing injuries.
- DOT physicals. Truck drivers need mandated regular physical examinations and drug testing to maintain their licenses. This is another opportunity to establish long-term relationship with companies.
- Rehabilitation programs. Conditioning programs and work hardening can strengthen the worker, contribute to shorter healing time and prevent recurrences.
Data from companies involving chiropractors have consistently shown reductions in injury rates, lost work time, and insurance premium costs. Another result of chiropractic involvement is reduced employee turnover.
Other chiropractors have started to promote this paradigm shift to corporations. With their primary focus on wellness, prevention and/or health promotion, they have offered a successful and unique solution. Companies are fed up with ever-increasing health care costs and are choosing to shift their attention to wellness. The same companies with comprehensive and successful wellness programs have shown a tremendous reduction in health-related expenses. The role of the chiropractor expands to becoming a facilitator, resource, motivator and coach. Programs concentrated on prevention and wellness are more employee-centered, whereas in reactive care, the injury is still the focus. An industrial chiropractor has the opportunity to address health dimensions that go beyond the physical elements. An effective consultant will be able to offer a variety of options for companies to create a healthier work force.
In conclusion, Joseph Sweere, DC, DACBOH, DABCO, professor at Northwestern Health Sciences University, says it well in his upcoming and inspiring book, Golden Rules for Vibrant Health in Body Mind and Spirit: "(...) the greatest gift you can give others is your best you. Your healthiest you. The greatest gift a husband and wife can give each other is optimal health. The greatest gift parents can give their children is vibrant health in body, mind and spirit. This is true for everyone: workers to employers, employers to workers (...) regardless of who you are and what you do."
To this, I would add that the greatest gift of a chiropractor is to give employees and patients their best and healthiest you.
Andy Pieren, DC, DACBOH
St. Francis, Wisconsin
