Surveys have been performed to help determine the attitude of the American public toward the medical profession as compared to the chiropractic profession. Not surprisingly, medical doctors tend to rate higher than chiropractors in several key categories.
So, square that one around in your mind. A portion of the population thinks chiropractors are lame (or whatever negative term they use), but if an MD works with a chiropractor, that MD is extra special cool. What's up with that? It doesn't even make logical sense.
Then, if you ask that same person about the chiropractor who works with an MD, you will almost always find the perception of that chiropractor is higher than the perception of other chiropractors who practice alone. Although there is absolutely no basis for such conclusions, you will find it holds true for most people.
The perception of both the medical provider and the chiropractor in a multi-specialty practice is higher than the perception of either one of their colleagues who are in independent practices. This is a significant finding – one that should be considered when constructing your business model.
Public Response to Marketing Efforts by a Multispecialty Practice
It is estimated that approximately 10-12 percent of the population is open to seeking assistance from a chiropractor. Compare this to the 90 percent that continuously seeks health care from medical providers, but does not consider chiropractic. In light of these percentages, it should not surprise you that chiropractors have to work five to eight times harder than their medical counterparts to earn business from their community. However, that problem does not exist for chiropractic services delivered as part of a multispecialty health care clinic.
These facts are significant for chiropractors who consider hiring medical professionals or joining a multispecialty practice. When you advertise or do marketing activities as a medical center, as opposed to a chiropractic office, you suddenly unlock the opportunity to serve the 90 percent of the population that would never consider going to a chiropractor.
This is not only great for those patients and great for your business, but it's also great for the profession of chiropractic. There is nothing that will introduce chiropractic to more people than a multispecialty office.
What Does the Initial Patient Encounter Look Like?
A patient encounter starts with a consultation and exam by one of the broad-scope providers. In an office with a medical provider, such as an MD, DO or nurse practitioner, it is one of these professionals who will typically do the first patient visit.
It's an important concept to understand from a compliance standpoint that the clinical flow must be arranged with either concurrent exams (same day) or broad-scope providers doing exams first. This is to prevent the perception that a narrower-scope provider (such as a chiropractor) is determining which patients need medical care. That perception can be particularly problematic from a compliance standpoint if the chiropractor is also the owner of the clinic.
This aspect of practice management goes back to the chiropractor's willingness to delegate authority for the sake of expanding the practice. This puts chiropractors in a dilemma, wondering whether employing a medical doctor with a broader license will override their vision of health care. However, finding a medical doctor who shares the chiropractic vision is often easier than most chiropractors imagine.
Chiropractors contemplating medically integrating their offices often complicate this part of their practice development. But a hospital is a good example of a multispecialty center run by a business manager – often with no medical license – at the helm. The boss doesn't have to make the final decision on care if the right staff members were hired at the start.
Hospital administrators hire doctors and staff who agree with the hospital's philosophy. Hospital administrators make decisions about which medical services will be offered at that hospital. So, if a medical doctor under their employment believes a patient needs a procedure that is not offered at that hospital, the doctor must send the patient elsewhere.
Obviously, chiropractors aren't going to hire medical doctors who disagree with chiropractic or holistic treatment and their visions of their practices.
Based on this initial encounter with the medical provider, diagnostics may be ordered. Those diagnostics may be performed on day one or may be scheduled for a subsequent day. Also, if there are other providers in the office who need to see the patient, those visits are performed either on day one or a subsequent visit. After all the consultation, exam and diagnostic data are collected, the team (medical professionals, chiropractor and any assistants) meet and a treatment plan is created. The plan is aimed at attaining the best possible result for the patient.
Practitioners contribute their perspectives on individual patients' conditions and offer their treatment recommendations. These treatment plans include the individual provider recommendations, but also can be plans based on discussion and group consensus. Once plans are established, patients are given their recommended course of care. Then all care accepted by the patient is scheduled and administered as part of a program.
For any program that includes many treatments of care over a period of time, there should be follow-up assessments to determine how the patient is doing. Follow-ups that include subsequent changes to treatment plans or release-from-care determinations can be made by the team during team meetings. The team can discuss how treatment is going, results and what needs to be done to help get the patient to achieve the goals of the program.
The Future of Health Care
Just about every white paper, think tank and futurist in the health care space predicts that the practice of the future will be a multispecialty practice. There are few that argue against that point, because it seems so obviously correct.
Combine all this with the fact that as a multispecialty health-care center offering chiropractic, you will introduce chiropractic to 90 percent of the population who would otherwise never have the chance; it becomes a wonder why more chiropractic business owners don't consider this option.
Current estimates suggest 3,000-5,000 chiropractors work in multispecialty settings. Some predict that number to rise to 8,000-10,000 by 2020. The future is clear – it's just a matter of deciding how you would like to proceed.
Dr. Eric Huntington is the CEO of Advanced Medical Integration (AMI), a training and consulting group that assists chiropractic practice owners in transitioning their businesses to multispecialty health care centers; and the president of the Chiropractic Business Academy (CBA), a business management and coaching firm for chiropractic and multispecialty practices. Dr. Huntington was both the ICA representative for Maryland and a board member of the Maryland Chiropractic Association from 2002-2013. He also served on the executive committee of the ICA Best Practices and Practice Guidelines, published in 2008. To learn more about AMI, visit www.amidoctors.com.