CF 034: Chiropractic Information To Help You Form Your Practice - chiropracticforward

Chiropractic Information To Help You Form Your Practice

Integrating Chiropractors

Today we’re going to talk about a couple of interesting articles that have come out recently touching on some chiropractic information and it’s all good in the neighborhood for chiropractors. 

But first, here’s that bumper music

OK, we are back. Welcome to the podcast today, I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  That’s this one…you’re listening to it right now so you don’t have to do anything else at this point. Just listen and chill out. 

Since you’re here, I might as well ask you to go to chiropracticforward.com and sign up for our newsletter. It makes it easier to let you know when the newest episode goes live, when someone new signs up it makes my heart leap a little and in the end, wouldn’t you just like to know when new episodes come out and, what if we end up compiling a team and coming up with some great ideas? Heck yeah, you want to know about that stuff so make sure you’re on the newsletter. It’s just an email guys. Not diamonds or gold. Lol. 

I want to share with you all the fact that our downloads on this podcast have almost DOUBLED from last month. We’ve picked up that much steam in just one month. Thank you to you all for tuning in. If you can continue to share us with your network and give us some pretty sweet reviews on iTunes, I’ll be forever grateful. 

If all you do is listen, that’s awesome and I’m glad you’re a part of this thing. But, if you can take the extra few seconds to share the episode with buddies on Facebook or wherever, THAT’S the real difference.  

We are honored to have you listening. Now, here we go with some vital information that we think can build confidence and improve your practice which will improve your life overall.

You have bee-bopped right into Episode #34

Before we get into it too far, I’m going to be honest with you all. 2018 has been a challenging year for me both business wise as well as personally. For several reasons really. 

When your attention is taken away from where it needs to be, things tend to fall apart little by little and then finally, you go into a mode where you are all hands on deck and really focused on righting the ship. 

Well, that happened to me at the end of 2017 and through a lot of 2018 as well. I’m only sharing this with you because I want listeners to understand that we’re in this dude together. Issues I deal with and are ultimately able to solve…..if I share those experiences with our listeners, I believe it serves to help you in your practice. 

Here’s the deal, an evidence-based chiropractor, whether I like it or not, is somewhat dependent on a steady stream of new patients. That is due to the fact that we don’t try to see our patients a hundred times, right? We don’t develop the reputation of seeing how many times we can run our patients through the door. Do we? Hopefully, this is chiropractic information you can use.

Oh looky here….your insurance allows you to have 27 visits in a year and….what dya know….your specific condition requires exactly 27 visits to resolve. Ugh. That stuff makes me crazy and, unfortunately, chiropractors are notorious for it. I am hoping some updated, reasonable chiropractic information can sway them to the light. 

Just so chiros don’t think I’m bashing too hard here, medical doctors do useless surgeries just because they can do it and get paid for it with little to zero concern about the person it was done to. It’s rampant in all fields. I just notice the chiropractic side of it more than the others because I’m in it. No chiropractor holds on to 100% of their patients. It just doesn’t happen. 

But, if those NUMBERS DOCTORS – the ones hitting certain stats and the ones that are doctor-centered rather than patient-centered….those guys and gals…..I wonder if they have any idea how many patients they drive away by having that kind of model. And I don’t mean drive away from just their practice. I’m also talking about the number of people they drive away from ANY chiropractor because they assume we’re all the same. It all gives me a rash when I think about it. The public doesn’t have the kind of chiropractic information the rest of us have. 

Anyway, new patients: we depend on a steady stream of them. Now, last year, I would average 55-65 new patients a month but, while we started having issues with billing/collections department, I really got down, I got stressed, and honestly, for a bit, doubted the future of my practice remaining in its current state. That leads to self-doubt too. Where you had a ton of confidence, there remains only a shred after having your foundation shaken, right?

As much as you’d like to avoid it, business gets brought home. Especially when it’s an all-consuming feeling of self-doubt and potential impending doom. Lol. Maybe I’m being a little dramatic looking back on it but, when you’re in it, it’s intense. 

As a result of my focus being altered, my new patient count went to 38 here, 42 there. We’re talking 20+ less new patients per month there for a little while. Without changing anything to my knowledge. 

I spoke with a colleague here in town and his numbers have been down as well so maybe it’s not just me. Who knows?

Here’s what I DO know though. As soon as things lined out in the billing/collections department, guess what, the new patient stream started to line out.

How’s that exactly? I don’t know. I’m guessing an increase in confidence in regards to finances leads to an increase in self-confidence and, when all of my focus isn’t on billing/collections, I have the freedom to work on and consider other aspects of the business. And let’s face it, I’m just a much more pleasant person to be around when I’m not worried about the financial health of my company. I’m going to guess you all are the same way. 

Seriously, once we made a change in the billing/collections department (as badly as I did not want to do it), my billing and collections turned around immediately. I mean immediately. Front desk staff became more confident. I became more confident. Patients started paying what they were supposed to pay. Outdated balances got current. THAT’s some good chiropractic information!

Long story short, what started out as a slow 2018 has become a little bit crazy for me and, if it continues, I’m going to have to hire an associate so I can come up for air. Just getting the podcast written up and produced has started to become a real chore in the last several weeks but I’m committed folks. I’m here for the long haul. 

I hope you are too. 

Let’s start our research talk with one from Chiropractic & Manual Therapies dated 17th of July, 2018 called “Chiropractic in global health and wellbeing: a white paper describing the public health agenda of the World Federation of Chiropractic[1]. This was authored by Michele Maiers, et. al. 

The article begins by saying, “The World Federation of Chiropractic supports the involvement of chiropractors in public health initiatives, particularly as it relates to musculoskeletal health.” I noticed there is no neuro before the musculoskeletal description. Curious. 

The authors then say there are three topics that require out focus as chiropractors and they are

  1. Healthy aging
  2. Opioid misuse
  3. Women, children, and adolescents’ health

I guess the men in the crowd are either built heartier or we’re just not quite as important. Lol. 

The WFC want to help us in participating in these areas and promote chiropractic as partners in the broader healthcare system. That’s certainly something I can get on board with. 

Now, this article is pretty darn long so we’re just going to hit some of the more interesting spots. I will have it linked in the show notes so you can go hop online and read the whole thing word for word should you feel the desire. 

In the background section of the article, they say, “In an era where both medical costs and years lived with chronic disease are increasing, calls have been made for closer collaboration between public health officials and healthcare providers. The potential contribution of many providers, including chiropractors and other health care professionals, is often overlooked.”

But then they go on to say our profession needs to identify priority areas of focus and have plans for our engagement in public health based on these areas of focus. 

I am wondering why they feel that men engaged in manual labor activities having chronic low back pain are not worthy of being a focus group here? We’ve talked so much about how low back pain is such a global epidemic and how so much work is missed as a result blah blah blah. 

Maybe I’m just old school. I don’t have any stats to prove my thoughts here but, I would assume the majority of manual labor is on the backs of men. If I’m not right about that, please email me and show me the stats at dr.williams@chiropracticforward.com. If I’m wrong, I need to be educated. 

Still, what gives on this? I want to be positive so let’s get back to the paper. 

In the area of Healthy Aging, they state the world’s population is getting older and older with the number of folks over the age of 60 years old expected to double in the first half of this century. 

That’s assuming they get control of opioids right? We covered an article some time back that said the US expected lifespan has actually decreased in the last two years rather than increased because of opioids so there is that to keep in mind. 

They mention that “Musculoskeletal conditions are a leading contributor to non-communicable burden of disease, predominantly low-back pain and osteoarthritis.” 

And…”Physical activity is key in the prevention, treatment, and management of most chronic conditions affecting older adults, including musculoskeletal complaints. Chiropractors should consider prescribing exercise, with or without manual therapy, for spine care in older adults. Such approaches are supported by an evidence-based framework, which includes clinical practice guidelines.” Great chiropractic information.

Isn’t it nice to see the WFC using evidence-based terminology and approaching things from an evidence-based platform? Everything mentioned in this article has resources that are cited. It feels good and it gives me a warm fuzzy feeling all over. 

They also talk about how falling is a major concern among the older crowd and how exercises and physical activity helping to maintain strength and balance can help prevent them. 

They mention potential barriers to older folks getting chiropractic care. If you are a regular listener of our podcast, you know about the White House report that actually said CMS creates barriers to patients seeking care under a chiropractor[2]. I just linked that in the show notes if you want to look at it. It’s on page 57 so you can avoid reading the whole thing just to get that snippet.

https://www.whitehouse.gov/sites/whitehouse.gov/files/images/Final_Report_Draft_11-3-2017.pdf

How does that get resolved exactly? I think that’s what happens when we have government-run healthcare in my opinion. They have to cut costs and the services they feel are of the least value will go away in terms of coverage. 

I think that’s what is going on with Medicare. Research shows it’s effective but we can’t get anything other than an adjustment covered. What other reason would there be? Pass on any of your chiropractic information you can share with us on this.

Onto focus area #2: Opioid misuse. 

Boy we’ve covered this one. Like….a lot. Let’s see if they have anything new here for us to chew on. 

Here’s a new stat I haven’t seen before, “Opioids account for 70% of the negative health impact associated with drug use disorders globally, and are considered the most harmful drug type .” They also say, “Approximately 69,000 people worldwide die from opioid overdose each year, with a large toll of overdose deaths in the United States and Canada.”

Then they say something I completely agree with, “The opioid misuse crisis creates an impetus for chiropractors and chiropractic organizations to collaborate with other healthcare providers, decision makers, and stakeholders. Patient-centered, inter-professional collaboration should be expanded for the treatment of musculoskeletal pain, with chiropractors playing a larger role on multidisciplinary pain management teams.”

Notice they say “Patient-centered.” Not “Doctor-centered.” Not offices and doctors that do things to hit numbers. Not doctors that see a patient 80 visits. Not those guys. Patient-centered, evidence-based chiropractors are in the right spot right now folks. 

OK, priority #3: Women’s, Children’s, and Adolescents’ Health. 

When covering some of the relevant issues for this group, they cite pregnancy-related back pain and pelvic pain and post-partum spinal disorders which may impede recovery. 

The second issue cited is hormonal changes, dietary factors, and physical inactivity are all factors for osteoporosis. 

The third is violence against women and girls causing injury. I’m just not sure how in the year 2018 we still have violence against women and girls or children in general. Human beings can be cretins, can’t we? Lack of parenting? Inherent evil in the offenders? Who knows? It’s hard to postulate on something you understand nothing about. 

Here’s something in the article I can agree with 100% they say that women are the major decision maker for their families. If you are marketing men…..in most markets, you are wasting your money. 

I can’t tell you how many men come in here and when we ask how they found us or what brings them here today, they say, “My wife. This is where my wife told me to be. I didn’t want to come. I don’t like doctors but my wife is tired of my griping about my back.”

Market the ladies and you market effectively. End of story. 

To summarize the article, the WFC says they are developing tools with the goal of empowering chiropractors and WFC member organizations to engage in public health activities in the three identified priority areas. I’m looking forward to seeing what they’re going to come up with. Exciting stuff here. Great chiropractic information.

The next article I want to cover quickly is one written by Dr. Christine Goertz called “What Does Research Reveal About Chiropractic Costs?” and it was published on the ACA Blog on July 10, 2018[3]. 

Dr. Goertz by saying something ALL evidence-based chiros can yell, “Amen,” at and that is where she says, “Without a doubt, the most common issues raised by those outside the profession relate to the quality and consistency of chiropractic care delivery. The second most commonly asked question invariably pertains to the costs associated with chiropractic care.”

So….AMEN! 

Another amen quote would be this one: “(Evidence) consistently shows that patients with low back and neck pain who are treated by chiropractors have either similar or lower costs than those seeking care from other providers. In particular, it appears that patients who visit a chiropractor are less likely to undergo hospitalization, resulting in lower global healthcare costs than those who receive medical care only.”

Hallelujah. If you love this chiropractic information you need to share this chiropractic information.

When addressing the cost of chiropractic care, Dr. Goertz mentions a paper we have covered here by Hurwitz[4] that concluded that found that health care expenditures for patients with low back pain, neck pain, and headaches were all lower in those who received chiropractic care alone when compared to any other combination of healthcare providers. 

Well, that’s some sexy chiropractic information, isn’t it? Of course it is. You realize you can use articles like this and the information you get from podcasts like this to help you educate your population and your area’s Medical professionals right? Are you listening or are you listening and utilizing? That’s a good question to think about. I have cited the Hurwitz paper in the show notes for your own independent review. 

She then covers a paper by Martin et. al. that we will be covering soon. Over 12,000 patients with 4,300 or so using alternative healthcare. 75% of the alternative users (3,225) were treated with chiropractic. This is big for chiropractic since those treating with alternative means had $424 less in spinal care and $796 less in total healthcare costs. Average healthcare spending for alternative care users was on average $526 lower. 

Huge, absolutely huge folks. If that doesn’t put a grin on your face, you’re dead. You need a defibrillator muy pronto, amigo. Share this chiropractic information won’t you?

This week, I want you to go forward with this: Don’t you understand that if we chiropractors were wrong, we’d have been wiped out by now? We are right. We have been right and we will continue to be right. What we do is so powerful that our profession has persisted and, in fact, prospered in spite of the non-evidence-based people out there on the fringe giving the rest of bad names. The hucksters and profiteers have not even been able to destroy it. They’ve held us back, no doubt. But they haven’t been able to extinguish us and that’s pretty powerful. We are right. Keep on keeping on with confidence. 

Integrating Chiropractors

I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is a mechanical pain and responds better to mechanical treatment instead of chemical treatments.

The literature is clear: research and experience show that, in 80%-90% of headaches, neck, and back pain, patients get good to excellent results when compared to usual medical care and it’s safe, less expensive, and decreases chances of surgery and disability. It’s done conservatively and non-surgically with little time requirement or hassle for the patient. If done preventatively going forward, we can likely keep it that way while raising overall health! At the end of the day, patients have the right to the best treatment that does the least harm and THAT’S Chiropractic, folks.

Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show or tell us your suggestions for future episodes. Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on iTunes and other podcast services. Y’all know how this works by now so help if you don’t mind taking a few seconds to do so.

Being the #1 Chiropractic podcast in the world would be pretty darn cool. 

We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward. 

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Bibliography

1. Maiers M, Chiropractic in Global Health and wellbeing: a white paper describing the public health agenda of the World Federation of Chiropractic. Chiropr Man Therap, 2018. 26(26).

2. The President’s Commission on Combating Drug Addiction and The Opioid Crisis. 2017.

3. Goertz C, What Does Research Reveal About Chiropractic Costs?, in ACA Blog. 2018: ACA Blog.

4. Hurwitz EL, e.a., Variations in Patterns of Utilization and Charges for the Care of Neck Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis. J Manipulative Physiol Ther, 2016. May 39(4): p. 240-51.

Relevant Links

CF 021: Crazy Update On Run-Away Healthcare Spending in America

 

CF 005: Valuable & Reliable Expert Advice On Clinical Guides For Your Practice

 

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