Building Better Practices Since 1954
Get your leadership in alignment
How to teach a life of wellness
Should you be involved in corporate wellness?
The mechanics of finding good staff members
Fabrizio Mancini, DC A healthy approach to Chiropractic Education
PLUS Supplies Resource Guide p. 84
Issue #1: January 21, 2010 www.ChiroEco.com
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contentsCHIROPRACTIC ECONOMICS • VOLUME 56, ISSUE 1
clinical research IN EVERY ISSUE Keeping current with the evidence ...... 17 EDITOR’S MESSAGE ...... 8 By Ronald Rupert, DC NEWS ...... 10 DATEBOOK ...... 94 marketing ADVERTISERS INDEX ...... 96 Are your gatekeepers hurting your bottom line? ...... 23 PRODUCTS ...... 98 By Lisa Roberts MARKETPLACE ...... 103 Team Tips: Plant the seed for referrals ...... 26 CLASSIFIEDS ...... 104 By Susan Hoy SUPPLIES GUIDE ...... 84
personal development It it’s broken, fix it! ...... 33 By Dennis Schone, DC Chiropractic Economics (ISSN 1087-1985) (USPS 019-178) is published 18 times per Align your leadership ...... 36 year and two of the issues, in July and By Monica Wofford, CSP November, will include a special editorial supplement. In addition, two issues are There is no better time to be a chiropractor ...... 40 mailed in January, February, April, June, Aug., and Sept. One issue is mailed March, By Charles E. Ward, DC May, Oct., and Dec. Address: Chiropractic Economics, Inc., 5150 Palm Valley Road, Suite 103, Ponte Vedra Beach, FL 32082. Phone: 904-285-6020, Fax: 904-285-9944. wellness Web Contact: www.ChiroEco.com. (A A life of wellness … or not? ...... 47 Florida Corporation). POSTMASTER: Please send form #3579 to By Gilles Lamarche, DC Chiropractic Economics, PO Box 3521, Northbrook, IL 60065-9955. Periodicals Should you be involved with corporate wellness? ...... 50 class postage paid at Ponte Vedra, Florida By David E. Wade, DC, CCSP, CCST, CHC and at additional mailing offices. GST #131868416. Subscription Rates: U.S. and possessions, $39.95 one year, Canadian subscribers add feature $35 per year shipping and handling; overseas subscribers add $60 per year A healthy approach to chiropractic education ...... 58 shipping and handling. Students, $19.95, By Stanford Erickson Single copy, $4. Statement: While encouraging the free expression of opinion by contributors to this publication, Chiropractic Economics and practice management members of its staff do not necessarily agree with/or endorse the statements made in the The mechanics of finding your next staff member ...... 71 advertisements or contributed articles. By Laurie Mosier, MPA Chiropractic Economics is owned by Chiropractic Economics, Inc. a Florida Practice freedom with an associate ...... 76 Corporation, Joseph D. Doyle, President and CEO and Wendy Bautista, Editor. By Ed Sharp Authorization for the use of photographs and/or illustrations is the responsibility of Coding Questions: What’s your coding IQ? ...... 80 the author(s). All materials submitted for By Marty Kotlar, DC, CHCC, CBCS publication shall remain the property of this magazine until published. Consult the Coach: High-velocity practices eliminate friction . . . . 82 By Mark Sanna, DC ACRB Level II, FICC Change of Address: Six to eight weeks prior to moving, please clip the mailing label from the most recent issue and send it along with your new address (including zip code) to the CHIROPRACTIC ECONOMICS studentDC.com CIRCULATION DEPARTMENT, PO Box 3521, Northbrook, IL 60065-9955. For a faster Building a successful practice through education ...... 92 change, go to www.ChiroEco.com and click on By Brian Jensen, DC “Customer Service.”
4 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CHEC_5.ps 12/28/09 7:20 PM Page 5 CHEC_6.ps 12/28/09 7:21 PM Page 6
NOW ONLINE HOME PAGE FOR THE SUCCESSFUL DOCTOR OF CHIROPRACTIC
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Chiropractic Tables More from this issue www.ChiroEco.com/hill Find charts from David E. Wade’s • Four factors to consider when corporate wellness article at: Find us online! investing in a table www.ChiroEco.com/wade Check out Chiropractic Economics on • The pros and cons of new, used, Facebook and Twitter. and reconditioned tables Resources for www.ChiroEco.com/facebook Canadian DCs www.ChiroEco.com/twitter Job Board Our Web site section for Canadian Visit www.ChiroEco.com/jobboard DCs features news from schools, Resource Centers for employment opportunity listings organizations, and seminars. The site for: Lasers also includes Canada-specific coding • Associates www.ChiroEco.com/erchonia and billing information. Check it out • Billing at www.ChiroEco.com/Canada. • What are you treating with lasers? • Chiropractic • The highs and lows of lasers Assistants Resource Guide Instrument Adjusting • Doctors of and Directory www.ChiroEco.com/neuromechanical Chiropractic Our patient retention resource guide • Bring adjusting instruments to • Faculty and directory is now available online the table • Front at www.ChiroEco.com/directory. Office/Reception/Scheduling • Integrating instrument adjusting in your practice • Independent Contractors • Marketing Online Poll Electronic Health Record • Massage Therapists Do you have a wellness www.ChiroEco.com/futurehealth • Multidisciplinary Practice program for your employees? Opportunities • Guest Editorial-How to keep To enter your response and EHRs secure • Office Management view the results of our last poll, • A case study in billing • Temporary Positions visit www.ChiroEco.com. • Other
Expert Insights Blogs by Jean Murray, Perry Nickelston, Gerry Clum, Kelly Robbins, Kathy Mills Chang, Jasper Sidhu, Paul Varnas, and the Chiropractic Economics editorial staff. We have chosen these bloggers from different niches: Practice startup, reimbursement, strategies from the ‘real world’ of chiropractic, and the chiropractic press. We do this to make sure you get the big picture about chiropractic success. Let’s Talk Chiropractic ChiroMasterMind Don't practice on Would you like to attract Who invented the laser your practice? news patients? and how does it work? Burden of proof
Lisa Roberts Perry Nickelston, DC Dr. Paul Varnas www.ChiroEco.com/roberts www.ChiroEco.com/nickelston www.ChiroEco.com/varnas
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editor’s message
Living life to its fullest BUILDING BETTER PRACTICES SINCE 1954 Volume 56, Number 1 umping out of airplanes, diving off cliff sides, hang Editorial Director Stanford Erickson Jgliding across canyons, and racing cars at their [email protected] highest speeds — these are some people’s idea of Editor Wendy Bautista living life to its fullest. [email protected] But that isn’t everyone’s idea — and it doesn’t need to be. Assistant Editor Ryan Daley Living life to its fullest is different for different people. For some, it is the [email protected] “daredevil” acts that do it for them; for others it is just living a full life. In Editorial Assistant order to accomplish either of these feats, however, you need to be well. Melissa Heyboer Wellness is defined in the article “A life of wellness [email protected] … or not?” on page 47. In it the author discusses how Art Director some of the most commonly described subdimensions of Christine Wojton [email protected] wellness relate directly to the art, science, and philosophy of chiropractic. Production Assistant Nicole Evans He goes on to explain that since subluxations can be [email protected] caused by physical, chemical, or emotional stresses, it Vice President, Web Operations/ makes sense to communicate a clear and consistent Audience Development Let me know what’s message relating to the appropriateness and Manuel Lirio on your mind: [email protected] 904-567-1539 effectiveness of chiropractic care in order to improve Fax: 904-285-9944 the health of the nation. Web Developer [email protected] Darryl Green Wouldn’t you, as a doctor of chiropractic, want to be [email protected] part of improving the health of the nation? Since many of you enrolled in Accountant chiropractic school to help people, the answer is more than likely yes. But Brenda Murphy have you considered how you could help more? [email protected] “Should you be involved with corporate wellness?” on page 50 offers National Account Executives another opportunity for you and your practice. With many worksites Jeff Pruitt, 904-567-1542 [email protected] promoting healthy habits and employers reaping the rewards of fewer sick days, Janice Ruddiman Long, 904-567-1541 greater overall productivity, and lower health insurance costs, the author [email protected] explains how you should take a lead roll in corporate wellness and what tools, Joel Morris, 904-567-1548 programs, strategies, and sales and marketing is needed. [email protected] And speaking of taking a lead role in wellness, see our Jill Upton, 904-567-1546 Editorial Director Stanford Erickson’s interview with Parker [email protected] College of Chiropractic’s President Fabrizio Mancini. “A Advertising Coordinator healthy approach to chiropractic education” on page 58 Hustin Wildman, 904-567-1543 discusses how since Parker College of Chiropractic appointed [email protected] Fabrizio Mancini, DC, president, Parker has emerged as one Classifieds Account Executive Tina Farber, 904-567-1551 of the more financially sound chiropractic colleges in the [email protected] Fabrizio Mancini, DC, (L) country — with Dr. Mancini gaining acclaim as a leading with Stanford Erickson. President/CEO educator and proponent of chiropractic worldwide. Joseph D. Doyle Chiropractic worldwide — that sounds nice doesn’t it? And you can be part [email protected] of it by improving the health of the nation through wellness and by living life Business & Editorial Offices to the fullest — however that may be for you. 5150 Palm Valley Rd., Ste. 103 Wishing you success, Ponte Vedra Beach, FL 32082 Phone: 904-285-6020, Fax: 904-285-9944 www.chiroeco.com
Founded 1954 William L. Luckey and Helen C. Luckey Wendy Bautista, Editor
8 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010
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news flash
TOP NEWS Northwestern Health Sciences University. Second Life is a 3-D virtual world that uses avatars, Parker opens moveable icons representing people, to interact through free voice and text chat. During the winter trimester, the state-of-the-art facilities Northwestern clinical education department will Parker College of Chiropractic has opened the new administer a Second Life beta test that will allow students Erchonia Laser Health Care Center and the Standard to conduct virtual interviews with patients in an online Process Student Activity Center. simulated clinical training environment. The Erchonia Laser Health Care Center was opened to Glori Hinck, DC, assistant professor and pioneer of this provide better facilities and laser equipment for patient program, has been working to integrate the technology care, to increase public awareness, and to improve into an active education program. chiropractic education. Not only will students have the Source: Northwestern Health Sciences University, www.nwhealth.edu/nwtoday/index.html opportunity to learn about laser technology, but as interns they will gain real-world experience as they treat patients To learn more about Second Life visit, with Erchonia’s low level laser equipment. www.ChiroEco.com/virtual.
HEALTH NEWS ACA: Proper mattress can improve sleep comfort, reduce pain A good night’s sleep is an essential part of a healthy lifestyle; however, an estimated 70 million Americans complain of sleeplessness. A 2006 study published in the Journal of Chiropractic Medicine showed that sleeping on a new mattress can significantly reduce stiffness and back pain. Researchers found that study participants reported immediate and sustained benefits after sleeping on a new mattress. This was especially true of participants who entered the study with back pain complaints, as they reported a 63 percent improvement in back discomfort with a new mattress. Source: American Chiropractic Association, www.acatoday.org Made possible due to Standard Process Inc.’s $1 million donation to Parker, the two-story, state-of-the-art To see tips on picking a new mattress visit, Standard Process Student Activity Center will help www.ChiroEco.com/mattress. advance the college’s academic potential and further the education of future doctors of chiropractic. INDUSTRY NEWS The Standard Process Student Activity Center will also help to maintain the health and wellness philosophy Foot Levelers donates that Parker promotes. It will assist in producing positive $23,000 to COCSA lifestyle choices and a healthy environment with its Foot Levelers donated $23,000 to the Congress of gymnasium, locker rooms, and student lounge. Chiropractic State Associations (COCSA). This Source: Parker College of Chiropractic, www.parkercc.edu donation will support the COCSA mission, which is “to provide an open, nonpartisan forum for the promotion Virtual world offers students and advancement of the chiropractic profession through unique patient experience service to member state associations.” New technology that will give chiropractic students “We are honored to support the Congress of the opportunity to conduct an online clinical rotation Chiropractic State Associations,” said Foot Levelers with a virtual geriatric patient is being introduced at President and CEO Kent S. Greenawalt. “COCSA
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news flash
provides an opportunity for state associations to work Midwest and one of only two universities in the country together and learn from each other and Foot Levelers is to offer degrees in naturopathic medicine, chiropractic proud to contribute to this effort.” medicine, acupuncture, and Oriental medicine on the In our tradition of continuing support to the same campus. Although only three years old, the ND chiropractic profession, Foot Levelers has donated millions degree program at NUHS is thriving and continuing to of dollars to chiropractic colleges and causes over the years. expand with the addition of new faculty and growing Source: Foot Levelers, www.footlevelers.com admission rolls. Source: National University of Health Sciences, www.nuhs.edu
COLLEGE NEWS Sherman returns to original name: Palmer receives full Sherman College of Chiropractic NCA regional accreditation Sherman College of Straight Chiropractic is now known Palmer College of Chiropractic recently received as Sherman College of Chiropractic. regional accreditation for all three of its campuses. The The college’s Board of Trustees voted unanimously to Higher Learning Commission of the North Central authorize the college’s name change on Oct. 17, 2009, Association of Colleges and Schools (NCA) notified during its fall meeting. Palmer that the college — including the main campus in Sherman College of Chiropractic is the name under Davenport, Iowa, and the branch campuses in Port which the college was founded in 1973; the college added Orange, Fla., and San Jose, Calif. — has been granted the the word “straight” to the name in the late 1970s. Source: Sherman College of Chiropractic, www.sherman.edu full, 10-year accreditation by the NCA. The Davenport and Port Orange campuses were granted reaccreditation, and the West Campus was WHCCS at forefront granted accreditation by the NCA for the first time. of CAM research Source: Palmer College of Chiropractic, www.palmer.edu The Wolfe-Harris Center for Clinical Studies (WHCCS) at Northwestern Health Sciences University NUHS awards first has earned an international reputation as a leader in ND diplomas since 1952 clinical research for complementary and alternative In historic commencement ceremonies on Dec. 17, medicine (CAM) treatments. National University of Health Sciences (NUHS) awarded The research team at Northwestern is led by Gert three graduates the institution’s first doctor of Bronfort, DC, PhD, vice president of research; and Roni naturopathic medicine degree (ND) since 1952. Evans, DC, MS. In addition to obtaining the federal grant The landmark commencement day honored Steven funding, Drs. Bronfort and Evans direct an active research Moore, DC (valedictorian); Carlos Quezada, DC faculty and staff that is continually pursuing a number of (salutatorian); and Lisa Leonard as recipients of the projects, as well as speaking and presenting at conferences doctor of naturopathic medicine degree. around the world. National’s current ND program opened its doors for the Source: Northwestern Health Sciences University, www.nwhealth.edu/nwtoday/index.html first class of students in the Fall of 2006. The addition of a naturopathic program was a major part of the university’s commitment to integrative medicine. To see some highlights of WHCCS’s research visit, www.ChiroEco.com/WHCCS. NUHS is the only naturopathic medical school in the
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clinical research
Keeping current with the evidence By Ronald Rupert, DC
e have all heard the term 4. How strong is the evidence for the use of low level laser in the treatment of fibromyalgia, osteoarthritis “evidence-based” with and carpal tunnel syndrome? What wavelength and Wrespect to chiropractic, power is most effective? medicine, and other disciplines. 5. What diet changes may reduce the risk of asthma in children? We know that the many key issues related to where the 6. The acai berry — just how good is it for you? chiropractic profession will be with respect to healthcare 7. What does the evidence say is the best conservative reform, scope of practice, and reimbursement are closely method to care for fibromyalgia? linked to this issue of evidence. 8. Based upon a review of all the scientific evidence, Chiropractors endure a lengthy education process with what is the best approach to the treatment for undergraduate college, chiropractic college, and annual cervicogenic headache? license renewal continuing education. Would you consider How well did you do? If you are like most chiropractors, this enough to keep up with important clinical information keeping up with the evidence is an unmanageable task, that impacts your patient’s care, or do you need to invest a and you probably did not know some of the answers or little more time with exposure to new information? missed some you thought you knew. Test how well you are current and see if you can answer the following eight clinical questions (links to the answers Examining evidence-based care can be found at the end): Let’s take a minute to examine the concept of 1. Do you know how to determine the proper dosage of evidence-based care because there is a great deal of vitamin D for your patient? misunderstanding and a high level of emotionally charged 2. Do you know which orthopedic tests are most opinions surrounding the concept. accurate in diagnosing biomechanical sacro-iliac The evidence-based movement is an attempt to put joint pain? more structure and sophistication to what clinicians have 3. What new nutritional supplement may be most always done. Good clinicians are lifetime learners. They effective in reducing the symptoms of osteoarthritis want to keep up with the literature and adopt what is best and has the evidence to confirm it? for their patients, families, and themselves.
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clinical research
Bloodletting, trephining, leaches, phrenology, Rife machines, along with thousands of other diagnostic and treatment procedures are not believed to be as valuable today as they once were. So, one of the keys to evidence- based care is to develop and use skills for finding and critically evaluating literature that can translate into better patient care. The second component is how this new grasp of better information is used. This is the source of a lot of controversy. The evidence is not meant to be a standalone component of how you treat your patients. If that were the case, most medical as well as chiropractic procedures would not be permitted. In true evidence-based care, the three components are the patient’s needs and desires, the doctor’s experience and expertise, and the evidence. Why would you dictate care the patient can’t tolerate or pay for? Why would you use an old treatment procedure you knew was demonstrated to be ineffective or harmful? Why not use the evidence and what is best for the patient if the patient is agreeable and if you feel from your experience it will serve the best interests of that particular patient?
The problems with evidence-based chiropractic There are problems associated with the evidence-based approach. First and foremost is the misuse of evidence. Some third-party payers and governmental agencies are completely ignoring the expertise of the doctor and the needs and desires of the patient and are basing reimbursement solely on evidence. To make matters worse, they are insisting on high-level evidence; primarily rigorous randomized clinical trials. These trials are difficult and typically very expensive. This becomes a significant challenge to a profession that has extremely limited financial resources and even fewer researchers. Based upon the misuse of evidence, the concept of evidence-based practice draws a lot of criticism from many of those in practice. The original publications related to evidence-based care were directed at elevating the skill sets of the physician in order to make more educated decisions based upon the evidence. There are several troublesome issues embedded here. What constitutes “evidence”? How do you weigh this evidence? To answer the latter question, the research community has developed dozens of evaluation strategies. Some for randomized trials, some for meta-analysis, and some for other levels of evidence like nonrandomized
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clinical research
cohort studies, case series, or case may exist on any one topic can be LINKS TO THE ANSWERS reports. cost prohibitive to the average Question 1: Other problems are associated practitioner. www.chiroaccess.com/Articles/The- Implications-of-Vitamin-D-Insufficiency-in-a- with elevating the skills of the Theoretically, it would be ideal to Chiropractic-and-Wellness- physicians to become more critical have highly trained chiropractors as Practice.aspx?id=0000107 consumers of the literature. Some of well as other health providers that Question 2: these include: can execute all of the above, but the www.chiroaccess.com/EBRs/Biomechanical- • Understanding the multiple reality is they can not. Sacroiliac-Joint-Pain-Diagnosis.aspx biomedical databases, their search It is doubtful if many of recent Question 3: www.chiroaccess.com/Articles/An- interfaces, and the indexing structure graduates from chiropractic colleges Evidenced-Based-Intervention-for- and terms. have these skill sets. Osteoarthritis-Avocado-soybean- • Developing critical reading So, as a profession, we have a long Unsaponifiables.aspx?id=0000112 skills that include a variety of way to go. But, in the interim, we do Question 4: research design concepts, selection not need to be without high-quality www.chiroaccess.com/Procedures/Laser- Therapy,-Low_Level.aspx bias, randomization strategies, threats evidence to insure the best patient Question 5: of internal and external validity, care as well as evidence to support www.chiroaccess.com/EBRs/Asthma- and proper statistical analysis, to reimbursement. Prevention.aspx name a few. Question 6: • Being able to set aside the time Ronald Rupert, DC, is dean of research at www.chiroaccess.com/Articles/Acai-is-it- to gather, critically read, and weigh the Research Institute of Parker College Berry-Berry-Good-for-You.aspx?id=0000097 the evidence. of Chiropractic. During 20 years of full- Question 7: www.chiroaccess.com/EBRs/Fibromyalgia- • Much of the biomedical time private practice, he developed the Therapy.aspx literature is not open access. Being MANTIS, the chiropractic and alternative Question 8: able to meet the high cost of medicine literature database, which has www.chiroaccess.com/EBRs/Cervicogenic- purchasing the many articles that nearly 400,000 scientific articles. Headache-Therapy.aspx
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marketing Are your gatekeepers hurting your bottom line? By Lisa Roberts
hances are, if you’ve been in practice for any length of time Cyou now have a team assisting you with patient care and your front desk. Hopefully, you have made the right choices when it comes to the hiring of these key players. More times than not, hiring a front desk person, CA, and/or office manager is based only on his or her technical skills without giving proper consideration to “people skills” or personality — which can be equally important. What is sometimes forgotten or not even considered is the fact that attitude and people skills really can’t be taught, but technical skills can. Hiring someone that smiles often, is friendly, and has a positive attitude is as important, if not more important, than hiring for office know how. Your “gatekeepers” play an intricate role in the success or failure of your practice.
Determining the proper players Here are a few questions to help determine if you have the proper team players. • Have I had any feedback (positive or negative) on the person who handles the front desk? Remember, your front desk person can be more influential than you, especially where a new patient is concerned. When new and existing patients walk into your office, that front desk person is the first person they will see. Any negative behavior or attitude can pollute your practice Remember, if you’re seeing 10 new patients a week and and cause you to lose patients. your staff is working harder but see no rewards, then it is • Does my team want my practice to grow? You not a win-win situation. may think the answer is a no-brainer, but it isn’t. Many If it’s not a win-win for all involved, your team has no make the mistake of assuming the entire team has the reason to want to help you expand. Offering rewards and same goal for the practice and that the growth of the incentives is a good way to keep everyone motivated. In- practice is a priority for all involved. Wrong! office rewards and contests keep your staff fired up as they Once you have determined that all team members have become busier. the same goals for the practice, here’s an idea to keep • Is my staff maintaining payments and everyone excited and motivated: Offer an incentive. collections? It really doesn’t matter how many patient
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marketing
visits you have weekly if you’re not getting paid. The active, they can’t be effective educators. simplest way to avoid embarrassment for your staff or • Is my staff amicable, but abiding, to patients patient is to be sure your patients are not allowed to and their care schedules? Remember, every accrue any big balances on their account. appointment missed by a patient results in the delay of You deserve to get paid for your services and the best attaining optimum health. way to insure you will is to establish from the beginning It’s crucial your staff reiterate the importance of staying what is expected from the patient financially. on track during care to the patient. The biggest injustice you can do for yourself, staff, and If patients believe that missing appointments is no big patients is to allow them to get behind on their bill. If a deal, they will miss appointments. If patients feel patient owes you money and is not able to pay, they will accountable to you and your staff, they will not miss just stop coming to avoid embarrassment. scheduled appointments. If you keep your patient on the payment plan that has Posture yourself and your chiropractic team so that been set up, your collections will increase and your all know and understand the value of your time and patient retention rate will also. treatment. • Is my team sold on chiropractic? Are all of your Remember, your bottom line is in the hands of all your staff members under chiropractic care? Do they really staff members. understand chiropractic? Can they explain the benefits to You can be assured that by underestimating the a patient or prospective patient? If you’re not sure, or significance and merit that each team member brings to think not, then you may need to reassess your team. the table will truly cost you patients and money. It’s highly unlikely that any member of your staff can Beware of the misguided staff member. The harm they truly add to the prosperity of the practice if he or she is may bring to your practice could be irremediable. not under chiropractic care. Your patients are looking for an advocate and a friend. Lisa Roberts is vice president of business development for Metro They’ll need to be educated and re-educated during their Marketing LLC. She can be reached at 800-696-7788 x251 or course of care. If your entire staff is not chiropractic through www.chirometromarketing.com.
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marketing | TEAM TIPS Plant the seed for referrals By Susan Hoy
t is believed that the best new Our goal is to improve the health and well-being of our patients, their families, and the community.” patients are those who have been Planting seeds is a very nonthreatening way to let referred by existing patients or patients know you love referrals. I Try targeting patients who refer. For example: Looking medical professionals. at your schedule you notice Mr. Smith has an Therefore, it stands to reason, that the task of enticing appointment today. Mr. Smith recently referred his friend new patients begins with encouraging existing patients Jim. Tell each team member to thank Mr. Smith and professionals to refer. It’s simple to do, but takes a personally for his confidence. This works especially well small step outside your comfort zone. when you thank Mr. Smith for his referral within hearing The following are some simple suggestions that will range of other patients. It gives them a subliminal message increase the flow of new patients to your office. that you appreciate referrals. Patients who receive an extra dose of enthusiasm Another nonthreatening way to get patients to refer is during the course of their treatment probably received to have pamphlets throughout your office about the more than they expected. They listened to you and your different kinds of conditions that can be helped with staff, got excited about the things you discussed, and can’t chiropractic care. wait to share what they found with others. One of the best places to display pamphlets is in your The first way to go about getting referrals from patients exam room. This is where a new patient waits for you or another team member to arrive. During that time, the Asking for referrals may be a step out of your new patient can browse at comfort zone; however, it is imperative that you the different educational displays. Very often, the new understand how important it is to your practice. patient does not know the scope of chiropractic care and is to let them know you want them. In other words, plant this is the perfect time to let them know the other referral seeds and ask! conditions you treat. Here are some simple ways to ask for referrals that New patients are looking for ways to connect with you, won’t leave you feeling uncomfortable. so discussing some of these symptoms is an easy way for Let patients know you like referrals during the first them to relate to you. Not to mention, an educational phone call by simply asking, “Were you referred by one of opportunity as well. our patients or a medical professional?” It is a proven fact that most patients refer others early You have planted the seed for referrals and given the in their treatment when they are getting better and are potential new patient confidence that you receive referrals excited about the results. So be on the lookout for the from professionals too. perfect time to ask. The next opportunity to ask for referrals is during the For example: Patient: “I am grateful for Dr. Smith! I feel new patient consultation. For example: You could say, better than I did last week. I never would’ve thought “Good morning Mrs. Jones, I’m Dr. Smith. I’m glad you’re chiropractic would be so effective.” here. I’d like to welcome you to our office and personally Team member: “I am happy to hear that! Why don’t thank Jane for referring you. It always makes people feel you call the person who referred you and thank them. It good to know when they’ve helped someone else. When makes people feel good when they’ve helped others. you begin feeling better, I hope you will take the time to “Also, if you know anyone who would benefit from call Jane to thank her and think about referring others. chiropractic we would appreciate it if you would tell them.
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Our business comes almost totally from satisfied patients!” Patient: “I have been telling everyone! I just haven’t been successful in convincing them yet.” Team member: “Don’t push too hard. As long as you told them, they’ll call us when they’re ready. I do have a suggestion though.” At this time offer a new patient referral packet or a complimentary phone consultation card. This card gives the potential patient an opportunity to have a phone consultation with you. The contents of the new patient referral packet should include: • Your practice brochure, • A pamphlet about chiropractic, • A pamphlet about the specific symptom the person is having, • Two business cards, • Any published article from or about you, the doctor, and • A newsletter or any other promotional item. Finally, at your front desk have this framed statement: “We apologize if we have not yet given you the opportunity to change someone’s life. New Patient Referral Packets are available at the front desk.” Asking for referrals may be a step out of your comfort zone; however, it is imperative that you understand how important it is to your practice. The more people you can serve, the more successful you feel, and you are fulfilling your purpose to make a difference!
Susan Hoy is an award-winning team trainer and consultant. She presents training seminars for teams throughout the country and is the author of two team training manuals. The newest is called Systemize, Organize, Simplify. She can be reached at 215-674-0130, [email protected], or through www.beefitup.net.
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personal development
If it’s broken, fix it! By Dennis Schone, DC
f you’re sitting there trying to figure time to write down your goals. Not having a road map to where you want to go is almost always a sign of failure. out why your practice didn’t change Some of you may have written goals, but maybe they are in 2009 and continues to be a either very old or haven’t been looked at after writing I them down. replica of 2008, then it must be broke Take some time today and write down your goals. Be — and you need to fix it. clear about what you want and when you want it. Review You and your team are the heartbeat of your practice. If these goals everyday and remember, you have to “see your practice is not growing or has declined in this recent before you can be.” economy, then you must look at you and your team and 3. Team: When was the last time you held team what you need to change. reviews? Do you continue to tolerate mediocrity? Do you To continue to practice in the world of sameness will have on-going training to help your team succeed? only get you and your team the same results you’ve already Make sure your team supports your goals. If your team is been getting. broke, you need to spend time fixing their problems. Here are some things that may need to be fixed. Remember, you and your team are the heartbeat of your 1. You: Sit down in a quiet place and review your practice. Your practice is where it is because of your team’s mission statement and purpose. Become clear as to what it efforts. When you and your team change, so does your is you’re doing. Many times just working on you and practice. fixing your mission and purpose can propel you to become 4. Procedures: Spend some time with your team and something bigger and better. When you change you, your review your procedures. Start out with all your forms and world changes, too. make sure they are up to date. 2. Goals: Many of you have probably never taken the Review your procedures for using the phone,
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consultations, examinations, releases, results of tests, new patients, re- exams, payment plans, etc. Tear them apart and put them back together; but this time, better. Find a way to improve at least one thing with each procedure. 5. Healthcare class: Many of you have probably never tried a healthcare class. Maybe changing the name of it to “special consultation” can improve the value of the class. Are your new patients attending this class? Are they bringing a guest? This is a very valuable tool that can help educate your patients to lifetime wellness care. It is also a great way to introduce chiropractic to their friends and family. If you haven’t already incorporated a class like this, it’s important to do so. If you have, this class must become bigger and better for practice growth. 6. Marketing plan: Do you have a marketing plan? Is it written down and reviewed each day? Is it visible to the whole team and is everyone involved in it? If the answer is no to any of these questions, then you need to fix it. Make sure you have many marketing projects going on inside and outside of the office each and every week. The weaker the marketing plan the weaker the practice. It’s time to get busy with your team and fill up your marketing calendar. It’s time to have the practice of your dreams. Make your practice contagious. When you decide to fix what’s broken you will be on your way to maximizing your potential.
Dennis Schone, DC, is a consultant and partner of ProPractice Partners. He can be reached at 614-361-4833, or www.drschone.com, or www.ProPracticePartners.com.
34 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010
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personal development
Align your leadership By Monica Wofford, CSP
ou treat patients almost daily • Being you. When you are trying to be your most adored chiropractic college professor, you are not being with loving care and hope that you. You might be doing a wonderful job of being they will continue to improve, someone else, but it’s still not you. However, in order to Y be you and share that pure authenticity, you must first heal, and return for regular care. know who that is and what you look like. Do you, however, provide the same sort of TLC to your With authenticity and the ability to be just you, comes leadership skills, behaviors, and attributes? a feeling of calm about your actions and behaviors. That is That would mean you work on it, practice new also accompanied by a sense of confidence and a comfort techniques, always put the needs of those you work with in your own skin. If you feel those things, then you are as a priority, and spend dedicated time being an even likely being authentic and being you. more effective leader. If you consistently question what you are doing and feel Maybe you don’t do all of that, but you should at least a bit lost, then this is an area of focus. If you are begin with the basics. consistently edgy or find yourself reacting instead of One thing to consider is your corporate wellness — responding, then it is quite possible that whoever you are meaning the wellness of your practice and its ability to “playing on TV” is rather far from the real you. That kind last into the future and even become something you leave of disconnect can cause some real communication as a legacy. Your corporate wellness depends largely on problems and can be rather easily resolved with a bit of how well you lead — now and in the future. awareness about who you are and the permission, from Your ability to lead begins with you. How well are you yourself, to be just that. leading you and is it in alignment with how you lead • Leading you. The saying “lead by example” exists for others and your practice? a reason. People who work with you watch how you lead yourself to determine if what you are telling them to do The concept of alignment has any credibility. This is why the “do as I say, not as I A direct correlation exists between how well you lead do” rule is so laughable, yet true. yourself and how well you lead others. Much like you try When you know who you are and are comfortable in to align a patients’ spine and have all the parts working your own skin, your actions will match your words. Those well and in concert with each other for the betterment of you work with pay attention. If you instruct everyone to body, mind, and spirit, you also have moving parts in your remember patients’ names and treat them with leadership: being you, leading you, and leading others. exceptional courtesy, then you must do so as well.
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If you snap at patients when they you behave outside of what you Leading others is the key to your are not on time or at an employee would prefer in order to maintain long-term success, yet often so much who has done something wrong, then consistency. Sometimes leading more time is spent selecting lobby you are not leading you and your yourself is merely about awareness furniture or buying a new adjusting actions well. Leading you comes from and the breaking of bad habits. table or traction gadget than is spent practice, focus, discipline, develop- • Leading others. Before you can on your leadership skills and ment, concern for the needs of others, lead others, you must first be you and development. That is much like and a distinct desire for consistency in then lead you — it really is that spending more time planning a your words and actions. simple. Leading others can be more vacation than picking out your Take a close look at your actions. complex, however, when you look at retirement plan. Even ask for an outside objective the multitude of behaviors, actions, You can lead others regardless of opinion on how you behave or ask for and beliefs that truly effective your title, personality, or current skill someone to gently remind you when leadership takes. level. The key is to determine what they need and provide it within parameters you are comfortable with and that will help your business grow. You are running a business, not a day care center, yet if you find yourself “babysitting,” do not think for a minute that your own leader- ship or lack thereof, is without blame in that equation. Leading others takes practice and patience, power and persistence, consistency and consequences, love and care, and dedication — as well as action. Leading others isn’t something you just show up to do it’s what makes you want to show up in the first place. Simply put, leading others begins with you and ends with them. In the middle, there must be an alignment of your actions, beliefs, and behaviors, as well as the alignment of where you are going and whether your current leadership level will take you there. The future of your practice depends on how well you are aligned and how well you lead.
Monica Wofford, CSP, is the CEO of Contagious Companies Inc., an Orlando-based training and consulting firm. Her 20 years of leadership experience makes her a highly sought after coach, consultant, speaker, and trainer. She can be reached at 866-382-0121 or through www.contagiouschiropractic.com or www.contagiouscomapnies.com.
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he first thing to ask yourself about Tbeing a chiropractor in the 21st century is “Am I thinking big enough?” Are you realizing your potential? Do you know that people need chiropractic now more than ever? With the stresses people are facing everyday — including emotional, chemical, and physical stress — you must realize there is no better time than now to be a chiropractor. What causes vertebral subluxation? There is no better time to be a chiropractor By Charles E. Ward, DC
Stress! Who detects and corrects vertebral subluxation? Believe to succeed You! So if everyone has stress and most people are What are your beliefs about yourself, your city or town, subluxated, then why don’t you have a line of people out and your practice? Do you believe you can be successful? your door, waiting to see you? Do you realize success is 85 percent attitude and 15 The answer to this is fear. Not theirs, but yours. The percent ability, and that all of your success in life is only thing that holds you back from telling thousands the determined by the choices you make? truth about the devastating effects of subluxation on the Have you decided to tell the truth about what you do? nervous system (the master control system of the body) is Have you decided to tell the people that come into your fear of rejection. practice the truth about vertebral subluxation and how it Too many of you tell people what you think they want affects their health and well-being, and the health and to hear, and not the truth. This is why chiropractic is not well-being of their children and their loved ones? A wise the number one healthcare system in the world. man once said, “The truth shall set you free.” If everyone knew what you know, there would be no When you make a conscious decision to master your question. So how do you work through your fears and be a profession and back it with high levels of energy and warrior for chiropractic? enthusiasm, you will move ahead further and faster than Your success is directly related to your passion. And anyone around you. When you decide what you want and success comes only as a result of time, determination, what you need to change to have it, you will begin to and prolonged effort. Success is also directly related to move toward it. When you back each of those desired your belief. goals with unshakable confidence and persistence, and
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keep on keeping on no matter what adversity you face, your future will be unlimited. The first thing you need to do is decide — decide to have a line of people out your door, down the street, and around the corner. The second thing you need to do is write a plan. How are you going to get there? To have a solid foundation for success you must master the basics. Part of that plan should include items such as having an educational system in place that helps everyone in your practice understand how the nervous system works, what subluxation is, and how it affects overall health and well-being, and having a team willing to do what it takes to lift your practice to the next level. Do you take a strong leadership role and provide the tools needed to support you in your growth? You should be meeting and training once a week so your team gains confidence in your procedures. Does your team wow your patients on the phone and in person? Are you exceeding the expectations of all your patients? During consultations, are you looking patients in the eye and truly listening to how this interference to their nervous system is really affecting their lives? Do you give a solid report of findings that helps patients understand what caused these problems and why it is going to take time to make the necessary corrections needed? You need to have the courage to tell them the truth and not just tell them what they want to hear. There are certain things that hold you back from being as successful as you deserve to be. One thing for certain is you have to work on yourself first. You have to find that passion for what you do and look forward to going to the office every day and serving people. There is fire within everyone; it sometimes just gets buried under garbage you have allowed to build up over time. If you dig down far enough, however, you will find that glowing ember. All you have to do is blow on it and the fire will burn bright again. Remember, it is up to you to tell people about the importance of a strong nervous system and how vertebral subluxation interferes with their life force and how devastating that can be on overall well-being. The beginning of your success is YOU! So decide now to be the best you can be — not only for yourself, but for your family, your loved ones, your team, and your patients.
Charles E. Ward, DC, is a Ward Success Systems head coach. He can be reached at 925-855-1635 or through www.wardsuccess.com.
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Innovative Ideas from the Industry Leaders
‘Go-to’ pain reliever By Melissa Heyboer
or years, ice has been recognized Topp adds that topical as the surest, safest, and cheapest analgesics are not only more portable and less Fform of cryotherapy. messy than the After all, it’s naturally produced and proven to be alternative, but effective in reducing pain and swelling. he admits that But is it really as convenient and effective as previously excessive use of thought? ice can be damaging to tissue. Topical analgesics have become an increasingly popular “You can actually get tissue damage by leaving ice on form of cryotherapy for doctors and patients — and too long,” says Topp. “But with topical analgesics, you can research is starting to prove its superior efficacy. keep putting it on up to four times each day and there’s no A recent study, completed by Robert Topp, PhD, RN, risk of damage that we know of.” compared blood flow in the arm after ice and a specific In fact, both Topp and Bishop believe that certain topical analgesic were applied.1 The results concluded that topical analgesics may actually have the potential to applying this topical analgesic reduced blood flow more improve a patient’s overall wellness. rapidly than when ice was applied. “We don’t necessarily know whether long-term topical The application of ice didn’t significantly reduce blood analgesic use is going to create overall functional flow until 20 minutes after application. At 20 minutes improvements in patients,” says Bishop. “What we do following the application of these treatments, the study know is that in the immediate short term, you have showed that this specific topical analgesic provided studies which proved patients received twice the pain significantly greater muscle function. relief and it was more comfortable. However, while it reduced blood flow much quicker “So if we can have the patient’s confidence in us … than ice, the reduction did last longer in the ice condition. then they’re more likely to come back. And if they’re This quick reduction may be a great benefit in the very likely to come back, then they’re more likely to have a acute stages of injury, but more research is needed. better, overall, long-term function and wellness.” A second study, completed by Barton Bishop, PT, DPT, A patient’s overall wellness can also be improved with SCS, TPI CFGI-MP2, CKTP, CSCS, indicated that the the avoidance of using prescription medication and non- same topical analgesic used in the Topp study had twice the steroidal anti-inflammatory drugs (NSAIDs). Something pain reduction as ice and lasted longer nine times out of 10.2 both Topp and Bishop say is another benefit of using a Both Topp and Bishop, however, say that while the topical analgesic. research speaks for itself, the benefits of using certain topical “There are definitely advantages over pharmacological analgesics extend beyond just documented performance. treatment of pain,” says Topp. “There doesn’t seem to be a Maybe the most noticeable difference between systemic affect that you would get from say, NSAIDS, or cryotherapy as a cream and cryotherapy as ice is the dependency on narcotics.” convenience factor. Bishop added, “If they would use that [topical “Being able to apply a gel to your body and within a analgesic] instead of taking prescription medication, then minute it’s dry … and still receive the cooling effect and they’d have better wellness. They wouldn’t have the the pain-relief effect, is a huge convenience factor to potential ill effect of taking any sort of prescription patients,” says Bishop. “You can put it on at work … and narcotics or over-the-counter drug that has long-term not be worried about trying to figure out a way to add ice deleterious effects on the body.” to your body and so on.” Because of these obvious advantages, Bishop says
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EDITORIAL SERIES SPONSORED BY PERFORMANCE HEALTH/HYGENIC CORPORATION
doctors — especially chiropractors — should consider, and another pain-relieving formula; it’s their go-to pain- would ultimately benefit, from selling certain topical relieving formula. analgesics in their practices. “The biggest thing to get across is that it is affordable, “With the way insurance companies are paying us, we effective, and is proven to provide great benefit for need to find ways to not only earn extra income to help patients,” says Bishop. “So using it is a no-brainer.” make a living, but to help patients at the same time,” says Bishop. Melissa Heyboer is the editorial assistant for Having certain topical analgesics in his practice allows Chiropractic Economics. She can be reached at Bishop to provide his patients with a quick and effective [email protected]. form of pain relief. He says this would benefit chiropractors as well. 1 Topp R, Winchester LJ, Sannes SH, Mink AM, Kaufman JS, Jacks “It allows immediate pain relief for my patients,” says DE. A comparison of Biofreeze and ice on blood flow, pain and muscle function (Abstract). Proceedings of the 11th Annual TRAC Bishop. “As a nonphysician physical therapist, I’m not Meeting. Cancun, Mexico. July 25-27, 2009, p. 4. able to prescribe anything that would give them pain 2 Bishop B, Greenstein J, Topp R. Effects of Biofreeze vs. ice on acute, relief, other than cryotherapy.” non-complicated neck pain. (Abstract). Proceedings of the 11th For Bishop and Topp, topical analgesics are not just Annual TRAC Meeting. Cancun, Mexico. July 25-27, 2009, p. 20.
Biofreeze® Pain Reliever – like ice, only better
Biofreeze® Pain Reliever is the Patients who experience #1 clinically used recommended Biofreeze Pain Reliever welcome topical analgesic in the U.S. For the opportunity to purchase the more than 18 years, Biofreeze product through their chiro- products have helped people practor’s office. Performance mange discomfort by offering a Health offers a Build Your Practice variety of benefits that assist in program, which can generate pain relief, therapy, and overall revenue with merchandising and comfort. Using natural menthol as marketing tools that are every bit the active ingredient, Biofreeze as effective as Biofreeze products. products penetrate quickly, to of Biofreeze and ice on blood flow One of the newest support tools help prevent or relieve pain and pain and muscle function, and is the online Where-to-Buy service. through cryotherapy. the other studied the effects of Available on www.biofreeze.com, Although ice is the time-honored Biofreeze versus ice on acute, this service helps potential patients means of delivering cryotherapy, it noncomplicated neck pain.1, 2 The and consumers identify practi- does have its disadvantages. It can short-term pain relief provided by tioners in their area where they cause muscle stiffness, decreased Biofreeze Pain Reliever facilitates can purchase Biofreeze Pain range of motion, pain, numbness, ease of movement, which can Reliever and receive treatments. prolonged vasoconstriction, skin promote faster, long-term healing To participate in the Where-to- irritation, and risk of frostbite and and recovery. Buy program, complete a simple nerve damage. Two new Biofreeze products online registration process. Register Biofreeze Pain Reliever has been from Performance Health/Hygenic at www.biofreeze.com/wheretobuy shown to be as effective as ice in Corporation, Biofreeze Pain signmeup. Use PR01 as the reducing pain and inflammation, Relieving Wipes and Biofreeze invitation code. but without the disadvantages. Pain Relieving Gel with Hands- Two recent studies have demon- Free Applicator, provide patients For more information about strated specific benefits of with more options for managing Biofreeze Pain Reliever, choosing Biofreeze versus ice. One their pain during treatment, at visit www.biofreeze.com or call 800- study compared the effectiveness home or on the go. 246-3733.
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wellness
A life of wellness… or not? By Gilles Lamarche, DC
he term wellness has been tough word to define. Charles B. Corbin of Arizona State University gives this utilized within the chiropractic definition: “Wellness is a multidimensional state of being Tprofession for decades. describing the existence of positive health in an individual Now, when you look around, you will notice it being as exemplified by quality-of-life and a sense of well-being.” utilized in so many other industries, as well. This is not much different than the definition written What is the definition of wellness? You hear it in the by WHO 60 years ago. Even though the words may be news, read it on billboards, see it on commercial signs, different, the concept is not. Wellness is an ongoing and and people talk about it in social settings and at work, but active process of becoming aware and making consistent interestingly enough, there is no universally accepted wise choices toward a more successful and fulfilling life. definition. If you break that down it means: You would think the definition would certainly relate • Process shows that improvement is possible; to health. The definition of health as described by The • Awareness means we are seeking information on how World Health Organization (WHO) is as follows: to improve; “Health is a state of complete physical, mental, and • Choice refers to having options, and our capacity to social well-being and not merely the absence of disease or select options in our best interest; and infirmity.” 1 This definition has not been amended since • Success is determined by each person. In the context 1948. of health, most would consider success to be related to the If this is the case, then why are we such a sick society? capacity of living a fulfilled life based on each individual’s Why have most healthcare practitioners not embraced the expectations — living a life filled with joy, vitality, energy, definition and what can you as a chiropractor do to help and an overall sense of accomplishment. humanity discover improved health and well-being? The most commonly described subdimensions of The goal is to get you to embrace this concept and wellness include: physical, mental, spiritual, social, serve your patients so they will get the “big idea.” occupational, financial, emotional, and family well-being. The WHO definition embraces total health, which can Physical, mental, and spiritual well-being relate directly also be referred to as wellness — which in most circles is a to the art, science, and philosophy of chiropractic. Since
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www.studentDC com Your 24-hour Career Advisor subluxations can be caused by Now, some may say that this can physical, chemical, or emotional be an arduous task. But, ask yourself stresses, it makes sense to what your life will be like if you do communicate a clear and consistent not start making these wise choices. message relating to the What will the life of your practice appropriateness and effectiveness of members be like if you don’t share chiropractic care in order to improve this knowledge with them and help the health of the nation. them begin their path to wellness? If you have chosen to share this With knowledge comes message of health with your practice, responsibility. Will you choose to act congratulations, you are steps ahead responsibly in service to yourself, and of many. But, have you chosen to your family, community, and practice teach the message to your members? Too many have made community, and are you a living unwise health choices over the years, example of someone who makes wise and the cost to them and their choices regarding your physical, families has been extraordinary. Not mental, spiritual, and emotional just in terms of economics, but in well-being? quality of life. If you are going to become the Chiropractic is well positioned to Informative articles, advice, and best wellness practitioner you can be, be the leading profession when it Web links hand-picked by our you must first live the paradigm. The comes to health and wellness. You editors – the best resources for physical dimension of wellness are well educated on the subject and students in one convenient location. encourages cardiovascular fitness, understand the value of good Financial Preparation flexibility, strength, endurance, great nutrition, proper supplementation, Getting your personal finances and posture, and a nervous system free of and an active lifestyle. You credit in order interference. understand the value of a nervous Job Search As you gain control of your system free of interference cannot, Types of employment and how to evaluate employment situations physical health, you will value every and must not, be understated. Checklists step you take to maintain good Join the wellness movement and Downloadable forms and lists physical health. You will recognize then choose to teach the paradigm. Practice Startup that it’s better to consume food that Become part of the solution rather Marketing, getting a loan, preparing enhances your health rather than than focusing on the problem. your business plan food that impairs it. You will see the Resources viability of making continuous wise Gilles Lamarche, DC, Links to helpful Web sites choices, and that it is much better to maintained a successful Career Development be physically fit than out of shape. practice for 25 years before About the chiropractic profession, educational financing, and practice Once you live this experience, it becoming director of Parker readiness will become simple to teach others. Seminars and vice president of Parker People do not learn well by the “do College of Chiropractic. He can be Don’t Miss A Single Issue! as I say, not as I do” concept and are reached at [email protected]. Sign up for your FREE e-newsletter much more willing to participate subscription at when the person sharing the www.studentDC.com information is congruent with the REFERENCE 1 The bibliographic citation for this definition What do you want from your message they are teaching. is: Preamble to the Constitution of the ultimate student resource? There is no doubt that achieving World Health Organization as adopted by Chiropractic Economics Online Editors health goals and living a wellness the International Health Conference, New would love to hear from you. York, 19 June - 22 July 1946; signed on 22 Reach them at [email protected] lifestyle requires conviction, the July 1946 by the representatives of 61 States application of knowledge, (Official Records of the World Health Sponsored by: motivation, and continuously making Organization, no. 2, p. 100) and entered Biofreeze • Dr. Fernandez • Foot Levelers wise choices. into force on 7 April 1948.
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Should you be involved with corporate wellness? By David E. Wade, DC, CCSP, CCST, CHC
mployers everywhere struggle to greater overall productivity, and lower health insurance costs. You should take a lead roll in corporate wellness. address the increasing cost of Employers need your assistance to participate in their Ehealth insurance and workers’ wellness and preventive programs to help improve the compensation. health of their employees and dependents. So what tools, programs, strategies, and sales and Whether you are fully insured or self insured, the issue marketing is needed to cash in on the most significant is the same — risk drives cost. Unfortunately, most fail to growth opportunity for healthcare providers over the next implement strategies to avoid claims to begin with. decade — wellness and prevention? The cost of healthcare for businesses threatens the nation’s ability to compete in the global marketplace. The What is wellness? escalating cost of health has taken a toll on private and Wellness has become such a broad term it could mean public sectors and is projected to continue to spiral. nutritional intervention, stress management, body wraps, Healthcare spending in these sectors doubled from 1990- immunizations, or lifetime chiropractic care — depending 2001, and if the trend continues, the entire gross national on whom you talk to. product will be spent on healthcare. In this article, wellness means practicing all the things Is it your moral responsibility to do something about that keep a person well. It involves activities such as the problem? Worksites are becoming a prime venue for maintaining proper nutrition, exercising, controlling promoting healthy habits, and employers who improve stress, as well as having good personal, family, and social employee wellness can reap the rewards of fewer sick days, relationships.
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Most importantly, wellness relies on practicing behaviors that prevent illness and disease. Many Americans are realizing that preventing an illness makes more sense than treating it once it has already occurred. More than 95 percent of healthcare spending in the United States goes toward diagnosing and treating existing illnesses, yet we know that 70 percent to 80 percent of these costs are from lifestyle risks that can be prevented. That’s why there has never been a better time for wellness. As healthcare costs continue to be a concern for employers, wellness programs offer a proactive way to help employees and their families maintain and improve their health.
Proposed tax breaks A bill pending in Congress will provide tax credits to companies who offer qualified company wellness programs. The bill would give companies a tax credit of $200 each for the first 200 employees participating in a qualified company wellness program, and $100 each for each additional participant. This legislation is attempting to encourage companies to be proactive and address health risks that lead to the spiraling high cost of healthcare that businesses are facing today. Research shows that a qualified wellness program can save a company money. For example: Being overweight costs the nation more than $117 billion dollars annually according to a report released by the American College of Sports Medicine. Inactivity adds another $76 billion of preventable healthcare cost yearly. A wellness program needs to be properly planned to be effective. The proposed legislation requires a program to have, at the least, the following elements to qualify for tax breaks: • Provide health screenings and assess health risks. The assessment is to identify harmful behavioral and lifestyle risk factors. Your program should offer a health risk assessment (HRA) including clinically obtained biometric data for enhanced validity and optional health screens including cholesterol testing, PSA, bone density, and more. • Provide health events to raise awareness. Intervention is started once the risk factors are identified through the HRA. Your program should offer a variety of options to fit each participant’s preferences and needs to be designed around the employee risks. • Provide seminars or educational programs. This
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7 benchmarks According to WELCOA, there are seven benchmarks that make a successful corporate wellness program. These are: 1. Capturing senior-level support; 2. Creating a cohesive wellness team; 3. Collecting data to drive your health efforts; 4. Crafting an operating plan; 5. Choosing appropriate interventions; 6. Creating a supportive environment; and 7. Consistently evaluating outcomes.
will assist people in behavioral changes, such as losing weight, stopping smoking, reducing spinal stress from repetitious movements, getting fit, and lowering blood pressure and cholesterol levels. Include a health risk review to evaluate the HRA with each participating employee. Offer wellness coaching to assist one-on-one in addressing risk factors, and perhaps make life coaching available. Invite health challenges to get everyone motivated, and provide Web-based tools for additional wellness information including customized nutritional and exercise programs. • Appoint a wellness committee. They will be responsible for overseeing the organization’s wellness program to be sure it is run effectively. The wellness committee can change the wellness culture of the company with educational resources to assist individuals in selecting a healthier lifestyle, including a monthly health and wellness newsletter, on- site presentations, healthy campaigns, and health fairs all based on risks identified. This legislation, if passed, could substantially help the chiropractic corporate wellness and prevention industry become a valuable and integrated part of healthcare benefits in most American companies. It could also significantly help improve the health of the nation while helping curb high rates of healthcare expense.
Why implement a wellness program? Adults with multiple risk factors are expensive employees in terms of insurance utilization, reduced productivity, and increased absenteeism. In fact, an employee with five or more risks will have approximately 21 hours of excess nonproductive time every month according to research done at the University of Michigan by Dee Edington, PhD. This equates to a $10 per hour employee with five or more risk factors costing a company $210 per month, just
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in lost productivity. By identifying rizing them as moderate to high risk. corporate wellness and who can assist and reducing those risk factors of the If you are not actively developing you in providing support of your employees you can show a relationships with local corporations, comprehensive wellness program. demonstrable improvement in you are missing out on the hottest productivity and profitability. growth area of healthcare. David E. Wade, DC, CCSP, Approximately 50 percent of the However, developing corporate CCST, CHC is the president workforce experiences a problem relationships isn’t as easy as it and founder of the Wellness known to reduce productivity that sounds. You can do it on your own, Education Foundation a often can be successfully addressed but you should consider an affiliation nationwide nonprofit organization. He can through an effective wellness program. with an organization that provides be reached at 800-287-9488 or through On average, more than 50 percent of efficient and effective ways to www.wellnesseducationfoundation.org. each employer’s employees will have develop corporate relationships and three or more risk factors — catego- can provide you with training in REFERENCES Creating Healthy States: Building Healthy Worksites NGA Center for Best Practices, Feb 26, 2006 Centers for Disease Control and Prevention. (1999). Framework for Program Evaluation in Public Health. MMWR [online], 48(No. RR-11). Centers for Disease Control and Prevention. (2005). CDC Evaluation Working Group: Resources [online]. Healthy Workforce 2010: An Essential Health Promotion Sourcebook for Employers, Large and Small
To view wellness charts related to this article, go to www.ChiroEco.com/wade.
Quick Tip Offer a wellness drink At community events, offer samples of a fruit and vegetable phytonutrient green-drink powder, mixed with juice, tea, or ice and lemon. (Make sure it cannot be purchased in stores.) Let samplers know the drink is available through qualified health professionals only. Providing samples helps expand your image from a back-pain doctor to a wellness- care practitioner. — John H. Maher, DCCN BioPharma Scientific Inc. www.biopharmasci.com 858-622-9493
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Since Parker College of Chiropractic appointed Fabrizio Mancini, DC, A healthy approach to president, Parker has emerged as one of the more financially sound chiropractic chiropractic colleges in the country, with education Dr. Mancini gaining acclaim as a leading By Stanford Erickson educator and proponent of chiropractic worldwide.
hen Parker College of sound chiropractic colleges in the country, with Dr. Mancini gaining acclaim as a leading educator and Chiropractic appointed proponent of chiropractic worldwide. WFabrizio Mancini president at age 33, one of the youngest presidents The world needs love The first thing you notice about Dr. Fabrizio “Fab” of any higher learning institution in the Mancini — “Fab” is short for “fabulous” as his admirers country ever, his first act was to survey are quick to point out — is his smile. It is ear to ear and joyous. The second thing is the hug. He wraps his arms fellow Parker alumni. around you with real affection before saying, “I love you.” “How could your education at Parker have been better,” This infectious quality personifies the philosophy of he asked. The answers generally fell into three categories: chiropractic first established by the college’s founder, Dr. • The science of chiropractic was overemphasized and James “Dr. Jim” Parker, and most effectively integrated needs to be better integrated into the philosophy of into Parker’s educational program by Dr. Mancini. chiropractic — it was the philosophy that first attracted “Parker College is a leading advocate of chiropractic the student to be a chiropractor; wellness — a set of values and behaviors that promote • Parker needs increased practical business education physical, mental, and spiritual well-being that enhance and training; and the length and quality of life,” says Dr. Mancini. • More hands-on clinical experience to better prepare “Scan the shelves at any pharmacy and you’re likely to the student for the real world of chiropractic. find hundreds of pills promising to cure your sickness. During the last 10 years, Dr. Mancini, staff, and faculty Then look at the state of health in the United States and have collected student and alumni input and used it to re- you’ll see that those pills aren’t making anyone well. engineer the academic curriculum and training to People are taking more medication today than at any thoroughly integrate it into the Parker education. other time in history, but ironically are the unhealthiest In the last decade, Dallas-based Parker has emerged as they’ve ever been. The truth is that health doesn’t come one of the more renowned chiropractic education with a prescription. institutions in the country; even though it first opened its “The body is designed to be self-healing and health- doors in 1982 — some 85 years after Dr. B.J. Palmer regulating on all three levels — body, mind, and soul,” established the first chiropractic educational institution in continues Dr. Mancini. “At Parker, we teach that the body Davenport, Iowa. is controlled by a master system — the nervous system. Parker also has emerged as one of the more financially Everyday wear-and-tear on your body can create slight
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misalignments in your spine. Since the spine affects nerves in all parts of the body, adjusting to ‘unlock’ misplaced vertebrae usually restores normal flow of nerve energy and assists the body back into its normal healthy state.” But, as Dr. Mancini never tires of explaining to new students when discussing the mission of Parker, a healthy nervous system is just one piece of the puzzle. Proper nutrition and plenty of exercise not only fuel the body, but tend to balance emotional moods. Just as important, however, is nourishment of the spirit. “Spiritual wellness is a search for meaning and purpose in life that gives a sense of direction, awareness, and peace. With peace, you are not living in guilt about the past or “Spiritual wellness is a search for meaning and purpose in life that gives a sense of direction, awareness, and peace.”
the fear of the future; you are living right now in gratitude of the moment. Ultimately, unconditional love of self and others facilitates this,” says Dr. Mancini. How does this all translate to chiropractic wellness? Dr. Mancini flashes his engaging smile. “One of several key principles Dr. Parker taught and lived by was ‘Loving service is my first technique.’ Dr. Parker taught what we teach at Parker today, that the philosophy of chiropractic has never changed, but that the application changes as we evolve the art and science of chiropractic. Also, on a personal basis, chiropractic does not change, but as we challenge ourselves to be more useful to our patients, we chiropractors become more of whom we are destined to be.”
Jim Parker’s legacy Parker College of Chiropractic is the natural extension of the Parker Seminars, which was first developed by Dr. Parker 58 years ago. Parker Seminars is one of the largest gatherings of chiropractic professionals and service and product vendors anywhere in the world. Its largest gathering takes place each year in Las Vegas in January with more than 6,000 attendees. Dr. Parker was one of Dr. B.J. Palmer’s esteemed protégés. While a senior in chiropractic college, Dr. Parker published a book on chiropractic and opened two successful practices in Illinois. After graduating from Palmer School of Chiropractic
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a car accident. Impressed, he approached learning about chiropractic with his normal thoroughness. He interviewed 62 chiropractors over six months and then, satisfied that he was “destined” to be a chiropractor, switched from pre-med to enroll at Parker. After graduation in 1990, his practice led him to a one-year contract to run the Nagel Chiropractic Clinic in Belgium, the most successful chiropractic clinic in Europe at the time with 130 patients a day. “I was making $10,000 a month, provided a house, a car, and a housekeeper,” says Dr. Mancini. Contributions When he returned to the states, he Alumni, friends, faculty, and staff make an impact on Parker College intended to relocate to Colombia and of Chiropractic with every dollar they choose to give. Each gift provides introduce chiropractic to that country. necessary funding for quality education, student scholarships, innovative He sought Dr. Parker’s advice. Dr. research, and campus enhancements to carry out the college’s vision — Parker did not think Dr. Mancini was to be the leading educational institution for wellness care worldwide. ready for that yet, so instead asked Dr. The Parker College Legacy Society recognizes those donors who have Mancini to work for him. made a minimum cash contribution of $10,000. “I asked him what he could offer me. He said $1,000 a month with no Parker College Legacy Society: benefits and I would have to work 16 Donor Gift Purpose hours a day, seven days a week. I Foot Levelers $1,000,000 Student classrooms agreed, but with one condition: Allow me, I said, to learn from you, Dr. Maurice Pisciottano $1,000,000 Building dedication be in your space, attend all your Standard Process $1,000,000 Student activity center meetings, attend sessions with you, Dr. John G. Donovan $250,000 Student lounge board meetings, and meetings with Erchonia Medical $35,000 Laser healthcare center you and the faculty.” Parker College Dr. Parker agreed, naming Dr. Alumni Association $25,000 Intern lounge Mancini assistant to the president and director of admissions. in 1946, he moved to Fort Worth, Because of the success of the “Why did I agree to that?” asks Dr. Texas, and in 18 months established 18 seminars, Dr. Parker was encouraged Mancini. “The truth is I would have clinics throughout Texas. to open Parker College of paid Dr. Parker for the privilege to When fellow chiropractors began Chiropractic in Dallas in 1982. learn from him. But I also knew that besieging him to assist them by Dr. Parker did not have the patience showing up at his various clinics, he The legacy renewed or inclination to teach anyone. He began formally holding postgraduate Dr. Mancini, who was born in was a loner; he ran everything seminars in 1951. These seminars Colombia and relocated with his himself. I knew that to learn from over the last half century evolved family to Miami at age 12, never him, I had to be there, every day, in into Parker Seminars, with more intended to be a chiropractor. his space. I did this for two-and-a- than 40,000 chiropractors and While a pre-med student in 1987, half years because I wanted to 250,000 chiropractic assistants in an orthopedic surgeon referred him develop the passion and conviction attendance since inception. to a chiropractor for treatment after that Dr. Parker had for chiropractic
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— a 50-year passion that cost him millions of dollars and many personal sacrifices.” Dr. Mancini also endured sacrifice in that two-and-a- half years working alongside Dr. Parker. Aside from the monetary and time sacrifice was the constant cigar smoke Dr. Mancini had to ingest when he was around Dr. Parker. “My girlfriend, now my wife, would not let me near her until I took a shower or two,” says Dr. Mancini. To some degree, because of the hands-on, controlling management style of Dr. Parker and his enormous personal prestige, the transition from Parker College and Dr. Parker also proved to be difficult. Although Dr. Year founded ...... 1982 Mancini had his own highly successful practice, in June Number of full time 1999, the Board of Trustees asked Dr. Mancini to become students as of fall 2009 ...... 936 president following Dr. Parker’s death. Male ...... 65% “I thought I was too young, not seasoned enough, and Female...... 35% agreed only if it was a unanimous decision by the board — Capacity of chiropractic program ...... 1,000 knowing full well that three members of the board were Annual number of graduates ...... 180 among the 60 candidates being considered to be Students to complete first year...... 86% president,” says Dr. Mancini. Students to complete entire program ...... 72% “To my amazement, only two days later, the board was Grads practicing after 10 years ...... 95% unanimous in its decision to hire me. I accepted, but only Student/faculty ratio ...... 13/1 with the condition that if in three to six months, it was Annual tuition ...... $21K apparent that the board had made a mistake, I would leave. “I kept my practice, which I had built up over six years
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assuming I would be at Parker a short time,” continues Dr. doctor with no business training will stay afloat? That is Mancini. “Six months later, my accountant said the why Parker College of Chiropractic has been on a mission revenue from my practice had declined drastically. It came to teach students to be not only superior doctors and down to where I could personally have a greater impact and clinicians, but also entrepreneurs with a keen that was an easy decision for me. I sold my practice and understanding of ethical business practices. have been here more than 10 years. Since that time, this “Parker students are taught budgeting, cash role has been a calling to help not only promote the Parker management, marketing, financial interpretation, suite of services, but also to advance our profession.” negotiating a lease, evaluating taxation status, determining legal liability, insurance, billing, and many The three concerns of the alumni other hands-on business practices,” says Dr. Mancini. Over the last decade, Dr. Mancini has methodically Under his leadership, clinical hands-on care by attempted to integrate the three concerns of the alumni chiropractic students begins in their first year. “We don’t raised when he first surveyed them when he became exactly let them treat patients starting on the first day,” president: emphasizing the philosophy of chiropractic; says Dr. Greg Page, assistant dean of clinics and director of providing students with practical business education; and the campus-based Public Clinic. “We have a staff of well- exposing students to hands-on clinical application of what chosen and highly qualified chiropractors who treat they learn in the classroom. patients,” he says. “But first trimester students watch “Our emphasis on the philosophy of chiropractic has treatments in observation rooms and then as they become positioned Parker as the pre-eminent wellness chiropractic more proficient, assist our doctors of chiropractic.” college in the country,” says Dr. Mancini. “But also for years, Parker College also supports an abroad program designed chiropractic colleges focused on training students to be great to educate and raise awareness for chiropractic around the doctors; the doctor-only mentality of chiropractic education world. Tri-nine students are given the opportunity to study which has neglected a very important aspect — business. abroad at Mexico’s Univesidad Estatal del Valle de “In today’s marketplace, where some of the country’s Ecatepec. Additionally, Parker students will actively top corporations are going under, what is the likelihood a support the Colombian Olympic Committee to prepare
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Research Under Dr. Mancini’s watch, scientific evidence for prevention, diagnosis, and treatment also has expanded. Dr. Ronald Rupert, dean of research at Parker, has developed ChiroACCESS, which houses MANTIS, online research relevant to chiropractic as well as evidence-based reviews that summarize hundreds of articles into condensed versions. See Dr. Rupert’s article on page 17.
athletes for upcoming competition. Future journey emulated worldwide. Back home, advanced students What has Dr. Mancini meant to “Parker graduates practice in 31 also work at The Chiropractic Parker College of Chiropractic in the countries throughout the world. Wellness Clinics located in Dallas 10 years he has served as president? The seminars always have been a and Irving, Texas, and serve as “Dr. James W. Parker deserves all vanguard to help promote this vision. chiropractic interns for the Veterans the honor and credit for developing They have taken us to Canada, Affairs in the greater Dallas area. Parker College,” says Matt Eiserloh, Mexico, Australia, Asia, and Europe. “In 2010, we will open a new type chief marketing officer at Parker. The seminars have enabled us to of clinic here in the Dallas/Ft. Worth “What Dr. Mancini has contributed, raise funds for chiropractic research area,” says Dr. Mancini. “We will aside from a charismatic style of and higher education in all those employ three or four highly profes- leadership, is that he has assembled a countries.” sional doctors of chiropractic at a group of talented faculty and staff to As part of his personal journey, Dr. clinic that we operate and oversee, contribute fully in all aspects of Mancini also is “involved and and where our tri-nine students serve education, research, and service. He evolved” in continued opportunity to as interns not only to learn to work encourages all of us to fulfill our own bring together diverse approaches to with patients, but also to develop the potential and reminds us that it is up chiropractic education and care in a entrepreneurial business skills to us to bring more credibility and a mutually supportive profession that is necessary to own their own practice. higher set of standards to advance highly professional in caring for and “Students will be exposed to a chiropractic.” treating patients. professionally developed marketing It would appear that Dr. Mancini’s With his broad engaging smile and plan and will actively participate in the style of management emulates the arms wide open, Dr. Mancini says, strategic decisions and execution of healthy wellness that Parker espouses “As Dr. Jim Parker always said, that plan. The clinic will look and feel in its philosophy of chiropractic. loving service needs to be our first like an actual clinic, where students “I believe life is a journey with technique.” will learn in a real-world environment. meaning and the more you seek As this model proves successful, we meaning, the more meaning life has Stanford Erickson is the editorial director plan to expand it geographically.” for you,” says Dr. Mancini. “The staff for Chiropractic Economics. He can be Under Dr. Mancini’s leadership the and faculty at Parker College not reached at 904-567-1555, college also expanded its educational only are dedicated to operating [email protected], or through program to include a School of Parker College of Chiropractic as a www.ChiroEco.com. Massage Therapy and certification highly professional and successful programs in sports medicine, neurol- institution of chiropractic wellness, To find your own meaning in ogy, science, animal chiropractic, and but to establish higher education each Parker Principle, visit chiropractic pediatrics. and clinical models that can be www.ChiroEco.com/Principles.
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Innovative Ideas from the Industry Leaders Care plans set the stage By Melissa Heyboer
hen the topic of compliance is Wbrought up, one word usually comes to mind — insurance. For some, however, the idea of compliance stretches beyond the walls of insurance, and instead, starts with patients. Patient compliance sounds simple, but its most important aspect — trust — is something many chiropractors struggle with. Jeff Chamberlain, DC, says building trust has to start the moment a patient walks into your team care for a patient without being bogged down by practice. He says the key to this is creating a dependable paperwork, and ultimately help third-party payers and thorough care plan. understand what they should pay for and why they should “The care plan really makes a big difference in making pay for it,” says DePice. chiropractors better doctors,” says Chamberlain. “and it’s a “Utilizing each of these steps, a practice spends less benefit to the patient as well. The patient feels more in time and money on the very things that drain a team and control. They know exactly why they’re there, what they’re doctor. The result includes a more prosperous outcome.” doing, what it’s going to cost, and what the insurance will Both Chamberlain and DePice say care plans not only pay. It really gives control to the patient as well.” help with patient compliance, but despite common Chamberlain believes, however, that the majority of misconceptions, may also help chiropractors get paid more. chiropractors don’t have a clear definition of what a good DePice says third-party payers would be more willing to care plan should entail. pay for care if they understood why it is being provided. “Most chiropractors think a care plan is three times per “Staging of care means that you are defining how a week, then two times per week, etc.,” says Chamberlain. patient will transition through the various chapters of “However, that is considered a treatment schedule, not a their recovery, therefore clearly defining to the third-party care plan. A care plan is not just about the frequency of payer, justification for the services,” says DePice. care, it’s about defining and recording your recommended “The care plan then defines how we know the patient treatment, the frequency for that treatment and most is progressing, and why the care should continue to be importantly, your goals and rationale for that patient’s paid for. We can ultimately provide greater quality of treatment and frequency of care. That’s what a care plan service to the patient if we can correctly document how is really defined as. That is what we, as doctors, are we are helping them.” responsible for. That is what auditors are expecting from Chamberlain says that creating a care plan can actually us … as they should.” decrease the number of audits from insurance companies. According to Dean DePice, DC, creating a thorough care “For me, the biggest misconception is that if I have plan is beneficial to more than just the doctor and patient. great notes, I’m safe,” says Chamberlain. “That is just not “Care plans … help the patients gain a better true. If those notes, no matter how great they are, don’t understanding of the bigger picture, help the CAs and point back to written goals and rationale, then they’re just
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nice looking notes, and you’re still open to audit or worse, average approximately $5 to $7 per visit.” losing an audit.” Most important, Chamberlain says that care plans not Many chiropractors who shy away from creating only create patient compliance and insurance compliance, detailed care plans not only fear that they will be too but they actually help each doctor become more educated complex to write, but are also afraid that becoming more and ultimately a better doctor. compliant will cause changes in their usual routine and “Having an accurate and documented care plan is the slow them down. number one way to enhance your practice,” says Chamberlain, however, says the exact opposite is Chamberlain. “The care plan is the foundation from which actually the case. your financial plans, insurance compliance, compliance in “I can create a detailed, accurate, and compliant care Medicare laws, etc. are formulated. It will make you more plan, that can easily be entered in to my computer aware in every aspect. And that also allows you to have a software program, in anywhere from 45 seconds to a better practice, a stronger practice, a practice that doesn’t minute and a half,” Chamberlain says. “That’s exciting, have any holes in it. Having a well-documented care plan is because I don’t really have to change my practice, or an advantage for the doctor and the practice as a whole.” anything I’m doing as a doctor to be compliant now.” DePice adds: “When you have a well-written care plan, Melissa Heyboer is the editorial assistant for you always get paid more. My experience … is that on Chiropractic Economics. She can be reached at average, every doctor ends up raising their dollar visit [email protected].
Simplifying care plan compliance – add water and stir!
One can certainly understand one-page treatment plan software that lets you automate why you, as a chiropractor, don’t summarizing a menu of the process of creating care plans want to deal upfront with compli- procedures/modalities prescribed quickly and efficiently. And most ance issues, or have to figure out 3x/wk for 2 weeks; 2x/wk for 2 importantly, it’s based on federal in advance what your next step weeks, and that finishes off with guidelines. This innovative Web- would be after the insurance estimated costs is all that’s based software solution company notifies you that a post- necessary to be care-plan revolutionizes how chiropractors payment audit is looming. compliant — WRONG! can create, explain, and manage Having said that, what if we the patient’s entire course of care. showed you how a few simple clicks PayDC can quickly develop of the mouse could implement an highly detailed and customized effective care plan compliance care plans; maximize reimburse- strategy that’s designed to avoid ment by accurately estimating these potential nightmares? In contrast, one can be care- monies due by both insurance Attorney John Leardi, special plan compliant in a way that is companies and patients; streamline counsel to the Association of New simple, effective, cost-effective, the patient’s financial report of Jersey Chiropractors and co- and most importantly, easy to findings; legally systematize counsel to national class actions implement. patient discounts; draft detailed brought against Aetna and BCBS, “PayDC is what chiropractors SOAP notes, and automate credit states – “A detailed and compliant need to create fully compliant card processing. care plan is an invaluable tool in care plans; it’s an ideal solution If PayDC is guilty of anything, limiting potential audit liability to help streamline practice flow it’s in making care plan compli- and ensuring that claim denials while increasing patient and ance simple — like “adding water can be successfully appealed. practice compliance,” says David and stirring”! Simply put, it is a provider’s best Klein, president of DK Coding weapon against so-called ‘medical & Compliance, and co-founder For more information, visit necessity’ denials.” of PayDC. www.PayDC.com or call 888- Many chiropractors believe a PayDC is the first-of-its-kind 306-1256.
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practice management
our office manager just gave you two weeks notice after being Ywith you for 12 years. Your front-desk assistant left for lunch and never came back. Your massage therapist is following through with plans to study advanced Shiatsu techniques in Japan for a year. While these scenarios may or may not be yours, they are very real and the impacts of these and similar “disruptions” can feel devastating to a practice. Whatever you do, don’t hire a replacement on impulse. Hiring your next staff member, either due to practice growth or as a replacement for a departed staff member, is the single most important task that contributes to practice success. Do so thoughtfully, intentionally, and methodically. Here are some tips on how to do just that: Tip #1: Know the details of the position. If you already have a written job description for the position, make sure it is current and applicable to how the job is performed today. If you don’t have a written job description or it is outdated, it’s time to start fresh. Thinking in terms of competencies required to perform the job will simplify this process. Competencies are the knowledge, skills, abilities, drives, motives, and ethics associated with the position. By using competencies, you The mechanics of finding your next staff member By Laurie Mosier, MPA
are able to define the job and create a firm yet flexible practice location, a link to your practice’s Web site, and framework for the position. ask for applicants to take action by replying to a question Tip #2: Create the job ad. Front desk asst. – or formatting their e-mail in a specific way. chiropractic clinic. F/T. 555-1212. This type of ad is a waste For example: Have you ever worked in a chiropractic of time. The vast majority of responses you will receive clinic? or When submitting your resume, use the following from this ad will not be qualified, interested, or available. format for the subject line: LAST NAME, FIRST NAME Spending up front time crafting a very specific ad will resume attached. save you time and headaches later in the hiring process. By having the applicants complete a simple response or Keep in mind that your ad is the first contact you will task, you will immediately know who follows directions have with potential employees. Pay attention to grammar and can eliminate those who don’t. and punctuation and be professional. Tip #3: Develop an advertising plan. Gone are the Include the full job description, position hours days when a two-line classified ad is your sole source of (including any evening and/or weekend work), your advertising. Today’s job seekers are online, belong to any
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number of social networking groups, visit coffee shops, and may be sitting in your reception area right now. In order to capture the attention of as many qualified job seekers as possible, focus your energy everywhere — place some online ads, some classified ads, and hang some posters at the same time you are sending a Tweet and updating your Facebook status. You want to use a fire hose to spread the word. Tip #4: Use a meaningful job application form. A job applicant’s resume is their marketing material and, as such, it shows them in the best light possible. A job application form will pull out additional information from applicants that they otherwise would keep to themselves. This is not meant to imply that applicants are sneaky and deceptive; they are simply presenting their best self. You know the needs of the practice and by asking for a few bits of additional information, can determine if you should proceed to an interview. Hiring your next staff member is the single most important task that contributes to practice success.
Reasonable and appropriate items for a job application form include recent work history and experience, salary history, reason(s) for leaving last employment, three to five professional references, and a consent area with check boxes that indicate the applicant is aware of and consents to a background check, drug screening, and a reference check. Tip #5: Collect applications. Set up a separate phone extension or e-mail address specifically to handle appli- cations and applicant questions, and then set aside time each day to review the messages. Certain carriers offer free e-mail accounts that can be set up quickly and customized to your needs. Some of them even offer automatic reply features that would allow you to automatically send a preformatted reply perhaps listing your practice’s Web address or outlining your timeline for hiring. Tip #6: Screen applications. You’ve collected dozens of applications and need to find the best of them. How do you do that efficiently and effectively? If you included an action step in your ad, start there. Not following simple instructions in a job ad is a definite
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red flag regarding the applicant’s ability to perform in your exceptionally good day. Doing multiple interviews practice. normalizes these anomalies. Several job-related screening tests are available online. Tip #8: Use references and conduct background Search “chiropractic competency test,” “chiropractic checks. Always contact the references and ask two things: employment test,” or “chiropractic job screening” to find The name of another person who can act as a professional one right for your practice. reference for the applicant, and “Would you hire this Ideally, a screening test will provide you with person again.” With the first thing, you will likely get information on the applicant’s ability to perform on the more information from this other person than you would job and will be administered without your direct from the person named on the application form. involvement, thereby saving you time while your And with the second thing, it is direct and removes applicant pool reduces to a manageable size. much of the awkwardness involved when discussing Tip #7: Interview. Once you have a manageable performance. number of qualified applicants, conduct phone interviews, Before finalizing a hire, conduct background checks group interviews, or one-on-one interviews. Your personal and drug screening as per your practice policies and state style and available time will likely determine which you laws. In the long run, it is far easier to go without a staff choose for the first interview. member than it is to get rid of a bad one. Regardless of format, it is critical to ask the same By focusing on the mechanics of hiring, you are questions of all interviewees. increasing the likelihood of having a good fit, long-term Failing to do so will result in you not having a fair staff member join your practice. comparison. Once you have narrowed the candidate pool to the top three applicants, it’s time for the second Laurie Mosier, MPA, is responsible for education and marketing interview. This should be conducted in person and for Harkcon, developers of the Chiropractic Competency involve the prospective employee’s supervisor. Toolbox, authors of The Chiropractic Hiring Guide, and specialists Keep in mind that good applicants can have an off day in chiropractic human resource solutions. She can be reached at during an interview and poor applicants can have an 800-499-6456 or through www.harkcon.com.
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practice management Practice freedom with an associate By Ed Sharp
here is nothing wrong with a These goals are worthwhile to achieve for his life and happiness. doctor who owns the practice to want to step back and have more What to look for T One important step and the primary solution to have freedom and time. time to accomplish these goals is to hire an associate, but He or she has more than likely been working hard and these desires and goals can get crushed if the following long hours for many years and wants some freedom to areas are not successfully handled: enjoy the fruits of his or her labors. • Hiring the right staff. Hiring the right staff and However, there is a difference between “freedom from” having them well trained is vital or you will find yourself and “freedom to.” continually having to solve problems your staff should Freedom from is to run away from something or leave have handled from their jobs. Hire well, train well, turn it. Freedom from means they were or are “trapped.” This is over the job, and then keep an eye on it. where the clinic is running them — not them running the You can keep an eye on it from afar if you have clinic. They feel stuck with having to be there all the statistical management, but once you have given a job to time. It is also called “burnout.” someone and they know how to do it, and are doing it, Freedom to, however, is quite different. It is freedom to then you must step back and let them get on with it and do what they want, and to pursue other goals. Freedom to resist any temptation to do their jobs. If you do otherwise, means they can now enjoy the new earned time. Goals you will by natural law end up doing their jobs. give fuel or purpose to the accomplishment of the targets Knowing when it is time to step back and let them get need to create a stable, absentee clinic. on with it and knowing when you must step back in and Personal goals, therefore, are very important at this do the job is an art you must master. level, and may be as varied as the individual doctors • Executing an effective report of findings. Since themselves. What motivates one person to get up in the you will now have more expenses with an associate, your morning may make another one want to stay in bed. demand for new patients and retaining them will be
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higher — which makes an effective and actions of the clinic’s marketing the rest of the above points in. It is report of findings vital. must be known and those areas more than just keeping numbers. You This, however, is the last thing reinforced before new areas are tried. must graph your vital areas. Graphs you would want to turn over to your Get this turned over to your CA or tell you a story. They tell you what associate, as he is trained in adjusting your office manager. In most cases, area(s) to repair or reinforce. patients, not in sales. You don’t want there needs to be more patient visits Handling the wrong area will only this area done incorrectly. The sales to warrant keeping the associate busy. frustrate the situation. Without some will drop (patient retention) and it That means more new patients. measurement of what the practice is will endanger your ability to have an • Strong financial planning and doing, and watching the numbers associate. control. Of course, none of these carefully, you are flying blind. When the owning doctor is still things matter if there is not strong Learn these areas well. Get them doing the reports and re-exams, he financial control. The clinic must be under better control and you can can stay in touch with the clinic’s making a profit and it has to pay the start to successfully back out of your patients and how they are progressing new associate without the owning clinic and still be successful. Do on their care plans. Then slowly turn doctor taking a pay cut. Reserves them incorrectly or neglect them and this action over to the associate until need to be accruing. All too often you will probably be back, usually he or she can do that very well. the clinic costs rise too much in with a smaller practice that you will • Marketing that creates a comparison to the income increases. have to rebuild. consistent volume of new • Strong executive skills using patients. Marketing must be internal statistical management. Finally, Ed Sharp is president of Sharp and external and continuously done. the doctor leaving for his new found Management & Consulting, That means, you must have a lot of freedom must be able to accurately which manages clinics or cost-effective outflow to get a lot of keep an eye on what is going on. You delivers consulting. He can be inflow of qualified people that want can run the clinic from your boat if reached at [email protected] or through your help. The successful patterns you have statistical management and www.thesharpmanagement.com.
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practice management | CODING QUESTIONS What’s your coding IQ? By Marty Kotlar, DC, CHCC, CBCS
1. CPT code 99201 requires you to perform what type a) The highest level of risk in any one category of history? determines the overall risk a) Detailed b) The lowest level of risk in any one category b) Expanded problem focused determines the overall risk c) Problem focused c) The presence of a chronic subluxation
2. What does the GA Medicare modifier represent? 8. CPT code 99213 requires how many past, family, or a) Maintenance care is being provided social history components? b) Patient is responsible to pay for the spinal a) None adjustments b) 1 c) You have a signed ABN form on file c) 2-9 d) All of the above 9. CPT code 99214 requires how many HPIs (history 3. The medical decision-making process provides how of present illness)? many points for ordering or reviewing x-rays? a) 2 a) 1 b) 4 b) 3 c) 6 c) 5 10. The medical decision-making process provides how 4. HCPCS codes are used to bill for certain supplies many points for the review and summarization of and procedures. What does HCPCS stand for? old records and/or obtaining history from someone a) Happy Chiropractors Providing Caring Services other than patient and/or discussion of case with b) Healthcare Common Procedure Coding System another healthcare provider? c) Healthcare Common Providers Coding Services a) 1 b) 2 5. CPT code 99203 requires you to review how many c) 3 systems? a) None Marty Kotlar, DC, CHCC, CBCS, president of Target b) 1 Coding, is certified in healthcare compliance, certified c) 2-9 in CPT coding, and has been helping chiropractors with reimbursement issues using proper and 6. Which of the following is not considered an compliant CPT coding for more than 10 years. Target Coding, in extraspinal CMT region? conjunction with Foot Levelers, offers CE seminars on CPT a) Abdomen coding and compliant documentation. He can be reached at b) Pelvis 800-270-7044, [email protected], or through c) Head www.TargetCoding.com.
7. The level of risk categories include the presenting How did you do? Check your answers here and see problem(s), the diagnostic procedure(s) ordered, and what your coding IQ is.
the management option selected. What determines 1. c 2. c 3. a 4. b 5. c 6. b 7. a 8. a 9. b 10. b b 10. b 9. a 8. a 7. b 6. c 5. b 4. a 3. c 2. c 1. the overall level of risk in the medical decision- quiz: to Answers making table of risk?
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practice management | CONSULT THE COACH High-velocity practices eliminate friction By Mark Sanna, DC, ACRB Level II, FICC
ew imperatives are forcing you services to patients. Analyze your practice on a regular to rethink your fundamental basis for “capacity blocks.” A capacity block is a bottleneck in the healthcare Nbusiness assumptions. delivery system of your practice that creates a roadblock Your practice is under pressure to perform at increasing to the growth and expansion of your practice. A capacity efficiency, and there’s no letting up. More than ever, your block creates friction, which reduces the efficiency of practice is being driven by intensified competition and your practice. patients with increasing need. Today’s educated healthcare consumers demand Knowledge and speed are the primary forces behind the convenience. Just as “location, location, location” is the extraordinary economic expansion the world is now mantra of the real estate profession, the mantra of your experiencing. new practice paradigm should be “convenience, convenience, convenience.” Savvy healthcare consumers The more responsive you are to the demand for There was a time when the most crowded room in any diversified services, the faster you’ll achieve success. practice was the reception room. You can understand then A great way to do this is to adopt a perpetual drive why this room came to eventually be known as the toward eliminating friction. “waiting room.” In the end, this friction will hurt the flow in your Doctors who practiced in the 1950s and early 1960s practice. Work relentlessly to address — and meet — the remember a time when patients dressed up to attend their time demands of your patients. appointments, just as they dressed up for traveling on an Do what the most successful practices do: Address your airplane. They saw their physician as a sort of demigod patients’ needs more effectively by performing an analysis and followed his or her recommendations unquestioningly. of patient flow. Most practices have times during the day As a result, patients would therefore wait for that are more productive than others. Begin your search indeterminate periods of time to receive services. for friction in your flow by analyzing the busiest hours of Today’s healthcare consumer is savvier about options your practice day. for their healthcare. They demand the highest quality Just as a fish doesn’t perceive the water it is swimming service delivered in the most efficient time frame possible. in, it may be difficult for you to perceive the capacity Time is very valuable to your patients. Successful blocks within your practice — you’re too close to it. practitioners have learned to deliver a diversified menu of A professional practice management consultant can services, while still remaining sensitive to time demands. provide you with an objective analysis of your capacity More and more, chiropractors are incorporating diverse challenges and make suggestions for facilitating flow healing modalities into the list of services they offer. It is within your practice. highly likely that a patient entering a chiropractic After all, your patients are doing things smarter and practice today will find a combination of chiropractic faster than ever before — so must you! care, massage therapy, acupuncture, physical therapy, nutrition, medical services, and more. Mark Sanna, DC, ACRB Level II, FICC, is the president and CEO of Breakthrough Coaching. Cultivate a mastery of “flow” He can be reached at 800-723-8423, A successful practitioner must cultivate a mastery of [email protected], or through “flow.” Flow is the speed at which you are delivering your www.mybreakthrough.com.
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resource guide
Supplies Chiropractic Economics is pleased to present the profession’s most comprehensive Supplies. The information in the resource guide was obtained from questionnaires completed by the listed companies. Companies highlighted in RED have an advertisement in this issue. For a complete resource guide of services these companies provide, please visit www.ChiroEco.com/directory.
2 Imagine American Anatomical Corp. Banner Mints/Chiropractic Today Body Responsive Sleep Systems 480-657-8506 800-344-5904 866-285-5227 866-463-2777 www.2imaginethis.com www.americananatomical.com www.bannermints.com www.BodyResponsive.com
3 Care Therapeutics American Medical Sales Inc. Banner Therapy Products Inc. Body Sense 888-372-3421 800-423-3535 888-277-1188 877-816-3615 www.omega3care.com www.digitalams.com www.bannertherapy.com www.shopbodysense.com
3DRX Inc. AmeriComp Barrington Equipment Bodyblade/Hymanson Inc. 360-909-3709 800-972-9776 800-848-2123 800-772-5233 www.3d-rx.com www.summitindustries.net www.barringtonequipment.com www.bodyblade.com
A Trusted Voice Anabolic Laboratories Beaumont Products Bodyline Comfort Systems 877-558-6423 800-445-6849 800-451-7096 904-262-4068 www.trustedvoice.com www.anaboliclabs.com www.citrus2.com www.bodyline.com
A-Cute Derm Inc. Analgesic Health Care Beauty Concepts BodyZone.com 800-922-2883 888-208-9155 866-609-8070 770-922-0700 www.a-cutederm.com www.analgesichealthcare.com www.Aquaoil.com www.bodyzone.com
A2Z Health Store.Com Ann Unicare Bedford Chiropractic Supply BQ Ergonomics LLC 888-303-3131 800-378-5367 800-430-5612 303-991-8802 www.a2zhealthstore.com www.annunicare.com www.befordchiro.com www.bqergonomics.com
Access Equipment Corp. Anson Aromatic Essentials Bennett X-ray Bruder Healthcare 888-463-1381 402-489-5064 800-972-9776 888-827-8337 www.usedchiropractictable.com www.therapeutic-grade.com www.bennettxray.net www.bruder.com
Activator Methods International Aqua Massage Bibbero Systems Inc. Bryanne Enterprises Inc. 800-598-0224 800-248-4031 800-242-2376 877-279-2663 www.activator.com www.aquamassage.com www.bibbero.com www.bryanne.com
Adio Business Promotions AquaJogger bio2 Cosmeceuticals Business Industrial Chiropractic 503-341-7833 800-922-9544 800-499-1372 Services BICS2020 www.ChiroCalendars.com www.aquajogger.com www.oxymist.com 404-518-4338 www.bics2020.com Advanced Musculoskeletal Ari-Med Pharmaceuticals BioActive Nutritional Inc. Therapies 800-527-4923 800-288-9525 C.A.I. Corporation 800-270-1141 www.ari-med.com www.bioactivenutritional.com 800-234-8583 www.d-actor.com www.caicorporation.com Austin Medical Equipment Inc. BioElectronics Corporation Agebest Basics 800-382-0300 866-757-2284 C’est Si Bon Co./CHLORENERGY 415-793-6577 www.austinmedical.com www.bioelectronicscorp.com 888-700-0801 www.agebestbasics.com www.BestChlorella.com Avicenna Laser Technology Inc. BioEx Systems Inc. Airpacks 888-284-5273 800-750-2756 Camexco/Nasaline 978-921-5566 www.avicennalaser.com www.bioexsystems.com 908-534-1101 www.airpacks.com www.squipusa.com Axial Trac Blue Spring International Al Rice & Associates 866-998-3428 866-470-4930 CDM Sport 800-456-1142 www.axialtrac.com www.doctorspainformula.com 800-400-7542 www.alrice.com www.backsystems.com B&B Marketing LLC BML Basic Alivee Massage Tables 800-737-9295 800-643-4751 Chattanooga, a Division of DJO and Chairs www.sacrowedgy.com www.bmlbasic.com 800-592-7329 231-267-6570 www.chattgroup.com www.aliveemassagetable.com Back Support Systems Body Balance of Winter Park 800-669-2225 407-671-7974 Chi Herbal Formulas Allman Products Inc. www.backsupportsystems.com [email protected] 858-373-1830 800-223-6889 www.chiformulas.com www.AllmanProducts.com BackProject Corporation Body Logic 888-470-8100 214-378-6100 CHI Institute ALLPRO Imaging www.BackProject.com www.ebodylogic.com 800-743-5608 800-247-8324 www.soundvitality.com www.allproimaging.com Ball Dynamics International LLC Body Relaxer LLC 800-752-2255 888-885-2639 China-Gel Inc. American 3B Scientific www.fitball.com www.bodyrelaxer.com 847-364-0353 888-326-6335 www.chinagel.com www.a3bs.com
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resource guide
Chiro Design Group CryoMyo Erchonia Health Gear Inc. 512-301-0821 866-765-5423 888-242-0571 800-272-0035 www.chirodesigngroup.com www.icetube.com www.erchonia.com www.healthgearweb.com
Chiro One Source CuraMedix Essence Therapeutic Innovations Health Visions Patient Education 866-318-3251 877-699-8399 800-508-1937 888-480-1350 www.chiro1source.com www.curamedix.com www.essencetherapeutic.com www.healthvisions.com
Chiro-Manis Inc. Custom Craftworks Exercise To Heal LLC Healthways 800-441-5571 800-627-2387 866-432-5356 800-486-6613 www.chiromanis.com www.customcraftworks.com www.exercisetoheal.com www.healthways.com
Chiro-Matic Cypress Creek Marketing F & B Chiropractic Inc. Hickory Brands 800-526-5116 800-549-5773 800-461-0507 800-560-1869 www.chiromatic.com www.wondawedge.com www.fbchiropractic.com www.tenseconds.com
Chiro950 Microcurrent D-MED Inc. Face Cradle Insert Hill Laboratories Company by TBI Inc. 800-872-3633 701-775-2854 610-644-2867 877-496-8838 www.d-med.com www.facecradleinsert.com www.hilllabs.com www.Chiro950.com Davlen Associates Ltd. Fenestra Corp. Himalaya Herbal Healthcare Chiroflow 631-924-8686 702-612-5029 800-869-4640 800-308-3069 www.davlendesign.com www.seefenestra.com www.himalayausa.com www.chiroflow.com Deseret Biologicals Fitness Together Human Touch ChiroInnovations 800-827-9529 Franchise Corporation by Interactive Health LLC 800-667-1969 www.desbio.com 877-663-0880 866-369-9426 www.Chiroi.com www.fitnesstogether.com www.interhealth.com DMX- Works Inc. ChiroPlanet.com 800-839-6757 Foot Levelers Inc. Hygenic Corporation/Thera-Band 888-364-5774 www.dmxworks.com 800-553-4860 800-321-2135 www.chiroplanet.com www.footlevelers.com www.thera-band.com Docs Inc. ChiroTables.com 800-455-7627 Forme Systems Inc. IIHS-Institute for Integrative 800-553-0057 www.docsstore.com 727-723-0040 Healthcare Studies www.chirotables.com www.formesystems.com 800-364-5722 DoctorPromo www.naturalwellnessonline.com Chirotec 516-867-8237 Freeman Manufacturing 866-591-9940 www.doctorpromo.com 616-651-2371 Illum Innate www.chirotec.ca www.freemanmfg.com 626-383-2527 Dodgen Mobile Technologies www.spine24.com CLA – Chiropractic 800-247-1835 Gallery Art/dba Art-Work Leadership Alliance www.dodgenmobiletech.com 800-378-1895 Inform for Life 800-285-9600 www.chiroart.com 800-234-8325 www.subluxation.com Dynatronics www.InformForLife.com 800-874-6251 Giovane Medical Services Inc. Code Blue www.dynatronics.com 888-333-8629 Innersense Organic Beauty 320-229-9000 www.giovanemeds.com 877-bli-sful www.codeblueusa.com E-Z BIS Inc. www.innersensebeauty.com 800-445-7816 GMP FITNESS Comfort Craft www.ezbis.com 888-467-3488 Innovative Healthcare Solutions 800-858-2838 www.gmpfitness.com 561-791-1198 www.comfortcraft.com Earthgear www.ihs-health.com 800-508-1937 Golden Sunshine (USA) Inc. Concept Therapy www.earthgear.com 800-798-3977 Integral Orthopedics Inc. 210-698-2254 www.golden-sunshine.com 866-608-2225 www.chiropracticprinciples.com Edom Laboratories www.mollersupport.com 800-723-3366 Graston Technique Core Products www.edomlaboratories.com 866-926-2828 InteMedica LLC 800-365-3047 www.grastontechnique.com 800-856-7250 www.coreproducts.com Elite Electromedical www.intemedica.com 800-743-7738 GW Heel Lift Inc. Corflex Inc. www.eliteelectromedical.com 800-235-4387 International Medical 800-426-7353 www.gwheellift.com Electronics Ltd. www.corflex.com Elite Manufacturing 800-432-8003 800-689-4730 H.F. Hill & Associates Inc. www.magnatherm.com Cozy Hold www.elite-chirotables.com 800-434-4551 800-559-2699 www.UsedChiroEquip.com Jones & Bartlet Publishers www.cozyhold.com Elsevier Sciences 978-443-5000 800-325-4177 Harlan Health Products Inc. www.jbpub.com Crescent Products www.harcourt.com 800-345-1124 800-989-8085 www.HarlanHealth.com Judah Manufacturing www.crescentproducts.com Eniva USA 800-618-9793 888-295-9519 Harvey Professional Supply Co. www.judahmanufacturing.com Cryoderm www.enivausa.com 631-585-1234 800-344-9926 www.harveyprofessionalsupply.com K-LaserUSA www.cryoderm.com Enzymes Inc. 866-595-7749 800-637-7893 Hausmann Industries Inc. www.k-laserusa.com www.enzymesinc.com 888-428-7626 www.hausmann.com
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resource guide
Kinesio USA Massage Elements Moller Back Support Pain & Stress Center 888-320-TAPE www.massageelements.com 888-795-8832 800-669-2256 www.kinesiotaping.com www.mollersupport.com www.painstresscenter.com Massage Warehouse King Bio SafeCareRX 800-910-9955 Morgan Professional Products Panasonic 800-543-3245 www.massagewarehouse.com 800-403-5295 570-823-0854 www.safecarerx.com www.morganprofessional www.panasonic.com/chiro Master Massage Equipment products.com Kool Fit America Inc. 888-710-7206 Parker Laboratories Inc. 800-852-5665 www.mastermassagetables.com Mother Earth Pillows 800-631-8888 www.koolnfit.com 800-344-2072 www.parkerlabs.com Matrix Sales & Marketing www.motherearthpillows.com Kustomer Kinetics Inc. 800-628-3162 Parker Share Center 800-959-1145 www.matrixorthopaedics.com MPower Media 972-438-6932 www.kustomerkinetics.com 888-232-9862 www.parkersharecenter.com Mavidon www.mpowermedia.com KYRO Manufacturing Company 800-654-0385 Patient Media Inc. 817-336-1319 www.mavidon.com Mt. Capra Products 719-488-6663 www.kyromanufacturing.com 360-748-4224 www.patientmedia.com MD Global Medical Products www.mtcapra.com Laser Therapuetic 914-500-3894 PBI Myo-Vision Technology Inc. www.mdgmp.com Mueller Sports Medicine 800-969-6961 800-235-3540 800-356-9522 www.myovision.com www.laserhealing.net Medi-Stim Inc. www.muellersportmed.com 800-363-7846 PDI Laser-Therapy www.medi-stim.com Multi Radiance Medical – 866-715-6770 877-527-3750 Super Pulsed Lasers www.aboutpdi.com www.ColdLaserTherapy.us Medical Arts Press 800-373-0955 800-328-2179 www.multiradiance.com PEL Supply Leander Health Technologies www.medicalartspress.com 216-267-5775 800-532-6337 MyoMed/BioForce Inc. www.pelsupply.com www.leandertables.org Medical Electronics Inc. 866-696-6330 866-633-4876 www.myo-med.com Performance Health/Biofreeze Learning Curves www.meditronics.net 800-246-3733 800-613-2528 National Access Medical Supply www.biofreeze.com www.learningcurves.us Medical Quant 888-678-1770 800-373-0955 www.namedical.com Perspectis Inc. Leasing Partners Capital www.medicalquant.com 866-586-2278 800-275-8800 National Health Education www.backvitalizer.com www.leasingpartnerscapital.com MediCordz by NZ MFG LLC Society Inc. 800-886-6621 800-241-7705 PI Professional Therapy Products Legacy for Life www.nzmfg.com www.voiceforhealth.com 888-818-9632 800-746-0300 www.pi-ptp.com www.legacyforlife.net Mediflow Neck Orthotic Inc. 905-470-7072 586-727-7557 Pivotal Health Solutions Lhasa OMS Inc. www.neckorthotic.com 800-743-7738 800-323-1839 Medistik – Natureteq Inc. www.eurotechtables.com www.lhasaoms.com 877-469-4006 Noromed Inc. www.medistik.com 800-426-0316 Polar Products Inc. LifeTec Inc. www.noromed.com 330-253-9973 800-822-5911 Medlink/ChiroPro www.polarsoftice.com www.lifetecinc.com 800-456-7800 North American Bancard www.medlinkimaging.com 212-920-1385 Positive Touch Lippincott Williams & Wilkins www.nabtoday.com 972-480-0678 800-638-3030 MedX Corporation www.positivetouch.org www.lww.com 800-876-6339 North American Distributors Inc. www.medxonline.com 800-995-0510 Posture Perfect Solutions Lords International www.nadinc.net 604-985-0634 800-222-6372 MedX Health www.evolutionchair.com www.lords-international.com 888-363-3112 Nutraceutics Corporation www.medxhealth.com 877-664-6684 Practice Makers Products Inc. Lotus Brands www.nutraceutics.com 800-345-3099 262-889-8561 Membrell LLC www.practicemakers.com www.lotusbrands.com 800-749-1291 Omni Manufacturing & Design www.membrell.com 800-543-6474 PrePak Products LSI International www.chirotables.com 800-544-7257 800-832-0053 Mettler Electronics Corp. www.prepakproducts.com www.lsiinternational.com 800-854-9305 OPS Medical Systems www.mettlerelectronics.com 800-430-0048 PrescriptionBeds.com/ Mannatech www.opsmedical.com Strobel Technologies 541-482-7099 Meyer Distributing Company 800-457-6442 www.mannapages.com/ 800-472-4221 OPTP www.PrescriptionBeds.com abbylazerow www.meyerdist.com 800-367-7393 www.optp.com Prince of Peace/Tiger Balm Martike Products Microlight Laser 510-723-2428 800-995-8865 469-385-4600 Orthogel/Orthopedic www.popus.com www.stopneckpain.com www.microlightlaser.com Pharmaceuticals 866-254-0932 www.orthogel.com
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resource guide
Professional Co-op Services Scrip Chiropractic Supply Techno-Derm Ulan Nutritional Systems Inc. 954-989-9970 800-747-3488 305-892-4588 866-418-4801 www.professionalco-op.com www.scrip-inc.com www.spineforce1.com www.unsinc.info
Professional Suppliers Inc. Select Comfort Corporation The Jojoba Company Universal/Del Medical 800-332-4696 800-693-0059 207-832-4401 800-800-6006 www.professionalsuppliers.com www.selectcomfort.com www.jojobacompany.com www.delmedical.com
Qpuncture Inc. Serola Biomechanics Inc. The Physical Therapy UPC Medical Supplies 714-685-0900 800-624-0008 Equipment Company 800-790-4888 www.qpuncture.com www.serola.net 800-282-0590 www.goacupuncture.com www.thepteco.com Quality Health Products Inc. Simple Slant UPRIGHT Golf 800-834-7058 866-928-5100 The Posture Pleaser/ 319-268-0939 www.qhpincb2b.com www.simpleslant.com MagEyes Inc. www.uprightgolf.com 800-210-6662 Quantum Products Siren Publishing LLC/Trial Guides www.mageyes.com Ventura Design 800-359-9686 800-309-6845 913-239-8465 www.quantumbadges.com www.colossusbooks.com The Saunders Group www.posturepro.com 800-779-2044 Quantum Products Inc. Sissel Inc. www.thesaundersgroup.com Visual Odyssey Inc. 800-307-7909 604-820-2578 800-541-4449 www.chiro-supplies.com www.sissel-online.com The Spa Exchange LLC www.neuropatholator.com 952-938-2652 Real Bodywork Sombra Professional www.thespaexchange.com Vital Age International Inc. 888-505-5511 Therapy Products 208-578-0800 www.realbodywork.com 800-225-3963 The Vitality Depot www.vitalage.com www.sombrausa.com 866-941-8867 Rehabilicare Inc. www.TheVitalityDepot.com Vitaminerals Inc. 800-213-4013 Soothing Touch 800-432-1856 www.rehabilicare.com 505-820-1054 thechirobook www.vitamineralsinc.com www.soothingtouch.com 800-333-3301 Rehabilitation Management www.thechirobook.com Viztek Specialists Spinal Care Products 904-226-0340 866-734-2202 800-877-6953 TheraLase www.viztek.net www.123rehab.com www.spinalcareproducts.com 866-843-5273 www.theralase.com Warren Labs Relaxo-Bak Inc. Spinal Reflex Analysis 800-232-2563 800-527-5496 877-259-5520 Therapeutica Inc. www.warrenlabsaloe.com www.relaxobakpro.com www.spinalreflex.com 800-348-5729 www.therapeutica.com Watt Media Inc. RF System Lab. Spine Research Institute 800-250-8233 800-605-1688 of San Diego Therapy & Health Care www.watt-media.com www.rfsystemlab.com 800-423-9860 Products Inc. www.srisd.com 800-842-8212 WAVE Whole-Body Advanced Rhoades Co. Inc. www.thcpweb.com Vibration Therapy 203-272-2930 Steam Embrace 866-420-7546 www.rhoadescompany.com 800-231-7832 Theraquip www.wavexercise.com www.steamembrace.com 800-632-1312 Rich-Mar NAImco www.theraquipinc.com Wei Laboratories 888-549-4945 Step Forward Company 408-961-9223 www.naimco.com 253-631-0683 TheWriterWorks.com LLC www.weilab.com www.stepforward.com 302-933-0116 Ridge Medical Products www.TheWriterWorks.com Wellness Wall/Scarborough 866-321-1732 Straight Arrow Products Chiropractic www.maxpainrelief.com 800-827-9815 Thrive Nutraceuticals LLC 207-885-9415 www.straightarrowinc.com 570-575-2365 www.wellnesswall.com riverrockmassage.com 319-364-7748 Stronglite Portable Top Massage Tables Westside Barbell www.riverrockmassage.com Massage Equipment 877-589-0048 614-801-2060 800-289-5487 www.topmassagetables.com www.westside-barbell.com RMXC Inc. www.Stronglite.com 800-822-7692 Tough Tables Yamuna Body Rolling www.rmxc.com Suncoast BioResearch 877-231-8833 800-877-8429 800-476-4112 www.toughtables.net www.yamunabodyrolling.com Rosen Coaching www.ventrescaenterprises.com 808-878-8384 TPK/Back Saver Wallet ZICO LLC www.rosencoaching.com Swedish Backcare System Inc. 800-433-4653 201-483-8467 770-850-9150 www.backsaverwallet.com www.zico.com Sarati International www.mastercare.se 800-900-0701 Treasure Chest Productions – Zimmer Medizin Systems www.sarati.com Sybaritic Group Miracle Bear 800-327-3576 800-445-8418 888-511-7709 www.zimmerusa.com Satori www.symedex.com www.miraclebear.com 310-738-6282 Zonsite www.satorimassagechairs.com SynCon Tables Truwell Health & Wellness 866-966-2778 419-448-4868 866-878-9355 www.zonsite.com Schiek’s Sports www.syncontables.com www.truwell.net www.schiek.com
90 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CHEC_91.ps 12/29/09 9:11 AM Page 91
ADVERTISEMENT CHEC_92.ps 12/29/09 11:35 AM Page 92
studentDC.com Click it! www.studentDC com Home Colleges Career Development Financial Preparation Job Search Practice Startup Checklists Resources The online resource for future doctors of chiropractic. Building a successful practice through education By Brian Jensen, DC
atient education and continuing each visit will help you monitor their improvements. Patients will see their ROM improve, feel less pain with education benefits your patients, palpitation, and realize that their pain ratings are getting your practice, and yourself. lower. This will remind your patients of the progress they P have made and help them stay committed to their Patient education and continuing education for you are program of care. vitally important to the success of your practice. Continuing your education and keeping your skills up- Simplicity is the key to patient education. The general to-date makes it possible to educate and care for your public is not very well educated about chiropractic and it patients more effectively. Seminars offer practical is up to you to help your patients understand how information, which you can put to immediate use in your chiropractic care can benefit them. It’s also important to practice. Covering topics such as chiropractic rehab, explain to your patients how chiropractic care can help caring for special populations, extremity adjusting, and them get back to the activities they enjoy. insurance regulations, these seminars are designed to The best way to educate patients about their problems is improve your adjusting techniques, build your practice, to have them “see it, feel it, and rate it.” For example: Let’s and enhance your care. say your patient, Mary has neck pain. If you have Mary do Education is an investment that will pay off through a range-of-motion (ROM) exercises in front of a mirror, she more successful practice and healthier patients. can see for herself how the problem limits her movements. When you do deep palpitation over a tender spot in her Brian Jensen, DC, is the associate director of education and neck, Mary will feel where the pain is located. Finally, you research for Foot Levelers. He shares more than 20 years of should have Mary rate her pain on a scale of one to 10. As practice experience in chiropractic colleges and seminars around a doctor of chiropractic, you will, of course, do all of the the world, speaking on a wide variety of topics including orthotic appropriate tests to thoroughly evaluate Mary’s condition. therapy, structural preservation, breaking free of the medical Having patients see, feel, and rate their pain during model of healthcare, and innovations in nutrition.
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92 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CHEC_93.ps 12/29/09 11:35 AM Page 93 CHEC_94.ps 12/30/09 12:23 PM Page 94
datebook
Activator Methods Feb. 20–21, Europe May 29–30, Canada April 17–18, St. Louis International Feb. 27–28, Las Vegas June 11–13, Canada April 24–25, San Francisco 800-598-0224 July 16–18, Canada May 1–2, Los Angeles Jan. 21–23, Honolulu Heel Inc. Aug. 20-22, Canada May 22–23, Denver 505-559-2954 Sept. 17–19, Canada Chiro Advance Services Inc. July 12, Miami Oct. 2–3, Canada Palmer College of Chiropractic 715-635-5211 Oct. 22–24, Canada 866-592-3861 April 30–May 1, Minneapolis K-LaserUSA Nov. 6–7, Canada Aug. 12–14, Davenport, Iowa Sept. 17–18, Minneapolis 866-595-7749 Nov. 19–21, Canada Feb. 20–21, Atlanta Dec. 10–12, Canada Parker College of Chiropractic ChiroPractice Mentoring March 13–14, Philadelphia 800-266-4723 608-489-7542 April 10–11, St. Louis Minnesota Chiropractic Feb. 6–7, Dallas Jan. 30, Charleston, S.C. Association Koren Specific Technique 952-882-9411 Target Coding Cox Seminars 800-537-3001 Feb. 25, St. Paul, Minn. 800-270-7044 800-441-5571 Feb. 6–7, Toronto, Ontario May 21–23, Minnetonka, Minn. Feb. 6, Atlanta Jan. 30–31, Naples, Fla. Feb. 27–28, Sydney, Australia Feb. 20, Ft. Lauderdale, Fla. March 13–14, San Francisco March 20–21, Chicago Neuromechanical Innovations March 4, LaGuardia Airport, N.Y. April 17–18, Atlanta April 10–11, Denver 888-294-4750 March 6, Newark, N.J. July 17–18, Boston May 15–16, Calgary, Alberta Jan. 30–31, Phoenix March 27, Chicago Sept. 18–19, Portland, Ore. May 22–23, Irvin, Calif. Feb. 13–14, Columbus, Ohio April 8, Philadelphia Oct. 9–10, Fort Wayne, Ind. Feb. 20–21, Washington D.C. April 10, Columbus, Ohio Nov. 12–14, Lombard, Ill. Meditech International Inc. Feb. 27–28, Charlotte, N.C. April 15, Boston Feb. 19–21, Canada March 6–7, Seattle April 22, Los Angeles Graston Technique March 19–21, Canada March 6–7, Canada April 29, New York 888-926-2727 March 27–28, Canada March 20–21, Chicago May 1, Phoenix Jan. 30–31, Folsom, Calif. April 16–18, Canada March 27–28, Morristown, N.J. Feb. 19–20, Europe May 14–16, Canada April 10–11, Boston
For a searchable list of more seminar and show dates, visit www.ChiroEco.com/datebook. Submit your event dates at www.ChiroEco.com/datebook/submitevent.html.
94 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CHEC_95.ps 12/30/09 12:24 PM Page 95 CHEC_96.ps 12/30/09 12:47 PM Page 96
advertisers index
Advertisers/Description Pg# Advertisers/Description Pg# Advertisers/Description Pg#
ACOM Health ...... 101 EduChiro ...... 95 Future Health ...... 52 Activator Methods Inc...... 21 Eon Systems ...... 65 Future Health ...... 53 Anabolic Laboratories ...... 39 Erchonia ...... 5 Gaia Herbs ...... 100 Beautiful Images LLC ...... 22 Essential Formulas ...... 67 GW Heel Lift Inc...... 78 Biosan ...... 87 EZ Bis ...... 20 H2O Massage Systems ...... 103 Bodyline Comfort Systems ...... 77 Florida Chiropractic Association ...... 93 Healthsource ...... 91 Bodyline Comfort Systems ...... 103 Foot Levelers ...... 13 HerbaSway Labs ...... 101 Foot Levelers ...... 72 C.A.I. Corporation ...... 94 Hill Laboratories ...... 55 Cash Practice ...... 103 Foot Levelers ...... 81 Hill Laboratories ...... 106-107 Cell Science Systems Ltd...... 28 Foot Levelers ...... 108 Hill Laboratories ...... 101 Celsius ...... 101 Foot Levelers ...... 100 Hydromassage/JTL Enterprises Inc...... 38 Chattanooga Group Inc...... 43 Forte Systems ...... 27 Impac Inc...... 54 Core Products ...... 49 Forte Systems ...... 85 Integrity Management ...... Belly Band Douglas Laboratories ...... 11 Foundation for Chiropractic Progress ...... 102 Douglas Laboratories ...... 56-57 FujiFilm Medical ...... 60 Kinesio USA ...... 99 Klaser ...... 63 Living Fuel ...... 100 Magnus Magnetica ...... 101 Medical Arts Press ...... 24 Medi-Stim ...... 100 Meyer Distributing ...... 37 MPN Software ...... 32 Multi Radiance Medical ...... 29 Nature’s One Inc...... 46 NCMIC ...... 25 Neuromechanical Innovations ...... 61 Northwestern College of Chiropractic ...... 97 NuCap Medical ...... 83 Nutra Research ...... 100 NZ Manufacturing ...... 34 Online Chiro ...... 19 OPTP ...... 64 Organix-South ...... 100 Orthopedic Pharmaceuticals ...... 14-15 Parker College ...... 70 Parker College ...... 101 PayDC ...... 68-69 Perfect Practice Web ...... 41 Performance Health/The Hygenic Group ...... 9 Performance Health/The Hygenic Group ...... 44-45 Performance Health/The Hygenic Group ...... 73 Pivotal Health ...... 30-31 Products Solutions ...... 101 ProSoultions ...... 74 Schiek’s Sports ...... 103 Scrip Chiropractic Supply ...... 7 Sombra ...... 16 Standard Process ...... 2-3 Standard Process ...... 79 Standard Process ...... 100 Tempur-Pedic ...... 51 The Masters Circle ...... 89 Tough Tables ...... 75 Transformation Enzyme ...... 42 Trial Guides ...... 101 UAS Laboratories ...... 98 UAS Laboratories ...... 100 Ulan Nutritional Systems Inc...... 18 Vital Nutrients ...... 101 Zyto ...... 35
96 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CHEC_97.ps 12/30/09 12:26 PM Page 97 CHEC_98.ps 12/30/09 12:27 PM Page 98
products and services
Nutrition supplement Immune system defense Living Fuel’s SuperEssentials Omega is a Quick Defense Liquid Phyto-Caps from blend of antioxidants and essential fatty Gaia Herbs are a combination of high acids designed to promote a healthy potency organic Echinacea, elderberry, lifestyle. Together with vitamin E and all- ginger, and andrographis, and intended to natural vitamins A and D, SuperEssentials support the body’s immune system at Omega is marketed as combining the onset. It was developed to be fast acting health benefits of Omega 3 and E and Pure and is intended to only be used for short D and A supplements into a softgel. periods of time during sinus and respiratory challenge. Call 866-580-3835 or visit www.livingfuel.com. Call 888-917-8269 or visit http://gaiaherbs.com.
Digestion support Probiotics guide Zypan from Standard Process contains The Consumer’s Guide to Probiotics proteolytic enzymes and pancreatin, from UAS Laboratories is marketed as which is meant to support protein an informative, comprehensive, and digestion. Betaine hydrochloride is easy to understand resource on formulated to provide the foundation for probiotics. Written by S. K. Dash, it proper gastric pH. Fatty acids are cites research on effects of probiotics included to help coat the pancreatin for on IBD, IBS, ulcerative, colitis, Crohn’s optimal digestion. These statements have disease, peptic ulcers, indigestion, not been evaluated by the Food and Drug Administration. leaky gut syndrome, constipation, lactose or gluten Call 262-495-2122 or visit www.standardprocess.com. intolerance, food allergies, and other digestive issues. Call 800-422-3371 or visit www.uaslabs.com.
Hot/cold packs Polar Products Reusable Stress aid Hot/Cold Packs distributed by Stress Ease from Organix- Medi-Stim are intended to be South contains adaptogens, heated in the microwave or ashwagandha, and shatavri. stored in the freezer. They include This formula uses ancient one reusable 6-inch by 9-inch Ayurvedic herbs combined with nontoxic wrap and one 3-inch by 27-inch elastic hook-and- carbon dioxide extracts and loop belt, which holds packs on the body while allowing hydrophilic extracts, designed continued mobility. to be fast-acting, with results appearing within 15 minutes to Call 800-363-7846 or visit www.medi-stim.com. 30 minutes. Call 888-989-6336 or visit http://organix-south.com.
Orthotics The Gait Cycle Joint supplement System by Foot Levelers ArthroAid Plus from Nutra Research is a system of shock- Inc. is a complete joint supplement absorbing, supportive, formula designed to offer both pain relief and propulsive materials, which are a key component in a and joint cartilage care. This product variety of Foot Levelers’ custom-made Spinal Pelvic contains seven ingredients, including Stabilizers. The product includes zorbacel in the heel to white willow bark extract, glucosamine, absorb damaging heel-strike shock, a StanceGuard for full Chondroitin, MSM, collagen, Hyaluronic weight-bearing support, and propacel in the forefoot to acid, and CM complex. provide a propulsive boost at toe-off. Call 888-386 8872 or visit http://nutraresearch.net. Call 800-553-4860 or visit www.footlevelers.com.
For a comprehensive, searchable products directory, go to www.ChiroEco.com and click on “Products and Services.”
98 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CHEC_99.ps 12/30/09 12:27 PM Page 99 CHEC_100.ps 12/30/09 12:29 PM Page 100
products and services
Immune defense Patient education software ViraCon from Vital Nutrients is Patient Education Software from ACOM Health is intended to help support and maintain designed to show your patients exactly what’s happening respiratory function, energy, and with their bodies immune defense. It’s a combination of through precise 3-D herbal extracts that are important for images. This product supporting healthy immune system will also help encourage function, particularly in the winter greater compliance of months. They are meant to function as exercises through potent immune enhancers to help boost cell defense and explanatory, step-by-step videos patients can watch at home. immune factors. You’ll also help patients understand how their condition Call 888-328-9992 or visit www.vitalnutrients.net. evolved and what your plan will accomplish. Call 866-286-5315 or visit www.acomhealth.com.
Calorie burner Celsius Calorie Burning Beverages Anti-aging formula and Packets are designed to burn HerbaSway Laboratories’ 7 Acai Blend is a 100 calories by raising metabolism formula including seven superfruit antioxidants and providing sustained energy. marketed as having anti-aging properties. It They’re also designed to increase loss includes fruit from around the world that are of fat mass and gain muscle mass intended to provide optimum health benefits and improve endurance. Celsius is and help support healthy and youthful skin. It made with green tea, ginger, can be served hot or cold. guarana, caffeine, vitamins B and C, calcium, and chromium. Call 866-846-0446 or visit Call 561-276-2239 or visit www.celsius.com. www.herbaswayspa.com.
Skin treatment DVD guide Aklarus Blue and Red Traumatic Injuries from Trial Guides is a Combination System from Hill DVD lecture featuring Dr. Aaron DeShaw, Laboratories Company is Esq. It’s designed to guide you through developed to treat acne and advanced medical imaging and how it can photo-damaged skin. This be used to prove serious injuries. It looks product is noninvasive and aims into how cutting edge imaging proves C1 to reduce inflammatory acne lesions. The narrow band blue instability using motion x-ray studies, using the Krakens light helps destroy the P. Acne bacteria while the red light protocol MRIs to image Alar and Transverse ligament damage. helps penetrate deeper to stimulate cellular mechanisms Call 800-309-6845 or visit www.trialguides.com. responsible for tissue repair and regeneration. Call 610-644-8598 or visit www.hilltherapy.com/aklarus.html. Acupuncture stimulation TheLaserLift distributed by Electro-magnetic Products Solutions are FDA therapy approved, Class III-A lasers for The Delta Pulse from acupuncture stimulation. They Magnus Magnetica LLC is are 635nm and 532nm wavelengths and feature laserlift tips, constructed to generate a high- which were developed by chiropractors. The tips are powered PEMF, which is designed to afford a safe, sanitary application of the lasers intended to penetrate and radiate through the entire area while helping shield the doctor and patient from harmful that the magnetic coil is placed, generating vaso-dilation scattered laser radiation, thus aiming to eliminate potential within two minutes. retinal exposure. Call 323-660-5411 or visit www.MagnusMagnetica.com. Call 719-201-8581 or visit www.thelaserlift.com.
100 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CHEC_101.ps 12/30/09 12:29 PM Page 101 CHEC_102.ps 12/30/09 12:33 PM Page 102 CHEC_103.ps 12/29/09 7:10 PM Page 103
Advertising Marketplace
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104 Chiropractic Economics www.ChiroEco.com Vol 56: Issue 1 • January 21, 2010 CLASSIFIEDMARKETPLACE<< PRACTICE OWNERSHIP HAVE YOUR OWN SUCCESSFUL OFFICE NOW! FOR DETAILS CALL 1- 800-300-2205 or visit us at www.chapmanmanagementcorp.com To place an ad call 800-533-4263 PRODUCTS ADD 2 PROFIT CENTERS FOR $1500 Ion Cleanse footbath, single diode, 5 mw cold laser plus Dr. Winchester instructional DVD on integrating muscle testing, detoxification and nutrition into your practice. CALL Dr. Shelly Dowling – 877-315-8638. SUPPLIES Vol 56: Issue 1 • January 21, 2010 www.ChiroEco.com Chiropractic Economics 105 CHEC_106.ps 12/29/09 10:53 AM Page 106 CHEC_107.ps 12/29/09 10:55 AM Page 107 CHEC_108.ps 12/29/09 10:56 AM Page 108