Clinical Competency A Glimpse of the Future

 - By Steven Kraus, DC, DIBCN, CCSP, FASA

Developing clinical competency is a crucial step towards increasing the number of patient referrals received from other health care providers. Clinical competency proves to orthopedists and general practitioners they can trust your practice. It proves to the community you have the authority to help them in their time of need.

How long do we have to offer our effective and successful treatments to other health care providers before we receive suitable recognition for all that we do? Why do chiropractic practices have to continue struggling to prove themselves to other professionals in the health care discipline?

With the rates of individuals utilizing chiropractic services constantly in fluctuation, many of us are wondering about the future of chiropractic health care. Have we really reached the critical mass of consumers? We will be unable to properly answer these and other questions until we gain more referrals from other health care gatekeepers in our communities.

Let's examine how five factors accompanied with Future Health's Software can make our demonstration of clinical competency most effective.

1. Chiropractic clinics continue to be cost effective
2. An increase in the number of multidisciplinary growth centers
3. Medical mismanagement of NMS conditions is not slowing
4. Chiropractic enculturation is slowly growing in key areas
5. Employers still depend on us to help their employees

This amounts to the perfect environment for chiropractors to once and for all prove their clinical competency.

The Five Key Factors of Improving Clinical Competency

Chiropractic is still cost-effective: I draw your attention to a previous column of mine that tells of how two Maryland doctors are using data from their own clinics for one-on-one negotiations with Blue Cross/Blue Shield. These clinicians are effectively immersing themselves in the health care culture of their community. Other clinics can do the same by adopting Future Health Software and using it to provide them with an extremely efficient integrated system to manage their data. Future Health's Virtual Office Suite (VOS) provides clinics with electronic versions of documentation, health records, billing, scheduling, and even offers them patient education. All of these not only improve the service of our chiropractic clinics but helps to increase efficiency and productivity.

Increasing enculturation: My home state of Iowa, defies the argument of those who suggest that current utilization of chiropractic practices has topped off. At 22 percent of the population, Iowa has the highest chiropractic usage rate in the country. Iowa also has the highest amount of chiropractors in practice per capita. When we adjust for regional costs of living, the cost of chiropractic is no lower than any other state. Iowa is proof of the fact that no state should be stuck or satisfied at 10 percent utilization.

Iowa is a prime example of chiropractic stability and elevated reputation in the Midwest. Chiropractic clinics have been utilized and received for many generations by a large number of Iowans. In fact, in some of the more rural areas, DCs continue to be the only licensed health care practitioner within a convenient driving distance. These two facts have allowed chiropractic clinics to be fruitful enough to allow the state of Iowa to hold nearly twice the rate of most other states. This unique position of Iowa is strong evidence that usage can grow and chiropractic can become a larger part of the cultural landscape, given time and the proper environment.

Increasing interdisciplinary growth centers: Each year, more and more chiropractors and chiropractic students are taking advantage of the Department of Defense's inclusion of chiropractic in the Veterans Administration and are completing rounds and clinical rotations in VA hospitals. Many of the young MDs enter into the private practice world free from any ignorance or distrust of chiropractors. They have seen their results first hand. While it might take at least a decade for us to begin to feel the effect of this remarkable health care shift, the extraordinary potential of this situation is there.

Medicine is still mismanaged: MDs continue to mismanage many common conditions chiropractors are most effective at treating. Take for instance back pain cases; over 80% of individuals still head to the MDs for assistance. If we could attract the same number of cases to our chiropractic clinics, chiropractors would be busy for the next half century. Studies continue to show that medical management of musculoskeletal pain's end results are not improving even though expenses continue to increase. This is a perfect example of how chiropractic can help to manage this societal burden.

The needs of employers: Employers still remain the largest purchasers of health care plans. Consider how their company's productivity continues to be negatively impacted by workdays lost to low back pain and other conditions. A conservative estimate for the cost of lower back pain in the U.S. is 90 billion dollars a year and that's not taking into account the actual time lost in productivity from days off or out-of-pocket expenses. Now all we need to do is convince more employers of the economic benefits of having chiropractors as the first line of treatment. We can get American workers back to work in less time and with less expense.

None of this information is new to any of us. In fact most of these facts have been documented for years. What we need is an army of general practitioners who realize many migraine or low back pain sufferers can benefit from chiropractic services. We need GPs to understand that chiropractic provides more unique and comprehensive methods than physical therapists because we actually can provide diagnoses and have diagnostic testing orders for immediate and practical management.

How to Improve Your Competency: Show It

Your patient's MDs will have very little exposure to your clinical competency. Even if patients are quoting off of Future Health's patient education software to their medical doctor, communication still remains largely one sided instead transferring between the two health care providers. The lines of communication between MDs and DCs are down. This leads to most chiropractors only seeing 7 to 8 percent of the population in their area and the only way to improve their market share is through the utilization of certain tools within technology.

Future Health's VOS to Make It Happen

The reason why chiropractors don't seek more referrals from GPs and other MDs is because they are afraid. We're afraid of rejection, we're afraid of criticism, and we're afraid to open our practices to that kind of scrutiny. We're afraid to show our records and management plans.

What would your communication be like, however, if you could produce pages of quality and meaningful patient data from your exams? How would your communication improve if your records could chart and graph the patient's pain patterns, trends in progress and setbacks in their functional abilities? Would your patient's GP understand what you do better if they saw the details of your postural and neuromuscular analysis, and how these values changed and even improved through your care? Just think: Future Health's Virtual Office Suite provides you with all of these options. And believe it or not, VOS lets you accomplish all of these things in just a few minutes or less.

All the options are here; our health care environment is ready. With electronic health records and digital documentation, we finally have the infrastructure to reap the rewards. The only thing we lack is the willingness to prove our clinical competency and start the communication process. Will you join me in making chiropractic part of the health care in the future? Are you ready to lead by being an early adopter of Future Health Software that will not only lower your overhead, and increase your bottom line, but help you to garner referrals from MDs to finally increase chiropractic market share?