Taking a holistic approach to multidisciplinary practice

After a few years of toiling in the trenches of practice development, owning an integrative practice can seem like a logical next step. But the decision to expand your practice to include other health-care practitioners can be fraught with hesitation and overwhelm.

When I was a chiropractic student more than 15 years ago, it was my dream to be my own boss. My road to entrepreneurship has been paved with experience working in various settings – from a strip mall rehab clinic in the inner city to a bustling multidisciplinary wellness clinic in the posh pocket of town. I’ve been an employee, a boss and a landlord.

Biggest lesson learned: In order to grow, you’ve got to approach business from a holistic perspective. That is, each practitioner represents an organ within the business, and the health of the overall business depends on each system functioning optimally. With this collaborative care approach, ideally, you want to see each practitioner doing well. Here are a few of my strategies.

Don’t be everything to everyone
Taking on additional skill sets, such as acupuncture or nutritional supplementation, to expand one’s market reach may work well for some. Personally, however, this broader scope does not resonate with how I feel I can maximally help my patients. Working in a multidisciplinary environment allows me to focus on chiropractic and do it to the best of my ability.   

In practice I actively pass on educational and health recommendations to guide my patients toward achieving their health goals, whether it be pain relief to overall wellness or anywhere in between. I also understand that I am not an expert in all fields. Actively managing a patient’s wellbeing through multiple disciplines can be daunting and exhausting. I like to focus my time with my patients on chiropractic adjusting and education, as my primary treatment modality, and refer to allied health professionals who can help the patient attain their health goals, too.  

For instance, if your patients are interested in supplementation for more organic issues, you can refer confidently to your naturopath associate. Perhaps diet is the missing link in your patient’s care. Instead of giving a blanket recommendation on nutrition, you would be able to refer them to your registered nutritionist, who can design a tailored diet plan for them – in effect, enhancing their level of care in a way that complements your efforts as a chiropractor.  

Although I don’t shy away from doing targeted soft tissue therapy when needed for my patients, utilizing a combination of chiropractic and massage therapy, I find, is a natural, powerful and seamless combo. When utilized appropriately, it helps improve the patient’s overall outcomes and clinical experience.

When you eliminate the need to be a jack-of-all-trades, you can focus on being the master of your domain. Keep in mind that not every patient will need or want every service offered under one roof, but having the option to ethically inter-refer patients is convenient for everyone.

Cross promote your team  
Maintaining a healthy working relationship with other health practitioners is not always an easy feat. Anyone who has ever been on a team knows the trials and tribulations of dealing with multiple personalities and differing opinions, all while treading the fine line between being competitive yet cooperative.

When working for yourself with others on board with complementary skill sets, you need to juggle two things: your bottom line and their bottom line. I have always been a believer that in business, if you help others succeed, you too will succeed. In practice, this is all about constant communication and regular check-ins with your team members.

It can be as simple as parlaying to each team member the importance and value to the patient of adopting an integrative approach to their health and wellness. For example, when a massage client is seeking relief for a chronic pain in his legs, there should be no hesitation on the part of the massage therapist to let that client know that there is a chiropractor in-house who can help. For a woman receiving weekly acupuncture for fertility,  the naturopath should feel comfortable mentioning to her about the invaluable benefits of adjustments during all stages of pregnancy, when the time is right for the patient. This can be beneficial to the woman who desires a natural birth.

Having an in-house referral system does not come overnight; it can take years to build. Ultimately, each practitioner should feel motivated to take time to understand the philosophy and scope of each modality offered at the clinic in order to refer appropriately. Cross referral should feel natural and never forced. When patients know you have collaborated with your colleagues on their behalf it helps to further build trust and confidence in you.

The clinic’s marketing message should align with this integrative approach, which can be achieved exceptionally well through your marketing communication material, such as newsletters and social media. For example, post a mix of team photos and individual practitioner tips and tricks along with the usual articles on topics like chiropractic, naturopathy and nutrition. In short, make time to celebrate each team member’s unique skill set publicly. Take a lead from the American lawyer and political leader, Robert G. Ingersoll, who famously said, “We rise by lifting others.”  

Stop fearing turnover
Staff turnover is an inevitable part of owning a business. People will leave a company for various reasons, some of which may be out of your control, such as personal conflicts. But as a business owner, there is one major thing you need to implement in order to maintain a high level of staff retention: company culture.  

Much has been written about this topic lately. In short, modern businesses are investing on the well-researched idea of “culture,” where managers work on instilling a strong organizational culture by investing time and money, when necessary, on its people. It is now seen as a critical component to any company’s success. Building a culture starts with hiring the right people. Team members are not simply tenants or additional income for the business; they need to be utilized as a team. Don’t fill a room with just anyone. Not only should you do thorough background checks before hiring, but you should also ask the person during the interview to give examples of how they’ve collaborated in the past. Ask them about their feelings on chiropractic, in general. You should be able to snuff out a “lone wolf” mentality by their answers.

This can seem like a big challenge for chiropractors because we weren’t taught how to be leaders, or in some cases, we don’t want to be one. This is not so much for the fear of managing people but rather not wanting to share the business with others.

Through my earlier years of practice I have come to understand the lone wolf approach to patient care, while trying to build a clientele – trying to be the hero who solves all the patient’s problems and fearing that another professional might be able to deliver on your promise better. Back then, owning a multidisciplinary clinic meant simply renting out a room to someone. I “co-existed” with a RMT tenant under the same clinic for years until she left. There was never any spirit of collaboration between us, and so we lost a great opportunity to grow.  

When I began to expand the services offered at my office and wholeheartedly put effort into working as a team, my practice grew progressively year after year. Call me an optimist but I believe that by shifting your focus toward seeing your colleagues grow and opening up the goodwill within your practice, you will always reap the benefits. Respect toward and reciprocity from your colleagues help to build a strong foundation for your business.

One of the greatest benefits of having a robust business is that for every person that walks through the front doors for any of the disciplines that you offer, it’s another person who knows that your services are available.

Collaborative care is the strongest path forward for the health of your business and patients. That’s a win-win.

Dr. Chad Morton graduated from CMCC and has been running a multidisciplinary clinic in Mount Albert, Ont., for the past 15 years. His team includes a naturopathic doctor, two registered massage therapists and a holistic nutritionist.