By Steve Rallis BSc DC
By Steve Rallis BSc DC
Business, insurers and the public search for proactive solutions.
A perfect storm has been brewing … escalating health benefit costs and deteriorating corporate profits … decreased accessibility to quality medical care … declining public health and medical doctor shortages … increased public skepticism toward drug therapy coupled with a greater demand for “wellness” and integrated therapies … heightened consciousness of employees as human capital … increased competition for corporate talent … sustained viability of the aging baby boomers …. The list goes on.
Enter the chiropractor – the perfect practitioner for the perfect storm.
There are at least two perceived health-care crises facing all Canadians: the lack of available medical gatekeepers, and the declining health of the average Canadian, both young and old.
There is virtually no community in Canada that hasn’t been affected by a physician shortage. As a result, health-care delivery and focus are stratified according to most-immediate needs. This means that heart attack management takes precedence over heart attack prevention but the ultimate result is a further deterioration of public health and a greater demand for physician services. Moreover, the traditional diagnoses have been supplanted by chronic conditions of lifestyle and aging, such as high blood pressure, diabetes, high cholesterol, depression, stress, chronic pain and non-specific syndromes.
Corporations are also suffering in terms of double-digit health-care inflation and devastating profit losses. In 2005, the cost of health benefits in the United States rose 9.2 per cent; in 2004 that figure was 11.2 per cent.(1) In contrast, inflation and wages were increasing by only about 3.0 per cent per annum during this same time period.(2) In Canada, a similar story is unfolding, to the point that benefits now account for 36 per cent of total labour costs in Canada.(3) For most corporations, this financial model is simply non-sustainable. Insurance providers, in turn, are not offering their clients much in the way of support or direction. But everyone is interested in proactive strategies.
Corporations and their respective human resources departments are simply not going to offer up their employees to the transparent marketing techniques of those who are just seeking new patients.
PREVENTION AS A SOLUTION
Prevention provides a viable solution to this epidemic, both in the workplace and in our communities. Wellness, as a conceptual health-care term, describes an elevated state of well-being or self-maintenance. Health-care economists and researchers have long touted the benefits of implementing health promotion and wellness strategies to control health-care spending and/or prevent health-care crises. Prevention has been a critical component of virtually every major published health-care reform document, including the much-publicized Romanow report.(4)
While all medical disciplines openly accept and encourage prevention, the actual practice of medicine makes the implementation of prevention and health promotion secondary to the business of treating acute illness and chronic disease.
Many chiropractors, however, already view themselves as wellness doctors, that is, the type of physician most likely to engage patients in improving their health as part of an active protocol, not simply a reactive one.
The Ottawa Charter for Health Promotion defined health promotion as follows: “The process of enabling people to increase control over, and to improve their health”(5) From a public health perspective, chiropractors offer a unique skill set virtually tailor-made for prevention, health promotion and public health management.
WHY TARGET CORPORATIONS?
In a time of medical doctor shortages, chiropractors are vastly underutilized (while estimates vary, the range of utilization typically falls between 6 and 12 per cent.(6) In essence, corporations can offer chiropractors the unique opportunity of increasing both access and utilization, ultimately resulting in a reduced public health burden. A well-directed wellness program could provide chiropractors with access to entire corporate populations. Such symbiotic relationships will lead to lower future health-care costs, increased productivity and better public health.
As a consequence, demand for corporate wellness services is at an all-time high as is the number of chiropractors now providing care in the workplace. Unfortunately, how some chiropractors attempt to access this market and what they propose to gain may keep them out. Corporations and their respective human resources departments are simply not going to offer up their employees to the transparent marketing techniques of those who are just seeking new patients. They are, on the other hand, interested in building professional relationships that will quantitatively upgrade employee health, cut health-care costs and positively impact productivity. In real terms, this entails pre-employment health examinations, injury management and smoking cessation programs, and the like.
Doctors who are new to the corporate environment need to be conversant with program design, health measurement, and cost-benefit analysis, etc. Successful corporate health promotion requires more than setting up an adjusting table once a week. It necessitates fully integrating clinical and practice management expertise, and interrelating with employees and their families, management and insurers. Lifestyle issues and identifiable problems associated with tobacco use, poor nutrition, stress and hypertension, which may be glossed over in the chiropractor’s office, now have to be assessed, measured and addressed.
AN UNPRECEDENTED OPPORTUNITY
The perfect storm has indeed been brewing and with it an unprecedented opportunity for chiropractors to align as the chief gatekeepers of corporate health and wellness. If given direct access to CEOs, CFOs, and insurers, doctors of chiropractic can have input into the design and implementation of health initiatives, benefit plans, and public health practices.
This would represent a quantum leap in the penetration and influence of chiropractic in business and, for those chiropractors who are interested, a viable means of achieving clinical and practice success.•
1. Kaiser/HRET Survey of Employer-Sponsored Health Benefits, 1999-2006; KPMG Survey of Employer-Sponsored Health Benefits, 1993-1996.
2. Bureau of Labor Statistics, Consumer Price Index, U.S. City Average of Annual Inflation (April-April), 1988-2006.
4. www.hc sc.gc.ca/english/care/romanow/ hcc0086.html.
5. Charter adopted at an international conference on health promotion*, “The Move Towards a New Public Health, November 17-21, 1986, Ottawa, Ontario, Canada
* Co-sponsored by the Canadian Public Health Association, Health and Welfare Canada, and the World Health Organization.
6. Lawrence DJ, Meeker WC. Chiropractic and CAM utilization: a descriptive review. Chiropractic and Osteopathy 2007, 15:2.