DCs share their thoughts
on adding services to their practices and maintaining their integrity.
By Craig Dekshenieks, publisher of Today’s Chiropractic LifeStyle
It’s the dilemma every chiropractor has faced at one time or another—whether
or not to incorporate other services in their practice. Chiropractors often
accuse the medical profession of putting the almighty dollar first before patient
care. Therefore, is it hypocritical to establish another profit center in your
practice?
Oftentimes those additional services come in the form of products—mattresses,
pillows, cooling gels, orthotics and herbal supplements. Immediately, the identity
crisis begins. On one hand, adding the services to your practice allows you
to be a one-stop practice for your patients. On the other, you rationalize that
you can’t be an expert on everything. So, then you wonder, if you should
include products outside of your expertise. And, then there’s the theory
that by not including additional services you could cultivate a community within
the health care profession—through referrals—giving patients optimal
well-being. The big question is can you offer additional services without compromising
your integrity?
For most DCs, it comes down to professionalism. “Don’t sell outside
your expertise,” says Brent Detelich, a D.C. in Ohio, who only has a limited
range of products available in his practice. Detelich believes that if he is
not an expert in a certain field, he will not sell or even promote a product
in that area.
“Take nutrition as an example,” he says. “Only 10 percent
of chiropractors are experts in nutrition, and I’m not in that 10 percent.
So, if a patient asks me about their diet, and the questions go beyond the basics,
I’ll refer them to a nutritionist.” Detelich might be turning away
revenue in the process, but it comes back to him in other ways, with the nutritionist
often referring patients to him. “So instead of making $3,000 a year in
profit from a vitamin supplement, you get 50 patient referrals. To me, that’s
more valuable.”
But Detelich is also philosophical about product sales in general. “If
I knew 100 percent that a certain product would enhance my patient’s care,
then the money doesn’t matter.” He continues by saying, “It’s
not just about delivering an adjustment, it’s about what the patient needs.
So it’s not about the money, but if you can get paid in the process, then
why not?”
Some chiropractors take those thoughts even further. Dr. Jeff Cook, a Life University
graduate who has been practicing in Kannapolis, N.C., for the past 13 years,
says, “You’re a businessman as well as a chiropractor. Other services
are within the scope of your job.” Cook offers nutritional supplements,
orthotics, sprays and lotions in his practice, among other products.
He too is philosophical about it, saying, “I’m not trying to argue
anyone’s philosophy here, but if a patient keeps coming to me, and he’s
not holding his adjustment, and we know why, it’s negligent if I don’t
help him get better.” For some, that means getting fitted with an orthotic.
For others, it’s simply a case of being vitamin B deficient, or calcium
deficient, or anti-oxidant deficient. So Cook doesn’t have any qualms
about having products on hand that address those issues.
Another thing to consider is the convenience factor. If you are doing your job
well, then most of your patients believe in proper nutrition, or the value of
orthotics, pillows or ergonomic products. Stocking these products in your practice
is convenient for those patients who want them.
“The products I sold in my practice were better quality than ‘off-the-shelf’
products. And those products require professional expertise,” says Dr.
Mark Mandell, a former practicing chiropractor who now works for Foot Levelers
in Roanoke, Va. “You have a duty to your patients to deliver the utmost
quality of care. The adjustment is the most important thing, but it’s
not the only thing.”
Dr. Mandell agrees that one should be an expert in the field before he starts
selling or even recommending products to patients. Many product companies offer
one-on-one education and training to get you started, so you feel comfortable
when it comes time to recommend that product to a patient who could use it.
Companies such as Foot Levelers even offer seminars and training that allow
you to earn CE credits along the way.
Mandell’s philosophy on selling products in a practice comes down to one
word—intent. “If you feel you are toeing the line, then you shouldn’t
be a doctor. It is about patient care, first and foremost.”
Intent is a good word to keep in mind. You don’t want to be seen as a
hawker of products, and you don’t want your practice to look like a chiropractic
version of The Sharper Image or GNC.
For some DCs, selling products just might not be your cup of tea. Dr. Jonathon
Schwartz, of Davy, Fla., was presented with the dilemma very early in his career.
When he first started practicing, he was getting a lot of new patients that
were coming to him from other chiropractors. When he asked them why they switched,
“more often than not, they said they felt like they were being sold something
other than chiropractic.”
Schwartz made a decision right then and there to not stock products in his practice,
and he has held true to that notion during his 11 successful years in business.
“I never wanted any of my patients to come in wondering ‘what’s
he going to try and sell me today?’”
He instead relies upon a patient’s natural curiosity to ask questions.
“If someone comes to me with a product they want or think they need, I’ll
be glad to get it for them if I agree they need it,” he says. “But
I’m not going to push anything on them.”
Selling vitamin supplements, orthotics, pillows, mattresses, analgesics or even
braces is a decision you must make for yourself. Each one of them can be an
excellent source of revenue for your office, but they can also lead to an ethical
dilemma.
Regardless of your chiropractic philosophy, and regardless of your stance on
selling products within your practice, you want to run an ethical business.
And running an ethical chiropractic business begins and ends with patient care.
Remember that as a chiropractor, you are caring for human life, a responsibility
of the highest order.
And while you deserve to be well compensated for your efforts to promote health
and well-being, that responsibility requires that you keep the best interests
of your patients ahead of all that. After all, life is much more valuable than
money will ever be.