Inside The World Of The Chiropractic Occupational Health Consultant
By James Panter

Since 1995, Dr. Chad Henriksen has taken his chiropractic skills from the clinic to the workplace to assist businesses in providing optimal working conditions for employees and reducing incidences of illness and injury.

He and Dr. Dan Neubauer manage a company, Genesis Health and Wellness, Inc., which implements on-site programs to provide employees access to chiropractic care, education on proper workstation set-up and motivational seminars. A 1995 graduate of Northwestern College of Chiropractic, Dr. Henriksen is a member of the board of directors of the International Academy of Chiropractic Occupational Health Consultants.

In the following interview, he provides insights on how he gained expertise as a consultant and how he works with businesses to improve their productivity.

While you were in chiropractic college, did you get any training in occupational health care?

Dr. Henriksen: I took a couple of elective weekend courses that Dr. Joseph Sweere provided through Northwestern College. Since graduation, I have been working on an Occupational Health Diplomate degree, a three-year program sponsored by Northwestern’s postgraduate department.

When did you become interested in becoming an occupational health consultant?

Dr. Henriksen: After graduating from Northwestern in November 1995, I had started work with Dr. Dan Neubauer. Starkey Labs, of Glencoe, Minn., approached us to take a look at their facility, so we went over and looked at it. We recommended that they start a health and wellness program that included on-site chiropractic care. They were interested, so I took over at that point and started to go on-site. I always had an interest in dealing with employees in the workplace and having a positive effect on business.

Obviously, the majority of our patients were working for somebody, so certainly we had been addressing workplace issues in the clinic setting. It made just so much more sense to me to do it on site, where we could have a better understanding of what they were actually doing at work and be able to guide them a little bit better as to what improvements could be made.

Who did you meet with at Starkey Labs?

Dr. Henriksen: We met with their human resources personnel, and their Glencoe facility is just one of many they have throughout the country. They are headquartered in the Twin Cities, so their head human resources person from their Eden Prairie, Minn., facility came out to meet with us, as well.

What type of presentation did you make?

Dr. Henriksen: For that initial presentation, we went in and did an assessment of their workplace. They were having some trouble with employees reporting headaches and other complaints, so we took a look at their workstation setups and interviewed the employees. Then, we came back with a proposal that pointed out things we saw that could be improved.

We presented the idea that a complete health and wellness program, which included on-site chiropractic care, really would be the way to go. And they agreed to do a pilot study at that time. The initial study was to include 50 people and to run for six months, just to see how the program worked. After four months, it was so successful that they decided to open it up to 100 employees at that facility, and then, by the end of the year, they decided that they would open it up to any employees who wanted to take part in the program. It was a voluntary program for health care.

How much time do you spend on site?

Dr. Henriksen: Right now, probably 98 percent of my time is spent working with industry. I spend three hours in the clinic setting, and then between the different facilities that we have contracted with, providing seminars or ergonomic work, I spend the rest of my time doing that.

At one particular facility, like the one in Glencoe, I’m there for three hours on Monday, for about a nine-hour day on Tuesdays and again about three hours on Friday. We have contracts with a cabinet manufacturing company, and a dental office, which has a group of businesses associated with it, to provide care for their employees. One day a week, I’m out trying to market to industry, providing seminars to different human resource personnel or doing ergonomic work.

Do you use any visual aids when making presentations?

Dr. Henriksen: We will use video, photography or PowerPoint presentations. The most effective presentation is to be able to do an assessment of the facility and use what they’re currently doing within their facility to show them where they have some shortcomings or where their strengths are,

Do you have a protocol for providing care for employees?

Dr. Henriksen: When we first start an on-site health and wellness program, we conduct a seminar to inform the employees as to what is going to be taking place and the idea of chiropractic. We explain what the program is going to be about, how chiropractic care works and how it is going to work in the facility. Then, they have the ability to sign up or take part in the program. From there, we go through, just we would in a normal clinic setting, an exam and a history, and then we set up a plan and provide care from there.

In the facilities where we have established programs, it’s open on a continual basis to any employee who wants to take advantage. So, if somebody is having difficulty or would like to get in to be seen, they just contact me and we proceed with the same process of the examination and history, just like in a clinic setting. Essentially, it’s as though we’re managing a clinic on-site. The procedures are pretty similar, in most cases. Billing, insurance and payment procedures are a little bit different, but as far as health-care provision is concerned, it’s pretty much the same.

What health problems are common to industrial environments?

Dr. Henriksen: It depends on what company we’re working with. For instance, the hearing aid manufacturer is light manufacturing, involving microscopic work and a much higher rate of cumulative trauma disorders. Certainly, upper back and neck conditions are prevalent, as well as headaches. Much of our care deals with those areas. Trying to control, or prevent, cases of carpal tunnel (syndrome) or tendinitis, and dealing with the cervical and thoracic subluxation complexes are certainly issues that we deal with quite frequently at that facility.

At the cabinet manufacturing company, we’re dealing much more with heavy labor, so low back strains/sprains and shoulder conditions are much more common. Our primary care procedures are done with the spine, but we do deal with upper and lower extremities extensively, as well.

What techniques do you use?

Dr. Henriksen: Primarily, I use the Diversified method of manual adjusting, and we use very few modalities. We do a lot of education, as far as home stretching and exercise, and we talk to employees not only about their postures at work, but postures that they use outside of the workplace.

How many employees do you provide care for at these facilities?

Dr. Henriksen: It ranges a little bit. We have a certain number of patients that continue to stay on the program, whether it be through the acute care, or into even the maintenance or wellness level. Of all the facilities where I work on site, we have a few hundred employees who are at that level. Then we have some that will come in for acute care and then be gone for a while and go back and forth. Of the facilities where we’re providing care, our utilization rates are around 40 to 50 percent of the employees.

How many companies do you work with?

Dr. Henriksen: We provide on-site care with three different facilities – a cabinet manufacturing company, a hearing aid manufacturing company (Starkey Labs) and a dental office that has associated businesses with it as well. The dental office is a little bit smaller as far as the number of employees. The cabinet manufacturer has just under 200 employees, and the hearing aid manufacturer has about 450 employees. That’s where we have the health and wellness programs, where we’re providing on-site chiropractic care, doing seminars and doing ergonomic work. In addition, we’ve contracted with numerous other companies for just ergonomic work, or for seminars.

Do you keep track of how much you save the companies in costs?

Dr. Henriksen: Tracking is a big part of justifying care. For the on-site program to work, you really have to make sure that the employees are satisfied with the care. Most of the time, that’s pretty easy because the convenience is so wonderful for them. Above that, you have to make sure you satisfy the companies meeting their goals and agendas, so tracking is big part of it.

Most of our statistics come from our program when it was in its initial stages, in 1996-1997. Soon, we will have three-year studies, which will have much more significance, because they will be over a longer time period. It will be done independently from our tracking services.

From 1996-1997, we saw wonderful things happen at the hearing aid manufacturing company, where we had an 81 percent reduction in headaches that interfered with the workday. We had 283 fewer hours of absenteeism for the people on the program. That was significant for the company, since production is a huge issue there.

We’ve also seen an enormous drop in worker’s compensation costs at those companies, too. For instance, in 1996, when they were working an extensive amount of overtime and putting a lot of hours in, the employees on our program had $607 in worker’s compensation costs for the entire year, or $6.07 per employee on our program. Whereas, the employees who were not on our program had expenses that year of $96,982, or $777.09 per employee. So that is an enormous difference. And it was partially due to the fact that they were working a lot of overtime, so the employees who weren’t taking care of themselves, or who weren’t on our program, were running into enormous problems.

The following year, in 1997, for the people on our program, per employee, the worker’s compensation costs were $4.55 for the year, and for the people not on our program, per employee, it was $32.81 for the year. So we’ve seen good reduction in worker’s compensation numbers, too. The worker’s compensation injuries in both 1996 and 1997, for employees on our program, resulted in no missed workdays and no claim over $1,000.

How do you perform worksite assessments?

Dr. Henriksen: We always make recommendations, but the final decisions are up to the company. My viewpoint is that I certainly never claim to be an ergonomist, and don’t market myself as an ergonomist, but my chiropractic training, as well as my experience in working on site, allows me to see how the human frame functions within a work environment. If we can make some improvements on that, then obviously the employee is going to experience improved health as well as perform better within that job.

Our recommendations are based on how best that human frame or that person can work within that situation, and if that means that we need to alter the height of a workstation, or change the manufacturing process, those would be recommendations that we would make. A lot of times, because of expense restrictions, companies can’t make extremely large changes in work environments. So, in that situation, where we’re not able to make the ideal ergonomic improvement, I feel we can have just as much effect in educating the employee on improving their health as much as they possibly can. We can also help them understand that if they have conditions that are arising that they need to be addressed early on. Regular exercises and stretches can be added to offset the sub-par workstations that are out there.

In doing the assessment, do you actually watch the people work and then take photographs or videos?

Dr. Henriksen: Every company is a little bit different. Some companies will not allow you to do a video, but we try to do that in every case that we can. The reason we do the photography, or more likely, video work is so that we don’t have to spend an enormous amount of time on site. I can videotape on site for a work cycle or two and then bring that back to my office, review it and draw my conclusions from there.

Even more effective in the presentation of my report is when I can show upper management what I mean by changing positions and the benefits we might have, or why they might be having some difficulties within an area. When they can see it, they can understand it much better. It’s ideal to do that, but it doesn’t happen in every case.

Do you see a lot of opportunities for chiropractors in industry, and what is the best way to develop expertise in this area?

Dr. Henriksen: There is an enormous amount of opportunity for chiropractors within the occupational health field. Nurses and physical therapists are doing a lot of the work, and they don’t have nearly the education that we do. So I think there is a large opportunity for chiropractic within this realm of practice.

The best way to get involved? Certainly, some additional training beyond the typical chiropractic college curriculum is important, as well as associating yourself with people who are currently doing it to avoid some of the pitfalls or obstacles that can come up in dealing with companies or dealing with cases on site.

The best resource for training is the International Academy of Chiropractic Occupational Health Consultants (IACOHC), which has information on where educational seminars are being given. The American Chiropractic Association’s Council on Occupational Health would be an option to look at.

This is an enormous opportunity for chiropractic, not only to expand our services, but also there isn’t any other area where we can have a bigger impact as far as the quality of health care that we can give. Industry holds the key to the whole third-party insurance area. They’re the ones who buy the policies. If we have a positive effect with those people, certainly that whole third-party insurance portion will come along with that. Even if it doesn’t, in working directly with the companies, we have our values set by whether we’re able to help their bottom line. In every instance I know, we’ve been able to do that.

It is an opportunity for chiropractic not only to grow, but to show the kind of quality health care that we can provide to people. At the present time, there aren’t a significant number of doctors who are doing it, but every doctor in practice has patients walking through their door who work for companies that would have a significant benefit from having a chiropractor on site.

When you can be on site three days a week, like I am at some of these facilities, there’s no better advertising for chiropractic or for each individual doctor. You can walk into the facility three days a week and get exposure to all those employees. It’s my hope that more doctors will realize the potential that exists there.

About the author: James Panter is editor of Today’s Chiropractic

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