Occupational Medicine is the branch of medicine
that deals with worker wellness and safety. Under
federal law, departments such as OSHA,
DOT, FAA, NIOSH, Homeland Security, etc., must
enforce mandates that specified categories of workers
must undergo earmarked tests done every year, and
that the companies they work for must pay cash for the
tests! What kind of tests are we talking about? Things
like physicals, hearing tests, pulmonary function tests,
heavy metal tests, respiratory mask fit tests, drug and
alcohol tests, and more. There are cUlTently around 25
different services of which 13 are mandatory and the
others are highly utilized in most businesses. For example,
all truck drivers, plane pilots, train engineers, bus/
subway drivers, and ship captains must have a physical
every 2 years or less. They all must have drug and alcohol
tests routinely to protect the public's safety. All
firemen, policemen, hazardous cleanup crews, and garbage
truck drivers in every city must have physicals and
drug tests. All school bus drivers, utility truck drivers,
and FedEx/UPS drivers also must be tested. Teachers,
preschool workers, nursing home workers, must have
background checks and be fingerprinted mandatorily.
Workers whose jobs take them around paint or dust
must have respirator mask fit tests. People in loud jobs
must have their hearing tested annually. In all, 80-90%
of workers in the US have at least one of these tests
done every year. CUlTent spending for these tests is $33
billion a year and that total is continuing to rise.
Why should DCs incorporate Occupational Medicine
into their clinics? It can be done by DCs in all 50 states
with only a few exceptions. Namely DCs in WA, MI,
and NY can't do the DOT physicals. An especially interesting
feature is that there are only 25 or so services
and most cost very little or nothing to start. Out of the
25 services, only 5 require extra training to become certified,
but two only take 4 hours, one requires 12 hours,
and two are 20 hours (2.5-day course), which means
that all training could be done in a couple of weeks.
With that training, a DC could then offer services that
nearly every single business uses, which mean the majority
of working people in your town could be directed
to go to your office when most of them have never been
to a DC. It is an opportunity to gain access to many new
patients that need chiropractic care, but have been apprehensive,
or told not to go to a chiropractor. This approach
allows you to get paid to see new patients rather
than you paying to advertise for new patients.
I conduct drug tests for my bank and grocery store. I
do physicals and drug tests for the city and county police
and firemen. I do physicals for the garbage trucks,
electric and cable trucks, railroads, and airports. I have
paper mills, construction sites, military contractors,
school districts, and just about every other business in
town. So, when a DC asks me, "How do I know there
is some of this business in my town?" I can say factually,
"It's in every single town in America."The need. is
growing, not shrinking. The time is now to capitalize on
the opportunity. Oh, and best for last, your assistant can
do everything but the physical without you having to be
present. Talk about a great way to make cash income
with no recoupments, no downgrades, no coding issues,
no fear of an insurance calTier coming to take all their
money back.
ALL DCs SHOULD KNOW HOW TO DO THIS
AND WORK WITHIN CORPORATE AMERICA.
Live life easier, without fear, and with more cash.

​Dr. James Raker DC, FADP, CME, CWP is CEO of
OccMed For DCs, has 30 years private practice including
Occupational health of several companies
in Texarkana USA area. Has been doing DOT work
for over 25 years, was one of the first doctors in the
country to pass the DOT ce rtification and become
a Ce led Medical Examiner for the Dept of Transportation of
the US government, and has been teaching Occupational Medicine
services since 2012. Has lectured in AR, TX, IL, SC, CA, FL,
NJ, and OH. Providing OccMed services for companies, he has
provided 500 drug tests in a single day, and 75 hearing tests
in a single day. He became a Certified Wellness Instructor by
the Foundat ion for Wellness Professionals on July of 2014. He
sta rted the OccMed For DCs training program in 2015 at www.
OccMedForDCs.com

CONNECT TO CHIROPRACTIC ECONOMICS DOWNLOAD FULL ARTICLE HERE
​HTTPS://CDN.CHIROECO.COM/WP-CONTENT/UPLOADS/2020/11/CHEC_18_2020_FULL-2.PDF

​

November, 2020 https://www.chiroeco.com/
James Raker, DC
TIMES ARE CHANGING, and in the profession of chiropractic
we often hear the rumbling (or is it a battle cry?) of “We need
to change with the times in order to survive!” or “We need
additional scope of practice changes to include more things in
order to survive.”
Without a long, drawn-out political fight to create a
change in our scope of practice, there are some 15 services
that DCs in every state can do right now under their current
scope of practice that can earn them money and recognition
from local business and government entities at the city,
county, state and federal levels. It’s easy to do, takes little
investment in equipment and little time to perform, yet can
generate more income than the primary way of practicing for
most DCs.
Chiropractic remains the focus!
Does this mean that practicing occupational medicine means
you don’t practice good old-fashioned chiropractic? Of course
not. It means that companies will send you workers for the
purpose of keeping them safe and healthy by complying with
federally-mandated testing such as:
• physicals;
• drug and alcohol testing;
• hearing and lung testing;
• respirator mask fit testing;
• heavy metal testing;
• vision testing;
• and more.

Think of it like this: People who would never in their lives
think of coming to a DC for any reason (a big chunk of the
American population) are made to come to your office by a
company or government entity like the county/state for a
spinal screening (really a physical exam). These physical exams
are usually very simple, requiring only five minutes of your
time (making you $65), but every single physical requires some
evaluation of neck and back range of motion and general
fitness (spinal screening).
During this exam you can inquire about their stiffness, pains,
headache, tingling, etc., and simply ask them if they have ever
tried chiropractic for help. Many have not and are tired of the
continuing pain or constant pills their MD has prescribed — and
many then ask me if I can see them as a new patient.
$30 BILLION THE AMOUNT SPENT ON OCCUPATIONAL MEDICINE
SERVICES ANNUALLY
New patients, new partnerships!
Not only do the workers ask me to see them as patients, but
the companies I work with usually end up asking me to be
their company doctor so that every single workers comp injury
comes to me. Talk about being in the driver’s seat!
I now am the one who gets to tell patients when and
where to go for care if I can’t give it to them. The companies
love having a DC as the company doctor if you understand
their needs as directed by OSHA, DOT, NIOSH and other
governmental agencies that the company has to report to.
There are many services your office can provide on the
business site, such as drug testing, alcohol testing, pulmonary
function testing, hearing testing, etc., that can be done by a
trained chiropractic assistant without your presence. That
means you can supervise from your vacation or home and
still get paid via the work your assistants do while you are
gone. This cannot be done with adjustments or therapy, which
require your physical presence at the office.
What if you become disabled? You can still make a six-figure
income with one eye, one ear and one arm that works doing
occupational medicine. You can work for yourself in your own
clinic, work for a company on their site, or work for a hospital
running an occupational medicine department.
Services all businesses need
Knowing how to provide the services that 90% of all businesses
need or are mandated to do is much easier than paying advertising
money for people to come to your office, then having to
convince them to spend their money with you.
I like it when a business or government entity forces their
employees to come to me and pays 100% of the bill every
single time I send it to them with no insurance billing involved.
The lesson here is to learn all the services you can provide
as a doctor of chiropractic and make income with them
before you go out of business waiting for the next generation
of full scope of practice rights to occur. Work smarter, not
harder, to get a piece of the $30 billion spent on occupational
medicine every year.
JAMES RAKER, DC, is the owner of Ark-La-Tex Health Center, which
serves not only regular chiropractic patients five days a week but is also the
company clinic for several companies ranging from 10-1,000 employees. He
can be contacted at OccMedForDCs.com for more information about the
occupational services DCs can provide to local companies.

jim raker, DC
All companies need help with occupational medicine testing and examsEVERY SINGLE TOWN IN AMERICA HAS MEDICAL SERVICES, MANDATED BY FEDERAL LAWS, WHICH DCS CAN PROVIDE.You may have heard about performing U.S. Department of Transportation (DOT) physicals, which DCs can do by law in every state except Washington, Virginia and New York; these physicals are mandatory for not only truckers, but railroad workers, pipeline workers, bus and subway drivers, ship captains (for whom DCs cannot provide this yet), and airline pilots (for whom DCs can provide in 28 states for private pilots as of 2018). 
Besides the physicals for these segments of the DOT industry, DCs in all 50 states can do drug testing, alcohol testing, hearing testing, Pulmonary Function Testing, Respirator Fit Testing, hand dexterity testing and more. All these tests are for safety and wellness issues. You are not diagnosing or treating an ill patient, you are trying to prevent them from becoming ill. Safety and wellness should go hand-in-hand with the chiropractic profession.
No insurance billingCompanies and municipalities such as school districts, cities, counties, states and federal government are all required to follow these mandated rules. The nice part for chiropractors and testing doctors is that there is no insurance billing. Every service is paid in cash by the company, municipality or individual. Some of these services require additional training and certification, and some don’t. Some services can be done with no extra cost in equipment, for example physicals and drug testing at a lab. Neither require an investment in equipment. Others may require buying a piece of equipment like an audiometer or alcohol breathalyzer, but they are only $750 and $2,000 respectively. Each can bring in far more income than its cost. 


Do the mathWhen a company needs their 100 employees’ hearing tested at $25 each, drug tested for $40 and alcohol tested for $25 yearly, the potential income is $9,000 in a single day (100 x $25, $40, $25). Do this for several companies every year and you now are talking about extra income of $40K-90K a year. 
I have contracts with school districts for their bus drivers, with cities and counties for their police and firemen, and state and federal contracts for drug testing their workers. I also do work for banks, grocery stores, cement plants, gravel and timber truckers, telephone and electric companies, and more. There is no town in America that doesn’t have this work. 
Patient communication is important and pays dividends. Many people ask me to be their doctor after doing a quick four-minute exam just because I’ve told them more in four minutes than their MD has told them in four years. It’s like getting paid to do spinal screenings, and the company is forcing all their employees to come to you. Someone has to do it — why not you?
​

Large companies looking for helpHere is another example. I have a company that had 15 workers who each needed a physical at $65 each, chest X-ray at $50, drug test at $40, alcohol test at $25, hearing test at $40, pulmonary function test at $40, respirator fit test at $40, and blood drawn for heavy-metal evaluation at $300. While I adjusted 40 regular patients that day, my assistants did everything except the part of the physical I had to do, which took me about four minutes on each person. At the end of the day we were paid $9,000 by the company. No insurance problems, no billing, no reductions, no waiting months or years, just a check and we were done. 
DCs who know this business can get jobs within a company such as Coca-Cola, taking care of all employee needs. I know several hospitals that run occupational health divisions within their systems. Occupational medicine is the future of chiropractic, to integrate into the health care system where there is a need and little discrimination over licensing. The medical establishment does not have a hold on this aspect of health care. In fact, most of the competition is non-medical workers doing all the testing, except for physical exams. You don’t have to compete with MDs; you are competing against regular people who are certified to do drug tests, or hearing testing, etc. 
Success examplesChiropractors have learned or become certified in this work and have gone on to land large contracts. 
“I learned how to do occupational medicine for companies and opened my doors in 2014,” said Wayne Hebert, DC, of Corpus Christi, Texas. “We immediately were covered-up in work and averaged $750,000 a year in occupational medicine work alone. I sold the business to my medical assistant after five years to move closer to family, and my assistant landed a $250,000 contract from a meat-packing plant last month. Yay to occupational medicine for making life easier for DCs.”
Steve Knoernschild, DC, of Illinois shared a similar story.
“For those chiropractors that are wanting to add another form of income to their office, I highly recommend learning occupational medicine,” Knoernschild said. “My office income has dramatically increased since I started a few years ago. I now have served more than 2,000 DOT drivers, countless companies, seven school districts, and the list goes on. Best of all, most of this is payment at time of service, and you are paid your full gross charges.”
Occupational medicine is where chiropractors can shine by putting their stamp on all the services with a guarantee they are done right, along with an ability to perform exams that non-medical workers cannot do. This can make chiropractors a one-stop shop for companies, which is what they need and want. 
JAMES RAKER, DC, is the owner of Ark-La-Tex Health Center, which serves not only regular chiropractic patients but is the company clinic for several organizations that each have 10-1,000 employees. He can be contacted at OccMedForDCs.com.

August 3, 2017—On April 24th, a new Federal Aviation Administration (FAA) medical exam became available to licensed private pilots.  The new program allows private pilots to obtain a BasicMed medical exam in lieu of a 3rd Class Medical Certificate provided by an Aviation Medical Examiner (AME). Providers are not required to become FAA “certified” to provide the BasicMed exam, however they must meet certain requirements.
The BasicMed exam can be performed by an AME or by a physician licensed by a state medical board.  That language seemed to apply only to medical and osteopathic doctors.  However, on July 14, TeamCME received FAA confirmation that DCs are Specialty Physicians when considered as “Chiropractic Physicians” by their state chiropractic licensing board. To be able to participate as a BasicMed provider, the state chiropractic scope of practice must also include the ability to perform the components of the BasicMed exam.
TeamCME is suggesting that DCs not perform the BasicMed physical until their state licensing board has clarified the board’s position on physician status and scope of practice. State chiropractic licensing boards are being contacted by the Federation of Chiropractic Licensing Boards with information on how to proceed. As state licensing boards take action, TeamCME will be providing updates to the FAA and the Aircraft Owners and Pilots Association (AOPA).


There are at least 31 state boards that allow DCs to use the phrase “chiropractic physician.” They are listed below. Performing physical exam similar to the BasicMed is included in the chiropractic scope of practice in 47 states.
For comparative purposes, the BasicMed physical exam is slightly less comprehensive than the commercial driver physical.  However, the protocol to determine the fly/no fly decision is significantly different.  Even those who are certified in the National Registry to perform CDL physicals will need limited preliminary training to get this right. Those not authorized to perform CDL physicals will likely need significantly more training.
There are tens of thousands of private pilots who are opting to obtain the BasicMed flight physical, and there are many reports of difficulty finding a provider willing to perform it. The FAA medical program is considered by many to be the gold standard. This significant opportunity has the potential to affect other federal physical exam programs that currently exclude DCs.


Get involved in the expanding opportunities that exist for performing the FAA BasicMed and FMCSA Commercial Driver physical exam.


For more BasicMed information go to: 
http://www.teamcme.com/faa-basicmed-flight-physical-training/J


Join our BasicMed Email List: http://eepurl.com/cYiHGb
Learn about CDL physicals: http://www.teamcme.com/national-registry-certificed-medical-examiner-training/certification-training/initial-training/
Already performing CDL physicals? Join our CME email list:  http://eepurl.com/cQK06b

States where “chiropractic physician” is acceptable:
Alabama, Alaska, Arizona, Arkansas, Connecticut, Delaware, Florida, Idaho, Illinois, Iowa, Louisiana, Massachusetts, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Washington, West Virginia
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State chiropractic scope of practice that allows physical exams:
All states except: New York, Washington, Michigan
Source: TeamCME-National Network of Certified Medical Examiners