"IN DIFFICULT TIMES, OCCUPATIONAL MEDICINE CAN TRANSFORM CHIROPRACTIC" November 2020, james Raker, DC
CONNECT TO CHIROPRACTIC ECONOMICS DOWNLOAD FULL ARTICLE HERE
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
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:
• 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
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.
Chiropractor eligibility for coronavirus relief funds expanded by U.S. government in October
Chiropractic Economics October 23, 2020
1 minute read
All payment recipients will be required to attest to receiving the Phase 3 General Distribution coronavirus relief funds payment…The U.S. Department of Health and Human Services (HHS) announced it will be making up to $20 billion in new Phase 3 General Distribution coronavirus relief funds available for providers on the frontlines of the coronavirus pandemic, including chiropractors.
The relief is targeted for providers that have not yet received Provider Relief Fund distributions.
“The Administration is committed to providing relief resources in an equitable manner to assist the diverse health care provider community regardless of whether they accept Medicare or Medicaid payments,” the HHS.gov website stated in a press release. “HHS is also announcing it will be updating its most recent PRF reporting instructions to broaden use of provider relief funds.”
Under the Phase 3 General Distribution, which began accepting applicants on October 5, 2020, HHS invited providers that had already received PRF payments to apply for additional funding that considers changes in patient care operating revenue and expenses caused by the coronavirus.
“We have worked closely with stakeholders across the health care system to ensure that the Provider Relief Fund reaches all American health care providers that have been impacted by the pandemic,” said HHS Secretary Alex Azar. “Today, we are expanding the pool of eligible providers to include a broader array of practices, such as residential treatment facilities, chiropractors, and vision care providers that may not have already received payments.”
Providers and all Phase 3 applicants will have until 11:59 p.m. EST on Nov. 6, 2020, to submit their applications for payment consideration. Once validated, these providers will receive a baseline payment of approximately 2% of annual revenue from patient care plus an add-on payment that considers changes in operating revenues and expenses from patient care, including expenses incurred related to coronavirus. All payment recipients will be required to attest to receiving the Phase 3 General Distribution coronavirus relief funds payment and accept the associated Terms and Conditions.
For more information on coronavirus relief funds go to hhs.gov/about/news/2020/10/22/hhs-expands-relief-fund-eligibility-and-updates-reporting-requirements.html.
Jan 6, 2020 DOT Program Change
This affects your CDL drivers and motor carrier clients!
Inform Your Clients of this Change
Drivers with a CDL License:
Starting on January 6, 2020, drivers who have a commercial driver's license who switch employers will be required to register with the FMCSA Commercial Driver’s License Drug and Alcohol Clearinghouse as part of their employment-related background check. Voluntary registration will begin in October 2019. (Click Here) to go to the registration site.
Motor CarriersEmployers must register and purchase a Query plan from the FMCSA Clearinghouse by January 6, 2020. Employers can register starting in October and review details on purchasing a query by following this link (Click Here) but query programs will not be available for purchase until November 2019. Queries must be sent to the Clearinghouse for current and prospective employees' drug and alcohol violations before permitting those employees to operate a commercial motor vehicle (CMV) on public roads. In addition, Employers must obtain an annual query for each driver they employ.
Drug and Alcohol Collection Sites:
Beginning January 6, 2020, when performing a DOT drug test, the driver's CDL number must be placed in either the space normally used for a social security number or employee identification number. This does not apply to drivers of commercial vehicles who do not have a commercial driver's license. Although the FMCSA notice uses the word "required" repeatedly, FMCSA has stated that, "this guidance is not legally binding in it's own right". Nonconformity with this guidance will not affect rights and obligations under existing statutes and regulations.
If the collector has not followed this guidance, the MRO is required to contact the driver, the employer, or designated representative to obtain it. If the collector does not fill in this information on the CCF for whatever reason, they still must send the specimen to the laboratory for testing.
FMCSA: Interstate 18 Year Old Military Drivers
Soon you may see 18-20 year old military interstate drivers in your office to obtain a medical examiner's certificate. The FAST Act military "pilot" program will allow selected military personnel 18, 19, and 20 years of age to operate a commercial motor vehicle in interstate commerce. The driver must have military "heavy vehicle training and experience". .FMCSA is looking for a small test number of military veterans of that age group to apply for the pilot program.
There is another discussion for a pilot program that will allow other 18-20 year old's to drive a commercial vehicle across state lines. We do not know what type of documents they will present when getting their medical certificate, but we will keep you informed on this effort that may in the future increase the number of interstate drivers of commercial vehicles. In the meantime, all drivers must be at least 21 years old to driver in interstate commerce.
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.
By Gabriella Borter
April 17, 2019
(Reuters) - Dozens of medical professionals in Appalachia, a region hard-hit by the U.S. opioid crisis, have been charged with writing hundreds of thousands of illegal prescriptions and committing healthcare fraud, federal prosecutors said on Wednesday.
Sixty people, including 31 doctors, were accused of illegally prescribing opioid drugs in exchange for cash and sexual favors in the rural, mountainous region stretching from Pennsylvania and West Virginia to Alabama and Louisiana.
“The opioid epidemic is the deadliest drug crisis in American history, and Appalachia has suffered the consequences more than perhaps any other region,” Attorney General William P. Barr said in a statement.
Some 130 Americans die every day from an opioid overdose, according to the Centers for Disease Control and Prevention.
The charges were the result of an investigation by the Appalachian Regional Prescription Opioid Strike Force, a joint law enforcement agency created in December to crack down on prescription fraud schemes that have contributed to the deadly drug epidemic.
The charges were filed against individuals in seven states: West Virginia, Tennessee, Ohio, Alabama, Kentucky, Louisiana, and Pennsylvania.
One doctor in Tennessee who called himself the "Rock Doc" was accused of bargaining for sexual favors by prescribing opioids and benzodiazepines, federal authorities said in the statement. Another doctor in Alabama allegedly recruited prostitutes to become patients at his clinic and allowed them to abuse drugs in his home.
Several doctors were accused of writing pre-signed, blank prescriptions for controlled substances without medically examining the patients that received them.
A few were accused of running "pill mills," including one in Ohio that allegedly distributed over 1.75 million pills between October 2015 and October 2017.
The period in which many doctors were accused of illegally and excessively dispensing drugs coincided with a spike in overdoses in the United States. Opioid overdoses increased 30 percent between July 2016 and September 2017 in 45 states, according to the CDC.
Reuters Health Information © 2019
Cite this: Dozens of Doctors in 7 States Charged in Opioid Fraud Bust - Medscape - Apr 17, 2019.
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:
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
State chiropractic scope of practice that allows physical exams:
All states except: New York, Washington, Michigan
Source: TeamCME-National Network of Certified Medical Examiners
"Virginia DCs Regain Ability to Conduct CDL Physical Exams"Monday, May 1, 2017
FOR IMMEDIATE RELEASE:
April 17, 2017
Virginia DCs Regain Ability to Conduct CDL Physical Exams
Afton, VA – The Unified Virginia Chiropractic Association (Unified VCA) is pleased to report that the organization’s HB 1688 was passed and signed into law by Governor MacAuliffe on February 24, 2017. It becomes effective July 1, 2017.
The legislation is an important affirmation that Virginia DCs have training consistent with the demands of the Federal Motor Carrier Safety Administration (https://nationalregistry.fmcsa.dot.gov/NRPublicUI/home.seam).
The Unified VCA would like to give special thanks to Michael Megehee, DC, President of TeamCME and the National Network of DOT Medical Examiners, and Craig Little, DC, President of the Council of Chiropractic Education. The doctors travelled to Virginia in June of last year to provide vital testimony to the Virginia Board of Health Professions in support of the bill. For the full list of actions through the legislative session on this issue, go to http://lis.virginia.gov/cgi-bin/legp604.exe?171+sum+HB1688.
As Unified VCA president Dr. David Dolberg observes, “Virginia Chiropractors can now take advantage of this great opportunity to train and become certified for listing on the national registry. This is a unique opportunity for our profession to provide a vital service to our respective communities while at the same time strengthening our practices.”
Before offering these CDL physical exams, a doctor must take a special course, pass a DOT test, and be registered as a “Certified Medical Examiner” (CME). To take the exam to be a CME, doctors need a registration number from the Federal Motor Carriers Safety Administration/ National Registry of Certified Medical Examiners (FMCSA/NRCME). Dr. David Brown, Executive Director of the Virginia Department of Health Professions, has forwarded the necessary documentation to the FMCSA/NRCME so that it can assign these registration numbers to DCs.
For more information, contact Dr. Joe Foley, Unified VCA Legislative Committee Chair, at firstname.lastname@example.org or Ms. Julie K. Connolly, Unified VCA Executive Director, phone 540-932-3100, email email@example.com.
OccMed For DC's Announces New CRL National Contract!
Effective March 1, 2019
OccMed For DC's now has a National Network Contract with Clinical Reference Laboratory (CRL) for Urine Drug Testing, and MRO Services. You can download the contract at our website. Clicking the link in the Members Section. National Contracted Services are for MEMBERS ONLY!
If you want to particiapate in Occ Med For DC's National Network. Contact us here!
James Raker, DC
Wayne Hebert, DC, FACO
Welcome to the Board of Chiropractic Examiners.
The New Hampshire Board of Chiropractic Examiners regulates and licenses the chiropractic profession in the state of New Hampshire. The Board's mission is the protection of the public as well as the licensing and regulation of the chiropractic profession. The Board of Chiropractic Examiners is a five-member board consisting of four Doctors of Chiropractic and one Public Member appointed by the Governor for five-year terms.
The Board of Chiropractic is responsible for assuring that applicants are qualified to practice in the state of New Hampshire and that they adhere to professional and ethical standards once they are licensed. The chiropractic profession in the state of New Hampshire is regulated by RSA 316-A and the Board's Administrative Rules. Complaint investigations are conducted by the Board's Professional Conduct Committee consisting of experienced licensed Doctors of Chiropractic.
Chiropractic is a branch of the healthcare profession that emphasizes the body's innate healing ability and the role of the nervous system in the achievement and maintenance of health. It is a portal of entry to the healthcare community. Chiropractors utilize many therapeutic modalities including spinal manipulation or adjustment, physiological modalities including electrotherapies, ultrasound, and traction among others. They also use rehabilitative exercise, nutritional and lifestyle counseling, as well as other therapeutic and preventative approaches. Doctors of Chiropractic provide health care services in a variety of settings including occupational health and sports medicine practices. Today's modern Doctor of Chiropractic enjoys good working relations with other healthcare providers, referring and receiving referrals and, when appropriate, with medical specialists, physical therapists, and other health care professionals.
NH Board of Chiropractic Examiners
121 South Fruit Street, Suite 303
Concord, NH 03301
(603) 271-6702 (fax)