Chiropractic An Epic Solution for a World in Crisis Nicole L. - - PowerPoint PPT Presentation

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Chiropractic An Epic Solution for a World in Crisis Nicole L. - - PowerPoint PPT Presentation

Chiropractic An Epic Solution for a World in Crisis Nicole L. Ingrando, DC - May 7, 2020 Outline. The Spine Pain & Disability World Crisis Current State of Spine Care Chiropractic Core Competency Communication Tools


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Chiropractic

Nicole L. Ingrando, DC - May 7, 2020 An Epic Solution for a World in Crisis

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  • The Spine Pain & Disability World

Crisis

  • Current State of Spine Care
  • Chiropractic Core Competency
  • Communication Tools
  • Promoting our Practice:

Overcoming the Fear

Outline.

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Bureau of Ocean Energy Management

“Ocean waves contain tremendous energy potential.”

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The Spine Pain & Disability World Crisis

Understand the storm to find the monster waves.

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Core Competency

Results Driven Patient Centered Outcome Motivated Low Cost

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Core Competency

A defining capability or advantage that distinguishes an enterprise from its competitors.

  • Remember our advantages.
  • What’s the difference between riding the wave and it destroying you?
  • Spine Pain is an Epidemic, it’s the STORM
  • Someone will ride this wave. The Chiropractic Profession is the most conditioned to do it right.
  • COVID moved in, but PAIN didn’t move out.
  • Already had a tremendous opportunity, it’s even better now.
  • Let’s explore the pain storm!
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US Health Care Crisis

  • “ It is widely recognized that the dramatic increase in health care costs in the

United States has not led to a corresponding improvement in the health care experience of patients or the clinical outcomes of medical care.”

Murphy DR et al. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States. Chiropr Man Therap. 2011;19(1):17.

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US Health Care Crisis

  • “ In no area of medicine is this more true than in the area of spine related

disorders (SRD’s).”

Murphy DR et al. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States. Chiropr Man Therap. 2011;19(1):17.

Back pain: how to live with one of the world’s biggest health problems The most common cause of disability is a condition as old as time itself. But is the industry that has built up around scans, injections and opioids a waste of time?

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Spinal-Related Disorders (SRD’s)

  • SRD’s Defined
  • Back Pain
  • Neck Pain
  • Many types of Headaches
  • Radiculopathy
  • Other symptoms directly related to the spine

Murphy DR et al. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States. Chiropr Man Therap. 2011;19(1):17.

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SRD Stats

  • CAM Defines
  • Chiropractic
  • Massage Therapy
  • Acupuncture
  • Herbal Supplements
  • Yoga/Meditation

Paskowski, Ian et al. A hospital-based standardized spine care pathway: report of a multidisciplinary, evidence-based process. Journal of Manipulative and Physiological Therapeutics. 2011; 34(1):98-106.

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SRD Stats

  • 85% of these individuals seek care from some type of health care professional
  • LBP is the most common condition for which US adults seek complementary and

alternative medical (CAM) treatment

Paskowski, Ian et al. A hospital-based standardized spine care pathway: report of a multidisciplinary, evidence-based process. Journal of Manipulative and Physiological Therapeutics. 2011; 34(1):98-106.

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The Burden of SRD’s

Problem Is Worsening

  • Patients with back pain incur 73% higher health care costs than those without back pain related

complaints (2)

  • Majority of this cost is related to improper management of LBP: (3)
  • Endless office visits for the same complaint.
  • Office visits should result in patient relief, proper patient referral/imaging or positive clinical

progression.

  • Between 1997 and 2005, expenditures for neck and back pain rose 65%
  • Measures of mental health, physical functioning and work, school and social activity among patients

with SRD’s declined

Paskowski, Ian et al. A hospital-based standardized spine care pathway: report of a multidisciplinary, evidence-based process. Journal of Manipulative and Physiological Therapeutics. 2011; 34(1):98-106.

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Low Back Pain

  • LBP is the most common reason for symptomatic physician visits [1-3]
  • Increasing the number of of SRD patients seeing PCP’s will serve to further

exacerbate the problem of under-availability [4]

  • 1. Wolsko PM, Eisenberg DM, Davis RB, Kessler R, Phillips RS: Patterns and perceptions of care for treatment of back and neck pain: results of a national survey.

Spine (Phila Pa 1976) 2003, 28(3):292-297. discussion 298

  • 2. Hart LG, Deyo RA, Cherkin DC: Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey.Spine (Phila Pa 1976) 1995, 20(1):11-19.
  • 3. Deyo RA, Mirza SK, Martin BI: Back pain prevalence and visit rates: estimates from U.S. national surveys, 2002.Spine (Phila Pa 1976) 2006, 31(23):2724-2727.
  • 4. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States, Donald R. Murphy. Chiropractic and Manual Therapies 2011, 19:17
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Costs of Low Back Pain

Wave of Financial Crisis

Supply Sensitive Care Demand Sensitive Care

  • 1. NIH: Na)onal Center for Complementary and Alterna)ve Medicine. Low back pain and CAM: May 2009 newsleCer. Available from hCp://nccam.nih.gov/news/newsleCer/2009_ may/

backpain.htm.

  • 2. Mar)n BI, Deyo RA, Mirza SK, Turner JA, Comstock BA, Hollingworth W, Sullivan SD. Expenditures and health status among adults with back and neck problems. JAMA 2008;299: 656-64.
  • 3. Deyo RA, Mirza SK, Turner JA, Mar)n BI. Overtrea)ng chronic back pain: )me to back off? J Am Board Fam Med 2009;22:62-8.
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Trouble with the current clinical approach.

“Supermarket of Spine-Care Services” (1)

  • 1. Haldeman S, Dagenais S. A supermarket approach to the evidence-informed management of chronic low back pain. Spine J 2008;8:1-7.
  • 2. The establishment of a primary spine care practitioner and its benefits to health care reform in the United States, Donald R. Murphy. Chiropractic

and Manual Therapies 2011, 19:17

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The Current State of Spine Care

Understand Needs First - PNA

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Patient with spine pain

Primary Care Physician

Physical Therapy/ Medication Primary Care Physician Orthopedist Physical Therapy

  • r PCP
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Patient with spine pain Orthopedist Physiatrist Physical Therapy

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Solution for Spine Pain

When needs are understood, opportunities flourish.

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  • Needs Based Analysis
  • Formal process that

focuses on the other person.

  • Similar to a history and

exam!

  • Companies beta test,

all we need is common sense.

  • What does a patient

need?

Our Patients.

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Patient Needs

  • What Do People Want from Their Health Care? A Qualitative Study.

Leana S. Wen | Jun 25, 2015

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Conclusions

What people want from their health care? It relates to the core of the doctor-patient relationship.

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Conclusions

What do patients need from doctors? Doctors! Need to listen, to care and be compassionate, and to be transparent and

  • pen with patients

Need to be accessible, practice in interdisciplinary teams, and demonstrate that they have patients’ best interests at heart Innovations that aim for patient-centeredness should encourage doctors to practice medicine in the way that patients need

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“We hope future studies will make use of our methodology to ensure that patients — people — are at the center of caring partnerships that prioritize dignity and respect.”

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  • We can communicate with them

more.

  • Demonstrate where we fit.
  • Position ourselves as the solution.
  • Habit = Patients are triaged to the

Chiropractors FIRST.

  • Exponential power potential in

positioning ourselves as a solution.

How can chiropractors help the healthcare system?

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Core Competency

I asked our referral partners…Why do you refer to our office?

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Physicians Assistant - National Pain Institute, Lake Mary, Florida

“The referral offers practical solutions for patients that doesn’t solely rely on manipulation. There is a multifaceted approach to patient care that includes the patient to encourage them to “buy into” the treatment. The other thing I like is consistently re-assessing progress and if goals aren’t being met, changing therapy or looking for a reason that they may need to see someone else. I want my patients to need less medicine.”

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Communication Tools

* Patient Narratives & Results * Newsletters * Thank You Cards * COVID Phone Calls * Appropriate office visits ** Clever grassroots lunch tips - restaurants need you more than ever. Consider having lunch delivered with a narrative.

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Communication Threats

* Misunderstanding * Lack of Understanding * Lack of Persistence * Fear

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Objection Resistance (How to push back.)

The ability not to be affected by something, especially adversely. Marriott’s advice in creating competition.

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  • J. Willard Marriott

“Good timber does not grow with ease. The stronger the wind, the stronger the trees.”

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  • Change the way we view objections.
  • Increase our focus on patient needs.
  • Reflect on patient results and intake

histories to share.

  • Identify other popular doctors

practicing in the area.

  • Build Strategic Partnerships

(Especially for students.)

  • Host Fundraisers (Seniors First)
  • Enjoy Riding the Wave (Winning

feels fantastic!)

  • Objections are a pre-requisite..let’s

explore

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“Claims to cure everything caused my patients to panic when they ran out of money and still felt their pain.” DM

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“Failure to diagnose.” NR

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“Lack of demonstrated results. I need to send patients out for care that works.” JS

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“I tell my patients that you won’t crack their necks or make them come back forever.” JC

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North Orlando Spine Center

Post COVID Traffic Statistics

  • Uncertainty in our “necessity” and “essential” posture.
  • Conflicting Guidance (You’re not alone.)
  • Chiropractic message hasn’t changed - Be The Solution
  • How did our patients needs change? Traffic became more essential every

week - CEO, surgeons, people trying to walk.

  • How did the needs of our referral partners change? (Waves are flat…)
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North Orlando Spine Center

Post COVID Traffic Statistics

  • NP Traffic Shifted
  • Units of Traffic Weekly Shifted
  • Week one by 39%
  • Week two by 33%
  • Week three by 23%
  • Week four by 19.8%
  • Week five by 19.2% (NP

traffic rose.)

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In Closing

Jump on this wave. Chiropractors are losing market share (closing) and the market share is GROWING. If you weren’t branding yourself as a pain solution, now is the time.