Chiropractic + Naturopathic Doctor • April 2019 • Practice Evolution

Simply stated, people today are very busy, and while health and health care are a priority, they’re a perishable priority. Patients increasingly have high expectations that their health care, including chiropractic care, should be cost-effective, competent, convenient and consumer friendly.

Let’s look at the benefits of collaborative care, first from the perspective of the patient and then from the health care provider.

There is an attraction for health consumers to align themselves with practices that have two or more health disciplines available. Many consumers of all income levels live from paycheque to paycheque. For those employees with access to extended health benefits, there is typically coverage for many complementary disciplines. Having several health professions under the same roof will certainly attract those patients who wish to use their full insurance benefits to avoid paying for health care out-of-pocket. After insured patients deplete their chiropractic coverage, they may opt to switch to another discipline under the same roof to use their remaining insurance coverage. To take advantage of the synchronicity of similar practice scope disciplines, I recommend adding massage therapy first, followed by another chiropractor, naturopathic medicine, physiotherapy, and then adding osteopathy or holistic nutrition, as these disciplines are normally covered under insurance benefits. Some multidisciplinary practices also work with chiropodists, hearing specialists, psychologists, occupational therapists and medical doctors. Newer medical graduates are often looking for fresh approaches to medical practice and may be open to co-locating with other non-allopathic providers.

As far as convenience goes, sharing space can also mean sharing financial records and, in some cases, clinical records. Patients appreciate the convenience of not having to reiterate their story to each practitioner, while having them also work together and collaborate on their care. Another point of convenience is billing; providing financial statements and dealing with insurance companies is all done in one place. Co-location of health care services equates to valuable time, money and effort saved for the patient.

Lastly, consider the convenience of scheduling a multitude of appointments at the same time. Appointment efficiency means less time spent in traffic, less gas, a more complete and thorough treatment experience, and a greater chance of a therapeutic breakthrough. With a range of practitioners and office hours, patients can avoid missing work and schedule more appointments easily.

Time off: When a solo practitioner goes on vacation or takes time off due to illness, the clinic must close. Depending on how long you are away, patients may end up finding alternative providers. On the other hand, not taking enough time off is another common problem. Everyone needs to take vacations, and collaborative practices allow other practitioners to provide trustworthy care for your patients while you are away.

Cash flow: When you have other practitioners working with you, they may pay you a fixed fee or a percentage of their income. This results in improved cash flow. Your practitioners will also be able to refer their patients to you when appropriate. Patients who already see other practitioners in your clinic may end up referring themselves or their family members to you as well. Proximity and familiarity are important to patients when choosing a health care provider.

Asset Management: Your practice life is only about 24-35 hours per week in most cases. Utilizing equipment and space for other practitioners to build their own practices will help pay for those leasehold improvements, business taxes, utility costs and maintenance costs. Housing other health care providers makes your space less costly for you and provides them with a complete practice environment minus the start-up costs.

Succession: Most chiropractors don’t have a company pension plan. What we do have though, is a practice. In many cases, it is possible to sell your practice to one of your co-located established practitioners upon retirement. You may choose to continue to practice full- or part-time while helping the new owner establish him or herself with your patients. Find assistance in preparing to sell your multidisciplinary practice, because you will need to have additional procedures, policies and systems in place so that the new owner can take over with no major drop in business. Start preparing for practice succession at least five years in advance, as there is more to consider than only valuation.

DIRK KEENAN is a second-generation chiropractor practicing in Ottawa’s oldest clinic for the past 34 years. Dr. Keenan pursues an active interest in multi-disciplinary clinics, inter-professional education, and chiropractic practices abroad. Interested parties in international locums, multi-disciplinary practices, or inter-professional education can contact him at [email protected].