Written by Ken Krimpelbein, DC
Tuesday, 15 March 2005 03:06
Dr. Ken Krimpelbein, former high school physical education teacher and personal trainer, and a 1995 graduate of Cleveland Chiropractic College, is now the owner of a successful multidiscipline practice in Oak Creek, Wisconsin. He presently employs three chiropractors, a massage therapist, a registered dietician, five personal trainers and will soon have a physical therapist and a neurologist on staff. “Treat your patients the way you would want to be treated. Implement nothing in your office unless you, yourself, would want that service,” is the cornerstone of his success.
In an interview with The American Chiropractor (TAC), Dr. Krimpelbein describes his practice now, and how he sees it and chiropractic in the future. With his dedication to his patients and to the chiropractic profession, he is a TAC “Amazing Chiropractor.”
TAC: How did you become involved in chiropractic, Dr. Krimpelbein?
Krimpelbein: In the summer of 1990, I was living above a chiropractic practice while I was doing my undergraduate studies in physical education and health. The girl I was dating at the time got a bug up her butt and wanted to move out to California; I had nothing better to do, so I moved out there with her. During the day, I would teach high school physical education and health classes and, in the evenings, I would ride my bike to a chiropractor’s office and personal train some of his clientele. The chiropractor I worked for had a fitness center connected to his practice. That is when the light went on.
Soon after this experience, I called my friend, Dr. John Freidrichs, who was enrolled at Cleveland Chiropractic College in Kansas City, Missouri. He told me to get my butt to Kansas City. The next thing you know, I had packed up a U-Haul and moved from California to Kansas City. I often tell other chiropractors that they did not choose chiropractic. Chiropractic chooses us. We are the chosen ones.
TAC: What types of patients do you generally treat or attract?
Krimpelbein: We treat anybody with a spine. The conditions we see in our office are no different than those that are seen in any other chiropractic office. My job is to take the spine from where it is to where it needs to be, regardless of the patients symptoms.
TAC: What techniques do you use and why?
Krimpelbein: Techniques that we use include Diversified, Chiropractic Bio-Physics and Cox Flexion Distraction. My motto is, “Fit the technique to the patient, not the patient to your technique.”
TAC: Tell us your most amazing patient success story.
Krimpelbein: I can’t tell you one that sticks out the most, but I can tell you about the patient that resonates with me the most—the patient that comes in here with the mindset that I’m going to make them feel better and they leave here with the mindset knowing that they’re responsible for their health. Based on that information, this patient decides, on their own, to continue with chiropractic wellness care, implement a sound nutritional program, and become a member at the health club I own. That is the reason that I get out of bed each morning. As chiropractors, we preach the inside out philosophy of healing, yet, most of our interventions are outside in. To me, a true inside out healer is one that has the ability to empower the patient to realize that they’re responsible for their health, not their doctor and certainly not their insurance company.
TAC: Is there any one thing or incident that really impacted your growth as a chiropractor and/or your practice’s growth?
Krimpelbein: Currently, I am a senior coach of Breakthrough Coaching. I originally became a Breakthrough Coaching client because of my desire to master Rehab/Active Care. Presently, I’m creating a multidiscipline practice. Multidiscipline practice is not for everyone. Thanks to my staff, I am able to run a very successful chiropractic practice. Other professions are certainly not needed in this practice.
However, I really struggle knowing that there are procedures that could help my patients that I can’t offer. Many times I feel uncomfortable referring to other professionals, because I don’t know what is being said to them when they are outside the walls of my facility.
At this time, my facility employs three chiropractors, a massage therapist, a registered dietician, five personal trainers and, in the near future, a physical therapist and a neurologist. The neurologist that is going to be working in this facility is not just any medical doctor. He has an M.D., Ph.D., Pharm.D. and an M.B.A., and played a key role in removing Vioxx from the market. He is very wellness based and I look forward to building on the relationship that we have established.
TAC: What marketing strategies do you use to attract new patients and to keep current patients?
Krimpelbein: Hands down, the one thing that has built this facility is my New Patient Orientation. I’ve been in practice now for ten years and have consistently done a New Patient Orientation every other week. Our Patient Visit Average (PVA) on a patient that attends a New Patient Orientation is double that of one that does not. The purpose of the New Patient Orientation is to sell the principle of chiropractic. Care plans tend to run out, but the principle lives forever. Once a patient grasps the inside out principle of healing, they are yours for life. It is also a great opportunity for them to not only buy into the message, but for them to buy into the messenger.
TAC: With your practice being multidisciplinary, can you tell our readers your advice about setting up and maintaining such a practice in today’s healthcare system?
Krimpelbein: My advice in creating a multidisciplinary practice is to not build a house of cards. Make sure you have all of your policies, procedures and protocols in place before another professional, such as a physical therapist or medical doctor, comes into your clinic. You do not want the inmates to run the asylum. If you’re not sure where to start, find yourself a reputable consultant with a good track record to help you with this process. Mistakes cannot only be costly, they can jeopardize your license.
TAC: Where do you see the future of chiropractic headed?
Krimpelbein: The wellness revolution is here and we are positioned perfectly to take over that role, but we all have our responsibilities. I can’t fathom why anybody would not belong to a national or state organization and would not contribute their money or energy toward the advancement of this great profession. I’m proud to be a coach for a team that just contributed $500,000 toward the Campaign for Chiropractic. I hope other organizations step up to the plate as well.
TAC: Any final words for our readers?
Krimpelbein: Treat your patients the way you would want to be treated. Implement nothing in your office unless you, yourself, would want that service.
You may contact Dr. Krimpelbein via email at
Written by TAC Staff
Tuesday, 15 February 2005 01:44
We interviewed eight representatives from the leading manufacturers of chiropractic tables to find out what’s new and what makes each company unique. From new, electronic features and tables made for specific techniques to tables that adapt to any technique, these companies, with a combined experience of almost 300 years, have something for everyone.
Lloyd Table Company
Lloyd Table Company is continually striving to make a table(s) that will meet all of the needs of today’s chiropractor, thus enhancing the health of the entire world through chiropractic care.
We know that most doctors use multiple techniques when they adjust. Our goal at Lloyd Table Company is to manufacture one table that will adapt to any technique, whether it is Activator, Flexion–Distraction, Thompson-type drops, Gonstead, CBP, SOT, Upper Cervical, Decompression or any other technique.
We pride ourselves on using cutting edge technology to help make the adjustment process easier. Some of the many new tables/features we are working on are:
• CBP-Type Drops, Elevating head & chest
• Drop Ankle–Manual & Automatic Cocking (extremity adjusting)
• Galaxy 905HS—This table has the capability to hylo & elevate in just over 8 seconds. The 905HS has an incredible height range from 18" to 38"
• Galaxy McManis Elevation 05—This table has the capability to elevate from 18" to 38" with up to 24 degrees of flexion.
Lloyd A. Steffensmeier, DC, is President and CEO Lloyd Table Company, one of the largest manufacturers of chiropractic adjusting tables in the world, located in Lisbon, Iowa. Dr. Steffensmeier began manufacturing equipment in 1963 from the basement of his Mt. Vernon practice and the company has steadily grown to encompass an approximately 50,000 square foot facility. For more information on Lloyd Table Company, call 800-553-7297/319-455-2110, or visit www.lloydtable.com.
I invented motorized flexion distraction, in 1981. I first built tables we named Leander. Then, after a few years of great success and professional acceptance, I sold the company to a Wall Street tycoon type, who proved his superior intellect and left me talking to myself.
After five years, I designed a new table that also incorporated flexion distraction and some new concepts, which have since been proven very effective treating patients. The mission of my efforts, as the principle of my company, has always been to serve the chiropractic profession and provide the best equipment and seminars possible.
Actually, I have long since developed a superior adjusting technique to reduce subluxations using the flexion distraction motion to assist in making the spinal corrections during motion.
The newest feature in my table is the two step pelvic drop device, which allows the doctor to correct just one sacroiliac articulation without insulting the integrity of the other sacroiliac articulation.
Dr. Leander Eckard graduated from Cleveland College of Chiropractic in Kansas City in 1964. He practiced chiropractic in his home state of Washington for 30 years. Since surviving a crash in a personal airplane in 1990, he has limited his practice to demonstrations at Parker Seminars and various State seminars. He presently lives in Idaho with his wife of 13 years, Diane.
Elite Chiropractic Tables
Elite Manufacturing has been in the chiropractic industry for over 30 years. Our chiropractic tables are considered to be the workhorses of the industry. Our mission is to provide chiropractors with the very best tables at a great price.
Our tables have been designed with a variety of techniques in mind, including but not limited to, Thompson, flexion-distraction and diversified. With the majority of chiropractors practicing a form of diversified technique, we have found that our tables will suit most, if not all, techniques being used by today’s chiropractor.
We have recently developed the ET Flex table (electric tension controlled flexion table). This table allows chiropractors to adjust the flexion with just a tap of a foot switch. This feature is superior to the manual tension control, which can be awkward and time-consuming. We have also developed our own distraction table, which allows the doctor to create axial tension in the lumbar spine. These features are allowing chiropractors to treat a wider variety of patients.
For more information, call Elite Chiropractic Tables, 800-689-4730; email
; or visit www.elite-chirotables.com.
Health Care Manufacturing, Inc. (HCMI)
The support of the chiropractic profession is the number one priority at HCMI. We take great pride in offering the highest quality X-ray systems, chiropractic adjusting tables and electro therapy units. HCMI will continue to develop new and exciting product innovations in an effort to supply chiropractors with the tools to grow their profession.
HCMI manufactures a full line of chiropractic adjusting and therapy tables. It is this diversity that insures that we can build a table suited for just about any of your clinical needs.
Since 1989, HCMI has designed, manufactured, and marketed a wide range of products to the chiropractic profession. Starting as a table manufacturer, HCMI’s growth and popularity allowed an expansion of the product line to include electro therapy units and, starting in 1999, 100 kHz high frequency radiographic systems. This has given HCMI the most comprehensive product line manufactured under one roof and the convenience of one stop shopping.
Rob Brice is a regional sales manager of Health Care Manufacturing. For more information about HCMI, call 800-641-4107/417-864-6511, or visit www.healthcaremfg.com.
For nearly 100 years, Williams Healthcare Systems continues to lead the world in developing, manufacturing and marketing Zenith chiropractic adjusting instruments, and related products that enable the doctor to provide a consistent level of high quality healthcare delivery to their patients throughout the life of their practice.
To that end, the company shall always endeavor to delight its customers with products and services which result from good manufacturing practices, ethical decision-making and on-going efforts to continuously improve the products, processes and services to achieve that objective, every day!
Our chiropractic tables are designed to support the practice of the generalist all the way through to the specialist.
Our Zenith adjusting instrument family compliments the widest range of multiple technique clinics, because they were designed by great innovators of chiropractic technique.
The NEW Zenith III table family incorporates state-of-the-art electronic control systems, auto-cocking “Terminal Point” airdrops, the supple “Sensation” upholstery and a product warranty that is unmatched in the industry.
The company is also very proud to offer the family of motorized flexion distraction tables designed and built to the demanding specification of Leander J. Eckard, DC, and has recently brought on-board the phenomenal work of two doctors, Dennis Woggon, DC, related to scoliosis treatment and chiropractic vibrating therapy and Arthur Copes, PhD, related to scoliosis treatment, bracing and nutritional management. In addition, the company is offering a brand new suite of Gonstead adjusting instruments that feature a clean and beautiful aesthetic design, rugged construction and uniquely-important features that will no doubt delight the Gonstead practitioner.
Thomas J. Kenny is President & CEO of Williams Healthcare Systems. For more information on Williams Healthcare Systems, call 847-741-3650, or visit www.williams-healthcare.com.
The Schultz family has been serving the chiropractic table market for 45 years. My brother, Doug, and I grew up attending chiropractic conventions and working on chiropractic tables. The third generation has now begun serving the chiropractic profession.
Hessco has grown from 1 location with 3 employees to 13 locations and 65 employees by offering service after the sale. Our service techs average over 18 years of experience. Hessco also offers the chiropractor a choice of many table brands. This allows us to help find the table that is right for the doctor. As the world’s largest dealer for Leander, Lloyd, Zenith, Chattanooga, and Aquathermassage, Hessco is trusted by these table companies to provide world-class customer service. Hessco also offers tables from 20 other table manufacturers. We have over 500 used tables in stock, all of which will be completely reconditioned with the doctor’s choice of colors. Reconditioned tables come with up to a 2-year parts warranty.
We are able to offer many different models that will fit all techniques.
The chiropractic table business is constantly changing and growing. Our sales reps are always undergoing training to keep up with the many new products continually entering the market.
David Schultz is the owner of Hessco. For more information about Hessco, call 800-237-5652, or visit www.hessco.com.
We, at LSI, have adopted the phrase Loyalty, Service and Integrity, to go along with the initials of our company. These three words truly exemplify our mission statement. We strive to build the highest quality, most reliable products on the market, while being loyal to the profession by providing exceptional customer service and always being honest in our business dealings with both our vendors and customers.
Since the table we manufacture is the Quantum 400 Intersegmental Traction table, there aren’t really any particular adjusting techniques that are used with it. Its primary function is to cause separation of the vertebra and to elongate and relax the trapezius, erector spinae and paraspinal muscles. This will help ease pain and spasm and make it easier for the doctor to adjust the patient.
Instead of moving the roller carriage on our table using rubber casters, we now use a rail system. We have the exclusive LSI Glide-Trak system, which consists of four permanently lubricated blocks that glide effortlessly over a polished steel rail. This eliminates the problem of the rubber casters wearing away and becoming very noisy and messy.
Mark Reiter is the Senior Vice-President of LCI International. For more information, call LSI International at 800-832-0053l, or visit http://www.lsiinternational.com.
Eurotech is one of the few table companies to be owned by a practicing DC, who knows and understands the problems and rewards in treating patients through chiropractic.
Our goal is to make the best tables available at the best price. As Eurotech’s owner, I will personally guide the doctor through his or her buying experience to make it as smooth and easy as possible, and then work with the doctor after the sale to help him or her get the most benefit from their new table.
Any form of flexion-extension therapy works well on the Eurotech tables. We furnish technique manuals as well as a thorough DVD, in order to teach the doctor always to get the most benefit from their new table. The doctor can use diversified and drop techniques as well. Eurotech tables can do double and triple duty as exam and therapy tables.
R.A.D., or Remote Access Distraction, now allows the doctor not only to do long axis distraction, but cycled spinal decompression easily and quickly through the use of the R.A.D. digital control module. This feature rivals tables costing ten to twenty times more. We also have the new R.A.D. II headpiece that permits cervical distraction as well as cervical flexion. We are very excited about a new feature called “E.W.T.”, or Euroflex-Wave-Technology. This new design will make flexion even easier for the doctor and the patient alike and, yet, still cost less than any electric flexion table on the market!
Dr. Gary Huddleston is the owner and C.E.O of Eurotech Mfg. His current practice is composed only of the film, entertainment, music industry and professional athletes.
Written by Albert Stabile, DC
Tuesday, 15 February 2005 01:39
TAC: How did you become involved in chiropractic, Dr. Stabile?
Stabile: I was injured in an automobile accident in 1964, and was having extreme lower back pain. One of my college friends, who was planning on attending chiropractic college, advised me to see the chiropractor that he was being treated by. I had been to numerous medical providers, including two orthopedists, two neurologists, and a neurosurgeon, and had had physical therapy.
After over a year of treatment with little to no results, I took my friend’s advice and saw the chiropractor. After an examination and X-rays, he advised me to begin chiropractic treatment. I felt that I had given the medical community ample opportunity to help my condition, with no positive results, so what did I have to lose by giving chiropractic a chance.
After 6-8 weeks, I was so impressed with the improvement that I decided to investigate a possible career in the chiropractic field. I called Columbia Institute of Chiropractic and spoke to Dr. Marty Greenberg, who made me an appointment for an interview. For me, that was the beginning of the most rewarding career that any human being could ever dream of or hope for.
TAC: What type of patients do you generally treat or attract?
Stabile: The patients we attract in our office are varied. We have a family practice, so we get all types. We see lower back, neck, mid back, headache and extremity pain patients. It is emphasized that they have problems due to subluxations, which were caused by injuries, poor sleeping habits, repetitive trauma, poor dietary habits, lack of exercise, attempting to perform tasks that they are not physically capable of doing, stress and a host of other causative factors.
TAC: What techniques do you use?
Stabile: We use Cox, Activator, Palmer, Diversified, S.O.T., Flexion Distraction, Applied Kinesiology, Pearce-Stillwagon and Grostic, as well as some other techniques, which are modifications of the standard ones. The reason for using so varied a number of techniques is based on the specific needs of the patient, their tolerance to force or non-force techniques and the desired result. Not every patient reacts the same to every technique. Just as medications affect different individuals differently, so does the administration of chiropractic adjustments. You must take these differences into consideration when developing a treatment plan. The desired goals are positive results for the patient. To achieve this result, we must use all the tools at our disposal.
TAC: What type diagnostic testing procedures do you use?
Stabile: We X-ray every patient, excluding children (unless they had trauma), whom we X-ray based on their individual circumstances. X-ray is essential to establish the presence or absence of pathologies, such as arthritic changes, fractures, genetic idiosyncrasies, and a host of other information that is necessary in the proper determination of what techniques would be most beneficial to the patient. X-ray is a window into the body that will reveal a multitude of information, if properly used.
We also use the MicroFet Muscle Testing Machine to establish baseline muscle strength, as well as retesting to evaluate the improvement the patient is making with treatment.
The Millennium 2000 (see tool kit) is used on every patient, man, woman or child. This diagnostic equipment is used to determine spinal range of motion, thermo-graphic and surface electromyography. These tests are used to establish a range of motion, muscle function and nervous system function benchmark, which will enable us to assess, objectively, the outcomes resulting from chiropractic treatment.
The MicroFet X-ray and the CLA Millennium 2000 are also excellent means of patient education.
The explanation of results of these tests has proven to be of immeasurable help in educating the patient. With X-ray they can see first hand what structural and functional changes have resulted to the spine due to their condition.
TAC: Tell us your most amazing patient success story.
Stabile: There have been many amazing patient success stories over the past 35 years. I have treated over 18,000 patients. I had a patient that was referred to me by his wife. He was suffering from long-time severe neck pain and stiffness, and also had been totally deaf for over 10 years. He began treatment and, after 4 or 5 weeks of treatment, he was extremely improved. He had a Friday appointment and, when he left, he made another appointment for Monday morning. That Monday, his wife called and changed the appointment to 3 p.m. that afternoon. She came in with her husband and asked if they could talk to me privately in my office. They then began to recount the happenings of the previous Friday and Saturday.
The wife explained that, on Saturday morning, when she went down to the kitchen, she and her husband were having coffee when her husband stated that he was hearing a strange clicking sound. He had become very adept at lip-reading and, because he had previously had normal hearing, he would read lips and his mind would hear the voices. This time, his wife noticed that when she answered his question about the clicking sound coming from the clock, he was not looking at her and he could not have read her lips. They explained that they went to the ear specialist on Monday morning, who confirmed that he had regained his hearing. He said that he’d noticed something different on the Friday afternoon after having his adjustment and, by Saturday morning, he was able to hear very clearly.
TAC: What marketing strategies do you use to attract new patients and to keep current patients?
Stabile: We use a short, but concise, Web-site, which we have both as our own and the Verizon Web Page. We are in the Verizon Phone book, the Yellow Book that is from Gannett Publishing Co., and we have newspaper ads in the local papers. We also mail to all the new residents of our city and the surrounding areas and we use a company that allows patients to go on the Web and ask for a chiropractor or chiropractic, and it prompts them to put in their zip code, which causes it to return with a chiropractor in their area as well as a link to our Web-site and a number of other similar programs. We also participate in the better insurance plans.
We do new patient lectures in our office and we offer a coupon to the attendees allowing them or someone they know to receive a Millennium 2000 scan, necessary X-rays, and a complete chiropractic examination. This has enabled us to bring in new patients without the burden of the large initial expense, which often times keeps people from entering a practice.
The best way to get patients is by referral, because they are already somewhat educated as to the benefits of chiropractic, due to the results and enthusiasm that the referring person will instill in them.
Keeping patients has become an ever-increasing problem. We have established a number of financial options for patients in our office. We have established plans ranging from prepaid treatment plans, family payment plans, monthly payment plans, etc., to enable people to receive the necessary care, while lessening the financial burden.
When all is said and done, the most important factor involved in patient retention is patient education.
TAC: With your practice being a Family Practice, can you give our readers your advice about setting up and maintaining such a practice in today’s healthcare system?
Stabile: With our practice being Chiropractic Family Practice and with today’s economic climate, we must be ever aware of the need to be creative with the financial needs of the patient as well as the ability to offer various methods of payment. We accept all the major debit and credit cards, checks and, the almost forgotten, cash.
The advice I can give regarding setting up and maintaining such a practice in today’s healthcare system is to do as I have done. PUT THE NEEDS OF THE PATIENT FIRST and ALL ELSE SECOND!!!!
When setting up a practice, be sure you equip the office with whatever equipment is necessary to deliver the best chiropractic healthcare possible. Choose reputable manufactures and distributors that will stand behind the equipment and will educate you and your staff on its proper use.
Choose a reputable computer equipment vendor that will only recommend what you need and not what he needs to make the most money. The most invaluable part of a computer system is the technical support necessary in the initial set-up and educational process. Follow-up technical support on a daily basis is also invaluable. Life System’s (see tool kit) technical support has proven to be the most reliable, with capable, qualified and friendly employees.
To function efficiently, an office must have rules and procedures. Set up a list of office tasks and identify the responsible person to perform the various tasks. Develop a set of detailed instructions, which outline the proper steps involved in performing the various tasks. Cross-train employees, so that, in the event of illness or vacation, the office will be able to function efficiently. Have a patient education plan in effect. Have a patient office policy statement, which the patient reads and signs on their first visit to your office. This should contain all the information necessary to insure the patient knows what they are responsible for and what the office responsibilities are. Give the patient a copy of this when you give your report of findings. This one document can prevent an immeasurable amount of grief, if the patient does not follow office policy.
TAC: What do you foresee in the future of chiropractic?
Stabile: There is nowhere for chiropractic to go but up. With the historic never-ending struggles that chiropractic has endured and has successfully overcome, if we continue to present a united front, we will endure the storms and become stronger. If we maintain our positive attitude, are truthful and steadfast with our beliefs, we will be successful in one of the most positive impacts on the better health of mankind.
TAC: Any final words for our readers?
Stabile: We must first educate ourselves, our patients, other professionals and the public about chiropractic and the subluxation complex. We must educate the patient about the chiropractic adjustment and how it restores nerve function and aids the body in healing itself. Chiropractic has been around for over 100 years without being destroyed. I can only remember a quote from B. J. Palmer that goes something like, “You are not to fear the medical community. They will not destroy chiropractic. Chiropractors will be the ones to destroy it.”
If we unite, love chiropractic, and respect its art, philosophy, and science, and practice what we preach, then we have nowhere to go but up.
Clinic: 3000 square feet facility in Teaneck, NJ.
Office Hours: Mon. & Wed., 8 AM to 1 PM & 3 PM to 7 PM; Tues. & Thurs., 3 PM to 7 PM; Fri., 8 AM to 1 PM. Emergency service available 24/7.
Techniques: All recognized and popular techniques are available, including Cox, Activator, Palmer, Diversified, S.O.T., Flexion distraction, Applied Kinesiology, Pearce-Stillwagon, Grostic, as well as some other techniques, which are modifications of the standard ones.
Staff: 3 DC’s, Office Manager, 2 CA’s, 2 Insurance Administrators
Patient Demographics: 40% Male, 60% Female, 10-15% Children, 30-40% Families, 10-15% Elderly.
To give you a clear idea of what an amazing chiropractor uses to run his practice, we’ve asked Dr. Stabile to share with us some specific products & equipment that he uses to reach his practice’s goal of bringing health into his community.
2-Zenith Hi-Lo with drop pelvic and headpieces
1- Flexion Distraction Table
3-DC 101 Tables
CLA Millennium 2000 range of motion, thermal
and SEMG scan
MicroFet hand-held electronic muscle tester
1-Spinalator Inter-segmental traction table
2-Chattanooga combination EMS and Ultrasound Machines
1-Medx Low Level Laser
4-Chattanooga EMS machines
1-Chattanooga high volt galvanic and interferential machine
1-Anatamotor combination static intermittent traction and Inter-segmental traction table
2-Ergowave Inter-segmental traction tables
2-G5 Percussive massage units
The Chiropractic Practice Ace and the regulations which have been established as a result of legislation do not permit the recommendation, sale or dispensing of nutritional supplements in New Jersey. We are permitted only to advise patients on general nutritional matters.
Physician Desk Reference CD: We give our patients a printout of the medications they are taking and their use, contraindications and side effects.
Rehabilitative Physical Exercise CD: We develop and print patient exercise tailored to specific patient needs.
Life Systems: ChiroOffice, Chiro and ChiroPad: We do our billing and patient record keeping with this software. It is the essential and premium software for chiropractic office management. I would recommend it most highly. See Ad on pg. C-2
Paraphrase is a drag and drop user customized data base program which comes as a stand alone or can be used in conjunction with ChiroPad.
Bennett Accu-Tech (Terry Yochum) X-ray unit.
Konica X-ray Film Processor
OTHER COMPANIES I LOVE:
Harlan Equipment: Medx Laser
Dale Surgical Supply—Therapy equipment and supplies: Headrest paper and patient supplies.
Medical Arts Press: Business cards, stationary, envelops, HICFA forms, etc.
New Jersey X-ray
Emerson X-ray Solutions
Chirotech Table Repairs
Foot Levelers: Spinal-Pelvic Stabilizers.
You may contact Dr. Albert Stabile, Jr., D.C., F.I.C.C., C.C.P.C.P., at Associates in Chiropractic Family Health and Wellness Center, P.A,, 381 Park Street, Hackensack, NJ. 07601 or call 201-342-6111; fax 201-342-9117.
Written by James Mathis
Sunday, 14 November 2004 22:51
James J. Mathis has been employed in the insurance industry for more than fifteen years. Formerly with Allstate Insurance and State Farm Insurance, during that time, he was also a claim representative as well as a manager in charge of all Med-Pay claims and Personal Injury Protection claims in the State of Washington. In addition, he was designated the company representative in class action lawsuits brought against the insurance industry for refusing to pay or reducing the amount paid for chiropractic treatment.
Mathis has been sought as a speaker for trial lawyers associations and chiropractic associations throughout the United States and Canada on the issue of insurance industry philosophy and procedures involving medical treatment provided by chiropractors. In the last four months of this year, he will be speaking at such seminars in more than 27 states, providing two- and three-day seminars and workshops for chiropractors who may be interested in knowing how to avoid the delays and denials by the insurance industry.
In an interview with The American Chiropractor (TAC), James J. Mathis describes the growing conspiracy against chiropractors by the insurance industry, and offers suggestions for chiropractors to help you “take back control” of your future.
TAC: What did you learn while working with Allstate and State Farm Insurance that would be of the most interest to chiropractors?
Mathis: While employed in the insurance industry, I was made aware of the adversarial attitude toward chiropractors by the insurance carriers. The employees of the insurance industry are actually trained to suspect all treatment provided by chiropractors. There exists a discrimination of the chiropractic profession, which results in chiropractic treatment and billing being denied, in part and in whole. The insurance industry determined that one of the largest areas in which claim cost could be controlled was the chiropractic care provided to injuries sustained in accidents. By significantly and successfully reducing or denying this medical cost, the industry would realize a reduction of claim payments. This would, naturally, affect the overall profit sought in the claim departments of the individual insurance carriers. Chiropractic care is targeted because of the large number of claims which experience this type of treatment.
The purpose of this claim-handling philosophy and procedure was to recapture billions of overpaid claim dollars as determined by the insurance industry. In fact, there appeared insurance industry slogans during this time period such as, “Bring Back a Billion”. Insurance industry claim departments were viewed as profit opportunity entities. Goals were developed to produce billions of dollars from a reduction in claim payments. To ensure the success in achieving these goals, the individual claim representative, associate or processor performance was determined based on their individual contribution to realizing these goals by their claim handling.
TAC: What do you discuss in your television and newspaper interviews with the likes of NBC Dateline and The Wall Street Journal about the insurance industry?
Mathis: I have been interviewed, video taped and quoted regarding the insurance industry’s use of “Captive Vendors” to perform reviews of medical treatment provided to their policyholders for the sole purpose of reducing or denying the duration, frequency, type and cost of medical treatment received for injuries sustained. These vendors would be sent, by insurance carrier, the chart notes and medical billings of a policyholder. Subsequently, the vendor would return an opinion that the treatment type, duration, frequency and/or cost was unnecessary or unreasonable and should be denied. The insurance carrier would rely on this opinion to deny the payment for medical treatment.
This practice of “Captive Vendors” was one of the most egregious processes used to reduce payment of policyholders’ claims and generate profit for the insurance industry. This secret practice by the insurance industry was kept from the community of policyholders throughout the country. While the insurance carriers were realizing profits from non-payment of claims, the policyholders were being denied treatment. The treating physicians (mostly chiropractors) were being denied payment for the treatment provided. The relationship between the treating physician and the policyholder, as a patient, was strained, if not completely obstructed.
If a policyholder or treating physician complained, they would be provided with scripted responses so as to dissuade any disagreement with the opinion of the vendor. Should a policyholder or treating physician seek the assistance of an attorney, they would be dealt with by defense counsel prepared to harass, intimidate and prolong the process to the point of complete frustration by the policyholder or treating physician. Ultimately, most complaints by policyholders and treating physicians would be forsaken. The economic strain, emotional intimidation, as well as the long delay, would finally force the policyholder and/or treating physician to abandon the disagreement. The insurance carrier was well aware that this would be the result of these com-plaints. Those few instances where the issue was taken to the final outcome (trial and judgment by jury) and a victory for the policyholder and/or treating physician was realized were not an economic deterrent to the insurance carrier. The savings of claims not paid far exceeded those too few legal losses.
TAC: When did you stop working with the insurance companies and how did your relationship with them end?
Mathis: I stopped being an employee of the insurance industry in September of 2001. I had been working at Allstate in their “Represented Unit”, and made the decision to continue to work as a consulting expert and begin the initial steps of creating the software corporation, Sequoia Visions, Inc.
TAC: What important trends do you see happening in the insurance industry and its relationship with chiropractors in the future?
Mathis: There is a trend by the insurance industry to rely on computerized programs in the determination of reasonable and necessary duration, type, frequency and cost of medical treatment provided for injuries sustained in accidents. These computer programs remove the human element and human intelligence previously associated with the handling of medical claims. This trend also has allowed the insurance industry to reduce their claim personnel. Now, more claims can be handled by fewer people. The claims no longer involve the process of intelligence or decision-making. Also, the claims no longer require that experience of the claims handler be a factor. This has allowed the insurance industry to replace many seasoned and experienced claim handlers with computer data processors.
The insurance industry is realizing additional savings by centralizing the handling of medical claims, increasing inventory levels of processors and eliminating the need for higher salaried employees.
The future will be dictated by the adaptation of the computer programs and electronic services available to the insurance industry. Many treating physicians will be offered immediate payment in exchange for a 20% discount. This discount will increase each continuing year so as to represent another considerable savings for the insurance industry. The treating physician will be tempted to accept this offer in lieu of realizing months of delay, or even eventual denial, if they don’t.
The only recourse available is for all treating physicians to demand all that is owed in payment for treatment provided and to continue to suffer through the obstructive tactics by the insurance industry. But, even more importantly, the chiropractic physician needs to understand how the electronic processes, procedural requirements and practices of the insurance industry actually work. With this information, the treating chiropractor can successfully receive full payment for all treatment without denials or delays. It is possible, without an agreement of a reduction of payment, if an understanding of the processes and an application of significant practices occur by the chiropractor.
TAC: Tell us about your software program and how it can be used in the chiropractic clinic.
Mathis: Sequoia Visions, Inc., has developed software which allows the treating physician to realize success in dealing with the computer programs being utilized by the insurance industry. It has developed software for the legal community as well. All the software is compatible with each other. This means that the successes realized by the treating physician in having the insurance industry accept frequency, duration, type and cost of medical treatment results in more reasonable settlement offers for the claims of their patients.
The medical software is used by the chiropractic physician to document all the aspects of their patients’ injuries, symptoms and manifestations in the correct terminology, phraseology and sequence, so as to respond directly to the insurance industry programs. The program leads the chiropractor sequentially through their patients’ injuries in a very user-friendly style. Medical Report Expert, at the click of a button, will produce a medical report (Initial, Interim or Final) which will translate all medical documentation into the correct terminology, sequence and with the acceptable drivers for the insurance industry.
TAC: Do you have any final words or advice for our readers?
Mathis: Now is the time for all treating physicians, especially chiropractors, to take back control of their future. Failure to realize the importance of this opportunity will only result in the continuing discrimination by the insurance industry. As a result of the adaptation by the insurance industry of these computer programs and the procedural requirements surrounding their use by insurance employees, the window of opportunity exists to establish acceptable treatment frequency, duration, type and cost. The sole defense to future decreasing reimbursement for medical necessary and reasonable cost is knowledge and concerted effort. I would encourage all chiropractors to acquire the necessary knowledge and participate, as a group, through active communication.
James Mathis can be reached for questions or additional information by contacting Sequoia Visions, Inc, at www.sequoiavisions.com; phone (888) 737-8642 / (775) 849-8400; or snail-mail James Mathis, 205 Scotch Pine Rd., Reno, NV 89511.
Written by Dr. Rand Swenson, MD, DC
Sunday, 14 November 2004 22:48
Dr. Rand Swenson, a second-generation chiropractor, received his chiropractic degree summa cum laude in 1976, from the National College of Chiropractic. He subsequently entered the graduate program in the Department of Anatomy at Loyola University Medical Center in Maywood, IL. His graduate research was in the field of neuronal plasticity and he received his PhD in 1981.
After a two-year post-doctoral fellowship investigating autonomic nervous system neurophysiology, he became a visiting professor of physiology at the Tokyo Metropolitan Institute of Gerontology, investigating autonomic nervous system responses to sensory stimuli, especially pain. During his time at the University of Illinois College of Medicine in Chicago, he was named a James Scholar and to the Alpha Omega Alpha (AOA) Honorary Medical Society. Dr. Swenson is currently the Associate Professor of Medicine (Neurology) and Anatomy and Acting Chairman of Anatomy Dartmouth Medical School.
This past year, Dr. Swenson became an active Advisory Board member of Diagnostic Testing Centers of America (DTCA). DTCA serves as a national network of affiliated physician practices providing on-site precision diagnostic testing services.
In an interview with The American Chiropractor (TAC), Rand Swenson, D.C., Ph.D., M.D., discusses the growing trend toward bridging the differences between the chiropractic and medical communities. As an expert in neuroscience and neurology, Dr. Swenson explains how neurological evaluation can be of importance to the chiropractor.
TAC: Being a chiropractor, what made you decide to attend medical school?
Swenson: There are several reasons why I entered medical school. In the 1980’s, it was apparent that there was growing interest, in the medical and chiropractic communities, in finding appropriate ways to integrate orthodox medicine with several “complementary and alternative” (CAM) practices. It was really during that decade—and during the early part of the 1990’s—that medicine was confronted with the widespread use of these practices, largely forcing their attention to this issue. Of course, there was not a great deal of expertise or understanding in the medical community as to what it is that CAM practitioners could contribute to patient care, much less how such care could be understood and integrated. I felt that there was (and continues to be) a need for practitioners, particularly in medical academic settings, who have an appreciation for both sides.
TAC: How do medicine and chiropractic complement one another?
Swenson: First of all, most of the patients who are most effectively cared for by chiropractors are patients for whom medicine has no clear or easy answers. This should be an ideal ground for synergy, and that is evolving, in many quarters. Of course, not all patients are good candidates, for one reason or another, for chiropractic care. Also, some need further investigation of potentially serious complicating problems before chiropractic treatment. It is in the latter area that medical physicians should be particularly skilled. Therefore, I do not view these two professions as inherently antagonistic (history notwithstanding), but rather complementary. All of this should be directed toward the maximum benefit of patients
TAC: What advances have been made and/or are being made to integrate both chiropractic and medicine in today’s patient care?
Swenson: I have seen major changes in the involvement of chiropractors in the medical system over the past 15 years, along with major changes in attitudes— both by patients and medical practitioners. I have been invited to give presentations at major medical schools, state medical society meetings, as well as national specialty society meetings on chiropractic. I don’t believe that this would have happened 15-20 years ago.
The predominant attitude that I notice from my medical colleagues, and particularly from the current medical students, is one of curiosity—curiosity about what it is chiropractors do and what they treat. Some of this curiosity has been motivated by an increasing willingness on the part of patients to report that they are seeing or have seen a chiropractor. I believe that there will be a day when chiropractic will be included as a part of most multispecialty clinics and, particularly, those clinics that focus on orthopedic issues and rehabilitation. I think that these types of clinics will be the entrée to broader interactions.
I believe that the studies conducted by Dr. David Eisenberg’s group at Beth Israel Deaconness Medical Center were the studies that truly motivated a lot of the increased interest on the part of medical practitioners in chiropractic and, indeed, complementary and alternative therapies in general. The most impressive thing to me is how few of my medical colleagues realize the number of their patients who are already utilizing chiropractors, mostly for conditions that are not very responsive to medical management.
I will never forget giving a presentation on chiropractic to the state medical society about seven years ago. One of the points that I made was that it was critical for medical practitioners to be sure that they understood about their patients’ use of all kinds of complementary and alternative therapies, including chiropractic treatment. I was asked how a medical practitioner could identify who were the most effective chiropractors in the area. I told them that their best resource was their patients, if they would listen to what they had to say about their experience with chiropractic care in a nonjudgmental way.
I—along with most of the other participants at the conference—was floored when one of the doctors jumped up immediately and said that no patient of his had ever been to a chiropractor. This, of course, was patently absurd, and it was apparent that he had simply intimidated his patients into silence. The interesting thing to me is that everyone else in the room recognized this absurdity except, of course, the person who made the statement and, fortunately, this attitude is dying. The old joke in medicine is that attitudes change one funeral at a time, but I have observed changes that are substantially more rapid than that.
TAC: What is the relationship between the orthopedic and neurological examination?
Swenson: Orthopedic and neurologic examinations are complementary. The orthopedic examination is a structural examination and the neurologic examination is a functional exam. The orthopedic examination is designed to determine the tissue that is causing problems. By and large, it involves determining the particular positions and motions that reproduce the patient’s symptoms and signs. The neurologic examination is designed to test the integrity of the nervous system and neural responses.
TAC: Why is neurological evaluation interesting for chiropractors and how can it help them in practices?
Swenson: There are several reasons why the neurological examination and evaluation should be of interest to chiropractors. Firstly, patients expect, and have a right to expect, a thorough assessment of their conditions. Secondly, patients often have unrecognized problems that warrant further evaluation or that can complicate treatment. Thirdly, appreciation of the nervous system expands appreciation of the processes that attend dysfunction of any part of the body—these processes are not mysterious, although they may seem so at first. Finally, in discussing and sharing patients with professionals of other disciplines, it is critical to have some common understandings as well as our own unique perspective. It is not important for chiropractors to be neurologists, for example, but it is important to recognize what is and isn’t normal, how that can impact treatment and what can or should be done to follow up on such abnormalities.
TAC: What is your position on neurodiagnostic testing?
Swenson: There are limitations to the ability of the clinical neurologic examination to fully evaluate the nervous system. This is particularly true in the peripheral nervous system and in the sensory system. Since the nervous system works on the basis of electrical responses, electrical examination is appropriate. Electrodiagnostic testing is an extension of the neurologic examination, objectively answering the question of whether elements of the peripheral and sensory systems are intact, when the clinical exam cannot answer the questions with certainly. It also often uncovers additional levels of injury that are unrecognized clinically, due to the dominance of certain symptoms. Nonetheless, these additional problems may affect recovery and may necessitate different or additional therapy in order to hasten recovery. Finally, it is a fact of life that objective findings are always treated with greater deference than are subjective complaints. This may be in terms of explaining why patients have symptoms or even in answering questions such as, “Why is recovery taking longer than expected?” or “Are there additional problems complicating this patient’s response?”
TAC: Any final words for our readers?
Swenson: Try not to let the many pressures inherent in practice today distract you from your focus on patients.
Our sincere thanks to Dr. Swenson. He may be reached at HB 7100, Dartmouth Medical School, Hanover, NH 03455.
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