Good Help Is Hard to Find, Hard to Keep
JC Smith
Chiropractors for Fair Journalism
The importance of a good chiropractic assistant staff is understood by any experienced DC. While most new grads seem solely focused on getting new patients, those DCs in practice for years realize the key to a good office is a great staff. Ideal patients are hard to find, and the same can be said about ideal CAs.
One conclusion I came to years ago is that DCs don't find ideal patients or staff as much as you develop them. For a DC, finding hard-working, ethical, and knowledgeable staffers is a difficult task, especially considering few people go to community colleges to learn the workings of this profession. And the few LPNs I've hired were a bust—too medically minded and skeptical about chiropractic.
£i'ideal patients are hard to find, and the same can be said about
ideal CAs.33
At best, the people I've had the most luck with are previous chiropractic patients who knew it worked, even if they didn't exactly understand how chiropractic worked, or how to work in a chiropractic clinic. At least I didn't have to instill them with a strong belief in its effectiveness.
Because there are very few CA programs around, for years I've taken it upon myself to develop staffers by "practicing the practice" weekly, and by giving them reading assignments from books such as those by Bill Esteb and from my own textbook, The Path to Mastery in Chiropractic.
Imagine the difference it would make if Tom Peters, Mike Gerber, Stephen Covey, Wayne Dyer, Zig Ziglar, and other great minds had the opportunity to teach CAs!
Even with this help, I still believe it takes up to two years to develop and become a professional CA. If you want to be a case manager (CM), it may take even longer. The difference between a CA and a CM is largely
management abilities, not just being capable of taking X-rays and doing precursor exams.
In my office, my CMs are involved not only in transactional management, but also in transformational management. In other words, they help get new patients through their treatment program to a completed case, and they also help me with any misunderstandings or problems in patients' perceptions of spinal care. Indeed, changing attitudes is much more difficult than simply rendering treatments.
ÍÍ _
If you want to be a case manager (CM), it may take even longer. The difference between a CA and a CM is largely management abilities, not just being capable of taking X-rays and doing precursor
exams. 33
Being a professionally trained CA or CM is difficult since few colleges offer a chiropractic assistance course as they do for the medical and dental profes-
sions. In Georgia, the certified chiropractic assistant course simply consists of ten weekends of training that is equivalent to a low-grade technical training. I've sent more than a dozen staffers to this course and most of them were disappointed by the superficial training they received.
“while it was encouraging to learn of their efforts to upgrade chiropractic assistants and techniciansv until this type of program is available in every part of the country' most DCs will be left to find competent staffers among its local
talent pool or patient rosters. 39
Part of the problem with being able to be good CAs and CMs is the fact that DCs are not the best bosses, either. For example, Debra Southard, CCA, of the Chiropractic Educational Network gave some startling facts about her survey of 1,300 CAs. First of all, the average length of employment is five months and 29
days, mainly due to a lack of education and low pay.
According to her survey:
• 91% of CAs feel their pay scale is unacceptable
• 96% do not get health benefits
• 98% do not get retirement benefits
• 97% do not have a procedure manual
• 85% do not have an employee manual
• 66% have never had a job evaluation
• 93% left due to low pay
• 86% received less than one day of training
• 96% do not feel they were adequately trained before interacting with patients
What does this survey tell us? That most DCs are unable to train staff, and unable to keep staff due to poor management, low wages, and benefits.
Southard also mentioned that lawsuits against DCs because of their CAs have increased due to burns from modalities and staff giving medical advice. Their inadequate professional training increases staff turnover, doctor liability, and patient risks. She also mentioned that while 14 states had some semblance of a CA certification program, only Florida mandates that CAs
must be certified to clinically interact with patients.
The other expert on this subject is John Huber, DC, of Highland Community College in Des Moines, Washington. He has written an excellent manual, Chiropractic Technician Skill Standards, which addresses the many issues a CA must be knowledgeable about—educational, professional, clinical standards, foundation skills, and personal qualities.
66A good doc with o poor staff is the perfect combination for frustration, but a good doc with a
great staff is a blessing.39
While it was encouraging to learn of their efforts to upgrade chiropractic assistants and technicians, until this type of program is available in every part of the country, most DCs will be left to find competent staffers among its local talent pool or patient rosters. In fact, I have a patient who administers the medical tech course at a local technical college, and when I
asked her about starting a CA course, she looked bewildered and stated that she didn't think CAs needed to be educated. Ugh.
Indeed, for most offices, the real "gatekeepers" are the receptionist and the level of excellence of the staff who determines the office's reputation. A good doc with a poor staff is the perfect combination for frustration, but a good doc with a great staff is a blessing.
Seek help from Southard, Huber, or Kim Klapp of Assistants for Chiropractic Excellence, and help begin an office training program with CDs and textbooks.
But, what do I know? I'm just a country chiropractor proud of my six staffers who enjoys when patients tell me what a wonderful staff I have.
chiropractor, Smith, author MA, DC, of The is a Medical 35-year War practicing Against Chiropractors, and he maintains a website, Chiropractors for Fair Journalism.
