Second Generation Chiropractor Moves into a Hospital to Treat and Rehab his Patients
INTERVIEW
Interview with
Eric Lee
DC
By The American Chiropractor
Dr. Eric Lee's journey into the chiropractic profession began with a father who made a career change while he had a young family, went to chiropractic college, and started his own practice in California.
Growing up, Eric played baseball, and his dad kept him “well adjusted” as Eric went on to play baseball at the collegiate level. He had hopes of becoming a professional baseball player, but he took a break to serve a two-year mission for his church. After he returned, he had a new perspective and determined to help people and athletes as a chiropractor. Ultimately, he graduated from Parker to fulfil this realization.
As he developed an integrated clinic of his own, the experiences helped him understand the dynamics of working with other disciplines and where he needed to fill in the gaps of his own knowledge. Through his path ofcontinuing education and his relationships with other healthcare practitioners, his perspectives on coordination of care have brought him many opportunities. In addition to his practice in the Pain and Spine Center, Dr. Lee also enjoys helping student-athletes at Brigham Young University as one of their official chiropractors.. In an exclusive interview with The American Chiropractor (TAC), Dr. Eric Lee (EL) shares some of the things that he's learned along the way, and offers some tips for anyone looking to follow a similar path.
TAC: How were you invited to work in a hospital?
EL: There were a couple of things that created the right timing and environment for the invitation to work in the hospital. The postgraduate training through the academy helped me further develop my skills and understanding of spine trauma, hospital triage, and mechanical versus structural dysfunction of the spine. I was working with a patient who did not want surgery because she had worked for an orthopedic spine surgeon. In her observation, she felt that after surgery, patients never got better. With my training, I reviewed her MRIs and advised she get a second opinion from a neurosurgeon. The neurosurgeon and I discussed her case, and this began a professional relationship that continued to develop. We began talking about how many cases he receives that are not surgical and how we could better help the patients by working together and referring to each other. It was at this time that he was preparing to move into the hospital to be part of the Pain and Spine Center, and he felt that having me there would provide a missing piece to the treatment team. Then I met with the CEO of the hospital, and we discussed the ideas of how an integrated system could work and what role a chiropractor could play. I had met the CEO several years ago when he worked for another healthcare system and had maintained a connection with him throughout the years. It took some time and effort, but with the recommendation of the neurosurgeon and other physicians, we worked through the logistics. So if I had to summarize, I would say the two key components were:
1. Credentialing that improved my skills and confidence.
2. Relationships with people.
TAC: So does the hospital own the clinic? Is there pressure by the hospital to encourage surgery because of your presence in their facilities?
EL: There are different guidelines pertaining to the en-
tities and physicians within the hospital based on their contractual arrangements. My clinic is separate and functions autonomously with our own scheduling and staff. However, we have access and relationships with the physicians, specialists, and ancillary staff that allow us to work together for the benefit of the patient. When this happens, I believe the patient care is optimal. This is something we are always working to improve and will get better over time. For many of the doctors and staff, there are misconceptions about what chiropractors do. Right now, I spend a lot of time teaching and educating physicians about the science behind what we do and that takes time, but I know it is well invested.
Especially when the cardiologist next door brings me a patient with rib pain and suggests that I can help her, rather than just prescribe her some pain meds and muscle relaxers and send her on her way. Of course, the hospital is there for surgeries, but they also want to develop patient satisfaction and optimal care. There will always be patients who will need to have surgery, but we are the ones that are the best for biomechanical failure in the spine.
TAC: What is the biggest difference that you have seen between chiropractic when your dad practiced versus when you practice today?
EL: My father practiced in California in the 1970s to early 2000. In the early days of his practice and into the mid-1990s, he would bill health insurance and get paid typically at full fee. As managed care has evolved with more stringent guidelines and regulations, the administrative burdens for doctors and staff have increased. Documentation is scrutinized regularly to deny, reduce, or recover payments made to physicians and clinics, and this is across the board, not exclusive to chiropractors. So I would say the biggest difference is the burden to create irrefutable documentation, which includes the science
behind the treatment provided. The challenge is to be able to do this and still have a life outside of the office.
TAC: What percentage of your clinic is rehab?
EL: All of my patients are given rehab guidance, whether we are discussing how they lift a laundry basket or approach their pitching biomechanics. Some I help directly for a short time, and I refer to the physical therapy department in the hospital. The physical therapists and I have discussed the biomechanical failure of the spine and how I look at it. With the X-ray digitizing summary, it is easy for them to see the imbalances and where to focus the exercises. Biomechanical failure and how we address it is so key to explaining to other entities in health care.
TAC: How did you get involved in sports chiropractic?
EL: I have always loved sports, and when I first met Bill Welle in Dallas, I got to see the training he provided to professional athletes firsthand. When I met Bucky Dent shortly thereafter, I soon learned that they both understood the benefits of chiropractic in optimizing an athlete’s performance. Through the years, we’ve addressed functional biomechanics and muscle balance to enhance performance and decrease predisposition to injury for athletes they worked with and trained. As I treat athletes at BYU, each has their own specific needs when it comes to
extremities and adaptation to their sport.
However, whether it’s gymnastics, softball, track and field, football, volleyball, swimming, soccer, etc., the spine and neuro-biomechanics are the directors of the body, and we are great at optimizing that function. Now there are many excellent chiropractors with collegiate and professional teams helping athletes perform at an optimal level.
There are amazing trainers and sports medicine doctors at the collegiate and professional sports arena that, when working together, produce some amazing outcomes.
TAC: How is treating an athlete different than treating a patient who was injured in a car accident?
EL: There are differences and similarities and both can be complicated. With a car accident you have to clinically correlate 1. Causality 2. Bodily Injury and 3. Persistent functional loss. The injuries can be permanent and coordinating the care and having a correct diagnosis, prognosis and treatment plan are vital.
Athletes perform by putting the body through maximal output repeatedly, which creates consistent spinal stress. When they are already in submechanical failure on one side or the other, stresses are enhanced during their performance. This is why it is difficult to have a start and stop time during the seasons of their events. The need to optimize the mechanics of the spine more frequently is of great value to their recovery and performance, but it will be difficult to get to a level of maintenance while they are still actively participating. However, the techniques I use to treat both are essentially the same.
TAC: Can you tell our readers about your practice?
EL: I run a personal injury and cashbased practice. I spend a few hours about four to five days a week at BYU treating the athletes, and that is contract work. I have elected not to accept health insurance and offer competitive cash pricing that allows me to treat the patient
according to their needs. When I treat personal injury patients, I do accept their personal injury benefits and work with attorneys on lien. My training at the Academy of Chiropractic really taught me how to quarterback my cases, and it has made all the difference in how I am able to approach patient care. There are so many auto accidents in Utah with over 150,000 people involved per year, so there is plenty of work.
TAC: What is it about the Academy of Chiropractic that has helped you expand what you do? Explain a little bit about how it has helped you.
EL: Dr. Studin’s postgraduate training program has given me access to information that has not only improved my skills as a clinician, but it also allowed me to earn credentials that are recognized by the Accreditation Council for Continuing Medical Education (ACCME). Eve learned how we, as chiropractors, with the right credentials and training, can really quarterback the care and treatment of the musculoskeletal system for our patients. And as Eve come to discover, there are MDs who recognize the void we fill in health care once they understand the science behind what we do. In the program, Eve learned to teach them about what we do, and how and why it works. It has made all the difference in how I approach patient care and how I am able to work with other physicians. To give you an example, part of the training through the academy is an exhaustive course in neurodiagnostic review under the tutelage of a renowned neuroradiologist. Without this type of training, I would not be reviewing MRIs as a peer with a neurosurgeon, and he would not send his nonsurgical patients my direction. The academy has also helped me quarterback the care for auto-injury cases with courses in correlation of care, diagnostics, and proof of disability for attorneys pursuing settlement.
TAC: Can you tell us about your mentors during your career?
EL: After my dad decided to become a chiropractor, there were many in my family who followed, including my uncle, my brother, my cousin, brother-in-law, and sister. All of them have helped and supported me along the way. I also had the privilege to receive some training with the late Dr. Ron Frogley and worked with his son Dr. Scott Frogley. Dr. Ken Thomas, who was one of my instructors at Parker, inspired me to pursue further training in chiropractic rehabilitation. When it comes to the multimodal approach to health care, I have to
recognize Dr. Mark Lee with RMG Rehab and Dr. Dave Berg with Redirect Health. At BYU, I would say Carolyn Billings, Director of Sports Medicine, whose main priority is improving the quality of care for the athletes. Dr. Mark Studin and Dr. Bill Owens with the Academy of Chiropractic have helped me improve skills and abilities to coordinate care with medical professionals and specialists as a qualified practitioner. To help me with my fellowship training, Dr. John Edwards (neurosurgeon) and Dr. Kendall Grose (pain management) have allowed me to attend rounds with them in the hospital and teach me more about what they do. My wife, Kristin, has supported and sacrificed to help me in all my endeavors.
TAC: Any recommendation for others to achieve something similar?
EL: Improve your craft and don’t stop learning, improving, and evolving. If science and technology are always evolving, then shouldn’t you? I’ve told you a lot about what I’ve done and continue to do, but you decide what’s right for you and take the next step. Definitely look into the academy if that’s what interests you.
TAC: List of essential products or vendors that you utilize that help you excel at what you do?
EL: I use a NeuroMed analgesic stimulator. It works fast with musculoskeletal issues. I also have a vibration plate of which there are many brands out there. One piece of equipment I would probably grab first in a fire is the ATM2 machine from BackProject. This simple piece of equipment is vital in my practice. I use the ArthroStim and VibraCussor, and also use Dr. Wiegand’s software, Spine Metrics, for digitizing X-rays, which is a vital part of my practice with all patients.
TAC: Any final words for a chiropractor just starting out?
EL: Do not be scared and continue to learn. Get a mentor and learn, learn, learn. When you come out of school, you are ready to work but know that there are many things you still need to learn. It is a great time to be a chiropractor, and there are many who need us.
You may contact Dr. Lee at [email protected].
