Orthotics as a Revenue Stream
ORTHOTICS
By. Brian Jensen, DC
The practice of Chiropractic has experienced countless changes as it has evolved over the past 125 years. While providing spinal adjustments is still a main stay in our profession, additional services, products, and modalities have become the norm. Technological advances have provided a new world of diagnostic and treatment options allowing us to create better patient outcomes while subsequently contributing to a healthy business model.
In 1952, Dr. Monte Greenawalt introduced us to his Spinal Pelvic Stabilizers after discovering the powerful influence of the feet and lower extremity on spinal function, posture, and pain. As our idea of what constitutes Chiropractic care has evolved, the use of custom, flexible orthotics has become a standard procedure in tens of thousands of offices around the world helping millions of people. The use of orthotics is now a mainstream practice that the public is aware of and is actively seeking but orthotic use is only the start depending on your practice model. Orthotics are a natural gateway to many other services and products that can become the multiple streams of income that nourish your business.
One of the keys to a healthy practice is a practice model that creates opportunity for your patients to experience services and products that help them reach their health goals beyond pain relief. Solely depending on third party payors to cover their portion of active care creates a stressful and potentially devastating scenario in which we have little control. We have all seen how quickly life can change around us, so it is a good idea to position our businesses with some flexibility and income diversity.
Income streams that are consistent with the purpose of your practice result from consistently following your office protocols. How do you evaluate your patients? Do you have a step-by-step evaluation process that is repeatable and provides you with the information required to justify treatment? What information are your sharing with your patient that they have never heard before? A thorough examination - including x-rays, digital laser foot scan, posture evaluation with a functional movement assessment - is a good starting point to giving them the opportunity be proactive in their care and creating value for your patient above and beyond symptomatic relief.
If your patient has an insurance policy that covers a portion of their Chiropractic care, what are you offering your patient in the way of corrective/supportive care after the active care portion has been completed? It is my experience that many people are looking for ways to improve their health, posture and longevity and are willing to invest in it, but we have to offer them something beyond temporary relief. We have an opportunity to create a support system that goes beyond the adjustment and a pair of orthotics.
The opportunity for our patient begins with the examination which must justify our recommendations. Postural stress and old injuries lead to wear and tear on the joints and that stress may begin in the feet. Evaluating the feet with a digital laser scanning device has become the new standard of foot evaluation. This is where we see the first clue that the feet are presenting with asymmetry between the right and left foot, causing postural imbalances. Posture evaluation and functional movement assessment will reveal the effect of that weak foundation. This is where we start building our care plan that includes making measurable changes in posture, pain and functional movement with orthotics, active care rehabilitation and all the supportive procedures and products that help them obtain that goal.
If the digital laser scan of the feet determines that the patient has an asymmetrical pedal foundation, it is important to recommend two pair of orthotics, one for athletic and one for dress shoes. Custom sandals or flipflops will provide the support your patients need during the warm weather months between visits. The simple fact is patients who you include custom orthotics in their care plan get better results.
Due to social distancing, patients may have apprehension about coming into the office. Mailing the patient a casting kit or placing a reorder is something I know some companies would be glad to work with you on.
This ensures your patients still have postural support, no matter what. And in many cases, the time you spend fitting the orthotic to the patient’s shoes and instructing them on the break-in procedures is a service you can bill for.
Chiropractic adjustments for the spine are standard in practice but it is important to evaluate and adjust the extremities as part of the treatment plan. Extremity adjusting adds value to your care and the fact that many insurance policies cover extremity adjustments is a bonus.
Muscle management tools like the Intracell Stick and Foot Wheel, manual therapy, cold laser, and massage can be offered to prepare the patient for the orthotic break-in period and active care rehabilitation and neuromuscular re-education the office. The use of a tape product to temporarily support the arches of the feet is another service to be considered. Home rehab equipment should be recommended for the patient to purchase once the in-office rehab is complete so the patient can continue to maintain the postural improvement they have achieved. Cervical pillows and cervical extension traction devices are another good way for the patient to continue to make postural progress when they are at home.
With wear and tear from bad biomechanics comes inflammation both from the microtrauma and the inflammatory American diet. A simple finger stick blood test can help determine how inflamed a patient is. This makes it easy to recommend necessary supplements to help combat inflammation which improves the patient’s outcomes and is another source of repeatable revenue. Patients are trying to figure out how to be healthier and we can help them by recommending dietary changes along with supplementation and other lifestyle changes. This is essential in removing one of the major contributors to chronic pain and the development of many chronic disease processes.
The list of products and services that we can offer is extensive and there is abundant opportunity to expand the sources of revenue in the practice. It is important to remember that successfully implementing multiple components of care begins with a good examination that justifies the recommendation and consistent, repeatable protocols that makes the office flow smoothly.
Dr. Brian Jensen, a graduate of Palmer College of Chiropractic, is the owner of Cave Spring Chiropractic in Roanoke, Virginia. In practice for over 30 years, Dr. Jensen is a highly sought-after Chiropractic lecturer and educator. When he's not practicing, Dr. Jensen speaks on behalf of Foot Levelers on a regular basis.
