Several years ago, I discussed with a good friend of mine, Dr. Tom Klesmit of Dallas, Texas, ways of educating industry in prevention concepts. Tom came up with the idea of a symposium. We committed to each hosting one symposium in our area and found the entire concept to be very successful.
The main problem each of us found was that we were not prepared for the number of companies that were interested in implementing some type of program. It is this procedure that I would like to discuss in detail.
First of all, this symposium, if done correctly, is a very powerful tool for gaining a foothold in local industry. The most important point to remember is that you must be prepared to handle the additional load that is placed on you in two areas. The first area is chiropractic treatment. During the symposium it would be wise to discuss proper protocol for the handling of injuries in your office, touching on several important aspects. I will discuss those aspects later in the article. The second is the concept of a paradigm shift in thinking with regards to prevention.
You must convey to industry that the current trend of thinking is not working. A recent article in Industry Week made it very clear that OSHA's new director will not tolerate the disregard for the workers' safety and will reprimand those companies with unprecedented fines in the near future.
The overall idea of the symposium is to educate the local plants in your area to some alternatives in dealing with the rising cost of workers' compensation. To be most effective, the plant manager should attend, as that is the individual who must give approval for most anything. Most often however, the plant manager will not attend a meeting at this time. That leaves the support people, human resource, safety director, director of personnel, and plant nurse as those individuals most likely to attend the symposium. Remember, those individuals who do attend usually have a problem in this area and have pressure on them to find a solution. Therefore, those that attend have a problem at the plant regardless of how bored they may try to look during the presentation.
Identify those companies in your area that are having problems (it is usually pretty well known anyway) and send invitations to them for the symposium. Make sure that you have gotten the correct spelling of their names and the correct title of their position at the company. The invitation should tell them that there will be a presentation on prevention concepts for reducing workers' compensation costs that will last approximately two hours and will begin with an informal luncheon at an appropriate meeting place -- a hotel or a large meeting room at a restaurant. The luncheon does not have to be expensive, but have it in the room in which you will speak. Make sure that you begin the invitation process at least six weeks prior, and tell them to RSVP with follow-up confirmation calls. I would suggest allowing plants to bring more than one person as they feel more comfortable. I would also put the meeting during a Friday lunch time so that the people can go home from the symposium rather than return to work.
The topics that you discuss should fall into two areas: treatment and prevention. In discussing treatment, a hard sell on chiropractic will ensure you that no company will be sending you business. Instead, touch on these concepts with the overall emphasis that our care can be a very effective tool with which to treat soft tissue injuries.
I should say at this point that although I believe and follow what is espoused here, it may or may not fit into your ideology, but at least you will have ideas on making a presentation.
First, any doctor's participatory role in treatment is team oriented, both with the factory and other health care professionals. The obvious goal would be the overall well-being of the employee, and the whole process should provide the company with the least expense and recordability. That is, you need to work with the company and see if this could be a reaggravation of an old injury so as not to be OSHA recordable, or in the areas of time off work and the patient's attitude towards light duty and reducing the time loss in record keeping. The point is, learn those rules with which you can all work in lowering recordability, while still giving the worker the best possible attention deserved.
Another aspect is open the door of communication with the company so that they can call or respond with what is going on. Last, the people need to be treated on a per injury basis, not forever under workers' compensation, and the company needs to know that is your practice. There is more, but this will fill up the first half of your presentation easily.
The three main factors that affect the workers' compensation claim are (1) management/employee relationship, (2) physical demand of the job, (3) medical control. If these issues are addressed properly, there will be a difference in the numbers. The current procedures that are being used at this time say that these issues are being addressed, but the surgeons are still far too busy. I have discussed these points many times over the past year in articles. Dr. Pat Vedetti at Logan College has an excellent course on this that I would highly recommend. I will continue this discussion of prevention further in the continuation of the symposium article.
I would like to add that if anyone has discussions with companies that are progressing to the point of serious negotiations of instituting an effective program, I would be happy to relay my statistics in some prevention projects that have reduced overall compensation costs by 79 percent. Going into the third year (having decreased each year prior substantially), pre-employment physicals have reduced plant exposure by over 86 percent in new employee injuries, with no surgeries since the plant began its labor-intensive and repetitive, physically demanding work.
There are other examples as well. Please, serious discussions only, and we will continue this discussion next time.
Theodore Oslay, D.C.
DeKalb, Illinois
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
