1 Obamacare: Threats, Options and Opportunities
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Dynamic Chiropractic

dynamicchiropractic.com >> Politics & Government

Obamacare: Threats, Options and Opportunities

By James Lehman, DC, MBA, DIANM

As a chiropractor, you must be wondering about "Obamacare." What is it? How will it affect my practice? What can I do to prepare for upcoming changes and possible pitfalls?

As Denis Waitley, one of America's most respected authors and productivity consultants on high-performance human achievement, stated, "Expect the best, plan for the worst, and prepare to be surprised."

What is Obamacare?

The comprehensive reform law was signed in March 2010.

The name "Affordable Care Act" is the final amended version of the law.

The White House and President Barack Obama claim that health reform makes health care more affordable, holds insurers more accountable, expands coverage to all Americans and makes our health system sustainable. The National Association of Chiropractic Attorneys has applauded its non-discrimination features.

Given these promises, a chiropractor, who has weathered the shrinking reimbursements of managed care, must be expecting the best. But let's keep in mind the other half of Waitley's quote.

The Primary Care Question

As of the current state of the law, the Affordable Care Act permits chiropractors to function as members of the primary care team. The language in the bill ensures that doctors of chiropractic can be included on these patient-centered and holistic teams. The non-discrimination provision lifts some of the burden imposed by unfair limitations of certain insurance companies.

The provision reads in part, "A group health plan and a health insurance issuer offering group or individual health insurance coverage shall not discriminate with respect to participation under the plan or coverage against any health provider who is acting within the scope of that provider's license or certification under applicable State law."

This is good news for chiropractic physicians with practice acts that permit them to provide primary care services. Most importantly, a medical director employed by an insurance company could not decide to eliminate chiropractic services due to prejudice. Yet, we must wonder if the compensation schedule will provide adequate reimbursement.

Recommendation: Build a medical network and develop your health care team now.

As a chiropractic physician, you should improve your inter-professional referral relationships with primary care physicians to improve safety and quality of care and to position yourself on a patient-centered and holistic team of health care providers.

Create a plan that will increase your referrals from medical professionals. I suggest you learn the ABCs of inter-professional marketing described by Dr. Christina Acampora in her book, Marketing Chiropractic to Medical Practices. Learn to identify medical physicians' needs and objections to working with chiropractors. Medical doctors and chiropractic physicians can work side-by-side and patient-centered care requires health care teamwork.

What Challenges or Pitfalls Might Occur?

The American Medical Association and the Scope of Practice Partnership are studying chiropractic education, academic requirements, licensure, certification, independent governance, ethical standards, and disciplinary processes while intending to contain and/or eliminate the chiropractic profession.

Based upon the Texas Medical Association lawsuit against the Texas Board of Chiropractic Examiners, which has limited the chiropractic scope of practice, chiropractic physicians should plan for the worst-case scenarios.

We must suspect that the political forces within organized medicine will attempt to remove chiropractic care from the Affordable Care Act or have us designated as "specialists" to work under the prescription of the primary care "gatekeepers."

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