Pre-Employment Physical: Key To Practice Expansion

By: Joseph R. Schmitt

Business owners and industrialists of the world have a universal problem in the selection and hiring of new people. This problem can possibly provide a niche market for your services which is more stable than most areas of practice expansion.

With written paper tests the intellect, personality, honesty and drug tendencies (but not drug use) of prospective employees can quite predictably be defined. After a suitable new employee is found, the next step is negotiation about compensation and an enthusiastic and definitive review of the fringe benefits. But finally and most importantly any offer of employment must be contingent on the successful completion of an appropriate pre-employment physical.

I’ll admit, in writing and speaking on this subject many times I have whizzed over this necessary step in the process by just saying, “It is important to have a suitable physical done by a good doctor who practices industrial medicine.” This has not given the pre-employment physical the emphasis or attention which it is due.

I know, having been involved in the hiring process of thousands and the evaluation process of even more, how hard it can be to find a trusted, well-respected physician to perform pre-employment physicals. I believe this need may quite possibly be a specialty area of expertise which, once developed, will become that magic garden which bears fruit for as long as you care to pick it. Long after all other aspects of your practice have become uninspiring, long after you tire of managing the complicated staffing and paperwork of a full-blown practice, the cash flow and ego reinforcement of this valuable service to all who must hire help can be both a psychic and tangible reward.

Most employers can only dream of having a trusted doctor look them in the eye and say, “I would not want to discuss the reason but you must trust me, this applicant is not suitable for that job or your company. It is my professional opinion you must continue the search.” Once you, as a professional, have developed this degree of insight and trust with an industrialist you have entered the highest professional advisor status. YOU ARE BULLETPROOF! WOW!

Consider the problem of the top corporate officers who know that improved staffing will have a significant impact on improved operations and profits. In this process I know of no more difficult problem than finding and properly using the skills of a doctor to do a proper pre-employment physical. In most communities in the nation there is no one who really has developed industrial medicine as a specialty to the exclusion of the need to develop a continued patient flow. Doctors are seldom selected for the right reasons, are usually picked for all the wrong reasons and often aren’t concerned with evaluating the applicants’ physical and mental needs for specific job performance as would be expected.

For example, it would seem very easy to determine physical fitness for task when hiring a Rockette line dancer, but in reality the hiring offer should not be final until after an appropriate industrial physical. It is not enough to observe the necessary dancing and high kicks, the question must be how well will this applicant will be able to endure and thrive on the six shows a day and the constant rehearsals which are a must. Two applicants who seem equal in the normal interview process may be quite different under the skilled eyes of a doctor who understands the job requirements and the job circumstances.

An executive applicant from out of town is sent for a physical to the local clinic and the contact time is more devoted to sucking up to the candidate than really defining the suitability to task. All of the doctors in the clinic want this new face and his family to use the clinic for all services and the objectivity and subjectivity of the actual physical can be less than accurate or adequate. I personally would never hire the services of a doctor for pre-employment physicals without a clear understanding that job applicants could not become subsequent patients for an agreed amount of time and that if an employee were hired who later had work- injury that they would not be treated by that doctor or clinic group. Some of you will, I think, agree that this is a small concession and an attractive offer to any industrialist considering the use of your special skills.

Let’s take one area of your expertise where I know you have no peer. Face it, bad backs are constantly looking for good medical care packages. In my career I have hired more bad backs than I care to think about and not all of them were in the machine shop or on the foundry floor. There are different needs in each case, but whether the applicant is a sales manager who is expected to handle a heavy travel schedule with hand luggage and computer to match or a beef carcass “lugger” who is expected to do the intensely and repetitively brutal task of the lift, carry and heave required to load or unload a trailer truck load of beef sides, the entire physical decision process should start with the spine. As you well know, no other professional is the equal of your Chiropractic skills.

I must qualify my remarks by reminding you that this is an area where the rules governing pre-employment physicals are being written even as we speak. It is possible that what is true today in this nation, in this state or in this world may not be true or valid tomorrow. So you must look to your larger industrial clients for the current rules of engagement. I will then say, in stressing your professional value in the hiring process, that there are many things you instinctively know about an applicant, drawing from your insights gained through both your training and patient contact. Many of your reflex observations could not possibly be part of the normal personnel department interview and which, while not a part of the formal report, become valuable fringe benefits of your service to businesses, large and small.

The first step, after you have decided that this could be a comfortable extension of your talents and interest, is to develop a script which will explain what skills and tests you will provide to improve the value of the present pre-employment physical process, if any even currently exists.

List all of the tests you will make available as a part of your industrial physical. Be prepared to discuss the various levels of examination you will be conducting. An entry level factory or shipping exam will be different from that for a secretary or clerk or executive vice president, but there will also be many things in common. All should have a drug test, and if you can arrange to provide this as part of your service, all the better.

I would recommend you refine your proposal and gain experience with smaller companies, but I can assure you all companies in your trading area, regardless of size, have real problems in the selection/retention process. Employee turnover is very costly; I have read that some experts believe 80% of this churning of people is due to hiring mistakes. I will candidly tell you I think the percentage is small as it relates to companies who strive to excel. I preach hiring mistakes can be recognized early, and once such a mistake has been identified, it should be corrected quickly. Your skills in helping in the final hiring process can be important in reducing the number and cost of mistakes.

As you evolve your practice you will find there are many more services you can provide to the companies you serve. I have never discussed with the editors of Success Express the content of my articles before submission, but I am personally a very strong believer in Foot Levelers orthotics and as a user know how they improve walking and standing where these are part of the job assignment. You have probably already confirmed this through your personal use in your practice and should have little trouble developing an industrial relationship with your new industrial clients as a supplier of orthotics to those employees who must stand or walk for long periods of time. This is a practice expansion which I consider parallel to the relationship some optometrists have established with industrial companies, where some employees need special or safety glasses.

I would suggest you make your first presentations to companies who are below the current threshold of ADA (Americans with Disabilities Act), but caution you that in some states these laws apply to even the first hired employee. After you have gained some experience and familiarity with this field I think you will find it an exciting and challenging opportunity. I have known only a few doctors who specialize in pre-employment physicals but they render a valuable, rewarding and much needed service.

Let me make a totally unscientific statement based on only a small cross-section of the broad community of possible prospective doctor examiners. I believe the best Chiropractors I have observed are quite possibly the best judges of people I have ever encountered, and in some instances head and shoulders above some of the psychiatrists and psychologists I have worked with professionally. I can’t say how important knowing some of the best has been to me, in my career.

Finally, strive for minimal written reports. Ideally your role should be pass/fail rather than long dissertations which may some day cloud the reasons your services are so valuable.