What’s Wrong with Providing What Your Patients Need?

By: Peter G. Fernandez, DC

As a consultant to over 5000 DCs, I’ve witnessed the fact that many Chiropractors are reluctant to recommend, and/or charge for, ancillary products that would help their patients – products that could easily be made available in their offices. Why do these doctors feel uncomfortable in providing and charging their patients for patient-benefiting services beyond adjustments, X-rays, exams, or therapies?

In speaking with these doctors, it’s not because they have any doubt that these products will help their patients. The excuse that most try to hide behind is that selling ancillary products makes them feel more like a salesman, and less like a doctor. Think about it: The doctor who doesn’t provide his patients with total care, including the recommendation of ancillary products to patients who need them, jeopardizes his patients’ speediest recoveries. While this helps the doctor not feel so much like a salesman, it also makes him not so much a doctor.

Why Some Don’t

Doctors who refuse to recommend and/or charge for ancillary products are either confused, insecure, or misguided.

  • Some doctors confuse “teach” with “sell.” Teaching patients about their health problems, and how to get well and stay well, eliminates the need for the doctor to “sell” his patients on products that will help them. Patients want to be well, that’s why they go to doctors in the first place. Your patients are willing students… teach them well. And when you look at your products, think about how they can help your patients today, not how many you will sell today.
  • Some doctors are insecure about their ability to get patients to understand and accept the importance of using ancillary products. Of course, they don’t want to be stuck with a dusty inventory of products, so these doctors just don’t offer them. Their patients are left to fend for themselves, doing their best to follow their doctor’s recommendations, sometimes purchasing inferior products, sometimes paying too much for products, and sometimes purchasing the wrong products all together. Serve your patients well – learn how to educate them and then provide them with quality products at fair prices.
  • Some doctors have been grossly misled into believing that it’s wrong to sell those products that they have prescribed to their patients. Who better to evaluate the quality of products designed to help his patients? Who better to assure his patients receive the right formula, right fit, right quantity, etc., to assure their speediest recoveries? It is wrong, highly unethical, and illegal to recommend unnecessary products to patients. It is not wrong to provide legitimately recommended products to patients.

Think about it. Is it ethical for DCs to withhold services or product recommendations that could help their patients get well, get well faster, or stay well? Absolutely not! Is it ethical for DCs to evaluate, stock, and sell quality products at fair prices to their patients who need them? Absolutely, yes!

Four Scenarios

Still not sure? Consider a patient who develops lower abdominal pain, is constipated, has severe cramping and a slight fever in the following scenarios:

Scenario #1. The patient’s pain is so bad that he visits a medical doctor for an evaluation. The MD finds abdominal rigidity, and palpation reveals considerable pain in the patient’s mid-lower abdomen. The MD immediately refers the patient to a hospital for a CT scan, in order to determine if the patient has diverticulitis, peritonitis, or something even more serious.

Is it unethical for the MD to refer this patient for these medical procedures? Is it “selling?” Absolutely not! This referral has been clearly indicated by the patient’s symptoms and the MD’s examination results.

Scenario #2. If that same patient is referred for a CT scan in the medical doctor’s clinic, where a fair fee is charged, does that make the MD unethical or a salesman? Absolutely not! Given the highly inflated costs for hospital services, this referral not only has life-saving potential, it could also result in substantial cost savings.

Scenario #3. If the diagnosing doctor is a DC and not an MD, would it be an unethical act or salesmanship for the DC to refer the patient to a hospital for a CT scan? Absolutely not!

Scenario #4. If the DC owned a CT machine and referred the patient to his CT department and charged a fair fee for the scan, would that make the DC unethical or a salesman? Absolutely not! In this scenario, this is a clearly indicated procedure being performed in a location convenient for the patient and at a reasonable cost.

The Case for Orthotics

What about recommending custom-made orthotics to patients? For 20 years I offered functional orthotics made by the Foot Levelers company. I chose this company because their products were (and still are) extremely well made. My patients loved them, my seven children wore them, as did most of my relatives and myself.

Just as most DCs do, I did a lot of postural correction in my practice. As Chiropractors, we know the feet are the foundation to the rest of the body. When the feet are not in correct alignment, everything above them is prone to suffer an unhealthy chain reaction, i.e., when the feet hyperpronate (collapse inward), the knees will rotate inward, causing the pelvis to rotate forward, forcing the chest and head forward into the worst type of posture problem – the head forward posture.

One of the answers to this complex problem is simple – postural correcting functional orthotics By correcting the alignment of the feet, the knees will rotate back to their normal position, forcing the pelvis to rotate backward to its normal position, which causes the upper body to return to its normal posture.

Is it ethical for a posture-correcting DC to recommend orthotics to help correct his patient’s posture? Absolutely, yes! It clearly would be unethical for a DC to practice postural correction and not correct abnormal foot posture, because all DCs know that posture starts at the feet. And, the doctor should not feel it’s wrong to sell his patients the orthotics he recommends to them.

Think about it: How can it be wrong to provide high quality, custom-made orthotics at a fraction of the cost that a podiatrist would charge? In addition, with Foot Levelers, your patients don’t have to wear the big, ugly shoes typically associated with foot orthotics. This means your patients will be more likely to wear their orthotics as recommended, and thereby achieve postural correction as quickly as possible.

If you’re still uncertain about recommending and selling ancillary products to your patients, simply follow this rule: Recommend only the highest quality products and only to your patients who need them – nothing more, nothing less.

Give your patients the care that will help them get well, get well faster, and stay well – total care. Not providing the total care that will help your patients achieve total wellness is a very questionable act.

About the Author

Dr. Peter Fernandez, a 1961 Logan College graduate, is past president of the Florida Chiropractic Association. He has been a practice consultant for over 30 years, and in this capacity has consulted with over 5000 Chiropractors and in the opening of almost 3000 new practices. Learn more at http://www.drfernandez.com.