Original research
On-Site Chiropractic Care as an Employee Benefit: A Single-Location Case Study

https://doi.org/10.1016/j.jcm.2017.03.001Get rights and content

Abstract

Objective

The purpose of this report is to describe the role of on-site chiropractic care in one corporate environment.

Methods

A part-time chiropractic practice that provides services to a single company on site, 1 day per week, is described. Most care is oriented toward “wellness,” is paid for by the employer, and is limited only by the chiropractor’s few weekly hours of on-site availability. With approval from the company, the authors conducted an absenteeism analysis after obtaining ethics approval and consent from employee–patients who received care between 2012 and 2014. Comparisons of absenteeism rates of the sample were compared with lost worktime rates from the US Bureau of Labor Statistics’ Labor Force Statistics.

Results

Of 40 current employees, 35 used chiropractic services; 17 employee–patients met the inclusion criteria. The lost worktime rates of those using chiropractic services (0.72%, 0.55%, and 0.67%, for 2012, 2013, and 2014, respectively) were lower than corresponding rates from Labor Force Statistics (1.5%, 1.2%, and 1.1%).

Conclusions

Absenteeism for the employee–patients was lower than equivalent national figures in this sample of workers. Though these results may or may not be related to the chiropractic care, these findings prompt further investigation into this relationship.

Introduction

Although most doctors of chiropractic (DCs) practice in a health care office setting,1 recently there has been heightened interest in the role of chiropractic care in corporate on-site health clinics. For example, the Foundation for Chiropractic Progress (F4CP) report2 mentions 2 studies that found the inclusion of chiropractic care in on-site clinics resulted in lower utilization of some health care services, such as radiology, physical therapy, and emergency services; decreased overall health care costs; and improved neuro-musculoskeletal function.3, 4 Similarly, in another study comparing on-site and off-site treatment for occupational low-back injuries, it was found that on-site treatment was associated with lesser amounts of treatment, fewer modified workdays, lower treatment costs, better productivity, lower transportation costs, shorter duration-of-injury claims, and lower total claim costs. Treatment included spinal manipulative therapy, electrotherapy, back care education, and an exercise program.5 However, there seem to be few investigations of chiropractic care offered on site.

The owner and some longtime personnel of a company were interested in examining their employees’ absenteeism, which they speculated might be lower because their employees received chiropractic care. They had valid reasons to want a low absenteeism rate, as productivity losses resulting from health-related absences are expensive to employers,6, 7, 8 totaling well above $200 billion annually in the United States.9, 10 Much of the cost of care is related to low back pain and other common pain conditions.9, 11, 12 One theoretical model of “white-collar” worker absenteeism estimated additional annual expenses for the employer of nearly $10 000 (US) per employee.13 Absenteeism is associated with a lower quality of life for employees.13 Employer-implemented programs designed to improve employees’ health status have been reported to reduce medical costs and have positive impacts on absenteeism.14 The purpose of this article is to describe the role of on-site chiropractic care in a specific corporate environment.

Section snippets

Corporate and Clinical Environment

This case study describes a single, small company with chiropractic care available on site 1 day per week, offered primarily as wellness care (sometimes called “maintenance” care).15, 16, 17 The company is a local law firm, currently with 40 employees. The principal author is the treating DC, and the owner of the firm is a business partner of the chiropractor’s main clinic. The wellness care provided in this setting is for similar purposes, as has previously been reported for chiropractors17:

Absence Analysis

Of 40 current employees, 21 did not meet the inclusion criteria for the absence analysis: 16 had been patients less than 3 years, 2 receiving care worked only part-time, and 3 longtime employees had never received care. Additionally, there also were 2 longtime employees who had received care, but were excluded for not fitting a wellness model: 1 had made only 3 visits in 6 years, and the other had had only a single consultation. Seventeen employee–patients were included in our analysis. One was

Discussion

The LWRs calculated for the employee–patients in this study are consistent with the informal observations of the company owner and some longtime employees that their absences seemed low—about half of what might be considered the national norm. These results make a modest contribution to the limited previous investigation of this topic. However, we recognize that our absence analysis has substantial limitations, as discussed below.

Although it is not uncommon for chiropractors to recommend

Conclusions

The rates of absenteeism for the employee–patients in 2012–2014 was lower than equivalent national figures from the Bureau of Labor Statistics, though that may not be related to the available chiropractic care. On-site chiropractic care could be beneficial to both employees and employers, though a number of factors are yet to be examined. The generalizability of our results is limited, but we hope that, in the future, other chiropractic researchers will develop similar, more extensive projects

Funding Sources and Conflicts of Interest

The owner/founder of the firm described in the above study is a business partner in the principal author’s main chiropractic clinic, and the principal author was also the treating chiropractor of the study. No funding sources or other conflicts of interest were reported for this study.

Contributorship Information

Concept development (provided idea for the research): S.M.

Design (planned the methods to generate the results): S.M., B.R.

Supervision (provided oversight, responsible for organization and implementation, writing of the manuscript): S.M., B.R.

Data collection/processing (responsible for experiments, patient management, organization, or reporting data): S.M.

Analysis/interpretation (responsible for statistical analysis, evaluation, and presentation of the results): B.R.

Literature search (performed

References (42)

  • CA Krause et al.

    Value of chiropractic services at an on-site health center

    J Occup Environ Med

    (2012)
  • SL Kindermann et al.

    Impact of chiropractic services at an on-site health center

    J Occup Environ Med

    (2014)
  • ME Schneider et al.

    Effectiveness of onsite and offsite treatment management of workplace low back injuries in Worker’s Compensation claims: a cohort study of clinical and cost parameters for the petrochemical construction sector [conference abstract]

    J Chiropr Educ

    (2008)
  • S Nicholson et al.

    Measuring the effects of work loss on productivity with team production

    Health Econ

    (2006)
  • RJ Mitchell et al.

    Measuring health-related productivity loss

    Popul Health Manag

    (2011)
  • GR Asay et al.

    Absenteeism and employer costs associated with chronic diseases and health risk factors in the US workforce

    Prev Chronic Dis

    (2016)
  • WF Stewart et al.

    Lost productive work time costs from health conditions in the United States: results from the American Productivity Audit

    J Occup Environ Med

    (2003)
  • K Davis et al.

    Health and productivity among U.S. workers

    Issue Brief (Commonw Fund)

    (2005)
  • F Cocker et al.

    Depression in working adults: comparing the costs and health outcomes of working when ill

    PLoS One

    (2014)
  • CH Coulter

    The employer's case for health management

    Benefits Q

    (2006)
  • JR Jamison et al.

    Maintenance care: towards a global description

    J Can Chiropr Assoc

    (2001)
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