Original researchOn-Site Chiropractic Care as an Employee Benefit: A Single-Location Case Study
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
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2019, Journal of Chiropractic MedicineCitation Excerpt :In a similar vein, we suggest chiropractic care should be considered a form of tertiary prevention, that is, treatment aimed at maintaining the best functioning as possible in patients who cannot become free of disease or symptoms.50 In this context, we consider care provided by chiropractors to not only include manipulation and other forms of manual therapy, but also advice regarding exercise, lifestyle, diet, nutritional supplements, body mechanics and ergonomics, and stress reduction.51-55 At present, there appears to have been nothing published regarding chiropractic care with CPEO or other mitochondrial diseases.