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Hospital Chiropractic: A Win-Win Scenario?

Before seeking hospital privileges, consider what you can offer.

By William Morgan, DC

Many of the chiropractors who contact me, have misconceptions about the benefits of hospital affiliation and are often using flawed strategies when pursuing hospital privileges. Receiving hospital privileges is not the answer to one’s practice management concerns. Moreover, chiropractors should recognize that hospitals also need to realize a tangible benefit from allowing DCs on staff.

Hospitals and medical centers have changed tremendously in the past few decades. There was a time not too long ago when patients would stay in the hospital for weeks following back or neck surgery, childbirth, hernia surgery and other procedures with prolonged healing periods. But that practice has changed; currently physicians strive to send patients home as soon as they can safely do so. In this new environment of hospital care, only the very sick or severely injured stay in hospitals more than a couple of days. This new paradigm of hospital care makes it less likely that a chiropractor affiliated with a hospital will have admission privileges—privileges that allow a provider to admit patients into the hospital.  

What Can the Hospital Do for You?
Although chiropractors will probably not admit patients, they may still co-manage cases or consult admitted patients while collaborating with the admitting physician. Chiropractors are not alone; many emergency room physicians, radiologists, public health physicians, optometrists and psychologists work in hospitals without admission privileges.

The real benefit of a hospital-affiliated practice is access to outpatient services and the advantage of collaborative specialty care for the patients. This level of interaction typically yields the fruit of increased cooperation and inter-specialty referrals with physicians.

What Can You Do for the Hospital?
Most chiropractors intent on obtaining hospital privileges are so obsessed with the credentialing process that they neglect to create a profitable model for a hospital-based practice. Hospitals, even nonprofit hospitals, want to see a profitable practice model before they expand services. There must also be a demonstrable benefit to the facility and to the patients for expanding hospital services to include chiropractic. Before approaching a hospital, you should consider what you have to offer. How will you increase the hospital’s care and help its bottom line? Will you attract more patients to its Spine Center or Pain Clinic?  Will your practice attract more patients to the hospital’s ancillary services like radiology, laboratory, physical therapy, pharmacy or wellness programs?

Demonstrate Your Value
Once a hospital wants you on staff, it will handle the credentialing and privileging process. There is little reason for chiropractors to pay for training in hospital credentialing. More important is creating a profitable model of care that will make a hospital want you on staff. If the hospital cites credentialing or scope of practice difficulties as the reason that it will not admit you, it is actually because it does not want you in the hospital. It means that you have not overcome objections by naysayers or you have not shown a perceptible improvement in patient care and utilization. 

To gain access to a hospital you need to win over the naysayers, establish working relationships with other professions that would be enhanced by a hospital affiliation and show that the hospital would realize a net gain by your presence. This normally takes time, energy and hard work.