DC’s Aligned for $1 Billion Department of Transportation (DOT) Market


Chiropractic Physicians have an insurmountable competitive advantage over other health care professions to draw substantial new income into their practices. Nowhere else is the opportunity greater; all that is needed is for Chiropractic Physicians to “align” their practices to include driver physicals, alcohol and drug testing for the transportation industry.

The “adjustment” of where $1 Billion is spent annually is imminent, due to the upcoming mandatory training and testing of those that perform the DOT Medical Exam for truck drivers. Until now, any DC, MD, DO, ANP or PA could perform the exam with minimal preparation. That is due to change early this Fall, when the Final Rule is published for the National Registry of Certified Medical Examiners (NRCME).

No physician wants to be forced to take a training course, or even worse, to take a certification test. However, as a profession, this is one time when we should embrace inconvenience. Because few chiropractic offices offer this procedure, nearly all of the annual 4+ million driver exams are provided by the other professions. However, when faced with the new requirements, the number of these providers is expected to drop dramatically. As the trucking industry scrambles to find a new provider, the door swings open for chiropractic and those that prepare now will reap the benefits.

Cost has and will be an important factor in who gets the business. This is where chiropractic’s low overhead serves best. Chiropractic costs for rent, malpractice insurance, and employees are hard to beat. The result is that, when it comes to pricing, chiropractors can out-compete just about everyone, except another chiropractor. The significance of this can not be overstated.

Reimbursement will be a major deterrent for many clinics. Most chiropractors charge between $45 and $100 for a driver exam. This amount is frequently greater than that for chiropractic adjustments and/or therapy. In a medicine oriented office, however, this represents a relatively low reimbursement compared to what services could be billed. This deters medicine based clinics, and attracts the chiropractic physician. An added bonus is that there is no insurance to contend with and no waiting to get paid.

Motor Carriers frown when paying drivers to sit in an office waiting for an exam, or if an appointment is not available for several days or weeks in some clinics. Many self employed drivers are paid by the mile and time off the road is money lost. To add to the urgency, many drivers inadvertently allow their current exams to expire. It’s no surprise they’re looking for a same-day appointment, as they are either off the road, or subject to a substantial fine if caught driving. It’s been an unfortunate fact that many chiropractic offices are underutilized. However, chiropractic offices can often provide same-day appointments. For many drivers and motor carriers, this is “the” determining factor in physician choice.

http://www.theamericanchiropractor.com/images/megeheeartpic.jpgMost chiropractic offices also underutilize their staff. Since drug and alcohol testing can and should be performed by your staff, income from these services comes nearly cost free. The clinic gains an ability to generate income, even if the physician is absent. Companies prefer a one-stop shop which also offers the alcohol and drug testing. There is a nationwide shortage of clinics offering the alcohol test for truck drivers. This is a strong selling point to companies that struggle to find clinics with all three services. Once an office is providing the DOT drug and alcohol testing, there’s no reason not to provide drug testing for non-DOT regulated employers. The Non-DOT drug testing market is estimated as being 7X larger than the DOT drug/alcohol market. Opening a satellite clinic in a truck stop, or providing services at the client’s facility are options few clinics have the desire or ability to consider, but they are effective marketing strategies.

FMCSA estimates that 40,000 trained medical examiners will be needed within 2-3 years. As these services are federally mandated, they tend to be independent of the state of the economy. Even those ready for retirement may find this an appropriate avenue to continue at a reduced pace and a reduced physical stress to themselves.

Starting now deters other clinics from competing with you later, increases your visibility when trucking companies are looking for a provider, and firmly establishes your office with the client for years to come.

Training is available from chiropractic colleges, nationwide physician networks and third parties. Although training is not required to perform the driver medical exam, the physician should download and review the exam form and instructions from the FMCSA website. Training is required to perform the DOT drug collection and alcohol test. DOT alcohol testing many times requires purchase of a breath alcohol tester that is approved by the DOT. This is part of the reason why clinics that perform alcohol testing are in such short supply. If the physician will attend a “Train the Trainer” course for alcohol and drug testing, he is able to train his own staff which greatly reduces his costs.

For those looking to build their chiropractic visits, every driver exam, alcohol test and drug collection represents a potential chiropractic patient. What other marketing strategy pays to have a potential patient come to your office? Incorporating these services into a practice will not be for every chiropractor, but every chiropractor should investigate this opportunity to out compete the competition while the door remains open.

Michael Megehee, DC, is a FMCSA designated Subject Matter Expert and President of TeamCME, a nationwide network of physicians that provide services to the trucking industry. Dr. Megehee is a member of the FMCSA Team that developed the NRCME physician training course. For free information on how to get started performing driver medical exams, go to www.TeamCME.com.

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