“…when everyone is on board, amazing results become the norm”
Dr. Joel Dekanich is a 1994 graduate of Palmer College of Chiropractic in Davenport, Iowa, who practices in Vail, CO.
Beginning his practice as a sole practitioner in 1995, following a year long fellowship with extremity expert Mitch Mally, DC, Dekanich became a certified strength and conditioning specialist in 2002, certified Chiropractic Sports Physician in 2003, Emergency Medical Technician in 2005 and received his diplomate of the American Chiropractic Board of Sports Physicians in 2006.
Since graduation Dr. Dekanich has always believed chiropractic should be a primary discipline in conjunction with allied health providers. For the past ten years and unconventional at the time, he teamed with a physical therapist to run the rehabilitation and strengthening department of the office. “It’s simple and sensible,” stated Dekanich, “that my area of expertise is specific adjustments to both the spine and the extremities and the physical therapist’s expertise is in treatment and specifically rehabilitation of an acute or chronic injury.” “Also, like most chiropractors I don’t have 30-45 minutes to spend with a patient in rehab.”
Dr. Dekanich finishes first at Ironman Wisconsin (2002) Dr. DekaniCh’s wife, Elizabeth
“Dr. Mark Pitcher and myself in Vail outside the athlete treatment tent.“
“That started what is now a multidiscipline group comprised of 3 DC’s, 3 MD’s, 3 PT’s, 1 PhD in clinical psychology, numerous massage therapists, and an acupuncturist in 3 locations throughout the Vail Valley. Our mission statement is simple: To provide the residents and visitors of the Vail Valley exceptional integrative, multidisciplinary treatment for problems ranging from acute and chronic issues to comprehensive wellness care.
“There is constant dialog on patients’ being co-treated to make certain our protocols are in concert and in the best interest of the patient. In acute and subacute phases, many patients will see the DC, the PT and the soft tissue therapist and there never is a duplication of services. We each focus on providing the best our particular aspect has to offer, whether individually or in cooperation with one another. It’s miraculous that, when everyone is on board, amazing results become the norm. However, one of the biggest challenges we face is making sure we are more than the sum of our parts. That is why there is constant dialog and grand rounds on the patients’ progress.
“During much of our acute and subacute protocols, we are planting seeds with the patient on the importance of prevention and ‘protecting their investment’ when active care has finished. Following discharge of the patient, our goal is to have the patient appreciate prevention and wellness and to get them into one of our cash plans that offers different levels of services and products that focus on prevention. This includes monthly adjustments, sessions with the physical therapist to review exercises and workout goals, anti-inflammatory diet and supplement counseling, massages, guided imagery techniques to qi cong, acupuncture or sessions with the psychologist. With our Eagle office located directly in a gym, patients find it easy to use both the gym facility and our clinic. We are trying to get them to literally be one in the same and promote personal responsibility with an independent gym program.
“Chiropractors help thousands of people who are in pain everyday. One of our first goals with chronic myofascial pain syndrome is to help the patient recognize that they do, indeed, have chronic pain. Many patients are unaware that they are in a chronic cycle and, of course, it has much to do with being subluxated, eating pro-inflammatory foods, lack of exercise, poor coping strategies and psychological challenges. With so many concurrent causes, it only makes sense to offer concurrent treatments options. Our pain management program offers an eight-week program that is one-on-one and has incremental levels ranging from specific psychological techniques, meditation and qi cong, chiropractic, physical therapy, guided imagery and medication, if need be.”
#1 golf instructor, David Leadbetter (right) and Dr. Dekanich.
In an interview with The American Chiropractor (TAC), Dr. Joel Dekanish shares some of the secrets to his success.
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Joel Dekanich, D.C. Profile
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PERSONAL • Married: “I have been married for six years to my wife Elizabeth and we have three children Kate (4), Thomas (2) and Joseph (6 months).” • Recreation and Leisure: A few years ago I tried triathlon and completed my first Ironman in 2002. Since then, what little time I have left (when I am not working or being a father/husband) is spent running and training for various races. My leisure time is spent with my incredible family or on the golf course and playing guitar. • Professional Affiliations: Colorado Chiropractic Association, American Chiropractic Association, National Strength & Conditioning Association, Delta Sigma Chi Fraternity, The American Chiropractic Board of Sports Physicians and Breakthrough Coaching • Seminar Attendance: The annual American Chiropractic Sports Symposium, quarterly Breakthrough Coaching seminars and an occasional lecture to an orthopedic group or grade school. • Vacations: “Not with three kids under five.”
PRACTICE PARTICULARS
• Clinic: Vail Integrative Medical Group • Office Hours: 8-6 M-F and Sat. 8-12 • Techniques: Full spine with emphasis on Gonstead, Pettibon and CBP, decompression therapy and extremity adjusting. • Staff: The team at Vail Integrative Medical Group consists of: Drs. Joel Dekanich, DC, EMT, DACBSP, CSCS; Mark Pitcher, DC, MSc; and John Steffens, DC; Bradley Gibson, MD, board certified neurology; Scott Brandt, MD; and Ken Allan, MD, interventional pain management; Dave and Miki Blanchard, MPT physical therapy; and Michelle Laasi, PhD, clinical psychology. Dr. Dekanich is a Diplomate of the American Chiropractic Board of Sports Physicians. He is an Emergency Medical Technician and a Certified Strength & Conditioning Specialist.
Dr. Pitcher also holds a Masters of Science in Exercise Physiology. He has been a university lecturer for Human Factors and Occupational Ergonomics at Memorial University of Newfoundland. Dr. Steffens is a recent graduate of Logan College of Chiropractic who specializes in applied kinesiology along with patient education and prevention. He has over 200 hours of post graduate education in Applied Kinesiology. Dr. Gibson is a board certified neurologist and was one of the early pioneers to bring MRI into Colorado. Drs. Brandt and Allan are both board certified anesthesiologists who are fellowship trained in pain management and are Diplomats of the American Board of Pain Medicine. Dave and Miki Blanchard both earned their Master’s Degrees in Physical Therapy. They both have extensive outpatient orthopedic experience and, additionally, Dave is a specialist in Sports Injury and a certified Pilates instructor. Miki specializes in pain management and neurological rehabilitation Dr Laasi is a published psychologist with over 12 years of clinical experience with expertise in pain management. |
TAC: What inspired you to become a chiropractor? Do you have a specific story?
Dekanich: Yes, I had a lower back sprain in the seventh grade from gym class. First, our family MD prescribed three days rest flat on my back and, when that did not help, I spent one week in the hospital in traction. I saw my mom’s chiropractor as a result and, after that, I never looked back. It was pretty much then that I knew I had found my profession.
The Vail Integrative Medical Staff
TAC: What type of patients do you generally treat or attract?
Dekanich: Practicing in Vail, we see a lot of sports and musculoskeletal injuries. It is an extremely active area and pretty much everyone is an avid sports and recreation junkie. In addition, we see pretty much your garden-variety spine and extremity conditions, many of them chronic.
Also, due to the large tourist population in both winter and summer, we frequently see people for one or two visits while they’re passing through town. Our attempt is to emulate whatever technique their DC back home uses to have the most beneficial result. It is gratifying knowing that we have “saved” hundreds of vacations in Vail for travelers from all over the world.
We also seem to attract chronic and acute disc cases. It is convenient being associated with a neurologist and pain MD’s who can order medication faster (if the patient wants and needs it) than trying to get into their GP’s a few days later. Patients are frequently amazed at their options at our offices.
Lastly, I truly enjoy adjusting infants for ear infections and reflux issues.
TAC: What are your specialties and can you tell us more about them?
Dekanich: I am a diplomate with the American Chiropractic Board of Sports Physicians so, therefore, my specialty is in sports and related injuries. We provide care for some of the top professional athletes in the country and enjoy working in the field at events such as the Honda Pro Snowboard Session, Gravity Games and The Dew Action Sports Tour, to name a few.
I also feel comfortable in managing a case from start to finish and referring to an appropriate allied provider if I feel their collaborative treatment may be beneficial or the logical next step. This can run from referring to another DC, to physical therapy or interventional pain management such as ESI’s. It is simply a higher level of service when a team is working together on a case.
TAC: Which techniques do you use and why?
Dekanich: Full spine with a Gonstead and Pettibon/CBP interest. My extremity work combines proprietary techniques learned from interning and teaching with Dr. Mitch Mally, along with other “pearls” I learned along the way.
TAC: What type(s) of diagnostic testing procedures do you use and why?
Dekanich: When indicated, I order advanced imaging or testing on any patient who is not responding to care. These are mostly MRI scans and EMG’s. It’s important to get the correct diagnosis before treatment is initiated. Again, it’s great working with a neurologist across the hallway.
TAC: What has really impacted your growth as a chiropractor and that of your practice?
Dekanich: Creating a multi-specialty office changes the way you look at treating a patient. You go from having one tool in the tool belt to having a belt with many tools. Patients appreciate the convenience and we achieve remarkable results by working collaboratively. Our statistics indicate the faster we discharge a patient, the more new patients come in. Patients love the “one stop shop” concept, especially when they see results. Yes, we still (and always will) embrace supportive care.
| Dr. Joel Dekanich Toolkit |
| To give you a clear idea of what an amazing chiropractor uses to run his practice, we’ve asked Dr. Dekanich to share with us some specific products & equipment that he uses to reach his practice’s goal of bringing health into their community.
TABLES:
• Believe it or not but I am still using (and love) my Thuli table I left school with in 1994. I can’t even recall how many times it’s been reupholstered but it still is my favorite adjusting table. We also have a Cox flexion/distraction and a VaD decompression table along with numerous hydraulic high/low tables.
DIAGNOSTIC EQUIPMENT:
• EMG, ray and fluoroscopy.
RAY EQUIPMENT:
• Bennett high frequency.
REHABILITATION EQUIPMENT:
• Pilates reformer, phys balls, wobble boards, foam rollers and low tech banding/tubing.
NUTRITIONAL SUPPLEMENTS:
• We carry an array of different nutraceuticals and use primarily Anabolic Laboratories and Metagenics. For acute injury, we recommend natural muscle relaxers such as Ultra Cal-M and Myocalm to anti-inflammatories such as Zymain, Inflavinoid and Kaprex and similar bioflavonoids. Following the guidance of Dr. David Seaman, we promote the anti inflammatory diet and suggest supplementing EPA/DHA, CoQ 10, Magnesium, and a daily multivitamin. This is why I am a big fan of the CORE 5 from Anabolic Labs.
COMPUTER SOFTWARE:
• Medisoft and Write Pad.
OTHER COMPANIES I LOVE:
• Breakthrough Coaching (see ad on pg. 8) for consistently delivering first class products and services. They, like our practitioners believe in consistent, never-ending improvement. I also love the fact that BTC invites outside lecturers like Jack Canfield and Brian Tracy who are masters at quality of life challenges (regardless of your field). BTC truly promotes chiropractic while promoting balance in all areas of life. |
TAC: What marketing strategies do you use to attract new patients and to keep current patients?
Dekanich: We are thankful to have consistent new patients. The best marketing strategy focuses on following a yearly marketing calendar that implements both monthly external and internal projects. Look for “base hits” with marketing and not always “home runs” and always track your statistics. Stop being emotional about the results and confront the brutal facts if something is either working or not. If you are not achieving a 3 or 4:1 ratio on your marketing efforts, stop what you’re doing and change course. Lastly, look for pull marketing as opposed to push marketing.
TAC: With your practice being multidisciplinary, can you tell our readers your advice about setting up and maintaining such a practice in today’s healthcare system?
Dekanich: Every state has a different set of legislature or governing rules in operating a multidiscipline practice. Refer to an attorney who is well-versed in your particular state law on how to operate it legally. Some attorneys will claim they can set up your practice correctly, but make sure it follows the letter of the law in your state. You want to avoid any Stark Law issues and always keep your records and billing clean. Always bill what you do and do what you bill. Multidiscipline offices have a greater susceptibility to egregious billing and other pitfalls, so don’t go there.
One other large challenge is keeping all the providers on board with the vision of the practice. It is sometimes challenging to bring multiple providers with clearly different treatment strategies and philosophies into the collaborative treatment. Only hire team players. You have to check your ego at the door and be the best possible provider in your specialty, but also have enough flexibility to see when something is working or not.
TAC: What advice would you give a new chiropractor just starting out?
Dekanich: First, make sure you want to live in an area before you invest blood, sweat and tears into establishing a practice. It makes no sense to build something great and not enjoy where you live.
Second, never stop trying to improve and learn, as we should all be students for life. Consider joining a consulting group. The systems for effective management, practice building and profitability have already been time tested and proven so why recreate the wheel? It’s also nice to have a one-on-one coach for accountability and to keep you on track.
Lastly, do whatever it takes to surround yourself with a staff that is positive. I am blessed to have such an amazing group of colleagues (and friends) who are possibility thinkers and are dedicated to the vision of our concept. We all put the clinic first.
TAC: What general advice would you give an established chiropractor whose practice might be struggling?
Dekanich: Get back to the basics. Chiropractic works! If you are not getting results, you are doing something wrong. There are so many people who need specific chiropractic and never get it. If your results are average, reinvest some time and money into a technique to learn, master and enjoy. Perhaps, find one specialty that you would like to become the local expert in. That might be pediatrics, neurology or disc cases. Find something you enjoy treating and stick with it and master it. Stop trying to be all things to all people. That’s a tall order and almost always leads to failure and burnout.
Write down exactly what it is you want and then implement Jack Canfield’s “Rule of Five.” That is, do five things everyday that push you to your goal (which you have to have to even know where you are trying to get). Be clear on your vision and your expectations. You’ll be surprised that you will start attracting the things and people you want in your life.
Lastly, stop being territorial. Chiropractors are generally poor referrers within our own profession. Perhaps the technique you’re using is not appropriate on a particular case or an allied colleague may have a more effective solution. The only competition is the vast amount of suffering people who don’t know what to do.
TAC: Where do you see the future of chiropractic headed?
Dekanich: How much space is available? With history as my guide, we are often our worst enemy. We can’t agree on much and we’re divided. That hurts us at both the state and national levels. Our memberships should be higher at both levels as well. Get involved, as it protects your right to practice and earn a just remuneration for your education and expertise. The turf wars will likely get more arduous with the obvious foes and, until more significant and valid research along with substantial funding validates the efficacy, we’ll stay where we are, treating twelve percent of the population.
I love being a chiropractor working amongst “the other guys.” They respect me and our profession (more than you might appreciate) and that is what keeps me coming to work everyday.
You may contact Dr. Dekanich at [email protected] or 1-970-926-4600 x111 or visit www.vailhealth.com.
Editor’s Note: Are you an Amazing Chiropractor that you’d like TAC to highlight in our The Amazing Chiropractor series? Contact TAC’s Managing Director Dr. Joseph Busch by phone/fax at 1-305-399-3917 or email [email protected]. We want your inspiring story! Contact us today!