Chicago-based Rehability establishes the gold standard for patient care
The Rehability team members: (from left) Melissa Stevens, DPT, Jessica Welsh, Seth Lederman, DC, Vincent K. Roberts, DC, Christina Cottini, and John Loduca.
Ask Seth Lederman, DC, for his opinion of what constitutes a successful chiropractic practice, and he will tell you it is one that not only delivers excellent care, but also actually transforms the patients’ experience in receiving it.
“You have to raise the bar higher than it’s ever been when it comes to working with patients,” Lederman contends. “They shouldn’t be made to feel they’re nothing more to you than a number, a chart, and a condition. They shouldn’t have to wait an hour before finally being seen, and the whole time have no one even acknowledge the fact that they’ve been sitting there.
“The days of care being doctor-centric are over. It’s time for providers to get down off their pedestals and recognize that everything is about the patient.”
Such was the thinking that inspired long-established Lederman to leave New York for Chicago and launch earlier this year a practice that could well emerge as a new gold standard for patient care.
“Health care is a commodity,” he explains. “It’s plentiful in most cities—Chicago included. But what’s been in short supply is exceptional health care. That’s a gap that needs to be filled.”
Extraordinary Experience
Lederman says he wants to do precisely that with his new practice, which goes by the name Rehability. It is multispecialty, bringing together providers from the fields of orthopedics, physiatrics, physical therapy, anesthesiology, diagnostic neurology, massage therapy, acupuncture, and more.
“We’re looking to combine mainstream and alternative healing but, more important, to provide care at levels significantly higher than most insurance companies are willing to allow,” he says, noting that Rehability is targeted mainly at the growing ranks of consumers seeking to take charge of their own health—in other words, those who do not object to paying out of pocket for the services they expect.
Melissa Stevens, DPT, and Seth Lederman, DC, review a patient’s MRI scans.
The tagline of Lederman’s one-stop shop includes the phrase “extraordinary experience.” Clearly, he is not blowing smoke when he bandies those words. “We guarantee that patients are seen within 15 minutes of arrival, or the visit is free,” he says, adding that a visit to Rehability is akin to dropping by a Four Seasons hotel, the supremely upscale lodging favored by celebrities and the mega-wealthy. “Our amenities are very high end; for example, we don’t have a waiting room—at least not in the traditional sense. Instead, we have a hospitality suite, and it’s for the enjoyment of patients who arrive early or want to hang around afterward.”
The hospitality suite of which he speaks features a Starbuck’s coffee dispensing machine (cost: $5,000, and apparently the only one of its kind in a health care facility anywhere in Illinois). The suite also is outfitted with a large-screen plasma TV, a state-of-the-art sound system, and WiFi connections for laptop- or PDA-toting patients to check their emails and surf the ’Net.
The hospitality suite is set up in a space just beyond the reception desk, and is attractively set apart by means of illuminated acrylic panels. The reception desk itself is noteworthy in that it is hewn from polished granite and seems to be extruded directly from the wall. A Japanese-style indoor waterfall cascades onto a portion of the granite desk, then meanders along its surface before dropping into an adjacent rock pond. Can you say “chic”?
Farther back are five medical examination rooms (one of which is dedicated to x-ray imaging) and an equal number of semi-sequestered treatment bays. “The bays are curtained off to provide privacy,” Lederman says. “We avoided any truly open-bay configurations to avoid Health Insurance Portability and Accountability Act (HIPAA) of 1996-related problems.”
To make visits as pleasant as possible, Rehability pipes into the individual bays the specific genre of music a patient is known to enjoy. “We ask them while developing their case history what kind of music they like so we can have that music ready to play for them whenever they visit,” he says.
Along with the woofers and tweeters, found in each treatment bay is a top-of-the-line flexion-distraction table, including one outfitted with a multidimensional headpiece for cervical flexion-distraction. Elsewhere, a room set aside for consultations is designed to evoke the comforts of a den at home. “We felt that if we had put a big oak desk in the room, it would act as a barrier between practitioner and patient,” Lederman tells. “Instead, we have comfortable upholstered living room chairs that we sit in. It’s a lot more inviting that way.”
Rehability also has a rehabilitation room containing top-of-the-line exercise equipment. Dry hydrotherapy, meanwhile, is available for use in conjunction with nonsurgical spinal decompression therapy.
On the Waterfront
Rehability en toto occupies a small part of a renovated 100-year-old, 1.5-million-sq-ft warehouse along the Chicago River, about a 10-minute walk from the city’s famous downtown Loop district. Montgomery Ward was the original owner of the building, now converted to a classy mix of commercial, retail, and residential uses (Lederman lives in one of the apartments there, so getting to and from work is a breeze).
Rehability’s 4,000-sq-ft space looks out on a riverfront promenade, affording patients and staff a sensational view. Access is convenient, with buses and trains stopping frequently at the complex. “People can even come by boat—there are slips all along here,” Lederman adds.
No matter how they reach Rehability, patients arriving for the first time go through a trademarked, five-step process of evaluation, treatment planning, intervention, assessment, and follow-up. “The first step is called ‘Insight,’” Lederman explains. “We conduct a thorough evaluation, during which we explore our patients’ values and goals so that we can create a treatment program based around not just their physical needs but also what’s important to them in life.
“The second step is ‘Direction.’ As the name implies, we try to determine the best direction in which to take the patient. That will be based on their individual condition, the services we have available, their physical goals, and other considerations, including their insurance coverage and out-of-pocket budget. Decisions about the direction to take are collaboratively made.
“The third step is ‘Restoration.’ This is where we put our hands on the patient and restore him or her to preinjury status.”
“Reflection,” the fourth step, unfolds in tandem with Step Three and is a type of periodic assessment to measure the treatment plan effectiveness and modify it as necessary. Also measured is patient satisfaction—if that is not found to be sufficiently high, effort is made to raise it.
The final step is “Flight,” where patients are well enough to take wing, as it were. “We celebrate their success, provide education and resources to enable them to take care of themselves at home, and then let them go,” Lederman says. “Our intent isn’t to hold onto a patient forever.”
At least not where chronic-care intervention is concerned. Soon, Rehability will introduce a wellness component in which former patients can continue to stop by and avail themselves of various support services.
Growth Mode
The idea for creating Rehability came to Lederman following a bad experience he had with his own health care service a few years ago.
“I was seriously injured in a Jet Ski accident while celebrating my 40th birthday in Spain,” he shares. “I was thrown from the Jet Ski and landed on my head and shoulder. Back home in New York, I wanted to avoid shoulder surgery, so I went to what was considered a really high-end physical therapy center. The staff was well-credentialed, but the way my case was handled, I felt like a piece of meat. It was a cold experience. They were more interested in my coverage than anything else, and it made me wonder how and why consumers of health services put up with such nonsense.”
Lederman already had been thinking about upgrading the quality of the experience offered to his own patients; this only reaffirmed for him the need to do that—and aggressively so.
“To truly serve patients, a practitioner needs to have in place systems that ensure the quality of care experienced during an encounter is predictable and replicable,” Lederman remembers deciding. “There should be zero deviation from those systems. Staff should be taught that, ‘Here’s the way X, Y, and Z operational tasks are performed.’ Those tasks should become ingrained to the point of being automatic so that the staff is able to focus on taking care of the patients.
“My goal was to have a practice characterized by the efficiency of McDonald’s, the profitability of Microsoft, the thrill of Disneyland, and the spirit of Southwest Airlines. That’s what we’ve done with Rehability—taken the best from corporate America and brought it down to the small practice level where, historically, the bar has been set incredibly low.”
By following that formula, Lederman says he expects to attract enough steady caseload to justify opening as many as nine more Rehability offices in and around Chicago by 2010. “As of the end of this current year, I should have locations for the next two offices secured,” he reveals.
Lederman divulges too that he wants to keep all his Rehability sites within reasonable geographic proximity. “It’s easier to have multiple locations if they’re not scattered over long distances,” he says. “Plus, there are certain economies-of-scale that can be achieved if the units are clustered. For example, you can have one location serve the diagnostic imaging needs of all the others; in so doing, you avoid duplicating equipment from one site to the next, which means you also need less real estate and can therefore concentrate your financial resources on acquiring the very latest and greatest in radiology equipment for the one office responsible for everybody else’s imaging.”
As Rehability expands, Lederman doubtless will be forced to devote more of each day attending to administrative affairs and fewer to clinical care. Even so, he insists he will never completely stop seeing patients.
“To be the best I can be as a CEO of a successful, growing health care enterprise, I need to keep my hands warm,” he acknowledges. “I don’t want to become so focused on running a business that I lose sight of the purpose of the business, which is to help people. Rehability is about helping people, first, last, and always.” CP
Smart Moves  Seth Lederman, DC, is no stranger to success. The first office he opened—Lederman Back Center in Forest Hills, NY—proved to be a winner, especially after being converted in 1996 to a multidisciplinary practice set within a 7,000-sq-ft facility. “Ten specialties were represented in all, starting with chiropractic and including physical therapy, orthopedic, psychology, neurology, podiatry, temporomandibular joint (TMJ) dentistry, acupuncture, and pain management,” he recalls fondly. “I recognized early on that not any single discipline had all the answers, which is why I routinely referred patients to other providers around the city. But, then, by doing that, I wasn’t getting any referrals in return. In fact, I was lucky if I even got back the patients I sent out. That was frustrating. That’s when I decided to develop a multispecialty model, a one-stop shop.”
An ability to conceive and implement wise changes is something for which Lederman has been known throughout his adult life. For example, he originally planned to become a physical therapist until a Boston University schoolmate suggested he consider chiropractic. The friend posed it this way: “Why become a prescription for a medical doctor if you can be a doctor yourself?” Hmmm, Lederman responded. “I picked up a book about chiropractic, read it, found it really interesting, then spent about a week visiting a Boston chiropractor,” he says. “I saw some miraculous things happen to people. I saw people walk in bent over and green, and walk out pink and vibrant. The care was hands-on. And, it seemed like a great line to be in, given that the market was moving toward natural solutions and preventive methods. By the end of that week, I knew chiropractic was my calling.” A New York native, Lederman completed some of his undergraduate work at Boston University before transferring to State University of New York at Albany. He received his doctor of chiropractic degree, cum laude, from New York Chiropractic College and completed additional postgraduate work at the Southeast Back Institute. Lederman eventually sold his New York practice to two associates, a couple of go-getter young doctors who believed they could take it to the next level. Lederman then moved to Chicago in pursuit of bigger opportunities. “I was growing restless in New York,” he says. “I happened to look into a health care situation in the Chicago area, and when I did, it forced me to evaluate the reimbursement profiles and corporate practice issues there. I discovered both were more viable than what New York at that time was offering. In fact, Illinois was one of the best markets in the nation for reimbursement—and still is. Another issue for me was real estate costs and overhead—again, both were lower in Chicago.” Lederman also found Chicago’s ambiance much to his liking. “It’s a city similar to New York in terms of culture, only smaller, cleaner, and friendlier,” he says. “It was my kind of place. I’m proud to be able to call it my home.” |
Rich Smith is a contributing writer for Chiropractic Products.
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