Las Colinas Spine and Sports Medicine strives for a balance of allopathic and conservative care

Mary Collings, DC, and Ted Kern, PT.

Nice guys finish last—or so the saying goes. Evidently, the coiner of that maxim did not have in mind Mary Collings, DC, a warm-hearted and good-natured soul whose barely advertised Dallas-area practice continually takes and holds the lead in the race to be successful.

“People like coming to a doctor who is, above all, kind, caring, and compassionate,” Collings says—something she discovered early in her career. “If you’re that kind of a doctor, they’ll come without much marketing effort on your part. That’s just the way people are.”

Word spreads fast and far about a provider with those traits, as Collings can attest—even in a megalopolis like the Dallas-Fort Worth Metroplex. Consequently, she has been able to build her practice almost entirely on referrals alone. Today, she sees as many as 60 patients each day.

The majority of referrals come from people Collings treated previously. But a sizable number come as well from other health care providers—physicians, in particular. To encourage such referrals, Collings makes a point of inviting physicians to come see her 4,000-sq-ft Las Colinas Spine and Sports Medicine facility in the city of Irving, Tex, and experience for themselves what she offers.

“I want them to fully appreciate how it is that we’re going to treat the patients they’ll be sending here,” she says. “And, once they spend some time with me and my staff, they see what a friendly, comfortable place this is.”

Collings also is at pains to assure the physicians that referred patients will be returned to them quickly. Moreover, she pledges that patients she can’t help will be referred on to providers whom she knows can help them.

The invitation to visit Las Colinas Spine and Sports Medicine is extended by Collings via handwritten notes. She customarily sends such missives to physicians newly arrived in town. She also issues informal, verbal invitations to physicians she meets in the course of her involvement with various community-service organizations.

“It’s amazing how many MDs accept my invitations,” she marvels, noting that quite a few of them not only become referrer but patients themselves. “They trust me and like my approach.”

The Icemen Cometh
So do people from just about every walk of life. As currently constituted, roughly 75% of Collings’ patient mix is ordinary people, ranging in age from babies to near-centigenarians, and including both sedentary and active lifestylers; however, the balance—25%—are elite professional athletes. Since graduating from Parker College of Chiropractic in 1993, Collings has been working with sports celebrities.

For Collings, the most daunting aspect of providing care to superstar athletes has little to do with the nature of their sometimes mind-boggling injuries, but the fact that these individuals are worth so much money. It is a tad unnerving, she hints, to bear responsibility for treating someone whose ability to earn a $6 million-a-year salary derives from rarified athletic skills made possible by a supremely well-functioning body.

Another challenge is that professional athletes frequently require more attention to soft-tissue mobilization, which makes their care more time-consuming.

“Scheduling them for a visit can be difficult not just because of the extra time they require, but because their own schedules are usually pretty full, which calls for flexibility on the part of the care provider. That is not always easy in a busy practice,” Collings indicates.

The professional sports team with which Collings has the closest ties today is hockey’s Dallas Stars. She has been lending assistance to their athletic trainer for 12 seasons now (and that is among the reasons why Collings in 2002 was named Sports Chiropractor of the Year by the American Chiropractic Board of Sports Physicians).

The relationship started when Collings, at the time just launching her practice, decided to contact the Stars—themselves newly arrived in town—and ask the trainer if he might need an extra set of hands. Appreciative of her offer, the trainer sent over to Collings’ office one of his injured skaters to see what she could do for him. What she did was work wonders. Collings has been on board with the Stars ever since.

This year, the entire professional hockey season is on the bench as a result of a salary dispute between the players’ union and the teams’ owners. Even so, Collings continues to be busy helping the Stars—only now, instead of dealing with problems arising from time on the ice, she is taking care of complaints acquired out on the fairways and greens. According to Collins, many of the idled players have sought to keep in shape and maintain their hand-eye coordination by picking up the game of golf. “Fortunately, I already have quite a few professional golfers among my patients; so when the hockey players develop pain in their low back from a day out on the links, I’m up to speed on what needs to be done,” she says. The first thing she does is make sure they’re adequately hydrated. “Most golfers think muscle soreness and discomfort are solely from overuse,” Collings explains. “But a much bigger—and largely overlooked—culprit is dehydration.” Collings herself golfs when time permits, and says, “I’ve been playing the game for about 3 years now, although I don’t keep score—I’m embarrassed to because I’m still not a very good player.”

PT Teammate
Not long ago, Collings took up marathon running (this past January, she participated in her second such event, finishing with a time of 4 hrs, 19 min). One of the reasons she decided to start running was to be able to gain a deeper appreciation of the problems experienced by those of her patients long involved in the sport. “I like to think this equips me to be a better provider of care for their unique needs,” she says.

Mary Collings, DC, adjusts a patient.

Of course, she was pretty well-equipped to do that anyway, even before becoming a runner, thanks to the way her Las Colinas Spine and Sports Medicine enterprise has been put together. For one, it features three private chiropractic treatment rooms, two private massage rooms, an area brimming with rehabilitation equipment, and separate rooms for yoga and training. It is also a comfortable place, offering convenience for seekers of health care services in that right next door is a group of internists.

Importantly, Collings does not practice alone. She is teamed up with a physical therapist, Ted Kern, PT, ATC. “I’m a big believer in the power of chiropractic and physical therapy to work hand-in-glove to produce a better result for patients,” Collings says. “The way we partner on this, I address the pain and injury; then, afterward, Ted gets the patients ready to return to work to their sport. Ted also provides education that leads to a change in their thinking so as to help them avoid ending up back in the same bad situation that required chiropractic care in the first place.”

The workups performed by Collings on new patients typically entail the use of manual palpation as the primary diagnostic tool. “I’m not big on high-tech devices,” she confesses. “I like to be able to feel with my own hands the condition of the muscles. I also like to use my eyes; for example, I’ll customarily have the patient stand up from the chair and walk to the back of the room. I can tell a lot from those motions alone.

“Also, I conduct the exam myself; I don’t delegate that responsibility. That way, I have more hands-on time with patients, which is advantageous for building trust—they usually leave that first encounter confident that I’m going to take good care of them.”

Soft-tissue mobilization—Active Release Technique in particular—is her favorite prelude to adjustment, although she will often include a bit of interferential or ultrasound treatment to further prep the patient.

“I never adjust cold. I always make sure the muscles are warm and ready,” Collings says, adding that she is an adherent of the diversified approach when it comes to working the spine.

Insurance accounts for 80% of the revenue stream at Las Colinas. Cash and Medicare bring in about 5% each; another 5% comes from physician’s insurance and workers’ compensation combined. Those percentages have been consistent for Collings over the years.

“I’m perhaps the only doctor around here who actually likes insurance,” she says, admitting that her fondness for third-party payors has much to do with having an onboard office manager who is meticulous about supplying insurers with claims and supporting documentation in precisely the ways they want those materials—basically, doing everything she can to make their job easier.

Success Begets Success
On another front, Collings agrees with the proposition that many elements go into the making of a truly successful practice, but none is quite so key to that ambition as a good staff. Phone manners, she says, are particularly important.

“If someone isn’t feeling well, the last thing they want to do is come to your office if the person taking the appointment is gruff and mean,” Collings offers. “That kind of conduct only makes the hurt person hurt worse.”

Success also hinges on how much business savvy the chiropractor possesses, she adds. “You need to have at least a basic understanding of the economics involved in the running of a practice,” Collings stresses. “Because, in addition to being a clinician, you’re also a business owner. You can’t be a good doctor if you can’t keep your doors open and the lights on.”

Looking forward, Collings hopes Las Colinas Spine and Sports Medicine will evolve into a more diverse, multidisciplinary practice—or at least be part of a very strong practice collective—where patients will find not only one-stop convenience but access to the best of the best among providers.

“I want this to be seen and recognized by the community as the place you come when you don’t feel well because you know this is the place you’ll leave feeling well, whether it’s me or the provider next door who’s delivering the care.”

For a nice gal like Collings, that approach seems likely to guarantee she will cross the finish line far ahead of the pack. CP

Rich Smith is a contributing writer for Chiropractic Products.