Developing an ergonomics-based practice that can be implemented into your patients’ care and hopefully into the workplace is a very exciting venture. However, you must be ready for the work that is ahead.

First, let’s look at the history and meaning of ergonomics. Italian Bernardino Ramazinni (1633-1714) became the first physician to write about work-related injuries and illnesses in the 1700s. He called it, “De Morbis Artificum (Diseases of Workers).” It was later changed by a Polish biologist Wojciech Jastrzebowski in the late 1800s to “ergonomics.” (Greek translation of “ergon” is “work”; “nomos” means “laws”).  In the early 1900s It was called “scientific management” by Frederick Winslow Taylor; his approach was to find and implement the best method to perform a job and its tasks. Taylor focused his career on incrementally reducing the size and weight of coal shovels until the optimum shoveling rate was reached. Taylor tripled the amount of coal that workers could shovel in a day. Ergonomics also played a role in the 1940s during World War II, with the design of airplane cockpits to prevent human error. Today, ergonomics is made up of 20 sub groups, with the four most common being anthropometry, kinesiology, physiology, and psychology. For the purpose of this article, we will focus on kinesiology.

We Are Not Ergonomists
Kinesiology is the study of human movement and should not be confused with applied kinesiology, which is form of treatment. As chiropractors, we have a very good understanding of human anatomy and we see that when individuals do not work in a safe and efficient manner, they get injured. Workplace injuries occur from micro trauma (repetitive sprain strains such as carpal tunnel syndrome) or macro trauma (frank sprains such as lifting injures or falls). Ergonomic trauma should also be separated into specific dates of loss (macro) and non specific dates of loss (micro), this is especially useful in the workers compensation programs. Kinesiology also includes the actual treatment of work related injuries from DC, PT, OT and MD care and depending on the nature of the injury what licensed professional would be the best to manage and treat the care, this form of health care is become more and more the common than the uncommon, especially the DC, PT/OT and MD care.

As doctors of chiropractic, we do not want to portray ourselves as an “ergonomists.” Ergonomics entails much more than injury treatment and prevention. It encompasses anthropometry, biomechanics, engineering, kinesiology, physiology, and psychology to name a few.

Focus on Injury Prevention
Chiropractors who practice kinesiology or the management and treatment of work-related injuries on a daily basis do so by dividing the two separate departments, injury prevention and injury treatment. The big question that has you sitting at the edge of your seat is, “How do I get into industry to get more patients?” This article will focus on injury prevention, not the treatment.

First, it is a paradigm shift from the chiropractic to the allopathic model. It should not be about “How do I get into industry to get more patients?” That is why most human resources departments shutter at having employees treated with or having chiropractors “come in for a free lecture,” which many times is just a way to get access to their staff and insurance benefits.

The chiropractor should position himself as a consultant, charge a professional fee for the evaluation of the work site, and review the most common claims, with a written plan of reducing the claims. Also focus on injury prevention based on the work-site evaluation. If the company chooses to use you for patient care, then all the better. However, they should be treated as completely separate entities of your practice, so no conflict of interest exists.

The best way to develop a program is to do just that—develop a program on carpal tunnel syndrome (CTS), low back injuries, or a job-specific injury based on that industry. The program should include a professional PowerPoint presentation covering topics in your area of expertise.

Again, how do you get into a work place? I have had success speaking with the human resources departments of large local companies, as opposed to large national companies that always need corporate clearance. I have also had success targeting small companies. Large companies have money in the budget for consulting and also are more willing to allow you to make a presentation than the small company, unless you have a personal or professional relationship with someone in a small company. Industry is mainly interested in reducing the reportable claims, which is the amount of injuries that require a doctor’s visit or require lost time.

Much of our selling and marketing point as chiropractors is that we are the best at treating musculoskeletal trauma; thus, we are best at preventing it. When an employee suffers a work-related injury, that is the best time to speak with the safety manager and human resources department to perform a workplace analysis to prevent that injury from reoccurring and keep employees at work injury free. Once you start to develop rapport with the company, always remember that the company is looking at the bottom line. Its concerns are with cost of the care and return-to-work status. Keep in mind the paradigm shift from the chiropractic treatment model to the allopathic model.

Develop a relationship with the local medical specialists—such as orthopedists and hand specialists—who handle work injuries. You can start by calling them when you have common patients together. You can discuss the care, inform them of your type of treatment, and ask for any input. Once you become accepted in the medical community as a “qualified care provider,” ask for a recommendation from the doctors and use it as a segue into industry.

Your patients can also serve as a marketing tool. Make them your advocates at the workplace by eliminating their pain and getting them back to work quickly, and giving them at-work exercises that they can share with their coworkers. Once you start to treat a few patients with the same condition from one company, that is also a great time to call the company, set up a time to meet, and discuss the commonalities that you are seeing and how you think you can help them and their workforce.

Stephen C. Piserchia, DC, CCRD, practices in New Haven, Conn. Contact him at spiserchia@AHP-Health.com