CASE BY CASE: Entire clinic meets regularly to review each patient’s care
James Spina II, D.C., Davenport '81
Dolson Medical Plaza, Middletown, N.Y.
Years ago, Dr. James Spina, left, recruited like-minded healthcare
practitioners who could work together to “provide the
highest-quality and most-comprehensive care in the area.”
After years of running a successful practice,
Dr. James Spina II found himself drawn to
“Seeing the way patients were handled by other
practitioners or therapists, I knew I could do a
much better job,” he recalls. “So instead of
referring them out and the patients not being
satisfied, I decided to provide the same care all
in one place and now it’s working well for everyone
involved. Patients love it.”
At Dolson Medical Plaza, Dr. Spina practices
alongside other chiropractors as well as massage
therapists, acupuncturists, physiatrists, nurse
practitioners and physician assistants.
“We all work as a team and review all patient
charts twice a week,” he says. “We review any
tests that have been ordered such as MRIs, CAT scans, EMGs, special X-rays or any test the medical practitioners
or chiropractors may have ordered. This way everyone who touches the patient knows their condition as well as
their progress and test results.”
The group also discusses the best treatment for their patients, whether it be chiropractic care, physical therapy,
medical care or a combination of all three. While this environment can increase one’s referral base, Dr. Spina
says that the main reason to pursue a multidisciplinary care career should be out of a need to create change.
“I think B.J. Palmer said it best,” he adds. “‘Your right hand is your service hand and your left hand is your
money hand. If you do a good job with your right hand, you never have to worry about your left hand.’”
Sports chiropractors on the roster at integrative clinic
Taylor Rabbetz, D.C., West ’00
Chiro-Medical Group, San Francisco
Four of the providers at Chiro-Medical Group are West Campus
alumni. From left, Michael Lord, D.C., ’10, Daniel Lord, D.C.,
’08, Hal Rosenberg, D.C., ’01, and Taylor Rabbetz, D.C, ’00.
When Dr. Taylor Rabbetz began working at
Chiro-Medical Group (CMG), a multidisciplinary
practice in San Francisco, he thought
most of his time would be spent developing
the practice. Nearly 12 years later, he divides
his time equally between running CMG and
caring for his patients.
“Although I essentially maintain two fulltime
jobs,” says Dr. Rabbetz, “I love what
I do: being a chiropractor and helping
patients achieve optimal health.”
With 17 patient-care rooms and a fullyequipped
rehabilitation center, CMG
specializes in helping patients manage
sports-related injuries. Its sports chiropractic
staff includes Dr. Rabbetz, who played on the
Palmer Pride ice hockey team, and three other West Campus graduates, (above). Additional providers include
exercise rehabilitation specialists, physical therapists, M.D.s and a nurse practitioner.
“In the acute stage for injuries, medicine has a great role in decreasing pain,” notes Dr. Rabbetz, referring to the
scope of care provided at CMG. “However, for long-term success, patients want more. They want to know what
types of stabilization exercises they can do; and what stretches they can do in order to help reduce the risk of
suffering the same injury again. We fill this need with an ‘all-in-one’ facility.”
Healthcare with childcare
Tom Young D.C., Florida ’06, CCSP
Florida Campus Alumni Office Representative and Instructor
“I left school ready to
others how chiropractic
care can integrate
into current models,”
says Dr. Tom Young,
who found the
perfect outlet at
an integrative practice
in Raleigh, N.C.
Before joining the Florida Campus faculty in 2010, Dr. Tom Young was part of
the American Institute for Healthcare & Fitness (AIHF) in Raleigh, N.C. Set up
like a shopping mall, AIHF is filled with healthcare practitioners instead of stores.
Those providers include chiropractors, acupuncturists, massage therapists, family
practitioners, orthopedists, mental health professionals and imaging specialists.
“Many of us collaborated on patient cases, marketing and community service,”
says Dr. Young. “The lines of communication were always open. The providers
would meet regularly to educate each other about the types of patients we were
best suited to treat.”
According to Dr. Young, the close proximity of AIHF’s providers allows for faster-than-normal lab and imaging
results, and more timely referrals—saving patients time and the need for return trips. The facility also offers
families the conveniences of a fitness center, pharmacy, café and childcare center.
“Getting to know practitioners and collaborating on cases not only increased referrals to each other,” he says, “but
was a great learning experience as I was exposed to cases that I may not have seen in a stand-alone family practice.”
Dr. Young recalls two patients in particular who benefitted from AIHF’s multidisciplinary setting. The first had
ankylosing spondylitis, and another dealt with debilitating headaches and low back pain. “I was able to consult
with several providers regarding appropriate and available treatment and co-manage their care, so that they got
the pain relief they needed as they progressed,” says Dr. Young.
Pain management for patients undergoing cancer treatment
Jeffrey Sklar, D.C., Davenport ’97
Eastern Regional Medical Center, Philadelphia
Dr. Jeffrey Sklar, right, discusses pain management care with
a patient, left, and naturopath Dr. Sheba Roy, at the CTCA
hospital in Philadelphia.
What would a chiropractor be doing at the
Cancer Treatment Centers of America (CTCA)
hospital in Philadelphia? Plenty. Dr. Jeffrey
Sklar doesn’t treat or diagnose cancer at CTCA,
but provides chiropractic care to patients
receiving cancer treatment. Sometimes, he’s
asked to adjust patients the day before they
“My focus is to find and remove vertebral subluxations
and help patients with common side
effects to treatment such as chemo-induced neuropathy
or tissue fibrosis, which can often occur
with radiation treatment,” he says. “Additionally,
I assist in pain reduction, with the intention of
reducing the need for pain medication.”
Recently, Dr. Sklar had a patient with a chemo-induced
headache that kept her from sleeping through the night. After an adjustment, her headache went away
and she slept normally again.
Like all CTCA facilities, the Philadelphia hospital assigns a multidisciplinary care team to each patient. It also has
the “Mother Standard,” whereby each patient and caregiver is treated “like one would treat a member of their own
family.” The mission has special meaning to Dr. Sklar, as three of his immediate family members have had cancer.
“The patients here are truly amazing people,” he says. “They bring an undaunted spirit to the hospital, a spirit I
have never experienced before in my life. And, on top of it all, they thank us for being here.”
Some D.C.s make house calls. Dr. Doug Briggs makes hospital calls.
Doug Briggs, D.C., Davenport ’95
Beebe Medical Center, Lewes, Del.
At Beebe Medical Center, Dr. Briggs
says he’s noticing increased referrals
from orthopedic spine surgeons for
pre- and post-surgical pain, and also
as an option to try and avoid surgery.
“I am listed as ‘on call,’” says Dr. Briggs, referring to his working relationship
with Beebe Medical Center in Lewes, Del. “And if any attending doc
or hospitalist requests my care, I can see the patient in their room or in my
office upon dismissal.”
Dr. Briggs says having hospital privileges has given him a range of patients
with conditions that he might not otherwise get to treat. He cites one man
with spinal fusion pain who, under chiropractic care, was able to stop taking
narcotics and resume his regular workload.
“Patients in hospitals need chiropractic care, too,” he points out. “But if we
aren’t there to participate, how are they going to know what we can do?”
Dr. Briggs stresses that he’s developed good working relationships with
other providers at the hospital, which has, in turn, resulted in mutual
respect for everyone involved.
“Working in a hospital, or with medical doctors, does not dilute the
value, philosophy or ideals of chiropractic,” he says. “We have different
care options to offer. Isolating ourselves from mainstream health care
serves no benefit.”
Alaska Native gives back to her community
Angela Michaud D.C., Davenport ’08
Alaska Native Medical Center, Anchorage
Dr. Michaud has
found her training
at Palmer on
be very helpful.
Dr. Angela Michaud is a fourth-generation Tlingit
Alaska Native working her dream job: as a chiropractor
for Southcentral Foundation in the
Primary Care Center at the Alaska Native Medical
Center (ANMC) in Anchorage. Her patients are
Native American/Alaska Native descendants or
employees of ANMC.
“I love working in this setting because I am giving
back to my Native community,” she says. “A lot
of the patients I see would not be able to see an
outside chiropractor due to financial situations.”
Dr. Michaud is very appreciative of her education
at Palmer because the hospital receives patients
with all types of diagnoses that accompany their
musculoskeletal conditions. Her own patients are
referred to her by primary care physicians with whom she stays in contact regarding patient findings, care
and progress. “We also will contact them if we find useful information for their treatment plan or if we need
to have further studies ordered, such as MRIs or blood work,” she says.
Dr. Michaud encourages any chiropractors who are Native American or Alaska Native to contact a new
organization, the American Indian Alaska Native Doctors of Chiropractic (www.AIANDC.org) to help
provide more chiropractic care to Native communities.
New grad takes integrative initiative
Mike Olson, D.C., Davenport ’11
Bigfork Valley Hospital, Bigfork, Minn.
Dr. Mike Olson was
one of two class
salutatorians at the
Feb. 25 Davenport
Within days of walking across the stage at his graduation, Mike Olson,
D.C., walked into the hospital in Bigfork, Minn., and became its first
chiropractor. Dr. Olson had initially interviewed at an integrative orthopedic
clinic in Grand Rapids, Minn. While they didn’t have any openings,
they referred him to Bigfork Valley Hospital, where he now works.
“The clinic I initially applied at was not currently hiring, nor was the
hospital,” he says. “However, by taking the initiative and sending them
my résumé, much progress was made.”
His contract with Bigfork Valley provided him with two adjusting rooms
at the hospital and another two at the hospital’s clinic 15 miles away,
where he provides care once a week. “They’ve given me the wonderful
opportunity of developing a great system for the hospital,” says Dr.
Olson. “They are very open to all of my opinions, questions, concerns
and the way I envision myself practicing.”
“Chiropractic needs to be involved in multidisciplinary health care,” he
says. “We have so much to offer our patients, and by becoming involved
in a multidisciplinary setting, we not only can educate our patients, but
we can also educate other healthcare professionals as to what we do.”
Free care that has great value
Steve Agocs, D.C., Davenport ’00
Volunteer at Kansas City Free Health Clinic
Dr. Steve Agocs with a patient, who comes in regularly
to see him for adjustments as part of her overall care,
at Kansas City Free Health Clinic.
Dr. Steve Agocs first worked in an integrative
healthcare setting while precepting. Today, he
provides care part-time at the Kansas City Free
Health Clinic (KCFHC), one of the largest of
its kind. On average, Dr. Agocs sees 30 to 45
patients during the eight hours he donates
“My work at KCFHC has become the highlight
of my week, and it is very rewarding in a
professional sense,” he says. “I get to see cases
like none I ever had in private practice, and the
satisfaction of being able to use my talents to
help people who would otherwise not have
access to chiropractic care is just incredibly
rewarding in every way.”
Dr. Agocs regularly sees patients with multiple complaints, including a man who has lived with a heroin
addiction and diabetes for 10 years. Chiropractic pain management has proven to be critical for patients
like him because it doesn’t interact with drugs and can prevent the need for additional medications.
“There is an enormous market for chiropractors in the medical system that is almost entirely untapped,” he says.
“But a little bit at a time, all of us who work in a multidisciplinary setting are showing other professionals how
valuable chiropractic is to patients and, frankly, their bottom line.”
Where med students do chiropractic rotations
Donna Frederick, D.C., Davenport ’06
Frederick Family Chiropractic, LLC, Muncie, Ind.
Seen adjusting one
of her younger
patients, Dr. Donna
to host students
from a local hospital
to observe her work.
Some medical school students must observe the care of hospital
patients under the guidance of an attending physician. In Muncie,
Ind., some med students also do a rotation at the chiropractic clinic
of Dr. Donna Frederick.
Each rotation involves a student in residency at Indiana University
Health Ball Memorial Hospital observing Dr. Frederick during one
four-hour visit as she performs patient exams, gives reports of finding
and interacts with and adjusts patients. In some cases, the two
will discuss how each would address a particular patient’s case
before weighing the pros and cons of both actions. As an added
bonus, students are free to interact with the patients.
“They talk to the patients to find out how chiropractic has helped
them,” says Dr. Frederick, who believes the visits provide a win-win
opportunity for both parties.
“We don’t want the M.D.s to be closed-minded about what we do,
and we shouldn’t be closed-minded to what they do,” she says. “It’s
a learning experience.”
“I enjoy getting an opportunity to teach the residents things that they may not otherwise learn or be exposed
to,” she adds. “Plus, it’s always fun if they want an adjustment after their round with me!”
Creating a hospital’s first chiropractic department
Steve Barnett, D.C., Davenport ’79
Director of Chiropractic Relations, DeKalb Medical Center, Decatur and Conyers, Ga.
When Steve Barnett, D.C., retired from his successful, 30-year practice in Stone Mountain, Ga., a few years
ago, he never envisioned himself as a pioneer in enhancing collaboration between D.C.s and M.D.s. “I was
bored,” he says, “so I started a management company to facilitate chiropractic referrals to a hospital setting
for outpatient care, specialty consultation and diagnostic imaging services.”
After presenting his idea to the administrators of DeKalb Medical Center, with nearly 600 acute care beds and
campuses in several Atlanta suburbs, the hospital administration asked him to work for them and create a
chiropractic department. Dr. Barnett became the director of chiropractic relations for DeKalb Medical Center
(DMC) in Decatur and Conyers, Ga. He quickly began developing a network of Atlanta-area chiropractors in
the fall of 2009, which is now more than 175 members strong.
“From the beginning, the hospital staff was very impressed with the level of knowledge of the chiropractic
practitioners,” Dr. Barnett says. “The hospital’s imaging department has received most of the referrals, but
nearly all specialties have received chiropractic referrals and the hospital is reciprocating.”
The chiropractors are listed as non-staff physicians and invited to come to the hospital at any time, he adds. “I’ve
learned how the hospital works and they are learning a great deal about us, our education and the quality of care
The role of the chiropractors at DMC was expanded dramatically beginning in November 2010 with the start of an
emergency room chiropractic referral program. Through this program, all low-level motor vehicle accident (MVA)
patients coming into the DMC emergency room will be referred to the network of chiropractic providers for DMC.
These are ambulatory patients without cuts or broken bones, but who are experiencing back or neck pain. They
are stabilized in the ER and then referred to one of the chiropractors in the DMC network.
Dr. Barnett credits the “tremendous, tireless support of the chiropractors” in the referral group with the success of
both the original referral program and the new program for low-level MVA patients. “It is estimated that this new
program could introduce 300 patients per month to chiropractic care,” he says. “For those in our profession who
are worried that chiropractic will go the way of osteopathy, make no mistake—our program is one of integration,
not assimilation. It’s a wonderful concept that puts the patient first.”