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Advanced Medical Integration |
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January 14, 2019 Issue |
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CEOCFO MAGAZINE |
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Q&A with Mike Carberry, CEO of Advanced Medical Integration providing a Medical Services System that allows Practices to Integrate and Work with Chiropractors and Regenerative Medicine to achieve Better Patient Outcomes and Lower Healthcare Costs |
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Chief Executive Officer
Advanced Medical Integration
Interview conducted by: Lynn Fosse, Senior Editor, CEOCFO Magazine, Published – January 14, 2019
CEOCFO: Dr. Carberry, what is the concept behind Advanced Medical Integration? Dr. Carberry: What we are trying to do is get licensed professionals in healthcare, from different professions, to work together on patients for the purpose of a better patient outcome. We are trying to do it in a way that focuses on function instead of symptoms. For example, most of our clients have physical medicine programs. Many of our clients are chiropractors who hire medical people. Some of our clients are medical people who hire chiropractors. What we do is we teach them how to work together and how to try to get a better patient outcome by trying to improve the function of the patient instead of just giving the drug for their symptom.
CEOCFO: What is the stumbling block for members various communities in understanding the concept? Dr. Carberry: There are quite a few stumbling blocks. One of them is chiropractic. Many of our clients are chiropractors and chiropractic, whether it deserves it or not, over the years has developed a bit of a stigma on their reputation. Even though most people agree that chiropractic is a good service, there are many people hesitant to go, because they are not sure what it is. Therefore, we are trying to put that wonderful service, (I am a chiropractor), in the main stream medical with the philosophy of let us do what we can to get this patient better based on function, not give him drugs just to cover up the symptom. That is one of the stumbling blocks. The other stumbling block is, since we are not prescribing a lot of drugs, we have run into difficulties from the mainstream medical community like the AMA and the pharmaceutical industry, which is a very powerful industry. I would say that they are not happy with the stuff that we do.
CEOCFO: Why is it taking so long for chiropractic to be accepted? Dr. Carberry: Part of that is chiropractor’s fault. Part of that is the medical communities fault. Part of that is the public’s fault. Chiropractors are a valid therapy and there was a lawsuit back in the 1970s that was finally settled in1987 and it was the Wilk verses the AMA case. Chester Wilk was a chiropractor. He did a class action suit against the American Medical Association for restraint of trade. In fact, the judge, Susan Getzendanner, a federal judge, in the appealed case stated that the AMA did conspire against chiropractic because we were a financial threat to their industry and to the pharmaceutical industry. What they wanted to do was give chiropractic a bad name. That was a very effective strategy. In her closing remarks she said, “It could take decades for the chiropractors to overcome this.” Now, chiropractors have made advancements, but still survey shows that about ten percent of the population goes to a chiropractor and ninety percent do not. The leading health problem that human beings have in this country is chronic degenerative arthritis, which is something that a chiropractor can have a dramatically positive effect on. Therefore, it is a shame that there was this conspiracy because we do not prescribe drugs to make us look like bad guys. Chiropractors kind of fell into that by withdrawing and saying, “Then we are going to be isolated and we are not going to participate with anybody else.” What the purpose of AMI is, you know what, there is good in all professions. I truly believe that eighty percent of medical doctors and eighty percent of chiropractors and eighty percent of nurse practitioners all went to school with the purpose of learning how to help their fellow man. It is the twenty percent that mess things up, so what I suggest to our clients is to make sure that when you are dealing with someone you are dealing with that eighty percent whose drive and purpose is to help you to get well and that is what we are trying to do.
CEOCFO: How are you putting professionals together? Dr. Carberry: That is an interesting question, for example, I was just on a phone call before this interview and it was with a surgeon who was saying, “I want to do things less invasively and I like your concept, I have been looking at your videos.” What we are doing is, we have coaches that when he signs up with us, he will get assigned a coach. The coach has a training program to put in the systems that my wife and I have developed over the last twenty-five to thirty years. My wife is a physical therapist, I am a chiropractor. What we do is we have created a system to put medical personnel, chiropractors and physical therapists working together and not overstepping the bounds of their license. We teach them how to do that. Of those professionals, the medical license is the senior license. Many times, our clients are chiropractors. We have to teach them how they can bring medical people into their clinic, but they have got to make sure that they are not violating their corporate practice and medicine law, meaning that they are telling a medical doctor how to diagnose or how to prescribe. The idea is that they get someone of a like-minded philosophy, like the medical doctor that I just got off the phone with. He said that what he likes to do is he likes to help patients avoid surgery and avoid drugs whenever he can by doing less invasive things first. That is why he is interested in our program. We have put together a compliant model like that. There are things that medical personnel can do that a chiropractor cannot do, which dramatically improves the healing rate of the case. One of those things is Regenerative Medicine, (stem cells) or other injections like hyaluronic acid or even lidocaine injections or procaine injections, which is what John F Kennedy was getting as president of the United States after he injured his back in World War II. Therefore, we find doctors who are interested in these types of services, (which it is surprising how many are). Some of them have training on it, but most of them do not, so we help to facilitate getting them trained. For example, we have a nurse practitioner that works with us and she is licensed to teach continuing education to nurse practitioners on ultrasound guided injections, like joint injections, trigger point injections and so forth. She teaches that model to our clients. The good thing about it is that they also get continuing education credit hours after they that course with her. They have to pay for the course, but they are killing two birds with one stone. They are learning a very non-invasive way to inject some very safe substances and it goes perfectly with the philosophy that my wife and I have as far as helping people avoid drugs and avoid surgery by improving the function of the joints. That is how we do it.
CEOCFO: Do you find that it is primarily younger practitioners in all the disciplines that show an interest or is it reaching some more established people as well? Dr. Carberry: The surgeon that I just got off the phone with is in his fourth year of practice. However, we have reached across the board. We have new practitioners looking at it, but we have older practitioners looking at it, because especially for a chiropractor, chiropractic is rough on the body. If you have a high-volume practice, I do not think that people realize how it affects the chiropractor’s body. I had a very high-volume practice in Pennsylvania and I still have some arthritic conditions in my wrists and my fingers and my shoulders. I have had shoulder surgery twice from the trauma of adjusting patient after patient after patient. Interestingly enough, stem cells are something that would have probably prevented from having to get surgery if I had used it at the right time. We were not aware of that treatment back then and I learned of that treatment through the medical people. Therefore, by bridging this gap between medical people and chiropractic people, what is happening is services that are better for the outcome of the patient are coming together. Hence, the answer to your question is that we are reaching across the spectrum. We have guys that are seventy years old reaching out to us saying, “Hey, I am a little bit beat up and I want to put other services in my practice.” We have people that are at the very beginning of their career saying, “This seems to be a better way to go, I would like to do this,” and everything in between.
CEOCFO: Where does reimbursement come in or is it pretty straight forward these days in chiropractic? Dr. Carberry: There is nothing straightforward about reimbursement. The Affordable Care Act definitely put a spin on things. There are some aspects to that law that really muddied the waters. For example, one of those aspects is that an insurance company cannot make more than fifteen percent profit. That is what I have been told by various attorneys. You look at that and you say, “Okay” I have had at least one person tell me this. They said, “If you were an insurance company would you rather cover a non-invasive treatment that would help someone with degenerative back disease that costs five thousand dollars or would you rather cover a fifty-thousand-dollar surgery. If I am getting fifteen percent, I think I would rather cover the fifty-thousand-dollar surgery.” And then they said, “Would you prefer to have it work or not work, because if it does not work, they are going to have to get it again.” And I started looking at it saying, “That is a bizarre viewpoint on reimbursement for healthcare! It is actually more profitable for the insurance companies to cover more expensive things! It is also more profitable to cover things that must be repeated!” Therefore, that really muddies the waters. Many of the services, like Regenerative Medicine, are still cash services. They are not covered by anyone. Yet, they are so inexpensive compared to a surgery. The patient looks at it and says, “With the surgery, my out of pocket is about the same or maybe slightly more or slightly less that the Regenerative Medicine,” but they are comparing apples to oranges. If you look at the overall cost of surgery verses Regenerative Medicine, the latter is significantly less expensive. They are significantly less invasive and have significantly less side effects. Regenerative medicine is the art of using different types of tissues to help people heal, whether it comes from the patient’s body, like PRP, which we do some of that, which is Protein Rich Plasma or when we look at things like amniotic or umbilical cord tissue stem cells and that would come from a donor; from a healthy born baby. It is not an abortion; it is a healthy born baby. However, when you get these tissues, basically they are immune privilege, which means it is the barrier between the Mom’s immune system and the baby’s immune system, so they do not attack each other while the Mom is pregnant. That protective immune privilege makes it possible for this to be a very safe procedure in other people. This was first discovered back in the 1900s. There is an article where that was a doctor using amniotic membrane tissue and laying it on burn victims in 1913 and their skin was growing back in a very, very healthy way after they had a burn. It was actually the regenerative tissue in that amniotic membrane of the placenta that helped that tissue to grow back. That article was published in a prestigious medical journal. I think the doctor’s name was Maximillian Stern. That has now evolved into people looking at using Regenerative Medicine to help overcome degenerative arthritis. I am giving you the very skimmed version of this, but regenerative medicine is the art of using these tissues that are usually rich in stem cells or whether those stem cells or your own stem cells are stimulated to kick into gear, what we notice is a very high percentage of people who utilize this type of therapy get well faster and sometimes to levels that they never would have gotten before and we help people avoid surgery. Sometimes they have to get the surgery, but our goal is to help them avoid it; avoiding knee replacement, avoiding hip replacement or back surgery or neck surgery and things like that.
CEOCFO: Do you work with your clients or the practices on an ongoing basis or do you help them set up and then they take it on their own? What is the business model? Dr. Carberry: It is a two-year contract, because the first year is usually implementing a lot of systems. What my wife and I did was we recognized the value of systems in a business. My undergrad degree was in marketing. I did not go to school wanting to be a chiropractor. I got injured after I graduated from college. I had been working for a very large marketing company, the largest one in the world, and I basically got injured and ended up going through the whole medical system; being put on pain management, and not getting the answer. What happened was I eventually turned to chiropractic. My wife was kind of worried about that, because she is a physical therapist and she said, I heard that chiropractors are not really scientific, they are not real doctors,” and when she saw the results I got, she completely flipped her viewpoint on it. That is because she realized it is very scientific and it works. It is not like voodoo. It is just working with the function of the body and facilitating movement. Therefore, we became very, very passionate about chiropractic; that is how we got started. Putting that model together with the medical, it is a lot of work, so the first year is usually putting those systems in place. We recognized that we had to add systems if we were going to be able to step back and continue to grow and maybe open multiple practices or teach other doctors how to do our system like we do with AMI. We cannot be in the trenches doing the work, but to have good quality care we had to have good systems, so the clinicians who are in our clinics can make decisions that in agreement and alignment with the purpose and philosophy of the company and that is avoiding drugs, avoiding surgery whenever possible and the least invasive way possible to get the patient well. Therefore, we have created these systems and that is what we teach. The second year is usually working out the bugs. We do it by having trainings and conventions and coaches in constant communication with our clients. After the two years the bulk of the work is done. Most of our clients sign on for continued association with us, because they recognize the benefit of being part of this group and the group is getting larger and larger and larger. We do two conventions a year. The last couple of conventions that we did we had about five hundred people at these conventions and it is growing. Our goal is to keep connected with our clients so that we can grow as a team and actually facilitate a change in healthcare. That change that we are trying to facilitate is to start to focus more on function of the body instead of symptoms in the body, which are very unreliable.
CEOCFO: Can you tell when you are first working with professionals and you are putting people together whether it is a good fit from philosophy, from personality, from level of expertise maybe? Dr. Carberry: It is a combination of all of the above. Level of expertise is important, but I would say probably the least important. One of the things that we try to explain to our clients is that you need to have those discussions about purpose and philosophy and all of that, but you also need to do some observation in this interview process. We like to do some pre-employment testing and then maybe set up a shadow day, letting the candidate follow the owner/clinician around for a shift. This way they can see how the candidate interacts with other employees and other patients. Certainly, if you get someone who really interviews well, but then you put them in with other employees and they are looking down at them like, “Well, I am a doctor and you are just a peon,” that is not someone who would work out very well in my clinic! Therefore, I would want to know that before I hired them. I have respect for all my employees and I want my employees to have respect for each other, no matter what level they are at. Hiring is also an art. I would not say that I have perfected it, but I would say that I am really good at it compared to many and certainly better than I was thirty years ago when I started into this business.
CEOCFO: What has changed in your approach over time? What have you learned? Dr. Carberry: The biggest thing I have learned is, one, never think you know it all, because the moment you know it all, you stop learning new things. Number two, that your job as an employer is to inspire your employees, not force your employees, to do the job. That second one is huge! I have realized that by inspiring people, I get way more accomplished than I do by trying to force them to do a job.
CEOCFO: Did you recognize that over time or did you sort of wake up one day and have an epiphany? Dr. Carberry: I think I started recognizing it over time and it led to waking up one day and having an epiphany. Some people say to me, “You are an overnight success,” and I say, “Yes, it took me thirty years to become an overnight success.”
CEOCFO: You are on the Inc List, which indicates business is good. How do you continue the trajectory or is it sort of growing on its own today? Dr. Carberry: We definitely have a plan to continue the trajectory. It is growing on our reputation. However, we have definite plans in our marketing to keep reaching out and being in front of people. One of the keys to our growth was also, as we started getting attention through our marketing, we scaled our business focused on our corporate structure. We focused on businesses staffing, not over staffing. That is because I believe one can motivate a slightly understaffed group more effectively than an overstaffed group. However, if you cannot deliver and you cannot live up to your promises then that is a great way to burn out. It is riding that rail exactly at that level where we are going, “we are slightly understaffed, but we can still deliver more than we promise and we are keeping it at that level.” Therefore, we are constantly in a hiring model. One of the benefits of our reputation becoming more recognized, is that we are attracting a very high-caliber level of applicant. Our staff has doubled in our consulting company from fifteen to thirty employees, because we doubled the number of clients we have. We already had our meeting yesterday and we are going to double the number of our clients again this year. We also know that we are scaling to handle that volume as well.
CEOCFO: Why is Advanced Medical Integration so important? Why is your approach to pain management a meaningful concept? Dr. Carberry: The reason that I think Advanced Medical Integration is so important is because we have gotten a little bit out of control with our viewpoint on healthcare in this country. Basically, in this country, there currently exists a model of care for chronic degenerative arthritis that is pain management. Pain management officially is the leading cause of death fbor Americans under the age of fifty. It is a crisis. There is no one really coming up with an alternative to that. What we teach our clients is an alternative to that. It is actually saying, “Alright, I understand you are in pain. We do not want you to be in pain. However, let us fix the function of your body so that that pain does not continue, instead of putting you on a drug that is addictive that can lead to heroin addiction.” That is why we have gotten the attention of people like Dr. John Rosa, who is affiliated as a surrogate for the White House Committee on Opioid Abuse. Dr. Rosa has connected with our company and likes what he sees. That is because he says we have a program that could stop the prescription of opioids; not completely, but we could certainly reduce it to a normal amount. The United States is 4.6% of the world’s population and we are consuming more opioids than the entire rest of the world combined. That needs to stop and Advanced Medical Integration has made that their key purpose in changing that therapy which has been so costly to American lives. That is why we are important.
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“Let us fix the function of your body so that that pain does not continue, instead of putting you on a drug that is addictive that can lead to heroin addiction.”- Mike Carberry
Advanced Medical Integration
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Integrative Healthcare, Advanced Medical Integration, Integrative Medicine, Mike Carberry, Medical Services System that allows Practices to Integrate and Work with Chiropractors and Regenerative Medicine to achieve Better Patient Outcomes and Lower Healthcare Costs, CEO Interviews 2019, Healthcare Companies, Integrative Health Practitioner, Medical Integration Services, Medical Integration for Chiropractors, Medical Integration Systems, how medical integration affects patient outcomes, Adding Holistic Medical Services and Regenerative Medicine to your practice, Advanced Medical Integration Press Releases, News |
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Mike
Carberry