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#062: Crossover’s Integrated On-Site Healthcare with Dr. Daniel Lord

Dr. Daniel Lord is a Chiropractic Physician with Crossover Health and they provide an integrated approach to healthcare for many companies.

Disclaimer: This is a podcast transcript and grammar will not be ideal, but the info is valuable!

Announcer: We all have to earn a living, but sometimes, we don’t think of the effects sitting for an extended period of time has on our physical well-being.

Welcome to The Modern Desk Jockey, providing you with healthy solutions for the desk worker.Our conversations with industry professionals and topic-based podcast are guaranteed to keep you active for a healthy, more effective work-week.

Now,here’s your host,Dr. Kevin Christie.

Speaker 1: Hey,desk jockey. It’s Dr. Kevin Christie with another episode of the modern desk jockey.Today, I’m going to be bringing you an episode where I interview Dr.Daniel Lord who is a chiropractic physician with Crossover Health and they provide a very integrated health care system for many corporations and so, it’s an exciting conversation.Whether you are just an employee of a large company, if you’re the HR, if you’re a wellness director, if you own your own company,there’s a lot of useful information you’re going to get out of this episode how can manage your own healthcare from a multidisciplinary measure and really try to integrate different conservative solutions to try to help with your health and your fitness and then, getting off of potentially, some of the medications and we dive a little bit into that as well and obviously, we provide you know on-site chiropractic for corporations, and we work in hand with some other types of providers like primary cares and physical therapists,fitness and all that but what they’re doing at crossover health is they’re basically offering all of this under one umbrella, and the providers are communicating very well and so, one of the take homes I want you to have from this episode, if you don’t have access to this which many of us don’t, obviously,but it’s to make sure that your providers are communicating.If you go to your primary care and you’ve got a neck issue or headaches, and then,you end up seeing a chiropractor, and you get some benefit, and you get a massage, and you have a personal trainer, you know, setup conversations.

I know I always offer my patients to communicate with some of their other health care entities to try to make sure we’re on the same page.So take that and one piece of advice, if you are in HR or a decision maker of your company or corporate wellness, you could reach out to Dr. Lord he’ll give his information at the end, but it’s a very insightful interview from him.He provides a lot of information, and I know you will enjoy it so here we go.

Alright,Dr. Dan Lord, I really appreciate your time today. I gave our audience a little bit of an introduction about yourself but lets hear a little bit about yourself personally and professionally.

Speaker 2:Great. Thank you very much,it’s great to be with you today. I am a chiropractor by training. I graduated from Palmer West in 2008 and started from San Jose, California, and I started my career at San Francisco at an integrated clinic called Chiro-MedicalGroup, and so that was kind of my foray into integrative medicine.They had primary care, acupuncture, physical therapy and chiropractic all under one roof. I saw the value of what you could do for patients when you had kind of everybody together and working together as a team and you could,you know, do things for patients that nobody else can and then, I went to… the next kind of gig was America’s CupOracle Team in the USA, the sailing team.In 2013, they won the America’s cup in San Francisco and so the two years leading up to the Cup, I managed their Sports Medicine, and we had myself,another chiro, my brother actually,sports medicine doc, nutritionists,strength and conditioning coach.We had PTE, massage therapists and so, it was a cool sports medicine program and definitely learned a lot from that experience as well especially because, in sports medicine, you can design your whole platform based on getting the patient better as fast as possible because that’s what you’re there for.It doesn’t matter who delivers the treatment, whether it’s the MD or the PTE or the chiro or whatever.It just matters that you get that athlete back on the boat or you know back on the court as soon as possible and prevents them from having injuries.

I mean, that might be sound kind of obvious but as you know, that doesn’t always happen in mainstream communities because of just business and insurance and the barriers for fee for service and so, you know, was it a really cool opportunity to see what happens when you’re not worried about what CPT code is reimbursable. You can deliver high-level health care, and the outcomes are really what matters.

So, that was an excellent experience, and you know, obviously, being around that level of athlete in a huge program like that was fun.An excellent experience.

That brought me to Facebook.So, the next gig was with Crossover Health.Crossover Health is a medical group that they focus on self-insured companies, and the reason is because they’re interested in changing the way healthcare is delivered, and they found that utilizing self-insured companies would allow them to build a business around outcomes and patient experience and cost-effectiveness in really challenging the patient’s to be a part of their own health care and really have a holistic approach to do that.

So, it was a really cool opportunity to work at theFacebook clinic because their whole benefits team is aligned with that same idea and thus, they allowed us to really build something special and prove it and so, that’s what we did over the past five years and now,Crossover’s in several different Bay Area Tech companies as well as up in Washington, in Texas and now, in New York and so, we’re really excited.We’re seeing kind of the next progression of being able to prove this model, and I was, you know, right place right time to jump on board early on and then grow the company to serve other opportunities.

So, that’s my story.

Speaker 1: No, it’s excellent, you touched on a few things and one of the things I want to tease out a little bit that you mentioned, by having this integrated system and accessible for the Facebook employees at this point were before,obviously, was the sailing team was that you know, healthcare now gets so convoluted.It’s like, okay where do I go and then when you go, you maybe go to your primary care and then it’s a musculoskeletal issue.Then they send you out to an orthopedist and the orthopedist runs all these tests sometimes not really needed, maybe prescribes things that aren’t necessarily ideal for you as the patient but it’s definitely ideal for the for the orthopedist business,you guys are like cutting all that out and you just really have one single goal and that is the health of that employee whatever means it takes to get there and it just cuts through all the clutter of what health care has become now, and I think this model is something that is extremely needed,extremely desirable and obviously, like you said, you guys are growing because of that.

Speaker 2: Right. I mean, that’s exactly right, and if I zoom out, that’s what we’re trying to do at places that we…clients that we have across the country.It’s changed the way we approach healthcare.So, that model is super important to me, and I’m hoping that it’s the future.

Speaker 1: Absolutely and then,obviously, from the company being self-insured… for our audience, if you’re not aware that, you know, some companies will pay the bills essentially directly.You may have Cigna or Blue Cross or something like that, but if they can save money they’re behooves them to get the results and in an affordable manner as well.

Speaker 2: Exactly.So, if you’ve got a self-insured company, one of the things that we talk about is that, you know, all of these companies are in health care.Whether they know it or not, right, they’re in health care because thethat have is health insurance costs,covering their employees. So, if they can make strategic decisions and cost -effective decisions and performance-based decisions, it can make a significant impact.

Speaker 1: Yeah. I mean,just for reference, I’ve done presentations before where one of the slides I use was, the number one cost-saving measure that companies are looking for in the United States, is cutting the cost of healthcare and the premiums because I mean, it’s killing their bottom line.It really is so; it to get a get a hold of and then, from there it just makes for a more productive and a more satisfied employee base, a happier employee base and so it benefits everybody.The more that the company’s investing in the employees health , the better off that employee is.

Speaker 2: You know, you hit it on the head there. I love this model because it’s good for the employer. Of course, they’re saving money, and they’ve got a happier workforce, but it’s also great for the patient because the same things that are good for the value base or performance-based ROI are also equally suitable for the .So, it aligns, and it makes practicing easy because you don’t have competing interests right versus the fee-for-service or the insurance model where it’s a game, you know.However many services you can supply,however many CPT codes you can build is how much money you make.

So no matter how ethical you are, there’s always a conflict of interest on how you develop your relationship with the patient and so, when you when you design the treatment plan or the business plan differently, and your goals are the patient’s goals, are the company’s goals,man, it makes life a lot easier and it’s the right thing to do.

Speaker 1: It sounds like a very enjoyable way to practice.

Speaker 2: Absolutely.

Speaker 1: It really does.Good stuff.So, that’s perfect. I really thank you for clarifying some of that for our audience. Ian of… you know, some of the audience, they are desk sitters, they are HR, they are Wellness directors, and so it’s just good to hear some that in formation across the board.So,thank you for that.

Kind of transitioning a little bit.As a doctor and obviously,in an integrative setting, what are the different entities that are offered to these employees?What are the different health care modalities?

Speaker 2: I can speak to kind of Crossover as a whole.

Speaker 1: Yeah.

Speaker 2: So, in general, the crossover very primary care driven model, in a good way,where all the different ancillary care providers or all the different programs are standing shoulder to shoulder with them and have a really deep collaboration.

So, there’s primary care and of course, in nursing and then, we have health coaches who are usually, I think, actually always nutritionists. So they’re MDs and then, behavioral health.

I mean, this is a huge integration point to have therapists that can really help with some of the mental health issues, you know, when you talk about Silicon Valley and the stress levels and anxiety levels that can happen then physical medicine includes chiropractic, physical therapy, and acupuncture and so, having those three modalities work together without barriers, you know, there’s no turf battle.This is our patient, and so,collaboration happens on the fly.It’s easy for us, and it’s a symbiotic kind of relationship.

So, all those are the main components.We also have optometry on every site.That’s a nice convenience and then our newest product, we’re adding strength coaches, and so each of our clinics has a large rehab gym that the chiros and PTEs use for active care. Big enough , you know,and it’s high ceilings,gym space.There’s a big garage door off of each of them.So, it’s kind of nice to have like the outdoor space, and so, strength coaching and do some high-intensity interval training and personal training that really work into our whole lifestyle approach and will integrate with what the health coaches are doing, what the primary care Docs are doing and of course, it’s part of our continuum with physical medicine.So, we’re excited about that.

Speaker 1: Yeah that sounds good and what are a few of the… I know you mentioned some but what are a few of the benefits of the different healthcare specialties?

Speaker 2: Well, I think we can take care of patients in an entirely unique way, and you know, take the the patient that wants to improve their biometrics they have like Type 2 diabetes or they’ve got pre-diabetes even and so, we know that they have to change some behaviors and we know that they have to improve their nutrition, and we know that they have to improve their movement and so, if you don’t have experts I think around each of those components, and you’re missing one of those, the chances for success are much less, and also, behavior change could even be mental health, right?

Speaker 1: Yep,absolutely.

Speaker 2: Co-morbidity is with a lot of these things and so if you can add those components around one person and and kind of form a team around them and also a custom program where the health coach and maybe the mental health provider are really putting together a plan to not only help their nutrition but also improve their adherence and really coach them in a positive way and then, if you’ve got physical medicine where you’ve got chiro and PT you know really helping them move better and prevent them from having injuries and then transition them into high-intensity training class with the oversight of a high-level coach and then looking at seeing over the whole program primary care doc who is managing their medication and their risk factors overall, that’s a real program and not many people can deliver it with this type of a model where their employer can cover a lot or all of the costs of some of this, and we can actually show outcomes, right.It’s not just building CPT codes.We can say…look at these biometrics, look at their body comp,look at their fasting blood sugar, look at their insulin levels, look at their waist to hip ratio.

We can start to track this stuff and show measurable outcomes and get paid for it.I think that’s powerful.That’s different than what most people can do.

Speaker 1: It’s truly powerful, you know, it’s kind of like… I liken it to a professional sports team with an athletic training room, and these athletes have access to some of the best health care at no cost to them, and they’re tracking all the different measurable of these athletes, and you’re doing that for the desk jockey obviously where you’re able to… you know,if this person needs a combination of chiropractic and PT and then, the goal is to get them off this particular medication, or you know, whatever it maybe,you’re working together on it.Whereas sometimes I’m limited in our private practice where if I wanted to do that, I would have to send them out for all these different referrals, and they’d have different co-pays for each visit, and it just becomes this time-consuming and financially consuming process.That’s just not an option for most people.

Speaker 2:Exactly and to be clear, I don’t think…actually, I know Crossover isn’t simply interested in working with big companies, and we want this model to scale.For example, nearsite clinics are a model we’re excited about where multiple companies can kind of co-op, and we can build a clinic that’s near to where their work is.It may be a network of clinics that they can belong to, and it’s a and that includes dependence, and so we’ll take care of your employees and their dependents with this actual outcome-based model, and we know now,we’ve got enough data.It saves the company money, and it drives better health outcomes, and it creates an incredible patient experience.

Speaker 1: Absolutely.Good stuff.That’s exciting.It definitely is.It’s exciting for everybody.

Speaker 1: It is.It’s exciting, I mean, and then, if you drop it down to chiropractors, in my opinion, we need this to work.This must work.

In my opinion, private practices are always going to be around, but it’s harder and harder to have success because the margins aren’t that great with insurance, right.We know this isn’t something I’m coming up with right now, right?We know this.Physical therapy,also, is in the same boat.Practices are closing around the Bay Area for physical therapy right now because they can’t meet the overhead expense with the market and so, this is different.

We’ paying our providers.This isn’t like an associate job where you’re scraping the bottom of the barrel.We’re hiring high-level Docs, high-level Chiros,high-level PTEs and paying them a very fair rate with benefits and paid time off and so, for the chiropractic profession to have this opportunity, I think is huge for the future of our profession and by the way, I’ll also add,the type of practices that are around us,though. We’ve got, for example,several clinics in the Bay Area. I’ve heard the idea like, well are you going to endanger the success of product practices if you’re taking up all the businesses?

My answer is no.We’re filling private practices that are near our clinics because we’re seeing patients that chiropractors have never seen before.We’re getting referrals from MD’s all the time, or we already have that cultural authority .Patients will directly come and see us even if they’ve never seen a chiropractor before because you’re part of this integrative team and it’s expected that you’re evidence-based, science-backed and you’re high-quality because you’ve got to be. You got to know your stuff if you’re in these environments.

Speaker 1:Absolutely. There’s a high quality of care that’s required for sure.

Speaker 2: Yeah.So, I think it’s a huge opportunity for the profession to have success down the road also.

Speaker 1: Good stuff. I appreciate you sharing that with our audience for sure, and it’s definitely… it’s a reality, and this is obviously a goal of outcomes. I think that’s the big mind shift that we do have is it’s not about the codes, and it’s not about the office visits, and it’s not about those types of, you know,analytics it’s more about what’s the outcome and what’s the patient satisfaction.

So, that’s pretty awesome, and I appreciate that. I want to kind of transition into my next question that kind of piggybacks off that.

As a doctor, what is your biggest concern for the desk jockey currently?

Speaker 2: I think having a strategy to compensate for the amount of time that you are sitting or at a computer is the key to health right now especially when you’re talking about the current situation with the amounts of computer work that we do, the amount of sitting that we do, amount of committing that we do, right.So, we’re sitting a lot yeah and so, making sure that you take,you know, movement breaks, and we’ve got classes even though we teach this, but taking micro-breaks to do some small movements and aggressively get out of the slump position, aggressively stretch your shoulders and your hips during the day to compensate for the amount of sitting is needed and it’s probably something that we don’t talk enough about.

Speaker 1:Yep, I agree.That’s kind of the massive trans-formative purpose that I’ve had with the podcast is just to get people to understand that the movement is the key to really combat that sitting and it’s not hard,it’s just you got to form a habit, you know, and I’m releasing an episode about that… about habit forming and it’s critical , you know.It’s like the first step is understanding what you can do to move and then to is just driving that in to make it very habitual and I used another athletic analogy on that particular podcast and that was, you know, like a golfer, they do everything with their equipment and everything to make it to where it’s fine-tuned and they are drive that habit to make the consistency there and as the desk jockey, like your equipment is your desk and your computer and your mouse and your keyboard and you got to drive that habit of utilizing it properly and making sure the ergonomics is correctly and even with great ergonomics, you still got to get up,you got to move.You consider the perfect ergonomically designed lab, but if you sat in it for eight hours straight, that would be a huge problem.

So, it’s just driving some of that awareness which is definitely something that we try to encourage for sure.

Speaker 2: That’s right . You nailed it.

Speaker 1: I wanted to ask one question, and we’ll take it from there. In this country, we’re realizing, and I can’t speak for the rest of the world, but I know for this country, we’ve been struggling with an opioid issue.Are you guys tackling that a little bit and trying to get the awareness around that issue as well?

Speaker 2: Most definitely. I think we’re keen on tracking the mounted prescriptions that go out and looking for better ways to manage chronic pain and other things. I know there was a small pilot study showing our primary care is prescribing 18 times less than the community and I believe it’s because we have all that integration and we’re able to have chiros and acupuncture and physical therapy and behavioral health all working together with the primary care team to provide as many solutions as possible.So, I don’t have all the answers there, but I think that’s a part of it,right.It’s part of how does the team approach.

Speaker 1:Yeah, I think that’s the essence of what you’re doing is now your primary care has direct options you know and it’s okay.Let’s say they’re in severe low back pain, to make up a case. Obviously , some prescription medication may benefit that person to get them just to be able to bear it but while they’re getting some physical medicine and some more alternative care and then, from there you can meet in the middle to where you can communicate with that primary care and remove them off the medication and get them into more the all the way to… now,well, you guys are saying, all the way to the strength conditioning coach.

So, now they have a path away from it versus our country now, it’s like a path to it, and then this becomes this never-ending path,you know.

Speaker 2:Exactly.

Speaker 1:That’s exciting.Good stuff. I appreciate your time. I think this is something that’s obviously cutting edge and our audience that’s listening to it, it’s something that, keep it in mind, if you’re just a desk jockey and you don’t have access to this directly , hopefully, soon you will. Wellness,it’s something to take into consideration and how could they reach you, doc?

Speaker 2:Our website is, and you can always reach me onFacebook.

Speaker 1:Perfect.There we go. How about some LinkedIn?Maybe a little LinkedIn,too?

Speaker 2: Absolutely,yeah.

Speaker 1: I know you had I know you had a plug to Facebook

Speaker 2: I also plug to LinkedIn, absolutely.

Speaker 1: Good stuff. I really appreciate your time and would love to have you on again in the near future.

Speaker 2:Thank you very much. I appreciate it.

Announcer:Now that you have a better idea of how to improve your physical health while at work, let’s take it a few steps further by subscribing to our show and visiting our website can find immediate tips, preventative measures and the resources we mentioned earlier to continue to improve your well-being while at work.