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CAPA 1993-03-March

Rolfing… An Eye to the Future

Pages: 18-21
Year: 1993
Dr. Ida Rolf Institute

ROLF LINES – Vol XXI -nº 01 – March 1993

Volume: 21

BH: What’s the case for insuring your employees for Rolfing?

LM: We put Rolfing in place in 1989 because we’re very progressive with case management as it relates to medical clients’ general health insurance and that is having personal experience with Rolfing. Our plan also offers chiropractic care, of 26 visits a year. (Literal cost control is ten sessions of Rolfing.) As a benefits manager who has to make benefit decisions, I felt it was a better, more cost effective approach to help with structural integration or posture problems or whatever the problem might be than 26 visits a year for chiropractic care. I would say that a different way, ten visits of Rolfing seem to have more lasting benefits. However, many people are equally comforted by chiropractic care and one would therefore complement the other. We offer options.

BH: But is it an economic thing to do?

LM: My experience is that, yes, it is economic. Just the incidence of chiropractic versus Rolfing; chiropractic care seems to go on for years, that’s 26 visits a year and Rolfing has a much lower incidence of usage and max attendance each year so that the sheer dollar is a cost-effective approach.

BH: So you pay full cost of the Rolfing or some part of the cost?

LM: Rolfing is $100 deductible, 80/20. (Company pays 80% of cost after $100 deductible for all medical expenses is met.) Chiropractic care in general is $100 deductible, 80/20. To talk technically from a health insurance view, we do offer chiropractic care through preferred providers and once you have a PPO (Preferred Provider Organization) Network set up, there is discounting involved and we have no deductible and no co-pay.

BH: So how much does it cost your company to do that and do think it saves your company in the long run and how can you gauge that?

LM: We analyze our medical expenses in many different areas. Our chiropractic probably at this point in time exceeds 150,000 dollars a year.

BH: This is for your one plant in Minneapolis?

LM: This is nationwide. I don’t have the specific breakdowns at this point. Where Rolfing has yet to exceed 10,000 dollars a year. The bang for the buck out of 10,000 dollars seem to go significantly further than 150,000 dollars in chiropractic care. By the way, we’re neutral, we’re just offering both.

BH: Right.

LM: But to offer those alternatives, helps us provide not only something that we feel is going to help a certain population of the company, it’s more cost effective through Rolfing.

BH: How can you gauge that it’s cost effective? I mean, what are you looking at? Are you looking at down time, training, whatever?

LM: If we were trying to evaluate the comparison between the two, I would have to be honest with you, Bill, some of that is an apples and oranges comparison.

BH: Sure.

LM: Because I don’t know the diagnosis, prognosis and.

BH: Well I’m not really interested so much in comparing Rolfing to chiropractic, what I’m interested in is how it ends up being justified in your mind or in your pocketbook to pay for the Rolfing? How can you, can you look and say, do people who have been Rolfed have fewer injuries, do people who have been Rolfed recover from their ouches quicker?

LM: I don’t think we’ve had enough experience yet, Bill, because Rolfing is still relatively unknown. This year has been the most experience that we’ve had, and I go by subjective feedback that we get from participants. People who have seen chiropractors for years never call me up to make a point to tell me how glad they are we have Rolfing because finally they’re getting effective service that they have never received prior to Rolfing. But on a pro-active basis, I think we’re on to something here in terms of case management, cost control and employee moral. It’s not uncommon for someone to come back from a chiropractor and say they hurt.

LM: It’s common for someone to come back from a Rolfer ecstatic. Moral: I feel it will impact our sick leave, meaning fewer sick days. Some people wake up sick, some people wake up tired, some people wake up sick and tired. And when they’re sick and tired and don’t come to work, if Rolfing can also have that kind of subjective impact, that’s also what we would be looking at. But Bill, I would have to be honest with you, we haven’t had enough long term perspective to come close to a comparison. However, we are putting money where our attitudes are that we feel this is a more effective dollar approach and service approach. In other words, what you get through Rolfing we feel will have more than just physical impact on the employee.

BH: So that’s your insurance program. You also have a Rolfer in the plant from time to time.

LM: We’ve taken my experience with Rolfing and my responsibilities for our Workers Compensation Program to try to apply Rolfing at a point within workers comp case management to potentially to reduce the incidence of mandatory surgery. To date, we’ve had some remarkable surprising success. In 1992 we had approximately 22-36employees with various degrees of carpal tunnel syndrome diagnosed or potentially diagnosed. Some of those people have gone through with bilateral carpal tunnel surgery, some of them have been diagnosed as bilateral and have had one hand-done so far. There are several people we’ve asked to volunteer (for a trial program of seeing a Rolfer on-site) who have already had surgery on one hand done. We’ve asked if they would be willing to, with their orthopedic surgeons approval, postpone the other operation. The people who have volunteered were happy if this would help them avoid surgery. All I can say is that we have people whose orthopedic surgeon has told them they don’t have to have surgery at this time. We’re not getting glorious statements out of the orthopedic surgeons but we are from the employee who translate that into, I don’t have to have surgery because I feel fine.

BH: And what does a surgery cost?

LM: For a carpal tunnel claim, that’s not just the surgery, but the entire cost for wages or lost wages for an employee, all the medical expense, and the work hardening program, and some medical supplies, etc., is approximately 35,000 dollars.

BH: So by avoiding one operation you’re saving yourself 35,000 dollars.

LM: That’s a bilateral number, so about 16,000 dollars a hand.

BH: What does work hardening mean?

LM: Work hardening is where we have a production requirement where we have to have a release for eight hours of work, to come back to work from having carpal tunnel syndrome surgery. It would be ideal if we could bring one of these people back for two hours, then three hours, then four hours, in other words, an hour more every week. Our production process is too tight to allow that so to accommodate the employee we set them up with work hardening through a rehabilitation consultant and a rehab firm that will actually help them build up that hand again so that they can come from work hardening direct to full time work with no basic or major restrictions. So work hardening is to get them hardened up, get the muscles back in shape so they can come back to work without pain and much better use of their hands-we are teaching them ergonomics within the process.

BH: Wow.

LM: Work hardening also helps heal the person who has various emotional responses to having suffered a work related injury. There’s guilt, there’s fear, concern of retaliation, fear that they’ve done something wrong, and, of course, after a couple of weeks, an individual begins to identify with their symptoms or with their problems.

BH: Yeah.

LM: And that makes it harder for them to view themselves as a productive employee rather than an injured employee. And the goal is just not to fix the body, but to fix the person so that they can come back to work and be productive. Make them whole as if there was no injury.

BH: So, just for round figures, of the people who you have asked to volunteer to receive Rolfing instead of getting their second operation, what kind of stats happened? What happened?

LM: We’ve spent, in terms of cost?

BH: Yeah.

LM: Bill, we’ve spent probably about 800 dollars in Rolfing fees, using an approach with the hands and fore arms, and neck and shoulders-an approach developed by Siana Goodwin. I don’t know how unique that is but it sure works here. I feel that we’ve clearly saved approximately 2025,000 dollars in eventual work comp cost to close their claim, to close their file. Not only did we avoid surgery, but once we get through to maximum medical improvement and there’s a final rating on these people, we feel the rating will be lower because they also haven’t suffered the trauma of surgery and there will be less permanent injury making it even cheaper to close the file.

BH: So in essence, you’ve spent 800 dollars and saved 50, saved 48,000-I mean, if it came down to operations.

LM: Well, in this case there were three different people and claims do vary. That’s why I feel the real savings is in the 20-25,000 dollar range because, you know, all people are created equal but their bodies are not. (laughter) And so what it takes to take care of one body and one person is separate from maybe even a similar injury. But some jobs are easier to bring people back to because of the physical demands of the job and some require greater dexterity or have stronger requirements in terms of flexibility-how often can they get up and move around or switch hands, those kinds of things.

BH: Maybe a word of explanation for the reader: What is it that your workers do?

LM: Starkey Labs is a custom hearing aid manufacturer. Our employees work on the equivalent of circuit boards which are very small and they use dental equipment or soldering irons with a natal nose tweezers under a microscope. So they are working with small electronic parts in an assembly mode and using a microscope. It’s very labor intensive. They’re actually building very small electronic components on a very small circuit board about the size of the head of an eraser.

BH: Wow. (laughter)

LM: We’re very high tech, Bill. (laughter) But look at the size of a hearing aid, it has to fit in your ear.

The pinching, tweezing, grasping requirements and the repetitive motion leaves us somewhat prone to these kinds of injuries. Rolfing is one example that we’re using to help, the case management side once there is an injury. However, we’re taking a more aggressive, pre-emptive approach to redesign work stations, proper tools, and monitor proper body movements so that there’s a stronger ergonomic approach their work, including stretching techniques every hour or two.

BH: And Starkey is the leader in the field. I assume other that other hearing aid companies are curious about what you’re up to.

LM: We feel that, yes, word has spread about the pilot program that we’re working on. Our goal is that we do not want our employees hurt. Aside from that it’s good business not to have to retrain new employees in a kind of job that takes more than a year to become proficient at. It’s also good business to reduce our work comp cost. Although, please don’t ever forget the priority is that we don’t want our people hurt.

LM: Well, I would summarize, we can’t just buy an off-the-shelf program to reduce the incidence of repetitive motion injuries. There is no quick fix. We have looked at all ranges of the spectrum to try to reduce these injuries. Rolfing has become a very strong component to reduce the severity of an injury and also to put them back in place, not just physically so there’s no requirement for surgery but put them back in place for their own well being emotionally and financially. And that’s good for us.

BH: How is it that you know about Rolfing and that you even thought of it as a possibility?

LM: I was exposed to Rolfing in 1974 while I was at an Esalen Institute workshop. I was then Rolfed through the basic ten sessions in 1978, and as I’ve moved around the country, I’ve always have looked for Rolfers. That’s how I met Siana Goodwin. We will be looking for Rolfers elsewhere around the country, preferably Advanced Certified Rolfers.

BH: How old are you?

LM: I am, as of yesterday, forty.

BH: Happy birthday.

LM: Thank you, Bill. (laughter)

BH: It’s an interesting thing for me. I’m forty-three, but it seems that as we come of age, we get ourselves in a position where we can actually make a difference in the way that society happens.

LM: And Bill, I might add and you may want to consider putting this in: We were not greeted with open arms to introduce Rolfing. There was a tremendous amount of criticism, it was viewed as crazy, and yet I was in a position within a company, in terms of the management level and the respect level, that at least we had passive doubts rather than aggressive negativity. We have since earned our stripes and no one finds fault in it anymore. Any business that’s going to complain about the approach and not look at the results will probably soon be out of business.

BH: Yeah.

LM: We are results oriented company and now with just the sheer cost savings, that even our insurance company, our work comp insurance company, is beginning to acknowledge-we don’t have to justify what we’re doing to anyone because it has justified itself.

BH: Right, so you are self-insured, you create your own insurance.

LM: Yes, and we do work with insurance companies. There are legal requirements for how you have to set that up but when we’re spending money or saving money, it is literally dollars that would come out of general revenues. But we have a strong vested interest for cost containment.

BH: Uhuh. The word about Rolfing in hearing aid companies is going to spread, I would assume.

LM: Is going to spread and has already. People talk, there are top officials in numerous companies that have cordial dialogue with competitors. Urn, we are very open in trying to help our competitors with certain problems. And certainly this is one that’s common to all of us.

BH: Yeah.

LM: We know of one other company that has already begun to explore, at least using Rolfers. We do not know the extent of their program.

BH: Wow. Well, on behalf of Rolfing let me thank you.

LM: Bill, my pleasure. I am looking for stronger support. I do have a legitimate need and a legitimate problem and that is: I don’t know who to look to to help support this grand experiment we’re on.

BH: Right.

LM: So we have to create our own justification and it has worked. We intend to make it a lot stronger, and I continue to wish that I had more third party support to help guide us on how we would impact any and all of our injuries, not just the repetitive motion ones that can be helped by Rolfing.

We’re convinced enough of the value of the proper placement of Rolfing within either case management for an injured employee or as part of our preventative maintenance program. We’re now initiating a program that would be available for all employees that at approximately their ninetieth day of employment, they would have the opportunity to experience Rolfing and they would be unidentified primarily through comfort surveys. If there’s a discomfort coming up, we want to hear about it. Rolfing may be one of the solutions in conjunction with, you know, retraining a person on how to perform any specific task for minimal impact on the body. We feel that in the near future, we won’t be able to prove that Rolfing helps people avoid surgery; instead we feel we’re be able to show that our repetitive motion injuries decrease significantly over time.

BH: Right, that sounds terrific!

LM: And that’s the goal. I know we’re pretty progressive and as soon as we see a problem we get to it. We don’t ignore it. And yet this one has been cumbersome because it’s not easy to resolve. I think there are other companies out there that don’t have the kind of supportive environment we do, and yet I tend to agree with Siana and you that, unfortunately, I think it’s going to become even more of problem in the future.

BH: Yeah, there are a lot of companies that aren’t the least bit interested in their workers who are really-like chicken companies for example.

LM: Yeah, and then law suits and unemployment costs and work comp costs will eventually motivate management in many different companies to find a solution.

BH: Yeah.

LM: So eventually, I hope everybody wins.

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