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  Forms and Articles
for Michigan Doctors of Chiropractic

As described in the recent "Michigan Chiropractic Journal" articles' "Product Sales in Your Practice - Documentation System for Sales Tax Exemption, Medical-Legal Protection, and Staff Involvement in the Sales Process."

Easy to Use.


Product Sales in Your Practice
Part 3 - Prescription for Compliance and Staff Involvement

By Stuart A. Firsten, DC

Editor’s note: Previous articles in this series have presented protocols for effective health product sales in chiropractic practice. Topics covered have included; ethical issues, MI Sales Tax exemption, and a Prescription Form for better documentation to facilitate the sales process was presented. Part 3 of this series will reintroduce the “Prescription Form” and outline how it can enhance medical legal protection and staff involvement in the sales process. Parts 1 and 2 of “Products Sales in Your Practice” are available online at

Doctors have a unique opportunity to help patients improve their well-being and to live healthier lifestyles. As patients look for ways to take responsibility for their health, chiropractors are accommodating them beyond evaluation and treatment, by recommending better posture, improved ergonomics, stretching and exercise, and nutritional advice. They also are selling more health products with the goal of insuring the best quality chiropractic care. In fact, according to Chiropractic Economics, 92% of chiropractors sell retail products such as cervical pillows, nutritional supplements, topical creams, and backrest supports - so recommending appropriate health products has become a part of the standard of care.

When you are aware of products that have efficacy it makes sense therefore to bring them to your patient’s attention. When they are indicated, within your scope, and related to care then your recommendation can enhance medical legal protection. This is particularly important when you believe that they are medically (chiropractically) necessary to aid in recovery, or to help prevent future reoccurrences. Always make sure to document such recommendations recording whether or not the patient followed your advice to acquire a product that you prescribed.

You also need to provide adequate instruction, or demonstrate how to use a particular product that you recommend. In some cases the doctor may be hesitant to suggest products due to constraints associated with a busy practice. They may be reluctant to take the time necessary to provide patient education to support the specific health products that they may want to prescribe. This is where getting staff involved can really help - taking the monkey off your back when it comes to making product recommendations. Upon your direction (and prescription) a trained CA can provide the information, instruction, demonstration, referral sources, or sales support that may be required. However, to accomplish this you need to train staff, and implement office procedures to insure that they provide the follow through when required.

To assist chiropractors we have developed a Prescription Form with a quick and easy check-off system that satisfies most requirements for successfully introducing any product to patients. The “Prescription Form” is available online at where it can be reviewed or printed for use in your practice. Contact information is provided at the end of this article for those who may prefer a fax, mail, or email copy.

The “Prescription Form” serves several purposes and can become the backbone of your office procedures related to product recommendations. First, the form can help you handle MI Sales Tax exemption record keeping requirements. The form encompasses specific documentation criteria established in the MI Sales Tax code for licensed health care providers selling products - including the patients name, date, product description, medical necessity, signature, and amount paid for the item. Please refer to Part 2 of this series for detailed information related to MI Sales Tax requirements.

Second, the form can offer added medical legal protection by providing a hard-copy record documenting whether or not your patient obtained an item that you prescribed. Essentially you are recording your recommendation as a prescription in your clinical notes, similar to how an MD records a prescribed medication. If your patient did not acquire the product from your practice then you can check-off a box marked "Patient Declined". When the patient presents for follow-up visits you should inquire whether the product was obtained noting whether or not the patient followed your prescription. If you feel a product is necessary and recommend it, then you should record it on the form, or in the daily notes just as you would record other recommendations for care.

Third, the form facilitates staff involvement in the sales process. Whenever you recommend a product you can simply check-off whether you or your staff is to follow through the process with the patient. If you have the time you can explain all details to the patient. Then check-off the box marked “Instructed” to indicate that you have prescribed the product and provided any necessary patient education. Your CA can then reinforce your recommendation and provide referral sources, pricing information, and let the patient know if it is available from your office. Optionally, when you are busy you can check the box marked “Staff to Instruct”. Inform the patient that you are prescribing a specific product and that your CA will follow through with relevant patient education, product demonstration, instruction, pricing and availability information. When your CA sees the box checked, "Staff to Instruct" they will know that you prescribed a specific product and that they are to complete the process and provide any necessary information, and options how the product can be acquired, whether through your office, from a medical supplier, online, by mail order, etc. Referral sources that are provided should also be recorded on the form. If the patient purchases the product from your office, simply check the box “Dispensed from Inventory” and record the price after the sale. After the form is completed have your CA place a copy in a separate file labeled "Sales Tax Exemptions”, or “Medical Necessity” which will readily be available if you are ever audited for MI Sales Tax or need to support medical necessity for an insurance claim.

Future articles in this series “Product Sales in Your Practice” will explore common types of health products such as supports, cervical pillows, fitness balls, ergonomic chairs, and inversion devices that are often recommended by chiropractors to their patients. Articles will focus on reviewing specific product design features related to health benefits - as opposed to specific product brands. The "Prescription Form" and MI Sales Tax information described in this article are available free of charge at for you to review and reprint for use in your practice. To obtain the “Prescription Form” by fax, email, or regular mail contact FitCare Products at (248) 661-5088 or email

Stuart Firsten, DC is a licensed chiropractor in Michigan. His company FitCare Products an MCS Member Supporting Business developed and introduced the new AirFit™ BackRest last year. The AirFit™ is recommended by many MCS members, and hundreds of chiropractors, health care professionals and medical suppliers. The product is also available online to learn more visit . To contact Dr. Firsten with your comments or for additional information you can call (248) 661-5088, or email him at . © 2005 Stuart A. Firsten, DC. All Rights Reserved.

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