The clerical aspect of data collection in the medical industry is not often included in the immediate list of important concerns for licensed medical professionals. However, what data is collected, how it is collected, how it is distributed, and how it is accessed are just a few of the common, overarching issues that licensed medical professionals may personally encounter, and certainly a larger issue in the industry as a whole.

One component that makes the data itself problematic is the manner by which it is collected. A patient may see multiple providers, or go to multiple medical facilities. They may employ their insurance for certain visits, but other visits may not be covered. How does the patient’s medical history from one hospital visit make it into their file when they visit a completely different hospital or doctor? What about if they visit a hospital or medical facility in an entirely different city, state, or even country? Each individual facility certainly collects the data on the patient and retains it within their system. However, these systems are isolated and subject to the particular protocols of that specific facility that the patient visited. Of course, other medical facilities can “order” this patient history from different medical facilities, but this process is inconsistent and may take precious time that is needed to properly treat the patient.

In addition to the isolated nature of medical data collection, the issue is that a patient is often expected to self-report their entire medical history to help better guide their treating physician. Patients are unreliable for various reasons, including shame/guilt/embarrassment, forgetting and inadvertently omitting medical visits and information, improperly remembering specific medical issues, lack of knowledge on previously used medications, inability to correctly identify dates, times, and facilities, and so much more. If a patient enters a medical treatment facility, the licensed medical professional may simply rely on the patient to provide a relatively accurate snapshot of their medical history, and this is not reliable. This occurs, in short, because our nation does not have a systemwide medical data program that allows each person to have a conglomerate report of their medical history to easily provide to the person treating them.

Licensed chiropractors know that it requires extensive training, practice, and investment in time and money to become a professional licensed chiropractor in the state of Illinois. Despite the fact that chiropractors are governed by the Illinois State Medical Disciplinary Board, there is still a prevalent general stigma against licensed chiropractors due to years of false conflation/comparisons to other licensed medical professionals, and the general idea that chiropractors perform some kind of pseudo-medicine. We at Williams & Nickl know that is not the case, and we support our licensed chiropractors. However, we are aware of the particular stigmas that they face.

Arguably the most common misconception is that chiropractors are not “real” medical professionals and that their medical practices are not based in any kind of established science or medicine. In reality, as licensed professionals know, chiropractors are required by the state medical board to undergo extensive education and training, and this education often overlaps with all the basic medical and science studies that other medical professionals experience. They are also required to take and pass multiple national board exams to become licensed, in addition to their own state’s requirements. While there are distinct differences between a licensed physician and a licensed chiropractor, for example, both licensed professionals are rooted in a background of medicine and science with extensive education and training.

There is also the assumption that chiropractic medicine is not rooted in real medicine/science, and that the practices are just nonsense, or, worst case scenario, chiropractic techniques can irreparably harm a patient’s body. Just like in all medical and scientific fields, things can go wrong, or mistakes can happen. However, they are extremely rare, and occur in spite of the most stringent practices and protocols. If a medical mistake occurs, the stigma against chiropractors seems “justified,” and this is in part due to the overarching idea that chiropractors do not perform valid medicine. In reality, they have extensive knowledge of the body and this stigma largely stems from the baseless assumption that adjusting joints in the way that chiropractors do is simply random or meaningless.

Any licensed social worker across the country faces similar commonplace issues that directly stem from nationwide systemic problems such as: poverty, racism, classism, domestic and community violence, accessibility to education, and so much more. Social workers often find themselves helping families who are struggling to get their basic needs met, and it can be extremely disillusioning/disheartening to witness the experiences and daily lives of these individuals. Worse yet, many social workers cite the inability to resolve these issues, or provide substantive assistance when the issues are deeply rooted in society.

In Chicago, social workers face the above-outlined challenges, and even more. For social workers who practice within the educational system, they likely find themselves in Chicago Public Schools, which is the third largest school district in the country, and publicly known to be rife with various shortcomings, specifically due to the large number of students coming from various backgrounds. Chicago is extremely diverse, but there is a clear divide of race and class across the North and South sides. Notably, people of color, specifically Chicago’s Black residents, are systemically disenfranchised and face unique experiences of poverty, violence, lack of community support, and lack of educational options. Social workers are often employed within schools, where it is easier to reach a larger number of struggling individuals, but certainly also interact with these folks on a community “door-to-door” level. Licensed Social Workers in Chicago specifically note this clear segregation between the quality of life for Chicago’s white residents and its residents of color.

Chicago social workers cite the greatest area concern with the prevalence of high caseloads. Due to racial and class inequality in Chicago perpetuated by the long history of segregation between the North and South sides, and the perpetuation of this inequality by the last few decades of local government, Chicago struggles immensely in providing a high quality of life to all of its residents. Social workers note that with such high caseloads, they are often travelling across the city to various residences, or, if they are working within an educational setting, they are often expected to provide care to multiple institutions, sometimes even in the same day. Social workers are forced to hop from location to location, and the ability to provide help is limited by these conditions.

Most towns, or at least larger cities, have a veterinary hospital to take care of our furry family members. The demand for veterinary services is not decreasing, especially with the rise in pet adoptions during the pandemic, when more people were home to take care of and raise animals. So while veterinary hospitals are not hurting for clients, there can still be a loss in profit depending on particular conditions of operation, pricing, and business protocols.

Veterinary hospitals owned and operated by a larger corporate chain are less likely to suffer the direct blow of profit loss. These hospitals have a safety net of corporate money that allows the individual hospital owned by that company more wiggle room in spending and general costs. There is certainly a benefit to having this safety net, especially when expensive equipment purchases need to be made, or new employees need to be onboarded. For veterinary hospitals who are self-owned, the licensed veterinarian(s) may be more personally responsible and involved with spending. If money is needed for particular things beyond day-to-day costs, there is no corporate pool from which to grab. If the money is needed but does not exist, some small vet offices may even have to resort to loans to cover costs of equipment and employee onboarding.

One of the ways that independent veterinary hospitals can attempt to increase, at least stabilize, their profit is by carefully identifying cost, value, frequency of services, and other related factors. For a corporate-owned hospital, these fees and costs may be determined by a provided financial advisor, who can observe supply and demand, cost of goods sold, and comparative fees associated with the standard services provided to patients. These types of decisions must be made, and protocols must be enacted on a more individual level with a small veterinary hospital. One of the reasons an individual might choose the services of a small business is the attractive pricing, and the feeling of supporting an independent entity rather than a corporate one. However, these generally lower costs can gravely affect the profit of the independent vet hospital. Thus, decisions must be made on price increases to counteract the expenses, and this can be a difficult transition that may even result in loss of clients. It is certainly a level of balance and personal involvement that is virtually non-existent in a veterinary hospital owned and managed by a corporate entity.

Dentists and hygienists endure many industry-specific challenges with their respective professional licensure. Potentially the biggest area of concern and hardship is insurance, both that the patient has/does not have insurance, and if insurance is involved, struggling to work with the insurance companies to get patients’ procedures effectively covered. In the same vein, on the professional/business side, dental offices also must contend with insurance companies to get paid for their own work that they do. These struggles are industry-wide, and do not have a blanket solution.

In the United States, which has a for-profit health care system and citizens are not required to have health insurance, including the many individuals that simply do not have the ability acquire it. In addition to the struggle to obtain health insurance, dental (and vision) insurance are completely separate insurances that are often not included with basic healthcare plans. This results in individuals having to do one of three things: 1) do not get dental insurance, 2) pay extra/additional to get dental insurance through their main health insurance plan, or 3) pay for a separate dental insurance plan that is separate and different from their health insurance (and usually costs more than if it is attached to their main health insurance).

The above-referenced conditions for the patient directly affect the services that the dental office is able to provide. If the patient does not have insurance, many struggle to afford the services that are needed for their dental health. This could result in less visits to the dentist, having to go on a payment plan, or even being delinquent in payment on the care provided to them, which particularly affects the licensed professional who needs to acquire income in exchange for their services. If the patient does have dental insurance, whether it be dedicated/separate or alongside their health insurance, both the patient and the dental office may have to fight to get the services covered. Some services are not covered but are common procedures; some insurances cover certain common procedures, whereas others do not; some insurances claim to cover specific services, but then will not do so; the list of scenarios goes on.