Business Talk: Practising in matrimony
Chiropractic and Naturopathy, married to each other
By Anthony Lombardi
Naturopathic medicine has played a starring role in my personal life. Recently I was able to interview Dr. Ernie Bagnulo (DC) and Dr. Laura Imola (ND) who, not only work together, but are also married to one another. They own and operate WIN (Wellness Institute of Niagara), with locations in Niagara Falls and Fonthill. This interview provides our readership with a snapshot of how this multidisciplinary office functions and provides helpful ideas for practitioners thinking about adding another discipline to their practice.
Lombardi: Give our readership a brief outline of the path you both took to your respective professions and what influenced your journey.
Ernie: I wanted to be a chiropractor since I was in high school. I had a cousin who was a chiropractor and being an active and athletic teenager, I sought out his services and always had positive results. I wanted to do the same thing for a living; I enjoyed the ability to make a difference with manual therapy, almost immediately. It’s a wonderful ability to change someones circumstance in a positive manner from the first visit.
Laura: I knew I wanted to help people in their health, however I didn’t feel the conventional health professions were a fit for me as a career goal. I realized naturopathic medicine was a fit when I learned that naturopathic doctors offer a number of treatment options to address health concerns. In addition to helping to keep people healthy, a significant part of care involves health education, proactive health care and preventative medicine.
Lombardi: Dr. Imola, how do your apply naturopathic medicine to your practice? Is there a particular sub-set or group of conditions that your practice has a special interest in?
Laura: In my practice I listen to the health concern of the patient and combine this with the patient¹s health history, diagnostic testing, physical assessment and usage of pharmaceutical medication to create an individualized treatment plan that is the best fit for that patient. I utilize an eclectic approach to naturopathic medicine, with a focus on regulating the physiology of the body and promoting optimal health. My approach involves practicing all fundamental naturopathic therapeutics which includes nutrition, herbal medicine (Eastern and Western herbs), homeopathy (biotherapeutic drainage), nutritional supplements, acupuncture (Eastern and Western models), hydrotherapy, and lifestyle counselling. This eclectic approach has enabled me safely and effectively treat patients of all ages and in all health situations.
Through my approach over the last 17 years, I have kept my practice largely a general practice where all patients, whether they are presenting acute or chronic concerns or looking to live healthier lives, they can receive care.
Lombardi: Dr. Bagnulo, how do your apply chiropractic medicine to your practice? Is there a particular sub-set or group of conditions that your practice has a special interest in?
Ernie: In our practice we utilize a model of chiropractic that identifies functional limitations. We attempt to seek out why the function exists and try to correct those reasons –whether it’s a traumatic issue or one of repetition or poor adaptation. We utilize techniques and practices that are more commonplace today than they were 10 or more years ago. This includes manual muscular release, joint manipulation, neurofunctional acupuncture, shockwave therapy, laser therapy, exercise, nutrition, and taping techniques. Most recently, the chiropractic associates have trained and included Direct Current neurotherapy for rehabilitative and corrective purposes. We really try to push our services to those populations that want to move and be active. These patients find our services the most rewarding. There is not a single treatment to help everyone. We enjoy trying to alter the nervous system and believe it is paramount in the healing process of neuromusculoskeletal ailments. Whether it is an ankle sprain or major trauma or surgery, the integration of these therapies has been successful in our model and we believe it helps patients improve at a pace they are content with.
We also have the privilege of working in a team of four chiropractors, and each chiropractor seems to have they are own niche. Whether it is a particular region of body they enjoy, or a particular population group. This allows us to refer to one another and treat patients that we enjoy being with, thus creating a positive work and healing environment for practitioner and patient.
Lombardi: Tell us about WIN, when did it begin? How did you envision the combination of naturopathic and chiropractic services in the same practice? How that vision or application of the vision evolved over the years?
Ernie and Laura: WIN Health Solutions began in 2006 after we both spent a few years in practice in other capacities. We were married and always had a vision of integrating our services. Circumstance led us to make a decision in 2006 and we started out with just the two of us for a few months. We both experienced an uptick in patients just from working under the same roof. We would cross refer and patients appreciated the ability to be in one location for multiple services. We then added a massage therapist, and then another chiropractor, followed by another naturopathic doctor. Laura was the only naturopathic doctor in Niagara Falls at that time and her practice grew quickly. Within a couple years we added a physiotherapist and then outgrew our location. We moved to a larger facility in 2014 and now work as a team of three physiotherapists, four chiropractors, two massage therapists, a naturopath, an osteopath and personal trainer, as well as a support staff of eight.
Lombardi: What is the biggest challenge within your practice? What other challenges arise from having multiple disciplines within the same space?
Ernie and Laura: The biggest challenge in our practice is the balance between being clinicians and business owners. In addition to making sure our patients are cared for, we also must ensure all the professionals at WIN are experiencing a feeling of fulfilment.
Often professionals running a multidisciplinary clinic have their own vision of how things should be, and it can be a challenge to meet everyones expectations and needs. We focus on listening to all of our professionals and creating win-win experiences as much as we can, while remaining true to our vision. Gathering a team of professionals means respecting the different personalities, and challenges that will arise. This is why we strive to maintain a positive clinic culture so we can all see the opportunities in working together and continue to grow from challenges.
Lombardi: What alternative challenges are there in running practice while being married to one another? How do you facilitate the work/life balance while not at the office?
Ernie: This may be the single largest blessing in my eyes. I’m married to my business partner and we push each other to be better and more productive all the time. And not just in a professional environment, but also within our family and our time with our children. We started the practice as a couple but also grew our family at the same time. This, as any professional parent knows, is not easy because priorities and availability change when you have a family. We both put our family first and have hard rules about weekends being for family. We also try to keep work talk to a minimum at home during the week. Of course there are things that need to be discussed but we try to keep it light, simple and positive. I can proudly and truthfully say, we have never had an argument about work.
Laura: Thankfully we are very compatible business partners and life partners. However, yes, there are always challenges. We talk about it, figure out what we need to do and how to best tackle it. We create schedules for our family life and make sure our children’s needs are taken care of, and then blend that with our work life. The work-life balance comes and goes. There are times when we have everything and everyone taken care of and other times when we feel like this is lacking. It’s in times when we feel the balance slipping we regroup and re-adjust. Staying mindful and adaptable has helped us navigate balancing both work and life together.
Lombardi: What words of advice do you have for a chiropractor looking to incorporate naturopathic services in their practice and vice versa?
Ernie: I think, including a naturopath (or any professional for that matter) in a practice can only succeed if you allow them to be an equal part of the team and do not limit their ability to practice within the vision they may have. We are all trying to help and aid patients to be better and healthier. If you put your heads together and establish a way to cross refer and show how each discipline can help the other then success is achievable.
Laura: Chiropractors, working together with naturopathic doctors, can create healthier patients and healthier communities, helping to take some of the burden off our current healthcare system. Together, chiropractors and naturopathic doctors broaden the patient’s access to numerous therapeutic options, increased health education, motivation to stay well and – especially if the providers take a collaborative approach to care – a feeling of satisfaction in their health care.
This article was originally published in Chiropractic + Naturopathic Doctor’s July/Aug 2020 edition.