Dino Pappas DC - The DC/ATC Relationship

Prologue

I’ve seen some posts and rhetoric recently in chiropractic forums on social media that concern me.  Largely the context of these posts is negative and often misinformed. Typically, the posts ridicule athletic trainers. In some cases, the critique is pointed toward a specific athletic trainer. Fair enough.  

Every profession has the spectrum from superstars to clowns. In other cases, the negative critique is pointed towards the profession at large. These posts are misinformed.  I’d like to point out that a couple bad apples do not make a bunch. Let’s first clean our own mess up as chiropractors before we throw ridicule at another profession. Chiropractors have done more lately to damage the reputation of chiropractic than almost any other entity. Seriously, let’s clean up our mess before we scorn anyone else.

I’m writing this blog because of the unique vantage point as a dual credentialed athletic trainer and chiropractor. I’ve worked both sides of the relationship. I’ve failed, succeeded and learned so much over the past 19 years in health care.

My goal with this blog is to give you a different perspective. Hopefully, that perspective will help in forming outstanding professional relationships with ATCs. At the very least, I hope you’ll consider a different perspective. I hope the tidbits on relationship building benefit your athletes, your community, the ATCs you work with and your practice.

From the Outside Looking In

Things that cross the ATCs mind when a chiropractor shows up to assist their athletes:

1. WTF is this chiropractor doing here?

2. Doesn’t he just crack necks and cash checks?

3. Does he/she know anything about any other body parts besides the spine?

4. Does this clown know anything about sports medicine?

5. No, I don’t want my athletes touched by a chiropractor!

6. Chiropractors are not real doctors.

7. I’ll just send the athlete to physical therapy because it’s quicker and cheaper.

8. The recommendation of 3x/week for 12 weeks followed by 2x/week for 12 weeks and then 1x/week for 12 weeks seems a little absurd.

9. It’s a little ridiculous that the chiropractor thinks he will treat this ankle sprain by treating the spine only!

10. Why is this chiropractor “talking down” to me?

11. I don’t answer to him/her. I’m under medical supervision.

12. I already have a team doctor and I send my kids to the physical therapy clinic that sponsors the school, so why do I need a chiropractor here?

13. What value does this chiropractor provide to me, my athletes and my school?  Student trainers and certified athletic trainers often do not have much exposure to chiropractors. This is a harsh reality! This reality is a BIG obstacle towards building the ATC-DC relationship.  From the start, athletic training curriculum is housed within the university setting.

The university setting I’m referring to are large accredited 4-year institutions with a multitude of degrees, not the small, professionally focused chiropractic college setting with enrollments of 2,000 students or less. These large 4-year institutions often have allied health programs such as physical therapy, occupational therapy and medicine. At the very least, these academic institutions have pre-med, pre-PT, or other programs tailored towards entry into medical or other allied health programs. Relationship building and cross training with future professionals begins early. Chiropractors are on the outside looking in when these relationships begin.

Athletic training curriculum is heavily focused on neuromusculoskeletal, athletic injuries. The profession was built solely around taking care of athletic injuries. Specialization is a blessing and a curse to the athletic trainers. The ATC profession has long promoted the importance of the gate keeper role in the sports medicine realm. Specialization has historically hampered growth into other areas of health care, but works well in the original sports health care setting.

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The ATC is the central point of contact utilizing the sports medicine team is part of standard training within athletic training curriculum. Daily interactions come with athletes and coaches in all settings. Daily contact also occurs with equipment managers and strength coaches in larger settings. Periodic interactions occur with the team physician(s), other medical specialists, physical therapists, nutritionists, dentists, massage therapists, acupuncturists, opthamologists or other specialty personnel depending on the set up.

A Robust Sports Med Team Separated Into 2 Categories: Performance & Injury Management  Larger settings typically have robust sports medicine teams with frequent contact and communication.  Professional teams, Olympic athletes and high-level college sports teams have a more integrated setting exchanging the athlete from one provider to the next in seamless fashion. Settings like high school sports or youth sports almost certainly will feature less contact with members of the sports medicine team. Smaller settings effectively place the athletic trainer on an “island.”

High level athletic training jobs in professional sports, collegiate sports and with our Olympians are in short supply. It is far more common that the athletic trainer works in a smaller set up like youth sports, collegiate sports, club sports or within a clinic setting such as a physical therapy clinic or orthopedist’s office.  This is the ATC to DC perspective. From the outside looking in, many athletic trainers have no idea that a subset of the profession treats sports injuries. ATCs have not worked side by side on the sidelines with DCs. ATCs have not seen you in their training room. ATCs have not taken college coursework or post graduate continuing education courses with DCs.

ATC training from its inception is heavily biased towards allopathic medicine and the allied health model. Remember, training is often housed within the standard 4-year university setting with coursework and experiences geared towards developing relationships with the immediate support staff, team orthopedist and team physician.

DCs have a lot of ground to make up before the ATC will even let them in. Using a sports analogy, you are in the later stages of a baseball game and you are trailing by 3 runs. It may be difficult to get the win, but not impossible.

The difficult part is starting the ATC-DC relationship with obstacles in the way. Some of these obstacles were created long before you the DC, came into the picture. Some of those obstacles are based on historical educational training and the role of the ATC. Some of those obstacles were also created by the transgressions of past generations of chiropractors.

Those stereotypical questions above that began this segment can only be answered and put to bed for good once you’ve established know, like and trust. I would not let a provider near my athletes unless I knew them, like them and trusted them as an ATC. The most cherished thing an ATC can possess is trust.  Violating that trust with a screwball chiropractor isn’t worth the risk. It’s a bit of a harsh reality to some DCs that it will take some work to make this relationship flourish. Caveat Emptor – “Buyer Beware!” Be willing to put the work in!

From the Inside Looking Out

Things that cross a DCs mind when trying to help the ATC and his/her athletes:

1. What’s up with this guy/gal?

2. Why the ego?

3. Doesn’t this guy/gal understand I can really help his/her athletes?

4. WTF! I’m a real doctor that can order imaging, lab work and special testing like any other physician?

5. Doesn’t he/she know I treat more than the spine?

6. I’m not the 36+ visit chiropractor he/she is thinking about!

7. Building a relationship with the ATC and school will be HUGE for my practice!

8. Why is this athletic trainer not referring to me?

9. Why wasn’t I consulted first on the case since I provide conservative care treatments that most injuries respond to?

10. This is difficult to do because there are political, educational, legal and financial obstacles in front of me.

11. Is this worth it?  As a DC looking for forge relationship with ATCs, you’ll ask yourself the above questions. You may even wonder if forging a relationship is worth it? I can’t answer that question for you. I can provide some of the key pieces missing in creating professional understanding.  DCs are unique as professional doctorate level, portal of entry providers in that for many years we were on the outside looking in. We had a poorly acknowledged and defined role within health care.

Lack of mainstream integration and lack of cultural awareness historically has placed many DCs on an island.  This professional isolation includes things like our terminology, philosophy, our traditional and stereotypical business model and our lack of integrated, interdisciplinary training.  This is way it should be on the sports med team! Everyone playing nicely in the sandbox.

ATCs are trained to operate on an island if necessary in a small school setting as well as play nicely in the sandbox as part of the sports medicine team in larger, more integrated settings. Playing nicely in am integrated setting is foreign to many DCs where the DC serves the dual role of physician and small business owner. The DC is typically “king” or “queen” of their 4 walls. ATCs by training and position are the authority figures in their training room, but recognize the training room is a small part of the bigger house. The disconnect in roles can lead to quite a bit of frustration when the DC tries to gain entry to the sports medicine team.

Sometimes DC’s aren’t aware of the roles and politics within the sports med team and “pee in the sandbox”  Many DCs simply aren’t aware that the training room and playing field are typically the ATC’s domain.  They don’t defer appropriately to the ATC’s expertise. The typical response is that the ATC has an ego. It could be the DC’s ego getting in the way with the DC failing to appreciate the ATC in reality. A large part of this is failure to understand, appreciate and communicate roles.

ATCs wear many hats. They are part cheerleader, coach, medical professional, equipment manager, strength coach, rehab specialist, budget director, travel coordinator, intermediary and confidant. ATCs are the intermediate point of contact between athletes and coaches, parents & coaches and between support staff and athletes. Athletes confide some very personal things in ATCs. It takes a special person to balance these roles and wear all these hats.

ATCs do the stereotypical things of assessing injuries, enacting emergency plans, taping athletes, rehabbing athletes, making return to play decisions and more. ATCs deal with mundane things like filling water bottles, prepping ice chests, looking over the practice fields for potholes, filling out budget requests or checking for inclement weather. ATCs also deal with demanding coaches, parents, athletic directors or athletes.

Three Strikes and a Punch Out

Some ATC workweeks depending on the context are 60-80 hours/week in season. They get tired, fatigued and sometimes impatient. When you approach an ATC about helping their athletes and think “why the ego” be aware of the following:

1. Strike one: You could be dealing with a stressed out professional that’s overworked, underpaid and poorly appreciated.

2. Strike two: ATCs may have a preconceived notion of the stereotypical chiropractor based on DC professional isolation, lack of interdisciplinary co-training, lack of communication about roles/responsibilities and competing financial interests.

3. Strike three: The DC comes into the relationship with something to prove. This could be ego. This could also be an attempt by the DC to validate their expertise. Either way, trying to prove something comes across as abrasive to the ATC on their turf. Abrasiveness is the nail in the coffin!

Many DCs don’t even realize the deck is stacked against them. Many DCs don’t realize they could be behind by two strikes. It may seem like a harmless thing to show off your expertise to gain credibility, but that will rub the ATC the wrong way. Strike 3 and game over.

The best way of going after this is SERVICE! The DC needs to build trust. Humble service builds trust better than any other entity. Serve the athletes. Serve the ATCs. Serve the coaches. Serve the staff. Serve the community. Serve the sports medicine team. Listen first, serve, then speak. Your humble service opens the door, not your title, skill set, expertise or even monetary donations. Be a go giver, not a go getter.

Most Type A Motivated People Are Go Getters, But Maybe The Best Way To Get Ahead is Being A Go-Giver. Give First To Receive. The Book The Go Giver Illustrates This Point Well.

Our Story

Illustrating this point was the relationship we developed with District 230 in the south suburbs of Chicago. There are 3 high schools Stagg, Sandburg and Andrew high school. I attended one of the schools (Stagg) graduating in 1997. We had some familiarity with the district along with key personnel.  Former teachers, trainers and coaches were still working in the district. Some of athletic trainers and coaches in the district were classmates of mine at Stagg High School and at the University of Illinois. I also had previously worked for one of the physical therapy clinics prior to and during chiropractic school.

In addition, we had strong contacts within the physical therapy groups that sponsored the other high schools in the district (ATI Physical Therapy, Athletico & Flexeon).  On the surface, it appears that familiarity and relationships were a slam dunk easy way to access the district. We were mistaken. There were obstacles. Perception and politics stood in the way.  

The best way to overcome the perception and politics was to respond directly to the criticism in an open format. We sat down with the athletic trainers and sports medicine staff at one of the local high schools.  We had an honest discussion. We were there to serve the athletes, ATCs, staff and community. We had no expectation of referral of any athlete to our office. In fact, we encouraged referral to the team physician, team orthopedist and to the physical therapy groups that sponsored the schools.

We even utilized some of those sources for our patients that needed primary care, orthopedic and physical therapy services. We wanted to be there and enjoyed being there. We wanted to set up an integratednetwork to assist our patients that needed services that we did not provide. We wanted to use the sports medicine team’s expertise for second opinions on tough cases presenting to our office.

Eventually we earned trust. We noticed conversations were easier to start. Communication flowed more smoothly. We noticed genuine interest in learning about this “new” breed of forward thinking chiropractors that resisted dogma breaking the stereotype. We noticed our role growing from last man on the bench in basketball to 6 th man. We were providing on site second opinions after the ATC performed the initial on field assessment. We assisted with emergency situations including spine boarding athletes with suspected spinal fractures. We were asked to present at the high school’s career day about chiropractic and sports chiropractors. We became guest lecturers in sports medicine classes at 2 of the 3 high schools. Our topics were LE biomechanics, running injuries and orthotic fabrication.

We were asked to present at the district’s sports medicine symposium. The symposium was a regional gathering of south and western suburban high school students and sports medicine personnel. Students were interested in careers within the sports medicine fields. They came to learn about various sports med topics. Sports med personnel had a specific track discussing protocols, cases and pertinent research. Sports med personnel could obtain low cost, quality CEU’s from a multidisciplinary panel. We even took advantage of this opportunity to obtain ATC CEU’s and DC Category 2 CEU’s in Illinois.

It took well over a year to obtain a referral from this relationship. We really didn’t get as many athletes through the door as you’d think over the course of the 6-year relationship. The politics and financial interests of the district were firmly entrenched.; however, we did benefit from the relationship. The trust we earned through humble service eventually led to referrals of teachers, administration, coaches as well as the occasional referral from the team internist, team orthopedist and from the physical therapy group. Sometimes these referrals were athletes, but mainly they weren’t. We leveraged trust and eventually we saw referrals from the other 2 schools in similar fashion. Our patients also had great options for care including orthopedic referrals, primary care referrals, strength and conditioning referrals and for physical therapy services.

Tips To Forge Outstanding DC-ATC Relationships

1. Check Your Ego: Ego is a big turn off. Ego will end a relationship before you can really get it started. Rule #1 if working as part of the sports medicine team and approaching an ATC is check your ego. Serious misconceptions about chiropractors exist. Don’t play into that narrative. Throw ego into the mix and you’ve got no chance.

2. “Know Your Role & Shut Your Mouth”: DC’s are used to serving as the authoritarian figures in their office. They often aren’t challenged in the office setting. They are “king” or “queen” of their own castles. This mindset can lead to confrontation in the athletic training room or on the playing field. The ATC is quarterback. They organize the huddle, call the plays, audible, distribute the ball and orchestrate the offense. The DC’s role in many cases is that of the 3 rd or 4 th receiver.

Picture a slot receiver that’s a key player on 3 rd downs and in the red zone. DC’s are often an invaluable member of the team, but aren’t the star attraction. Get used to it. Know your role.  Thrive in it. Shut your mouth. Serve the team to the best of your abilities.

3. The Magic is the Relationship: Surround yourself with a great professional network and watch the magic happen. Sports med typically attracts a certain niche. The niche is type-A motivated professionals. Professionals that work to be better, wish to serve, want to win and prefer success within a team setting. They want their athletes performing at a peak level just as you do.  You want to work in a dynamic setting like this. Nurturing relationships in this environment benefits all parties involved. It worked for us and it can work for you.

4. Relationships Take Work: Even the best relationships take work. You don’t just do one nice thing a year for your spouse on their birthday or Christmas and stop. You appreciate your spouse in small ways daily. The same sentiment applies to the sports medicine relationships. Periodic interaction in small ways creates top of mind awareness. The intent isn’t a hard sale, but solidifying a relationship. Holding a door open for your wife isn’t a big thing, but it is appreciated and it does get noticed.

a. Lunches & Coffee Drops: We did this once per semester (2x yearly) We would text to confirm a time. We would stop in and drop off coffee for the athletic trainers, athletic director and staff. With minimal investment, this created better top of mind awareness.

b. In-services: Teachers often have in-service days. Utilize this concept and create one in-service day per semester. Create a theme. Have each team member contribute an article, video or lead a practical session during the in service. We led an in service on gait mechanics and orthotics for example. We covered our gait exam, orthotic evaluation and casting procedures.

c. Lecturing: Ask the athletic trainers if they have a sports medicine, anatomy or physiology class. See if you can guest lecture during one of the classes on a topic of interest.

d. Career Day: Ask to be a guest speaker at a career day. This is a great way to get a couple minutes of face time with the athletic trainers. Career day speaking spreads the brand of the clinic in the community as well as helps inspire the next generation of chiropractors.

e. Shadowing: One of the best ways to develop relationships is to shadow sports med team members on site. It’s a slam dunk, cost effective marketing strategy that builds trust. Shadow the orthopedist in their office. Shadow the team physical therapist in their clinic. DCs mostly train in DC sponsored collegiate settings run by chiropractic schools without interdisciplinary exposure. Seeing how an orthopedist, athletic trainer or physical therapist conducts business on their turf is eye opening. It’s great for your growth and their growth. The other team members haven’t not been exposed to an evidence based, forward thinking DC. Shadowing on their turf shows a genuine passion to be a team member.

f. Scheduling: There’s a quote by Woody Allen that says “80% of success is just showing up.” Simply put, show up and maintain a positive attitude. Collaborate with the ATCs to come up with a schedule based on their needs. When is their busy time of year? What tournaments do they need help covering? What other obstacles are present that impact the ability to deliver sports medicine services? Make a schedule and stick to it as best as possible.

g. On Site Injury Checks: I didn’t utilize this tool as much as I could have to be honest, but colleagues such as a team orthopedists and other sports chiropractic colleagues utilized this tool to great success. Set aside some time during the school week and perform free injury checks at the school. This saves the parent and athlete time and money of scheduling an in-office visit. What seemed to be effective without over reaching was 2 days/month for 1 hour near the conclusion of practice.

For example, on site injury checks were performed the 1 st and 3 rd Thursday’s of every month that school was in session. Make sure to coordinate with the ATC to confirm his/her availability along with athlete availability. It’s also a great idea and wise from a medicolegal standpoint to have the parent present to grant consent. You want the parent present so that there is no miscommunication. Some teenagers don’t talk to their parents at all. Other teens will relay inaccurate information.

Having the parent present eliminates the chances for no communication or miscommunication by the athlete. You really do want the parent present to get a better feel for parent-athlete dynamic. That matters in obtaining an outstanding outcome.  Last point, you really want the medical decision maker present.  They are ultimately the one “investing” in treatment.

h. Staff Dinners & Social Outings: This was a fun thing that we started after trust was built.  Typically, we went out for a sports med team social outing to a local gastro pub 2x/yearly. Often, it was after the last home Friday night football game and towards the end of the school year. The end of the fall season and beginning of the winter season was one of the busiest times of the semester as double the volume of athletes were technically “in season.” At the end of the school year, we wanted to celebrate the accomplishments of the year with a bite to eat and a beer. We typically treated to the 1st round and dinner. This was a business write off under marketing expenses.

i. Professional Newsletter & Content: Add the sports med staff to your professional newsletter and create custom content for them. What do they want to know about?  What weaknesses do they have? What strengths can you share with them? What do they need to know about you or your practice to effectively help their athletes or their patients better? We sent over a custom e-newsletter quarterly with relevant content.

j. Donation: Schools, clubs and smaller organizations have limited budgets. Often the athletic trainers are given lemons and need to make lemonade. Sweeten the deal a bit. If there’s a need and you are able, step up and offer some financial assistance. We donated free orthotic foam casts for the sports medicine orthotic casting lab. It wasn’t a big investment, but it was appreciated because the casts were not approved in the sports med budget. It saved the awkward conversation of the athletic trainers asking mom or dad for $30 to purchase a 1- time use foam cast out of the blue for the student’s sports med course requirements.

5. Market Your Outcomes: One of the central themes of sports medicine is rapid, safe return to action. Rapid, safe recovery is incompatible with the stigma of traditional chiropractic care of extended treatment plans for correction of the subluxation complex. Traditional chiropractors don’t have great baselines to gauge progress with failure to perform adequate re-exams, particularly in the context of sports medicine and sports performance. Many ATCs don’t know the subset of evidence based, sports medicine trained, rehab minded DCs exist.

This is where you can change the narrative. Providing athletes with rapid recovery and outstanding outcomes by obtaining functional and measurable baselines will blow the ATC’s mind. Imagine taking an ankle sprain from crutches to return to prior levels of performance within 4-6 visits over a 2-3 week time period. Imagine that athlete demonstrating the ability to descend an 8-inch step down symmetrically R vs. L with good neuromusculoskeletal control.

Imagine that athlete showing the ATC or the ortho that the 6-8 week time frame for recovery was way too conservative. Imagine the athlete actually demonstrating the improved 8” step down test directly in front of the ATC or the ortho. Imagine that you stated this goal from the start and communicated progress with your sent notes. Imagine that you’ve data tracked 50 or 100 ankle sprains in your athletes looking at the outcomes assessments, # of visits, and other return to play criteria.

Imagine you are leveraging that data to guide your opinion on a speedy recovery. Imagine you followed up with a phone call to the ATC and to the ortho after the initial assessment and at discharge. Imagine that you’ve created collateral marketing pieces around that data and your successful outcomes to distribute to the other team members and into the community. You’ve marketed yourself ethically and extremely well in this scenario. You’ve let your outcomes, data and communication do the talking. This sounds like someone that any rational sports med professional would want to do business with.

6. This is a Marathon Not a Sprint: One of the most common faults is that once you groove the relationship that you forget about it. You take the relationship for granted. Sports med professionals are marketed to on a regular basis. Marketing & sales reps from orthopedic groups, PT groups, medical device makers routinely approach ATCs. ATCs see advertisements in professional literature about products or devices. ATCs are often targeted with Google Ads, Facebook Ads and YouTube Ads just the same as the rest of us. The strategy here is to maintain top of mind awareness. Don’t take the relationship for granted. Be present, but not overwhelming. The marketing strategy is play the long game. Recognize this is a marathon not a sprint.

7. Give So That You Can Receive: Nothing greases the wheels of a referral relationship like giving.  By placing your trust in another professional, you’ll earn their trust. This is especially true if the patient you are sending has positive reviews of your care whether you helped them or not. The big point is that you were truthful, trustworthy and able to recognize strengths vs. limitations.

You didn’t waste the patient’s resources of time, money and hope. We utilized this concept with one of the team physicians. We sent a handful or two of cases his way before we received our first referral back. This was after developing a relationship on the sidelines for 2 seasons and setting up an in-office coffee meeting. At the coffee meeting he reported that he still didn’t know what to make of chiropractors or our office, but the patients sent over all had the same reports. They felt welcome. Patients felt they we weren’t trying to sell them anything. Patients reported that they thought they were told the truth.

This grooved the relationship with the team physician and several physicians in his group more than anything we had done to that point. The team physician (physiatry & sports med trained) would typically send over to us spinal cases that failed an initial bout of physical therapy, that had chronic pain, cases seeking to reduce medication use or cases that he felt required biomedical acupuncture. Most of these cases were not athletes. These cases were typically chronic pain cases with yellow flags. Cases like this required a bit more work. They were typically higher dollar cases for our office on the positive side, but the flipside was these cases had a higher risk of failure of our care. Regardless, it was nice that we earned trust to work on these cases. Remember though, this relationship started by giving first.

Summary

This blog turned out rather lengthy. I apologize if I’ve lost you in the middle somewhere. Some people need more and some people need less. The big take home points are that the DC-ATC relationship can be mutually beneficial. It does take some understanding. It does take some work. Don’t let this deter you!

About The Author

Dr. Dino Pappas

Dr. Pappas is a chiropractic physician, certified athletic trainer and certified strength and conditioning specialist. He recently has moved from Tinley Park, IL to Austin, TX. He works for Airrosti Rehab Centers. Airrosti is a health care company focused on rapid resolution of soft tissue and joint injuries delivering exceptional care and cost savings to patients. His goal is to provide the Austin community of NW Hills with the best conservative orthopedic, sports medicine, rehabilitation and soft tissue based care possible.

Dr. Pappas blends the best of physical medicine with the best of integrated medicine to help patients and athletes of all shapes and sizes. He utilizes tools such as chiropractic manipulation, soft tissue mobilization, functional movement based assessment, the McKenzie Method, strength training and conditioning, kinesiology taping, diagnostic imaging and specialty laboratory testing when needed.

Dr. Pappas’ sports medicine interests are endurance athletes, overhead athletes (pitchers, throwers, volleyball players and tennis players), tactical athletes (police, fire department, first responders and military), contact sports athletes (football, rugby, lacrosse, field hockey, soccer and basketball) and Crossfit athletes. He has worked with athletes at all levels from professional to amateur. He has provided sports medicine services to the University of Illinois, Indiana University, the Chicago White Sox, the Joliet Slammers (Jackhammers) minor league baseball team, the Windy City Thunderbolts minor league baseball team, Victor J. Andrew High School and Carl Sandburg High school.

On a personal note, he reads and interprets the medical literature daily to stay abreast of cutting edge advances in his field. The doctor is an avid runner and aspiring triathlete having completed 5 marathons, 5 half marathons and numerous 5 and 10k races. He has goals of qualifying and competing in the Boston and New York Marathons, the Ironman in Kona, Hawaii, and climbing Mt. Kilimanjaro in Kenya, Africa. He recently completed the Pikes Peak Ascent, a half marathon to the 14,115 foot summit of Pikes Peak. He is currently training to complete the Go Ruck Tough Challenge as well as ruck Rim to Rim across the Grand Canyon. One day he hopes to serve his country as a team chiropractor for the United States Olympic teams and serve as a team chiropractor for a high level collegiate or professional sports team.

The doctor practices in the Northwest Hills area of Austin approximately 7 miles from downtown Austin, TX. The office is located within a multidisciplinary surgical hospital. His mantra is “Why Put Off Feeling Good?” He can be reached by email at drdinopappas@gmail.com and drdpappas@airrosti.com. His business cell phone is 210-243-5734. Call 1-800-404-6050 to schedule an appointment with Dr. Pappas. Please make sure to request the Northwest Hills, Austin-TX office when calling to schedule an appointment.***

***Disclaimer:The views and opinions above represent that of the author, Dr. Dino Pappas. They do not reflect they official policy or position of any agency or company that Dr. Dino Pappas may have a relationship or affiliation with, they neither refelect an official policy or position of the FTCA.***