Issue 14 - November 2003

Chiropractic’s top consultants share
their quick tips to build a thriving practice
By Linda Segall

Achieving success in chiropractic is like balancing on a teeter-totter: On one side are technique, knowledge and skill. On the other side are practice-management knowledge and expertise. If one side gets too heavy, the other side can’t come down to earth — and the game is over. But when both sides are balanced, riding the teeter-totter can be exhilarating.

Practice management is a catchall term that refers to business management — managing all of the resources necessary to run a chiropractic office, from advertising to x-rays.

We asked chiropractic’s best practice-management consultants to share their top ideas to help you acquire essential practice-management skills in leadership, communication, supervision, marketing and advertising. Here is what they told us:

Reach out and ‘touch’
How often you have genuine contact with your patients affects the success of your practice. Here are easy ways to “touch” patients with genuineness to make them feel special:

• Meet and greet. Each patient should receive at least two welcomes — one from your front-desk CA and one from you when you meet him for the adjustment.

• Call patients by name. People take pride in their names. Ask the patient how she prefers to be called — by first name, nick name or last name — and respect the request.

• Make the first call. Call new patients the evening after their first adjustment. It will establish good rapport and usually surprise them. Often the only call they get from a doctor is in response to their call for information.

• Pay compliments. Show patients you appreciate their promptness, their compliance with your instructions or their progress.

• Thank patients for referrals. Say thank you or send a card or a small gift whenever a patient sends in a friend or a family member.

• Say you’re sorry. When things go wrong — such as running behind schedule or billing incorrectly — say you are sorry.

— David Kats, chairman
Kats Management
www.katsmanagement.com

Use all space to increase ROI
The greatest way to increase your return on investment for office space is to maximize its allocation — use all of your rooms at all times. Here are some ways to do that:

• Schedule testing on off days. Since most doctors schedule treatment every other day for individual patients, Tuesdays and Thursdays are typically “slower” days. Schedule all diagnostic testing and comprehensive exams on these “off” days.

• Offer free classes during lunch. During lunch hour(s) on Mondays and Wednesdays, offer a free one-hour nutrition class. On Fridays, instead of a nutrition class, ask your nutritionist to teach a “how to cook healthy” program.

• Evening classes. On Monday evenings provide birthing classes for pregnant women and their partners. These should be taught for four to six weeks by a birthing coach. Reserve one class however, for you to teach posture, healthy habits, exercises and yoga sessions.

On Wednesday evenings offer posture classes; on Thursday evenings, schedule biofeedback discussions. Friday evenings devote to relaxation techniques.

• Community meetings. On Saturday mornings host community meetings in your office. Invite your community’s small business association, city council, Lions Club and other types of community organizations to use your facilities. Basically, by accommodating these functions, your clinic becomes a diversified wellness center offering a wide variety of services to the public. Even though not all attendees will actually become patients, all participants will know about the center and its location and services — a great community partnership that you offer.

— Daniel H. Dahan, DC, president
Practice Perfect
www.dahan.com

Develop team spirit
Whether yours is a small office or a large practice, efficiency and effectiveness are dependent upon teamwork. These three steps will help you achieve a team spirit:

1. Develop a mission for your practice. Create a vision for your staff to give them a sense of purpose. Read it as a team every day before opening the office to patients. You can expect a more focused, enthusiastic and emotionally engaged team.

2. Set goals. Write clear, obtainable goals that are based on achieving your practice’s mission and share them with your team. Give the team direction and specific action steps to achieve these objectives. Everyone needs to understand how he or she fits into an organization. Goals help establish that “fit.”

When your team accomplishes goals — individually and as a team — celebrate! Reward the staff.

3. Lead. Every team needs an empowering and inspiring leader. Ask yourself, “Who do I need to be to lead my team to success?” Maintain high standards of excellence, be congruent in your words and actions and lead by example.

— Elisa Zinberg, DC, senior consultant
The Masters Circle
www.themasterscircle.com

Turn patients into referral agents
The average person knows at least 48 other people — but the average chiropractic patient refers only one! You can boost the number of referrals per patient, however, by doing three things:

1. Turn your patients into teachers. Educate them about chiropractic so they have the right mindset and the right tools to carry the message.

2. Thank each patient for every referral.

3. Reward patients. Every two months give them a gift as a way to recognize them for their decision to join the chiropractic wellness revolution.

— C.J. Mertz, DC, President
Team WLP
www.teamwlp.com

Reuse and recycle for better business
Save money on office supplies by reusing or recycling.
Some examples:

• Salvage and reuse paper clips, rubber bands, boxes and
x-ray mailing envelopes.
• Recycle paper. Use two paper-recycling boxes — one for confidential documents that are to be shredded and the other for paper that can be reused on the “clean” side (faxes and scrap copy paper, for example).

— John Heggie, DC, President
Lakeside Chiropractic Seminars, Inc.
www.Dcseminars.com

Improve your collections
To improve your collections, empower your front-desk CA to “own” this responsibility. Give him or her the authority to:

• Do a financial study of the practice. In that review, the CA should go over each patient’s payment history and identify all accounts that are deviating from office payment policy.
• Set up specific payment plans. Discuss these plans with the CA, but allow the CA to have control over finances at the front desk.
• Approach patients who deviate from policy. If the CA knows your practice’s payment policies and advises you about deviant accounts, there is no reason why s/he cannot assume accountability to collect payment.

— Pat Atanas
Pat Atanas Consulting Services
800-770-0344

Speak the language of reimbursement
Today’s language of reimbursement is the language of function. To participate fully in the mainstream of healthcare, you must become proficient in objectively assessing and documenting the functional outcomes of your care.

The CPT codes with the highest reimbursement value are the active care codes: therapeutic exercises, kinetic activities, neuromuscular reeducation and others. These are well reimbursed because, when added to the chiropractic adjustment, they produce lasting results.

— Mark Sanna, DC, CEO
Breakthrough Coaching
www.mybreakthrough.com

Conduct constructive staff reviews
One of the top concerns of employees in all sizes of organizations is performance feedback. They want to know if they are doing a good job — and how they can do that job better.

Here are some suggestions to make your staff reviews go more smoothly:

• Praise. Focus on what the staff member does right.
• Outline your concerns. Write them out and be prepared to share this with the person.
• Establish your expectations. Structure your discussion around the individual’s potential and the improvements you can help them make to achieve your expectations. Set specific time frames.
• Set out consequences and rewards. Every action has a reaction — either positive or negative.

—Janice Hughes, DC, LCP (hon)
The Palmer Institute for Professional Advancement
www.palmerinstitute.net

Add massage therapy as a new profit center
Offer muscle/massage therapy as a profit center to build your practice. Contract with a therapist to do pre-adjustment “spot” muscle/massage therapy, a 10-15 minute procedure, which can be billed to most insurance companies.

Spot therapy allows the therapist to showcase his/her skills to all patients and provides the therapist with the opportunity to build 30 and 60-minute full-body massage sessions.

— Marty Kotlar, DC, CHCC, president
Target Coding Inc.
www.targetcoding.com

Keep your patients happy
If a patient disputes the amount you say s/he owes, settle the account in the patient’s favor. If your billing and collection procedures are good and accurate, this may never be an issue. But if it does happen, you’ll be better off business-wise to keep the patient happy and move on.

Another way to keep patients happy is to treat only one condition at a time because you’ll increase your opportunity to succeed by reducing your potential risk of failure. If you have an 80 percent chance of success in treating a patient’s health problem, you also have a 20 percent chance of failure. In healthcare, these are very good odds.

But, when you treat three health problems at the same time, you triple your chances of failure (20 percent x 3), and the patient will get upset with you when one of the health problems is not resolved.

— Peter Fernandez, DC
Fernandez Consulting
www.drfernandez.com

One-minute goal meetings
Clear daily goals will grow your practice:

1. On Mondays, start the week with a team meeting in which you set your daily and weekly goals.

2. On Tuesdays through Fridays, start the day with a “one-minute goal meeting.” Affirm each person’s value to the team, then discuss progress toward the goals set on Monday. Adjust goals and plans to achieve them. End the one-minute meeting by discussing your vision for the office.

— Jerry J. Ac, DC
Personal Training Company
www.personaltrainingcompany.com