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Issue 8 - June 2003
Success Profile: Dr. Steven Brown If the three most important aspects of real estate are location, location and location, perhaps the same might apply to chiropractic and marketing a practice. Certainly, given the right situation, a positive point on the compass can go a long way. Steven Brown’s Brown Chiropractic and Acupuncture in Tempe, Ariz. isn’t just in a profitable neighborhood, it’s in the center of a health club, where scores of potential patients pass by daily. The practice’s front desk sits in the lobby of the Tempe location of L.A. Fitness, one of the largest sports and fitness club chains in the country. “I actually just kind of stumbled into that,” says Brown, who saw an advertisement for the space in a local newspaper. “There was an opportunity to lease inside of a major health club. I came over and checked it out. I just happened to be in the right place at the right time and I got in here.” Club members, who number as many as 1,000 per day (and 50 new members per week), parade past Brown’s front desk en route to various workout areas. “That’s what one of the sales people told me, and they may have inflated it to some degree, but it’s a big club,” Brown says of the membership numbers, which give him the ultimate direct marketing opportunity and which he says account for more than half his practice’s patient base. Certainly the location has played a large roll in the growth of Brown’s business. In 2002, the practice’s sixth year of existence, it approached $618,000 in gross billings. Along with the location, Brown says his biggest asset may be his one-stop shopping environment. In addition to providing chiropractic care, Brown has become his own acupuncturist, trigger point therapist and physiotherapist (he also offers Chinese herbal medicine, nutritional supplements and other products and services). Whatever a patient needs done, he can do. To Brown, the advantage of combining the different disciplines is glaring: It eliminates potential clashes.
“Have you ever seen a massage therapist and a chiropractor, and an acupuncturist and a physical therapist talk about each other’s professions?” Brown asks rhetorically. “All these practitioners may not be anywhere near each other, and usually disagree — sometimes violently — with any treatments being provided by the other practitioners.” The benefits, as Brown sees it, are for provider and patient alike. He knows exactly what care a patient is getting, and a patient knows exactly where to get it. Brown believes getting an encompassing variety of products and services under one roof, if not from a sole provider, is essential to the future of the profession. “A unified system of care is the secret to our economic success,” he says. “If you want to compete in the healthcare marketplace, the more services you can provide, the better you will do. People come here, they can get adjusted, they can get acupuncture, they can get trigger-point therapy, rehabilitation. It’s all right here. If you’re offering an adjustment as your only product, how many people do you think are going to buy it? I think it would benefit each practitioner and the profession as a whole to have more expertise in all these areas.” Brown prefers a full workload; he sees patients 32 hours a week. He says not having a family helps allow him to extend himself. Part of it is enjoying what he does, but perhaps a larger part is simply not wanting patients to be on an assembly line. In his days as an associate, he worked for a practice that saw as many as 650 patients per week. He learned during those days how much he liked the care- providing aspect of being a DC, but not the amount of time — or lack thereof — that he was getting to spend with patients. “I really liked the way the treatment I do could change people’s lives,” he says. “But … when you’re seeing that many people in one day, your average time with a patient is about 90 seconds. Some people just need the 90 seconds and that’s fine. But some people need more time, some people need more therapy, and just more time in general because of their history. It just gets frustrating when you just don’t have that time to give those people and you really have to send them somewhere else. Now, if somebody needs a minute and a half that’s what I give them, but if somebody needs 40 minutes, we have time for that, too.” The long hours and the intimate doctor-patient relationship Brown cultivated translated into rapid growth of his practice. From 1999 to 2001 the practice saw a more than 500-percent increase in patient visits. Billings over the same span increased by more than seven times, and collections were up better than 400 percent. As the practice got bigger, Brown’s financial advisor, Chris Rich, advised him to incorporate. With Brown the sole proprietor, he was losing money in the form of taxes. Calling it “basically an accounting thing,” Brown is paid a salary of $30,000. The corporation makes the rest of the money and is taxed at a lower rate. Anything he takes from the business at that point is considered a draw. Brown credits Dr. John Amaro of the International Academy of Medical Acupuncture in Carefree, Ariz., as being a primary influence for the way Brown’s practice is set up and they way care is provided. The main difference: Amaro’s practice is 100 percent time-of-service when it comes to payment. Brown’s is just about 25 percent. “Our office is modeled after his in the services we provide to our patients and in the way they are provided,” Brown says of Amaro. “He is the one who said if chiropractors are going to compete in today’s healthcare marketplace, they have to have something to compete with. If all you have is your adjustments, that’s a very good thing, it helps a lot of people. But there’s a lot of people who need more than adjustments.” Shortly after Brown started his own practice, he spent a half-day observing Amaro. He was drawn to the single-doctor aspect, as much as anything. He liked the way Amaro was able to go from room to room, patient to patient, without having to worry about butting heads with anyone. “You don’t have a lot of associates running around complaining about what they make and giving you a headache about everything,” Brown says. “Instead of hiring more doctors, (Amaro) hired more assistants. He has something like five treatment rooms and he had four assistants there at any one time. It does limit the amount of money you make. If I hired a bunch of associates, we could probably collect more money. But I think the stress that goes along with associates is almost more than it’s worth.” Brown has his own strategies when it comes to patient education and retention. He lets patients know what’s wrong, how he can help them, how long it will take and what the cost will be. He says he doesn’t use the word “subluxation,” nor does he give patient health talks. He sees the patient’s desire to get out of pain as quickly as possible and tries to get them there. “Some patients want to do more extensive rehabilitation, and some patients want to do maintenance treatments,” Brown says. “If patients do not want to treat on a regular basis for maintenance, we do not bother them about it, they just come back as needed and that is fine with us.” Brown emphasizes the importance of having multiple options for his patients, which he believes keeps them coming back as much as anything else he could say or do. He believes no chiropractic patient is merely a chiropractic patient. Everyone is a candidate for another kind of therapy, and different patients with the same ailment may respond to different treatments. Likewise, Brown knows that just being a chiropractor he might not have an answer. Nor would an acupuncturist in some cases, or a physiotherapist in others. Having certification across the board enables him a broader range of potential cures. “The (patients) might get advice from an acupuncturist that says, ‘Don’t go to a chiropractor.’ Well, I’m not just a chiropractor. I’m an acupuncturist and a chiropractor,” he says. “If a chiropractor is running down physical therapy, well, I’m a physiotherapist, too, certified through the state. Since I have certification and the training in all those areas, I think I can make determinations that other people can’t.” A day at the beach Like many DCs, Brown believes a healthy doctor induces more patient confidence. Preaching a healthy lifestyle, as the saying goes, is easier when one practices a healthy lifestyle. “People respect any doctor a lot more if they are in good shape,” says Brown, who placed fifth in his class in the 2001 Arizona State Bodybuilding Championships. His quest for physical fitness, as well as his chosen vocation, stem from some rather physical “un-fitness” throughout Brown’s life. A former law student, he incurred a spate of sports-related injuries that left him “barely able to walk.” It was then that he started seeing a chiropractor. His interest in the profession was piqued, and the rest is history. “After one semester of law school, I was doing well, but I found out I was more interested in going to my chiropractic appointments than going to class,” Brown recalls. “I became a law-school dropout and went to chiropractic school.” Since then, life has been like a day at the beach. At least, that’s what Brown strives for. And his staff enjoys those days at the beach with him, provided they meet their annual goals. Last year he took the office on a Caribbean cruise. This year, the goal is to get to Hawaii. “We set goals for all our categories, but the ones I make the trips contingent on is the main one: collections,” Brown explains. “If our collections are over a certain amount this year, we’re definitely going to take a trip. We just set the goal at $400,000 this year and we’re projecting over half a million, so it looks like it’s going to be pretty easy to do.” Brown Chiropractic & Acupuncture, PC Team Players Office hours Practice Revenue Year Gross Billing Collections % New Patients Patient Visits All figures are provided to Chiropractic Economics by the profiled doctor. Brown Chiropractic & Acupuncture PC is independently owned and operated and is in no way affiliated with LA Fitness International, LLC. A word about collections… Brown says that his collection percentages appear lower than other practices ‘because we do not exclude any of our services [in the billings] when we do the calculations. These are our total services.” Brown includes amounts that are disallowed by insurance companies as not being “reasonable and customary,” as well as amounts that are disallowed for being out-of-network with certain insurance companies, and accepts that he will not collect these fees. “We do not remove these services from our calculations,” he says. “We keep them on the books. [However, we] pursue action against the insurance companies when they deny services unfairly. We have been successful with several companies in getting these services paid, but many of these unpaid services remain on our books and reduce our overall collections percentage.” Todd Stumpf is a freelance writer from Akron, Ohio. He has written professionally for 14 years. He has been with Chiropractic Economics as a contributing editor for three years. He can be reached at TStumpf22@yahoo.com. |
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