Issue 16 - December 2004

Dr. Richard Langdon: A return to glory
By Todd Stumpf

Dr. Richard Langdon loves music. He owns a Wurlitzer jukebox and more than a dozen guitars. He even composes country music.

Today the music that resonates in his home and office is upbeat. But two years ago, if he was singing at all, it was the blues. That was because after watching his practice reach all-time highs in terms of patient numbers and income, Langdon saw it all slip away.

Now, however, less than two years after bottoming out, Langdon’s practice is thriving once again. His single-doctor practice, Cross Valley Chiropractic, bills out $70,000 per month, sees around 200 patients per week and is a far more efficient business than at any other time in its history — even in the salad days of the early 1990s, when Langdon saw more than 300 patients a week.

THE SLIDE

Things started going badly for Langdon in 1994 when he endured the tragic loss of two close friends, within a short time of one another. One of the individuals, Dr. Lou Spiccioli, was Langdon’s closest friend and professional confidante.

“We used to feed off each other,” Langdon says of his professional relationship with Spiccioli, who had been a district director of the former Pennsylvania Chiropractic Federation, while Langdon served as membership chairperson. “Lou was just an exciting guy. We would constantly be calling each other [to talk about our practices]." They were personal friends, as well.

A car accident ended that fun and set in motion a downturn in his practice that lasted eight years, along with other severely mitigating factors. It was a time of change in the industry. Insurance companies began altering their rules. HMOs became prominent. It became harder to do business. Payments were cut down. Income waned.

And at the same time, so did Langdon’s interest.

“There are ways to do well with insurance changes,” Langdon says. “But I didn’t have the energy or drive to see what I could do. I let the situation manage me instead of managing the situation.”

In the throes of professional and personal depression, Langdon wanted to leave the office, head west and just drive.

“It was a job, he recalls. “It was a basic job. I was just showing up because I needed to support my family.”

Office manager Teresa Maslar, there for the upbeat times that preceded the blues, says it was the combination of events that caused the situation to go bad. She pointed to changes in Medicare policies, for example, as something that contributed.

She also says Langdon took the loss of his two friends very hard. His personality, understandably, changed.

“You look back and ask yourself, ‘What exactly happened?’ I don’t know if I could tell you. It just happened,” Maslar says. She says changes in reimbursement policies contributed. But it was more than insurance policies that did it.

“He lost a couple friends he was very close with. That obviously affected him. He got into a funk. When you have one person, especially a major person [in your office], who’s down, that one negative person can drag down a lot of people.”

The irony is that the slump began shortly after the practice saw its best times. It was a Friday in 1993 that Langdon and Co. saw 120 patients in one day.

“And we broke a goal of 375 patients in one week,” Maslar recalls. “We were so psyched. Then it seemed like there was a gradual decline. Sometimes you don’t realize you’re in the spiral. We always thought we could rally out of it. It just went so steadily down that it took a lot to get back up.”

Langdon knew he had to pull himself and his office up out of the blue. He just wasn’t quite sure how to do it.

“I saw that red line on the practice-statistics graph going down. I sort of ignored it and hoped maybe it would stop going down.”

It didn’t. In retrospect, he sees that most of the cause could be traced to leaving his practice-management firm. Langdon admits that everything in his practice in terms of success (or lack thereof) can be traced to having — or not having — a management consultant to guide him.

For example: In 1980, his first year of practice, he made just $4,000. By his third year he was making $36,000, a fairly modest sum.

Then he joined a management firm and things took off. By the end of his first decade, his monthly patient numbers were steadily in the hundreds.

“We learned a lot about how to do things — about patient education and so forth,” Langdon says, crediting management firms with helping his practice. “I’d say from 1984 to about 1994 we were just on top of everything. When you go to these management meetings, you hear people doing things that just get you going. People get up in front of the class and talk about what they’re doing and you sort of get high on that stuff. Then you say, ‘I can do that!’ Then they give you the tools to do it. I wanted to do it.”

But when he stopped using a management consultant, his numbers began to slide. It was a slow process, and one that didn’t seem to have an end. The practice went from nearly 400 patients some weeks, down to 120.

Looking back, Langdon admits that his practice could have declined without the personal tragedies that happened. He believes such a downturn could happen to anyone if you don’t pay close enough attention to your business.

He says. “At our lowest point, we were still doing better than the average chiropractor. Some guys were seeing maybe 40-75 patients a week and thought they were doing well. So I thought I was still OK. I was just down from when I was doing very, very well. But if you aren’t paying attention, you might drop 10 patients a week. And before you know it, you are in real trouble.”

DRAMATIC CHANGE

Things changed in mid-2003. With his practice spiraling downward, if not circling the drain, an ad for a practice-management firm attracted his attention and he decided to call.

The results have been stunning. Langdon only sees around 200 patients a week — not as many as at his high point — but the net results are far better.

“We’re working a lot smarter now and we’re making as much as we were when we were seeing twice as many patients,” he says. “I have a purpose. Back [in my slump] I had lost my purpose.”

The key to his re-emergence was starting slowly. His consultant gave Langdon a six-month plan with new activities to implement each month, rather than just have him make immediate changes across the board.

Following the plan, Langdon first concentrated on new-patient procurement and new-patient activities.

Once he regenerated those activities, he looked at how patients were scheduled and processed.

Then he adjusted his paperwork and the consultant brought him up-to-date on compliance.

The consultant worked with Langdon to retool his marketing strategy, streamline targets and simplify marketing projects.

“The firm’s big thing is — you want to get a lot of base hits,” Langdon says. “You don’t look for the home run. You don’t have one project where you get, say, 40 new patients. You have a bunch of small marketing activities going on.”

His small activities included:

• Business appreciation projects for local companies. He held these a couple of times each month;
• Advertising;
• Screenings;
• Chamber of Commerce involvement.

And to commemorate 9/11 he held a special for the ambulance association.

“All of these little things just add up,” Langdon says.

Langdon says he follows what the management team tells him — things he already knew how to do but wasn’t doing.

“Sometimes,” he says, “you need a kick in the pants. I got it. And it worked.”