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Issue 2 - February 2004 Smile! You’re
on telemed! More via networking than anything else, Juergens’ practice, Spring Shadows Chiropractic Clinic, has blossomed to the point that in 2003 he had more than $750,000 in gross billings. He sees 160 patients a week, with 40 new patients each month. The latter numbers come despite no advertising, something Juergens has never done. Instead, his practice has grown through professional referrals, and plenty of them. Like all healthcare fields, chiropractic is getting more high-tech with each passing year. A recent innovation may take the profession, and the entire medical world, to new places while giving patients unheard-of access to care. Ground floor opportunity Juergens, through his associations with physicians in Texas, is in on the ground floor of a program known as telemedicine, which allows patients to see doctors in different parts of the world. It also allows doctors to refer patients with the touch of a button. Juergens is the director of chiropractic for back pain disease management for the telemedicine program, directed by Dr. Kim Dunn, associate dean of the School of Health Information Sciences at the University of Texas Health Science Center. Telemedicine is a multi-disciplinary practice association program in which practitioners and patients are linked via computers. The primary function of the program is getting patients linked to doctors in a cost-cutting manner. “In her research she wanted to focus on the largest monetary driver of healthcare costs, of which back pain is a large portion,” Juergens says about Dunn. “Instead of just going into the traditional medical models they were used to, she decided to look into chiropractic, both with some other physicians and insurance companies who were interested in the telemedicine program.” Piloted in Houston, the idea is for the telemedicine program to be a pioneer for healthcare accountability. The goal is for telemedicine to roll out nationwide, perhaps beyond, by the end of 2004. Once it does, quick access to specialized care will be available to all patients of networked doctors. Breaking it down to its basics, telemedicine connects, via computerized telelinks, doctors and patients (and other doctors), allowing physicians to “see” patients, who are hooked to a variety of monitors, or to view test results or images. Think “On-Star.” The on-board computers in new cars allow repair technicians to diagnose problems remotely. Telemedicine is a form of that for humans, minus the advertising.
“If I have a patient who needs to be evaluated, by a primary care physician or an orthopedic surgeon or a neurosurgeon or any other specialist, I can call up that specialist online and they pop up on the screen and we see a patient together,” Juergens explains. “I become the facilitator. The other doctor communicates with patient. They can listen to the heart or lungs, or view MRI images. “It’s great for our profession. It allows us to link ourselves within the medical model yet still maintain our role as a chiropractor. It helps facilitate co-managing a patient. It allows us to treat a chiropractic problem, while a primary care physician can [prescribe], if something [is needed].” From the other end, Juergens and other chiropractors can telemedically determine a patient’s need for chiropractic care. The patient is certainly the winner in any case. Doctors, meanwhile, can see more patients. Chiropractors will be viewed as specialists in the program and will develop referral relationships with other types of specialists. Practice built on old-fashioned networking Networking the old-fashioned way is how Juergens has built his practice. He doesn’t have an advertising budget, but he doesn’t necessarily preach the no-marketing formula. He knows that had he not been in the right place at the right time back in 1989, when his association with a Houston hospital catapulted his practice, things might have gone differently. “I probably would have had to take a different avenue to stimulate patient referrals, but I don’t think I’d have been nearly as happy,” he says. Traditional, lower-tech professional affiliations are Juergens’ favorite way to build his practice, after the standby of patient referrals (the latter account for 60 percent of his new patients, compared to 30 percent for the former). Professional referrals only happen, however, after nurturing relationships with other healthcare professionals. When you go out and meet other doctors, let them know exactly what you do, says Juergens. “Know your limitations and have an opportunity to see patients on a trial basis and then refer them back for re-evaluation to determine whether or not your chiropractic treatment is successful.
“If [chiropractors] do that, it opens the line for a lot of doctors, once they see the success that you have and you develop trust in their eyes, then they’re much more willing to work in your network.” Trust is a key factor in all referrals, Juergens says. Patients trust doctors, and they also trust people they know. Referrals are essentially an expression of trust and an extension of a comfort zone in patients’ minds. Once a new patient is on board, it’s up to the chiropractor to develop his own layer of trust with that person. “They should see results very quickly,” Juergens says. “Obviously, we’re not going to help everyone. But I still get referrals from those [physicians] with patients who might require surgery. Patients develop trust with another practitioner. Maybe I’ve been given a little instant credibility, because of them being referred by someone they trust, whether it is another patient or one of their other doctors.” Once patients come to his practice, Juergens makes sure they’re treated well. And he offers a two-week trial period. “I have a great staff and a real friendly environment. I tell my patients up front that if I feel like they are a candidate for chiropractic care, I will treat them on a trial basis,” he says. “If there are no improvements after a two-week period, we may need to re-evaluate their condition. I want them to know from the beginning it’s not going to be a long drawn-out process.” He also gives lectures on sports injury and fitness-related topics and ergonomics to local business, again marketing himself directly, though at no cost. But he doesn’t do it in a burdensome manner, allowing plenty of time to spend with his wife and their five children as well as stay active as a weekend athlete himself. While fully realizing his good fortune, Juergens believes his professional life would have worked out fine, had he not gotten the breaks he has. And while he understands his strategies for expanding a practice may go against the flow of conventional wisdom a bit, he believes they can work well for anyone willing to put in a little time and energy to developing a practice without a tremendous amount of financial expense. He has worked hard to build his affiliations and has built scores of them over the years. His networking days didn’t begin in 1989, and they haven’t ended now that he has found a home inside an outpatient environment in a large city. Juergens realizes there is still work to be done and he still looks for avenues to do it every day. And he never stops concentrating on his craft and improving as a chiropractor. For him, complacency and mediocrity will never be a virtual reality. Todd Stumpf is a freelance writer from Akron, Ohio. He has been with Chiropractic Economics as a contributing editor for four years. He can be reached at TStumpf22@yahoo.com.
Vital Statistics Spring Shadows TEAM PLAYERS Mary Stewart Lisa Searcy Karrie Garbs Jeannie Juergens OFFICE HOURS Monday-Wednesday Friday Practice revenue Gross Billings Patient visits per week: 160 Sources of new patients All
figures are provided to |
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