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Dr. Michael Perusich
Sports minded DC
By Todd Stumpf • Photos by GErald Schlomer
Michael Perusich, DC, considers himself neither a serious athlete nor a weekend warrior. A former multi-sport competitor as a high schooler, he instead places himself somewhere in between.
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An integrated approach to healthcare
Perusich doesn’t have an MD on his staff of practitioners, but his is an integrated healthcare practice, to say the least. Patients have access not only to chiropractic care, but also to rehabilitation, acupuncture, and naturopathic care.
Perusich’s professional team includes his associate Emily Lane, DC, and Gretchen Knust, ND. In addition to performing chiropractic, Lane is also staff director of acupuncture therapy. Knust is not only a naturopath, but also a certified yoga instructor and personal trainer.
With that type of diversity, Perusich sees no reason to add a medical doctor. In fact, he believes doing so might actually be counterproductive in terms of relationships established outside the practice.
“We don’t have an MD partially because we work and have a great relationship with a lot of the medical doctors here in town,” he explains. “I don’t want to go into competition with them.
“Our concept is whole body, holistic wellness. That’s why we have a naturopath on staff. We do a lot of rehabilitative therapy. We work very closely with the physical therapy department in our hospital. Our concept of multi-discipline is being able to offer patients what they can’t get at their medical doctor.”
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With much of the athletic spectrum within the horizon in either direction, Perusich has gotten a handle on the type of chiropractic treatment just about any athlete might require.
That knowledge, along with an enthusiasm for teamwork in the office and an aggressive patient-education strategy, has helped Perusich build the Perusich Chiropractic and Rehab Center in Sedalia, Mo., into a $1 million entity (based on projected billings for 2005) in a little more than five years.
“I consider myself a weekend dabbler at this point,” Perusich says of his athletic prowess. “Part of why I got into chiropractic care was because of sports-related injuries. I still play a little softball. I absolutely love golf, water skiing, snow skiing. My wife and I still are very active.”
Sports-related matters comprise about 20 percent of the cases at Perusich’s practice. And as many as 70 percent of his patients are rehabilitation cases.
In addition to his own experience, Perusich has learned much about treating sports-related conditions from his dealings with high-caliber performers. This included a stint as one of 40 DCs involved in the World’s Greatest Athlete Chiropractic Decathlon Club who worked with candidates for the 2004 U.S. Olympic decathlon team. Decathletes are considered the most rounded athletes in sports.
“Guys who train on that level are on a different level than the weekend warrior who plays basketball or softball with a group of people in town,” says Perusich, who was also an on-site DC at the U.S. Olympic trials in Sacramento, and is the team physician for a group of rodeo riders and an arena football team in town. “Those guys are dedicating their entire life and their bodies to their physical capabilities of trying to compete in their sport.
“They are very in tune with their bodies. They are treated very regularly. It was fun to help them enhance their abilities. Not only have they been in my office, but I’ve been out on the training field with them, at events with them. It was an awesome experience.”
What Perusich saw from watching the top-notch competitors was the detail with which they approach their sports, spending hours watching tapes of themselves running, focusing on such minutiae as the gait cycle, and seeking the slightest imperfection in their technique, knowing that the tiniest of flaws can lead to a health-related setback.
The way the high-caliber athlete takes care of his or her body is the way a weekend athlete should, says Perusich. They both, after all, are essentially the same. One is just far more finely tuned.
“We all have the same muscle groups and we all should use them in the same way,” Perusich says. “That’s allowed me to develop better rehabilitative care. The high-caliber athlete is out there using his body every day to its absolute maximum potential, so they need to stay finely tuned. On the other hand, you’ve got the weekend warrior, who is not using on a daily basis their neuro-musculo-skeletal system to its full potential.
“Because of that, the weekend warrior suffers from a lot more dysfunction. As far as which one needs more help, they both need a lot of care. The weekend warrior is a lot more problematic. The high-class athlete requires a little more fine-tuning and maintenance. With weekend warriors, you’re putting them back together a little every week.”
NEVER-ENDING LEARNING
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Making the move
Soon Perusich and his staff will pack their bags, so to speak, and move to their new, modern, and very large office. Although the move is “small” (taking about a week and covering only about a city block), Perusich wants it to go smoothly, so it is being planned to the smallest detail to ensure the patients are in no way inconvenienced.
“We started the process of letting patients know that we’re going to be moving about four months ahead of time. This isn’t going to be any big surprise to them.”
For a while the current office was filled with teasers, including a board on the wall that said “We’ve got a secret” and “We’ve got a surprise.” Patients were invited to write down what they thought the surprise might be. The secret was finally revealed when Perusich hosted a VIP (very important patient) dinner.
He used a Power Point presentation scripted to run to the theme music to 2001: A Space Odyssey. When the slide that announced the move finally made its way to the screen, the response was overwhelming.
“Every patient jumped out of their seats and applauded,” Perusich says. “We had patients crying; staff was crying. It was just awesome. We’ll do a series of similar events along the way.”
Why the move? It’s necessary, to say the least. In spite of being in a location at the back of a medical building and not being visible from the road, the practice thrived to the point of overflow.
“In the beginning, people told me our location would hurt our growth,” Perusich says of the original location. “And gosh, maybe it has, but I think we couldn’t have handled any more growth in this facility. We are bursting at the seams.”
The move was precipitated by the practice’s rapid growth. In fact, the clinic outgrew its original 1,500-square-foot office in about a year, and Perusich had to open a second office in town, just to accommodate patients.
The second space was about a mile away from the first office. He and his staff split their time between the two clinics.
“The original clinic focused mostly on traditional chiropractic services,” Perusich explains. “At the other clinic we focused on not only chiropractic but rehabilitation, yoga, nutrition, and personal training as well. Now we’re in the process of bringing those clinics together.”
The new clinic will be in a 6,400-square-foot state-of-the-art building. The practice will offer additional services and feature a patient- and staff-friendly layout and design focused on flow.
The new facility will include a 1,200-square-foot rehab room, on-site laboratory and X-ray equipment, a completely paperless record-keeping system, and a wireless communication system that will allow staff to communicate with each other via headsets.
The clinic will also have big-screen televisions showing patient education videos and PowerPoint presentations, as Perusich takes his patient education to a multi-media level.
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As Perusich learns, his patients learn. And he makes sure they always learn. He holds frequent patient education seminars. Pictures of top athletes training are very visible to his patients. Videotapes and PowerPoint presentations are staples in his program.
When Perusich moves his practice later this year into a much larger facility, the patient-education program will expand along with the square footage. Patients won’t be bombarded, but they will be immersed.
“I think our patient education is probably one of the biggest key factors in our growth,” he says. “We spend an enormous amount of time on patient education. Virtually every patient visit is an opportunity to educate them. All three doctors on staff get out into the community and do health talks on a variety of topics. That has been a huge tool. It has a huge impact on patients. It helps their understanding of why they need chiropractic care. Patients enjoy learning about their health and all the things we do.”
SPORT-SPECIFIC EDUCATION
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Where everyone knows your name
The theme song to the 1980s sitcom Cheers posed the question: Don’t you want to go where everybody knows your name?
At Perusich Chiropractic & Rehab Center, the chances are pretty good that “everybody” will know your name.
Perusich says, “When a patient walks in the door, at least one staff member says, ‘Hi, Bob,’ or ‘Hi Shirley, how are you doing today?’ The goal is to see how many of us can say their name. A patient may walk in and have seven people immediately say hello. Patients absolutely love that.”
That closeness is part of the allure that led Perusich to open shop in Sedalia, Mo., about 100 miles from Kansas City. He found that it was easier to market his services in a town with a population 20,000, where he could meet the folks he was marketing to.
Perusich originally practiced in a large, upscale suburb of Kansas City, where he worked for about year. When he and his wife JoAnn learned they would be having a child, they decided parenthood was a good reason to head for the small-town environment. They chose Sedalia because it was where JoAnn grew up.
They already knew some folks in town because of that. Now, they know most of the rest of them. More importantly, most of the rest of them know of Perusich.
“An area like Kansas City has so many doctors in it,” he says. “The ability to communicate your message from a marketing standpoint becomes difficult.
A newspaper covers such a vast part of the population that it becomes difficult to focus on what you do and where you do it.”
Living in a small town has also created many opportunities to get involved in the community, and Perusich has made sure to take advantage. His activities include:
- Boys and Girls Clubs, currently president of the board;
- Relay for Life, gold-level sponsor;
- Missouri Minutemen Arena Football Team, team chiropractic doctor;
- Child Safe, a local non-profit organization that protects abused kids;
- Summer youth baseball league;
- Doctor participant with the local high school to offer free sports physicals;
The clinic has also raised money for many charities, including Support our Soldiers, MDA, Boys and Girls Clubs, and Special Olympics.
“Sometimes in a big city it’s more difficult to get involved,” he says. “Not so, in a small town. Help is always welcome.”
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The new facility will have technology and equipment available to develop sport-specific education, enhancement and restoration programs. With two trainers on staff, patients can get plenty of attention in that realm.
Currently, Perusich offers such a program for golfers. The idea is for casual players to learn to take care of themselves before and after they play.
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Diversified marketing
Perusich understands that marketing must be planned and it must be consistent. To that end, he reserves between 5 percent and 10 percent of collections for marketing programs, which include:
• Newspaper advertising in the weekly paper for approximately $200 a week;
• Radio advertising, $500 per month, for ads on the station having the best target audience;
• Special promotions. These vary. For example, in return for a donation to a charity, patients receive a free day of service, a t-shirt, or other item.
• Themed patient-appreciation parties. The clinic has a summer family picnic, holiday parties, and parties to celebrate other occasions. Each costs about $1,000.
Additionally, he sends out press releases as often as he can.
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The program features a four-hour class that breaks down swing dynamics and helps players gain strength and endurance. It, of course, includes patient education.
“It’s a lot of fun to teach,” Perusich says. “We’ve got a fairly large percentage of patients who are golfers, probably at least 10 or 15 percent. Patients are amazed when I just show them a couple of quick, easy exercises they can do. Every one of them comes back in a couple weeks and says ‘I don’t know how that worked, but whatever those exercises are, they improved my game, and I’m not sore anymore after I get done playing.’”
Perusich says knee and shoulder problems are the most common problems. In fact, he says he treats more shoulders than spines. The problems arise, he says, from incorrect mechanics. People don’t run properly, throw properly, or swing a golf club properly. The result is overuse injuries.
Perusich not only treats these athletes, but also makes sure they learn how to do things right the next time.
“Because they’re not in a training program, and not making themselves work correctly, they’re causing essentially long-term damage,” he says. “We work with a lot of them on just their mechanics. I was working with a patient who is a high school softball player. She’s having difficulty with her anterior shoulder. To understand why she’s having trouble, I had her throw some balls to me.”
Perusich says his own experience as a high school and college athlete helps a great deal. And while not every DC can be a former athlete (or a current one), it certainly helps to have that background.
“It’s almost a must,” he says. “You have to have done something to be able to really experience what the patient experiences.”
TEAM PERUSICH
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Team training
Teamwork just doesn’t happen; it needs to be developed. Perusich works at creating a team-like atmosphere within the clinic. He accomplishes this through daily staff meetings, designed to motivate, inform, enrich, and ultimately achieve targeted goals.
Team training doesn’t stop with the morning meeting, however. As team captain, Perusich makes sure his teammates attend quarterly training sessions offered through his management-consultant company. In these sessions, staffers gain skills and knowledge to keep the practice on course.
Skill development is one thing; teamwork is another. To develop a keen sense of teamwork, Perusich annually sends his staff to a teambuilding event. Past events have focused on developing interpersonal cooperation to accomplish tasks, group relationship building, and teamwork.
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With his practice revolving around athletes and athletics, it’s perhaps fitting that Perusich considers his staff a team. Although it’s his name on the shingle, he sees himself as just another team member. The staff accomplishes things as a group, not as individuals.
The group meets daily to make sure everyone is on the same page. Education and training are always focal points of the meetings.
“Because the team working together can accomplish more than one member working alone, we are able to accomplish so much,” Perusich says. “We are also a very goal-driven office. We set all kinds of goals.”
Naturally, the team has statistics-based goals, and Perusich is a big believer in using statistics to drive a practice. But the practice’s goals are more on the lighter side. They set goals such as the number many patients names they can remember, how many health talks they can have in a month, and how
many patient-education opportunities they can take advantage of.
Then there’s the big goal: How many times a day can they ring the bell? The bell signifies a patient “graduating” from his or her treatment program and have reached maximum improvement. Graduates get a certificate, applause, and a lot of whooping, hollering, and fanfare.
“Patients love coming here. They enjoy their time,” Perusich say. “Every day we have patients who tell us they don’t want to leave. They want to hang out with us for the day.”
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Whole health focus
Although Perusich runs a chiropractic clinic and rehab center, he focuses on whole health. That’s why he offers his patients a number of ancillary products and services. Some of these products and services become part of the patient’s treatment program.
He says that approximately 50 percent of his patients purchase products and services other than chiropractic, and he attributes about 15 percent of his total revenues to their sale.
What does he offer, as a support to maintaining patient health?
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• Nutritional counseling,
• Acupuncture (actually considered primary care), |
• Chiropractic pillows,
• Yoga, and
• Sports enhancement training. |
 Todd Stumpf is a freelance writer. He can be reached at tstumpf22@yahoo.com.
Perusich Chiropractic & Rehab Center
3405 West 10th Street,
Sedalia, MO 65301
Telephone: 660-829-2600 • Fax : 660-829-2607
E-mail: backboneofhealth@charterinternet.com • www.backboneofhealth.com
Hours: M-Th, 9 a.m. to noon, 2-5:30 p.m.; F, 8-10 a.m. |
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TEAM PLAYERS
- Michael Perusich, DC, clinic director
- Kelly Ramey, patient services coordinator
- Leah Barth, clinic coordinator
- Emily Lane, DC, director of acupuncture therapies
- Gretchen Knust, ND, director of wellness; certified yoga instructor and personal trainer
- Marisa Mateja, operations manager
- Rochelle Hockett, marketing director
- Maleah Perkins, therapeutic services director
- Stacey Morrison, therapeutic services associate
PRACTICE REVENUE BY PAYMENT TYPE
HMOs/PPOs/IPAs: ...less than 5%
Medicare: ..................10%
Cash: ..........................30%
Personal Injury: .........10%
General Insurance: ....45%
GROSS BILLINGS*
1999 — (practice began in Sept.)
2000 — $360,000
2001 — $540,000
2002 — $600,000
2003 — $700,000
2004 — $780,000
2005 — $1 million (projected)
GROSS COLLECTIONS*
2000 — $180,000
2001 — $280,000
2002 — $350,000
2003 — $448,000
2004 — $501,000
2005 — $800,000 (projected)
2006 — $1 million (projected)
*All figures are estimated and approximate.
MARKETING STRATEGIES/BUDGET
• Budget: 5% – 10% of collections
• Weekly newspaper: 2x3 inch ad, $200/week
• Radio, one station: $500 per month
• Frequent patient-appreciation parties: $1,000 per event
• Patient-education expenses: Approximately $2.50 per patient
PATIENT VISITS
• Patient visits per week: In 2005, 300–350
• New patients: 50 per month
• Patient visit average: 24
PATIENT RECRUITMENT
• Referrals from other patients: 60%
• Health talks: 5% – 10%
• Advertising: 20% – 25%
• Professional referrals: 5% – 10%
OFFICE TECHNOLOGY
• Nine networked PCs; new office will have 18
• Eclipse for accounting
• WritePad
• Practice technology: EMG, Dual-inclinometry computerized ROM; Laser; Low- and Mid-tech Rehab
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