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Issue 3 - March 2005
Dr. Carmelo Caratozzolo
Perseverance pays off
By Todd Stumpf • Photos by Walter teal
Dr. Carmelo Caratozzolo is a symbol of perseverance and success. His Accredited Chiropractic and Therapeutic Massage practice in Woodbridge, Va., grosses more than $750,000 annually in a combined chiropractic and massage therapy practice and he sees 440 patients a week.
Rock–and-rolling chiropractor
People come to chiropractic from different directions. Often, a sports injury sends them to seek chiropractic care for the first time.
Caratozzolo is an athlete — a power lifter. But it wasn’t power lifting or body building that sent him for his first chiropractic adjustment. It was music. Drumming, to be specific.
He injured his wrists while playing drums in a rock band. A friend referred him to a chiropractor and he discovered what would eventually become his livelihood.
First, though, he had to pursue the rock-and-roll dream. Although many young people try to become a rock star, few actually get the opportunity. Not Caratozzolo.
He and his mates formed a group called Rockland, bought a school bus and headed down the road to stardom.
The band made it as far as the Whiskey A Go-Go, the famous Los Angeles heavy-metal club that spawned the careers of such players as Motley Crue and Van Halen.
Mega-stardom was not in the stars for Rockland. Although a number of record executives looking for the “next big thing” made them offers, the band realized that the offers would have made them “slaves” to the music industry. They turned down the offers and went the way of the "real" world.
The rest, as they say, is history. Rock-and-roll’s loss was chiropractic’s gain.
Caratozzolo still picks up the sticks occasionally. He has designs on playing again some day, though more casually. Someday, he might even build a studio in his basement and maybe even lay down a track or two. Although it’s a long way from the Whiskey A Go-Go, he still loves banging out a beat.
But for now, his first love is practicing chiropractic, in which he’s drumming up more business than ever.
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But at the outset of his career in chiropractic, his experiences were so bad that he nearly threw his hands in the air and walked away from his chosen career.
With the help of some advisors, some resolve, and cooperation and support from his wife — and keeping his aim on the goal of having his own practice and doing things his own way — he eventually got things going in the right direction.
He remembers those first lamentable years out of Life College.
“I came out of school pumped up and ready to enjoy the world,” he says. All he wanted was to work with a doctor who would mentor him so that he could later grow his own successful practice.
DIFFICULT EXPERIENCES
Two weeks after graduation, Caratozzolo began working with a DC in Pennsylvania. He thought his dream was coming true, especially when he learned that his new boss was somewhat of a philosopher.
“He was a philosophy teacher, so I thought that was great,” he recalls. But the philosophy he preached was not chiropractic. “He was into this ‘cult’ thing,” explains Caratozzolo. “Rather than focusing on chiropractic, he focused his philosophy on this other thing. I worked with him for about six months and I had to get out of there. It was very stressful and I was very disheartened for my very first shot out of school.”
From there he found another position. The owner of the clinic was a symptom-based doctor. Caratozzolo was not.
To make matters worse, the young doctor discovered that his boss’ ethics were “challenged.” Caratozzolo recalls, “It was amazing what he would bill for, charging thousands and thousands of dollars to insurance companies, purely to make money, whether treatment was justified or not.”
Taking a hint from a former associate at that practice, Caratozzolo made his way to another associate position, this time in Virginia. But, as luck would have it, he again had a bad experience.
This time around, the “inmates” seemed to run the asylum.
“The doctor was a very nice guy, but his staff skewed him from his mission. He allowed his staff to run him. They ended up having me fired because they made it look like I wasn’t doing things. It was a weird experience,” he said.
NOT QUITE OUT
Three strikes and Caratozzolo was just about out. Just about — but not quite. Having always harbored thoughts and hopes of one day starting his own practice, he decided now was the time.
A number of patients from his last position decided to follow him as he started his own wellness-based practice. He knew he could not rely on them alone, so he began to market at every opportunity: He did screenings, gave lectures, handed out business cards, joined business groups and built relationships with attorneys and gym owners.
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Parties and Fairs
Caratozzolo budgets $1,500 a month for marketing, which includes such expenditures as space in a monthly magazine called The Merchandiser and has a full-page yellow pages ad in a small local phone book.
But Caratozzolo does his most unique, and perhaps most successful, marketing, in the realm of patient-appreciation parties and corporate health fairs.
When he gives a patient-appreciation party, Caratozzolo does the chiropractic equivalent of Mardi Gras. He doesn’t simply sponsor appreciation days. Sometimes the parties go on for weeks.
Caratozzolo says he finds that week-long events to be effective in educating the public about chiropractic in general and his practice in particular.
“With one-day events, it’s such a short period of time that you get bombarded with lots of people," he says. "All of a sudden you get 30, 40, 50 new people that want to sign up for an evaluation and what happens is maybe 10 people truly commit. I’d rather give more time to those other people who are coming in and not excite them into coming in, but educate them into making the right decision.”
Caratozzolo estimates costs of the parties to be no more than about $200, including the cost of printing flyers to announce them and food and drink to offer visitors.
FAIR TIME
The corporate health fairs, Caratozzolo says, are among his most effective marketing efforts and they can generate income. By managing the fairs, he charges vendors. He uses this income to hire an organization that does screenings for him.
The one caveat he has concerning health fairs is that vendors must deal in health and wellness, rather than sickness. “We don’t invite pharmacies or drug companies,” Caratozzolo says. “We have about 20 to 25 vendors who like to go to organizations that appreciate the health mentality.”
At the fairs, vendors set up their own tables. Employees come through and get an idea of what the vendors have to offer, while Caratozzolo introduces them to chiropractic and its benefit. On a typical day, the vendors and doctor can see 300-400 people.
“So the entire time it’s packed,” he says. “All the vendors support each other and we refer to each other outside of the health fair.”
Caratozzolo also sponsors local high school sports and charities, but beyond all of that, at least 60 percent of his business comes the old-fashioned way — patient referrals.
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His ambition allowed him to become moderately successful. But he admits that he did not have a clue how to make things work. “I was always taught what not to do, but never taught what to do,” he says. “I didn’t really have a set plan.
“I wanted to do wellness, but I was taught from those other practices to do pain management. My practice was doing well, considering. But I knew at some point we were going to hit a ceiling.
“My first four years in practice I went through 30 staffers. I didn’t know how to teach them or educate them. I didn’t know how to hire good people. One time I had 80 people come in for treatment and I didn’t have any staff, because I had just fired them. It was just insanity.”
Ultimately, things settled down, with the help of a practice-management group he finally clicked with. He called them several times a day for advice and heeded it. He didn’t, as he says, try to reinvent the wheel but found a way he liked to do things and stuck with it.
Caratozzolo quickly learned that the key to a wellness clinic was education — patient education. Through patient education he would be able to recruit and keep patients and care for their wellness.
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Vital Statistics
Accredited Chiropractic and Therapeutic Massage
13820 Smoketown Rd.
Woodbridge, VA 22192
Phone: 703-897-8400
Fax: 703-590-1294
Web: www.chiroaddslife.com
E-mail:
drcaratozzolo@aol.com drnmrsc@comcast.net
Hours of practice
M-T-Th: 9 a.m. - 12:30 p.m.
and 3:30 p.m. - 7 p.m.
W: 3:30 p.m. - 7 p.m.
Team players
• Carmelo Caratozzolo, DC
• Shannon Doyen, office manager, CA
• Jamie Dellinger, CA
• Christina F. Caratozzolo, CMT; massage, bookkeeping and accounting
Gross Billings to Insurance Companies
2004................... $480,000
2003................... $415,000
2000................... $415,000
2001................... $300,000
2000................... $235,000 1999................... $200,000
1998................... $120,000
Gross Collections*
| Year |
From insurance
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Cash
|
| 2004 |
$336,000 |
$354,000 |
| 2003 |
$286,000 |
$239,000 |
| 2002 |
$249,000 |
$166,000 |
| 2001 |
$195,000 |
$105,000 |
| 2000 |
$157,500 |
$67,500 |
| 1999 |
$100,000 |
$25,000 |
| 1998 |
$50,000 |
$12,000 |
*Collections are for chiropractic care only. In 2004, the practice also had revenues of $90,000 from massage therapy.
Ancillary products
• 40% of patients use them
Patient Visits Per Week —
Yearly Comparison
2004..............440
2003 .............320
2002..............270
2001..............240
2000..............200
1999...............150
1998.................75
New Patients Per Month
2004...............25
2003...............20
2002...............15
2001...............17
2000...............20
1999...............30
1998...............35
Patient Visit Average
PVA................70
Marketing Budget
$1,500 per month.
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“Let me reassure you that people are pretty smart today and that they want to know about all of the benefits [of chiropractic]. Educate people and give them choices,” he says. “You may be surprised about the results. People just need to know how to participate. So, learn how to speak the language with confidence and don’t play games.”
By being precise in the type of services he renders, Caratozzolo also believes he is very precise about the kind of patients he tries to attract. By searching for and finding those types of patients, he estimates 90 to 95 percent of his patients renew with him for a second year of care and beyond.
“I’m not educating somebody on coming in for 12 visits and having them pay extraordinary fees and then disappearing so I have to do it again and again and again,” he says. “I educate them at a very high level so that the people who do choose to accept care in my practice — something like 55 to 60 percent of people who walk into my door in general — are going to accept care because of trust.
"You can take a shotgun approach and basically just advertise everywhere and say everything you think people want to hear — neck pain, back pain, headaches and promising the world to people — or you can mention that chiropractic is about improving their health potential, which has an effect on these other health issues, “ he says.
“If you educate them that health isn’t about a lack of symptoms, it’s about optimizing the function of the body … if you really educate people, people will understand,” he says.
Caratozzolo says that some people might criticize that a 55 percent to 60 percent rate of converting first-time visitors to a treatment program is not very good. But he sees it as a whopping success, because those 55 percent to 60 percent are getting educated to the point that they will always want to come back.
He believes in telling the whole story from the start, so patients know exactly what they’re in for. This may cut down the volume he does, but his PVA of 70 shows he makes up for that elsewhere.
He remembers well the lessons of his first four years in chiro-practic, which he now views as a period of painful growth.
“When I opened my own practice, I said, ‘Thank God. I can do my own thing.’ I am happier on my own than working for somebody else. I talked with my wife and we said we were going to make it work one way or another. I was going to win this battle.”
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A proper exchange
Among the things Caratozzolo lists as keys to his success are the concepts of charging a “fair fee” and being in “proper exchange.” In other words, heeding the words of his advisor, who cautions that chiropractic becomes “small and valueless if you play games with your fees,” Caratozzolo says patients should all be given the same opportunities and DCs need to find the balance point for how much is enough or too much.
“That’s up to any of the doctors out there,” he says.
“For me a fair fee is anywhere between $30-$50 per visit. I think that’s fair. I’m trying to strive to get my average up to $35-$40 per visit. There are chiropractors who think $20 is a fair fee, or some who think $80 is a fair fee.
“What it ultimately comes down to is this: I don’t think I practice better than anyone else. I’m happy with the way I practice. Some people are unhappy, although they’re collecting a lot per visit.”
Those who are unhappy, he suggests, are not in “proper exchange,” one way or another. Those seeing many patients, but not charging a lot to see them, are devaluing their services. Those seeing only a few patients, but making up for it with higher fees are also out of balance; they aren’t getting the satisfaction of helping as many folks as possible.
“A particular doctor has to come to an understanding, so if they want to make a great living and enjoy their life financially and not burn themselves out, there has to be a balance when it comes to their fees,” he says.
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Success Keys
Practice management consultant
Dr. Eric Plasker, The Family Practice,
ww.thefamilypractice.net, 866-532-3327
Financial consultant
Preston Wines, Edward Jones Financial Group,
703-492-9623
Fitness
Gold’s Gym, www.goldsgym.net, 703-680-7000
Technology
Inphase Technologies Group, www.inphasetech.com,
800-282-6991
Patient education and diagnostics
Dr. Patrick Gentempo, CLA, www.subluxation.com,
800-785-2001
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Todd Stumpf is a freelance writer from Akron, Ohio. He can be reached at TStumpf22@yahoo.com.
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