Good nutrition, good business
By Tom Deters, DC

Talk about market demand! Everyone needs proper nutrition. And everyone needs to have his or her nutritional status monitored.

That’s because essential nutrient intake, macronutrient (caloric) intake and eating behavior (such as meal timing throughout the day) all play key roles in the health of every patient who walks into your office.

Chiropractic is about holistic care. This is our opportunity! The area of nutrition lacks market leadership. And the general patient population is confused. Patients can’t figure out if they should go to a diet clinic, talk to a personal trainer or buy the latest infomercial product. They get lost in vitamin stores.

If you doubt that we have an opportunity, consider: What percentage of your patients are overweight? How many have a “forward shift” in the abdominal center of gravity, anterior pelvic tilt, increased L4, L5 intra-discal pressure, tight hamstrings and a host of other biomechanical implications.

These patients may come to you for other problems (such as shoulder pain), but that does not preclude your counseling them! Do them a service — not only for orthopedic purposes but to reduce their risk of heart disease, hypertension, Type II diabetes and cancer.

And what about your pregnant patients, kids and baby boomers? They all have unique nutritional demands.

The bottom line is that everyone can be helped with nutritional monitoring and analysis — whether supplements are included or not.

AN ORGANIC SERVICE BUSINESS

Incorporating a nutritional component into your practice — such as diet analysis, body-composition testing, patient seminars, diet formulation and consulting or supplements — can help both you and your patients. Nutrition can strengthen and deepen your patient relationships.

You can offer these services in many different ways — initially just by marketing to your current patient population. An internally-based marketing program minimizes risk and expense and can be maximally productive.

Too often when doctors think about a “nutritional practice” they just think about introducing patients to supplements (detoxification, antioxidants or other types of supplements).

But the biggest business opportunity may be with nutritional services. These may include:

• Consultations concerning body-composition, using a computer report on metabolic profile (a great tool to help educate and enlist patient buy-in to your program),
• Dietary analysis and counseling, using software that reports the caloric and nutrient composition of the patient’s self report data,
• Possible laboratory analysis (such as blood work or 24-hour urine analysis, depending on your scope of practice laws) and
• Seminars.

So how does this service become a business? The first step is to do a “first pass” strategic and business analysis.

Let me show you a “back of the envelope” hypothetical business model:

1. Patient source: Current patient base only (no outside marketing). This includes only women patients (the greater source of dieters).

2. Program includes:

• Patient intake: Diet inventory, body comp analysis, possible lab analysis.
• Counseling: Review of findings, goal setting, diet design (caloric ratios, meal timing, etc.), menu planning, exercise program integration.
• 1-hour class the first week of the program in a small group.
• Bi-weekly assessments: One phone call and one office, caloric/timing review.

3. Program duration: 28 days. It ends with comparative body comp.

4. Program continuation: Patients can continue the program for additional weeks at a price discount.

5. Estimated commitment of the doctor’s time: Approximately six hours per week. (Roughly 24 hours per month in the busiest of the models.)

PROGRAM ASSESSMENT

To assess the benefit of implementing this type of nutrition program, do a “good model/poor model” evaluation.

The “good model” makes these assumptions:

• You have 50 individual patients who come into your office each week from which to recruit.
• Twenty-five of the 50 individuals (50 percent) are female (your targeted market).
• Approximately 70 percent of the women (17.5) are interested in losing fat.
• And 40 percent (7) are interested in a program and sign up for it, for a total of seven patients per week or 25 per month.
• Administering the program to these patients requires approximately 24 hours of your time each month.

To make your evaluation, consider:

• Each participant pays $249 in fees for the initial program and $199 in fees for an additional 28 days.
• Each participant purchases $100 in ancillary products: $50 of lab work, $30 of supplements and $20 for logs, DVDs and books.
• Revenues from program participants are $6,226 per month ($74,000 annually).
• Revenues from ancillary products are $2,500 per month ($30,000 annually).
• Total revenues from the program: $6,226 + $2,500 = $8,726 per month or $104,712 per year). Participants’ fees provide 71 percent of the revenues; ancillary products produce 29 percent.
• Value of the doctor’s time: $8,726 / 24 hours worked = $363 per hour worked.

The “poor model” is based on a different set of assumptions:

• You have 50 individual patients who come into your office each week.
• Twenty-five of the 50 individuals (50 percent) are female (your targeted market).
• Half (50 percent or 12.5 of the targeted market) are interested in losing fat.
• And 20 percent (about 3) patients per week sign up for the program. (This is 12 per month and will cost the doctor approximately 12 hours of time each month.)

To evaluate the program, calculate:

• Each participant pays $149 in initial program fees and can pur-chase an additional 28 days for $99.
• Each participant buys $100 in ancillary products and services (the same as in the “good” model).
• Revenues for program participation are $21,456 per year.
• Revenues from ancillary products and services are $14,400 per year.
• Total revenues include $1,788 + $1,200 = $2,988 per month or $35,856 per year. Program participation fees account for 59 percent of the revenues; ancillary products account for 41 percent. Total $2,988 per month or $35,856 per year (gross).
• Value of the doctor’s time: $2,988 / 12 hours worked each month = $249 per hour of doctor the doctor’s time.

All business models are only as good as the assumptions that they are based on.

This model assumed that no male patients were interested and that participation would not grow over the year.

Furthermore, the model does not take into account the revenues from any additional chiropractic services you might provide for new patients attracted solely because of the nutrition program.

Neither does the model give any consideration to your market and community penetration, reputation or prominence. And it assumes no outside marketing or advertising — just in-house patient education.

Develop your own assumptions and program. If the opportunity still looks interesting it’s time to dig deeper and flesh things out in terms of operational impact.

Keep in mind that this is a new cash business that requires few forms and paperwork. You collect approximately what you gross.

Did this get you thinking? Good. Business decisions should be built on thinking strategically — that means doing the research and modeling and considering all angles (including the exit strategy if it doesn’t work!) before anything is launched.

Nutrition offers an excellent chance to grow both revenue and market share.

Growing market share means getting new patients into your system. Nutritional programs (assuming the scope-of-practice laws in you state allow them) are some of the best ways there are to attract new patients — patients you can also introduce to chiropractic.

For further information on seminars, workshops and consulting on strategic practice development by Dr. Deters, go to his website www.tomdeters.com or you can e-mail him at info@tomdeters.com.