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The ABCs of starting out Your insurance agent would be happy to sell you, a new practitioner, a variety of policies as you open the doors to your first practice. What he or she can’t sell you is a policy that insures your success. One thing you can do for yourself, however, is to learn from those who have “been there.” Chiropractic Economics tapped into the knowledge bank of chiropractors we have featured as Success Profiles over the last several years. We asked them to share tips to help get you on your way. Here are their ABCs for opening your first practice. A rrange a special kickoff party. Invite all your patients and their family and friends! I treat all my guests to food and drinks, and have my patients introduce themselves and share their experiences with chiropractic and our office. This is very powerful for the other guests to hear. We raffle a special gift, such as a massage or bicycle, and put a checkbox on the raffle ticket that allows us to contact the guest for a complimentary exam. The patients have a great time, and they talk about it with their friends. B elieve in yourself — and focus on the future, not the past. Don’t look at where you are now or have been in the past, because the past has nothing to do with the future. The past is the past. And if you are starting a new practice, you have no past! Develop a vision of where you want to be. Stay true to the vision, and the future will be yours. C omputerize your notetaking. The right software can save you time and money. One of the best investments I made was a computerized travel card/ SOAP notes program that is used in every room. The software allows me to take and record thorough notes immediately, therefore making documentation easy. And documentation, as you should know, is critical for reimbursements. D iscipline yourself. Leadership consultant John Maxwell says, “Discipline is doing what you really don’t want to do, so that you can do what you really want to do.” Learn to control and master your thinking, emotions, and actions. Envision where you want to be in one year, two years, five years, and 10 years. Write down your goals and review them regularly. I recommend having a coach or a mentor who will remind you to be accountable for the discipline to achieve goals. Stay confident, set goals, and be disciplined! E at in a different restaurant each time you dine out. Never go back to the same restaurant twice! Introduce yourself to the wait staff and give them your business card. Tell them you are new to the area. When you pay your bill, leave your business card upside down with the tip. On the back of the card, write, “Thank you for the great service!” F orecast your future business. All companies, private or public, forecast their future business based on past performance in the same quarter (revealing seasonal trends), the present state of the company, and the implementation of new concept/initiatives in the coming quarter. Why should a chiropractic practice be any different? Use software that enables “time-period” data queries for tracking both services rendered and payments received. If you offer multiple services, look at the overall type of service usage per patient. Track your patients’ use of services and encourage them to get a “taste” of everything your clinic has to offer. G ive out business cards. Carry at least 10 business cards in your pocket at all times and pass them out at every luncheon or business meeting you go to. When I first started to practice, I did this. Five years later, one of the people to whom I had given my card came into my office. He needed a chiropractor and found the five-year-old card in his wallet. H ire an accountant. Ask other professionals for referrals, and then interview several accountants. Hire someone who specializes in working with incorporated small businesses, preferably healthcare practices. Look for an accountant who does tax planning and will do projections throughout the year to advise you on strategies to minimize your tax liability. I nstall an accounting system before you open your doors. Buy accounting software and familiarize yourself with it. Set up a filing system that will allow you to retrieve records quickly. You’ll save time by doing it right from the start, instead of having to re-do your accounts and files later. J oin a practice management group before you open your clinic. I didn’t, and as a result, I struggled during my first couple of years in practice, trying to piece procedures together from the practices that I had worked in. The procedures frequently conflicted with one another, which made it tough to grow. After experimenting with a number of different practice management groups, I found one congruent with my belief system and worked hard to learn its systems. Now my practice is thriving. K eep focused and stay positive. There will be times when “the going gets tough,” whether you have a traditional practice or a non-traditional practice that includes physical therapy, pain management, or orthopedics. But if you set your goals and stay focused on what you want to achieve, you can make it. L ove your patients. And love what you do. The key to my success has been my love of healing people. This desire leads me to educate myself constantly through unique seminars, so that I have the tools available to handle any problem that comes in. Because of this, I am as much inspired today as I was 30 years ago when I started. M onitor your practice. Measure new patient visits, patient visit averages, services, and collections. Make a monthly graph. This gives you an objective picture of how you’re doing. Ideally, these graphs will show a gradual or sharp increase during your first years. Most practitioners then level off in their “comfort zone.” If you are not heading in the right direction, look first at yourself. You will find that the cause of the problem is not the economy or the number of chiropractors in town or your staff. N etwork in your community. Many new doctors get hung up on the clinical/documentation aspect of practice in the beginning. While this is a vitally important function of a practice, in the beginning you need patients. The best way to bring them in is to go where they are — meet and greet. Get out of the office and make your name and face well known in the community. Health talks, screenings, and networking are great ways to get those new patients in the door… and they don’t cost much! O vercome your weaknesses. As human beings, we are much more comfortable polishing our strengths than we are working on our weaknesses. A wonderful mentor of mine once said, “We can never grow past our weakest areas.” Grow yourself first and all else will follow! P ick the most popular time to book your patients. Book all of them during this period; don’t schedule patients throughout the day! For about six months, you’ll need to spend about 75 percent to 90 percent of your time establishing your practice — and only 10 percent to 25 percent of your time practicing (producing cash flow). Schedule all your patients in a 30-minute to 60-minute period. This will build energy and excitement and make you look successful (with a busy waiting room). You will also be able to afford a front-desk CA for that short period. And you will be able to go out, “meet and greet,” and build your practice during the hours when you don’t have patients scheduled. Q uit being afraid. As you start out in practice, identify those things you know would help you develop a practice but you fear the most, and commit to overcoming them. In fact, get great at those very things. Common “fear” examples are public speaking or doing external screenings. View those fears as a roadmap to your success and tackle them consistently and persistently. R each out. But always do it professionally — no handwritten signs! Always look and act like the professional you are, even when you give out business cards. I give out five cards a day. Once, I almost didn’t give a woman my card because I was afraid she would think I was being “forward,” but when I introduced myself as a chiropractor and gave her the card, she said she needed a chiropractor, but didn’t know anyone! She ended up referring 45 patients to me. S eek advice from professionals. Ask the experts — such as accountants, consultants, and advertising firms — for help or guidance on each aspect of practice management. Chiropractic school teaches us very well about diagnosing and treating patients. You may have excellent grades and you may be an excellent chiropractor, but that doesn’t mean you are going to be successful in chiropractic business. Talented doctors need help from other experts to be successful in the profession. Michael Jordan had a coach. Tiger Woods has a coach. Why not you? T ravel to your patients. Taking chiropractic to your patients (mobile chiropractic) may be a better business decision than waiting for patients to come to you. Going mobile improves patient and market access, increases patient selectivity, decreases operational expenses, and ultimately boosts profits. U se the best software right from the start. Switching software later is expensive, stressful, and time-consuming. Take the time to research and select practice management software that enables you to file electronic claims and take computerized notes. Make sure it offers technical support that will not keep you on hold for hours when you call. If you use money-management software, get the small business version. You will be able to do your own bookkeeping, which will save you on accounting fees and keep you in touch with the cash flow of your business. V isualize the practice and life of your dream. Then take the necessary steps (and help) and make the dream come true — it isn’t all about money. Learn how to build your life as big as you want it to be. Watch for trends. Monitor your records to identify trends, such as the time of year you acquire more new patients, patient attrition patterns, patient compliance to various protocols, etc. As you watch for trends, you can repeat actions that cause good trends or change practices that cause downturns. X out attrition. The first 30 to 90 days are paramount in establishing and evaluating patient compliance to care. Attrition occurs for four reasons: lack of education; lack of service value; lack of finances; or poor patient service. If you see attrition occurring, pinpoint the cause and correct it. Y ield to a professional look. Don’t give in to “cheap.” If you furnish your office on a shoestring budget, you’ll have a shoestring practice. Buy waiting-room furniture that makes you look successful. Spend a little money. You’ll look successful and you will be successful. Z ero in on developing a professional referral network. Often MDs do not refer patients to chiropractors because they do not understand what we do or that we are well trained to do our job. To develop a professional referral network, ask each new patient for permission to send a report of findings to his or her primary-care physician. Send a thorough, professional report. MDs are impressed with the knowledge and skill behind the report.
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