Learn from the experts
30 consultants answer 3 questions
that can affect your success
By Linda Segall

Who do you talk to when you have a problem to solve? In large companies, co-workers talk to and learn from each other.

Their interactions can be described as peer learning. By definition, peer learning is learning that occurs among people who work together. Author Peter M. Senge, in his classic book on organizational development, The Fifth Discipline: The Art & Practice of the Learning Organization, suggests people learn best when they work on real-life problems and when they can exchange information with others who have similar situations.

Small chiropractic offices do not lend themselves well to peer learning, so Chiropractic Economics decided to simulate a peer-learning experience by posing several questions to individuals who have been “in the trenches.”

We asked chiropractic practice-management consultants to answer one of three questions:

• When new clients come on board, what is their biggest need?
• What is the most important activity a chiropractor can do to attract and retain patients?
• Thinking back to when you opened your first practice, if you were to do it again, what would you do differently?

Their answers (and tips) provide a learning experience.

When new clients come on board, what is their biggest need?

THINK 5 YEARS IN THE FUTURE.
Clients usually want to increase their number of new patients, patient-visit average, or dollar-visit average. The problem is doctors who don’t have a coach lose focus easily.

The answer is to work on all three areas at the same time. The way to do this is to develop a strategic five-year plan that incorporates goals in all three areas.

A five-year plan is not just goal setting. It is building a true business foundation for the practice; the same type of foundation used by multimillion-dollar corporations.

If you want to make real money, do what real businesses do: Operate under a five-year plan.

— Keith Maule
Integrity Management, www.Integritymanagement.com

BECOME ACCOUNTABLE TO CHANGE
Without question, their biggest need is developing and accepting accountability. Most practitioners already know what to do and how to do it. However, because human beings place such a high value on comfort, it often becomes easier to stay the same rather than change.

With an accountability partner, change happens more consistently and more rapidly. In business and in life, your rate of change often equals your rate of personal and professional growth.

 — Daniel T. Drubin, DC
4th Dimension Management Corp., www.masterofchange.net

LEARN CODING RULES
DCs who intend to bill services to insurance carriers need to understand three things that may not have been taught in school: Medical necessity for reimbursement, documentation skills, and reporting under the coding system.

First, doctors must understand medical necessity as a reimbursement concept. Next, they must acquire efficient and effective documentation skills. Finally, they need to master how to report services using the CPT/HCPCS/ICD system.

Reporting requires not only a knowledge of the codes, but the various rules for how these codes are properly used. Understanding and applying these three core concepts is essential to getting paid and staying paid.

 — Michael D. Miscoe, CPC, CHCC, CRA
Practice Masters, Inc., www.codingexperts.com

BELIEVE TO ACHIEVE
Their biggest need is to start believing in themselves — “You gotta believe to achieve.” It does not take long for new doctors to get beaten down once they have to deal with building a practice and surviving under the burdens of student loans and other obligations. It is just a matter of having them refocus on what they do and the benefits they can give to their patients. Once that happens, they present a better picture to potential patients — and those potential patients become patients.

 — Stanley B. Greenfield
Greenfield’s Financial Power Program, www.stanleygreenfield.com

DISCOVER YOUR NEEDS
New clients inevitably want less stress, more money, and more fun. They have no plan for their practice or personal growth, and have often lost their passion for practicing. The first thing they need to do is figure out their needs and then develop an action plan for growth and success.

 — Charles Ward, DC
Ward Success Systems, www.wardsuccess.com

MAXIMIZE INNATE STRENGTHS
What they don’t need is more strategy. What they need most is to make some adjustments related to the “subluxations of their mind” — to discover and maximize innate strengths.

Most people already know what they can do to improve workflow and staff efficiency. Many have invested large amounts of time and money, yet they have not achieved the results they wanted.

Every doctor has a unique set of innate gifts and strengths. Those strengths are what will carry the person long after the coach or consultant is gone.

 — Peter D. Demarest
Mentis Education, LLC, www.amindforsuccess.com

SOLVE CHRONIC PROBLEMS
They are looking for solutions to chronic problems and need help seeing their situations more clearly. And they want to be seen, heard, understood, and respected — the same things a new patient who walks into their office wants.

 — Shelley Simon, RN, DC, MPH, EdD
Beyond Practice Management, www.beyondpracticemanagement.com

BE REALISTIC
Many doctors don’t have realistic expectations. They hire a management consultant and expect their status to change quickly. They want the benefits of a successful practice, yet are unwilling to pay the price by acting outside their comfort zone. These doctors often end up going from one program to the next looking for that “one thing” that will make their practice a success. They need to be realistic.

 — Frank Sovinsky, DC
DC Mentors, www.DCMentors.com

CLARIFY YOUR PURPOSE
Their biggest need is to develop a clear purpose for both their practice and their business. Epidemic in this profession, and in other professions I’m sure, is the seemingly endless quest for more.

Ask any DC what he or she wants, and the response invariably starts with “more” — more patients, more time, more money. And while wanting more is not, in and of itself, wrong or a problem, not knowing how much or why is.

Once you know the goal and that goal is yours, and it actually means something, the discipline to do what needs to be done appears.

 — Steve Hoffman, DC
Mastery Coaching, www.masteringchiropractic.com

IMPROVE PROFITABILITY
New clients most often need to improve their profitability. Many practices lack the organization and systems necessary to help withstand the rapid pace of change as practice regulations increase and reimbursement rates decrease. These factors can result in poor hiring decisions and an environment of low job satisfaction and high staff turnover — which have a major impact on a practice’s bottom line.

To improve profitability, new clients must work on a plan to improve the consistency and commitment of their practice team.

 — Mark Sanna, DC
Breakthrough Coaching, www.mybreakthrough.com

MASTER BUSINESS SKILLS
Their biggest need is business skills. They master the skills needed to be a great chiropractor in chiropractic college, but do not learn the skills needed to succeed in business. The skills are different, and to have a successful practice requires having both sets of skills.

 — Marty Kotlar, DC
Target Coding, www.TargetCoding.com

DON’T ‘SHOOT FROM THE HIP’
The secret to success is following a proven system of practice procedures and protocols while ceasing to “shoot from the hip” and function with inconsistencies in the practice routine.

Most new clients don’t understand the reason(s) why patients refer others to them. That “why” is mastering a system that allows them to use their talents to the fullest.

 — Tom Owen III
AMC, www.amcfamily.com

What is the most important activity a chiropractor can do to attract and retain patients?

MEET AND GREET
Each week, meet 10 new people. You can do this in a variety of ways, such as introducing yourself to people where you shop or go to eat, getting involved with charity work, or volunteering to help at blood drives by giving people a free five-minute massage before they donate blood.

Tip: People often have a preconceived idea that chiropractors only deal with pain. When you meet new people, introduce yourself as a wellness chiropractor who uses exercise, nutrition, and natural methods to help people regain and maintain their health. This introduction will give people a reason to visit you even if they don’t have back pain.

 — David Singer, DC
David Singer Enterprises, www.davidsingerenterprises.com

USE HIGH-END MARKETING
Chiropractors need to position themselves as celebrity experts in their communities. They can do this through custom infomercials, newspaper inserts, outside lectures to businesses, and in-office presentations. All of these activities position the doctor as the celebrity expert authority on chiropractic.

Doctors should never offer discounted services beyond a complimentary consultation. Be proud of what you do and confident that you provide incredible care no one else provides; stop feeling as though you have to discount your care to generate new patients.

 — Jeff Hockings, DC
Cash Practice Success System
www.CashPracticeSuccessSystem.com

ASK FOR REFERRALS
Focus on patient compliance and always ask for referrals. Knowing exactly when and how to ask for those referrals is paramount to building any practice.

 — George Thompson
The Office Coach, www.theofficecoach.com

TAKE ADVANTAGE OF YOUR CA
Use your CA! CAs are invaluable in recruiting new patients. For example: When a CA and DC are in public together, such as at a restaurant, the CA can introduce the DC to the waiter and hostess, and in the course of the conversation tell them they’ve now met the best chiropractor in the community. The DC can then offer a complimentary consultation.

 — Karin Toner-Pierce
ChiroAbility, www.chiroability.org

BECOME AN EXPERT
Become an expert in your chosen service. If your expertise is your adjustive technique, then obtain the highest possible certification the technique offers. Certified DCs are recognized as real experts. Patients want the very best, so set yourself apart from the competition, and become the very best.

 — Jeff Blanchard, DC
Golf Injury Seminars, GolfInjurySeminars.com

TEACH, THEN TEACH SOME MORE
Teach patients the nutritional, emotional, and visceral disease concomitants of subluxation.

When you teach patients during each exam, re-exam, and report-of-findings, they become patient-advocates.

 — Tariq Faridi
Faridi Group Consulting, www.faridigroup.com

THINK ‘HEALER’
Become absolutely convinced that you are more than just an adjuster. Become absolutely convinced that you are first a “healer.” If you think of yourself as a healer first, then everything else — attracting and/or retaining patients, marketing, and referrals — will fall into place and the practice will grow.

 — Warren McKenney
Concept-Therapy Institute, www.chiropracticprinciples.com

MARKET EVERY MONTH
The most important activity you can do to attract new patients into your practice is to have a planned marketing calendar full of internal and external events.

If you plan internal and external events every month, your practice is sure to attract new patients. And, your marketing will make existing patients wonder what is coming in the months ahead.

 — Michelle Geller-Vino
MGV Marketing, www.mgvmarketing.com

BUILD AN MD REFERRAL SYSTEM
To attract patients, establish mutually beneficial referral relationships with medical doctors and specialists in your community. This enables you to tap into thousands of people who live and work in your community, and also stimulates word-of-mouth advertising.

To retain patients, serve each patient as best you can. Practice with integrity. Be present with each person. Listen, listen, and listen some more. And, implement a consistent, weekly, research-based, staff-driven patient education and referral program.

 — Len Schwartz, DC
ChiroPractice Marketing Solutions
www.ChiroPracticeMarketingSolutions.com

WALK THE TALK
If you believe in lifetime chiropractic care for yourself and your family — and for your patients — set up a business model (including marketing, advertising, and community outreach) that supports lifetime care. When you do this, your practice will grow effortlessly year after year after year, as it becomes filled with lifetime patients who pay, stay, and refer.

 — Eric Plasker, DC
The Family Practice, www.thefamilypractice.net

BECOME A PERENNIAL STUDENT
Keep upgrading your skills — clinical, communication, business, and technological. Any doctor who doesn’t develop all of these skills will never do well. Graduation is just the beginning of what will be a lifelong journey of change and personal and professional growth. Being a lifelong student and eventual master is the only real key to attracting and retainings patients.

 — John Hayes Jr.
Perfect Practice Web, www.perfectpracticeweb.com

AVOID COOKIE-CUTTER CHIROPRACTIC
Involve the patient in the decision-making process concerning his or her care. Avoid a cookie-cutter approach by tailoring the plan to the patient’s needs and goals. When you provide the risks and benefits of the various treatment options, the patient can make an informed choice about care and will be more likely to comply with the treatment plan and get desired results.

Patients who are satisfied with their treatment results and your personal attention are more likely to refer. Unfortunately, building a solid patient base takes time. Your ultimate success is determined one patient at a time.

 — Sherry Davis
Wake Up Coach, www.wakeupcoach.com

DELIVER A STRONG ROF
Deliver a powerful report-of-findings (ROF). A strong ROF establishes the need and reason for care and is the tool to gain patient commitment. Committed patients refer others for care.

 — Ed Sharp
Sharp Management Consulting
www.thesharpmanagement.com

BE UNIQUE
To attract new patients, use a combination of being different and being consistent with your message. In advertising, different is perceived as being better. Stand out from other chiropractors in your area by focusing on what makes you different. Then be consistent and put that unique message on your marketing materials.

To retain patients, produce results and educate. If you produce results but do not educate, your patients will not continue care.

 — John Heggie, DC
Lakeside Chiropractic Seminars, Inc. www.LakesideSeminars.com

TALK SAFETY
Attorneys used to be the preferred networking source of new personal-injury patients. But times are changing. To access crash victims, talk automotive safety to the public, police, and emergency medical service personnel. Your public relations programs help educate people about how chiropractic helps in the aftermath of an accident.

 — Arthur C. Croft, DC
Spine Research Institute of San Diego, www.srisd.com

Thinking back to when you opened your first practice, if you were to do it again, what would you do differently?

DO DUE DILIGENCE
I had no plan. Given another chance, I would have written a business plan that would have considered location, demographics, management, and finances.

I didn’t perform due diligence to learn about the industry and the profession. I would have identified doctors that are local industry leaders and sought their understanding of how the industry worked and used that knowledge to my benefit.

I didn’t fully consider all my options. I only considered starting a practice, not buying a practice. With the right deal, it would have been wiser to buy an existing practice.

I thought clinical competence should be enough. I’ve learned that a well-trained staff, up-to-date office systems, efficient office procedures, continuing clinical education, ongoing internal marketing, and prudent financial management make up the foundation on which success is built. Going through the motions or planning to get to it some day is not enough.

 — Terry Flanagan, DC, DABCO
Circumference, www.CircumferenceServices.com

DON’T GIVE AWAY SERVICES
When I started, it was common to offer free services through direct mailings and coupons. The future of chiropractic is to stop cheap coupon advertising and giveaway screenings and become more community-based with local chiropractic groups representing county or state associations.

When chiropractors work together to educate the public, credibility increases. We need to have direct contact with the public to give them valuable information, but we do not need to give valuable services away to attract potential patients.

 — Timothy J. Gay, DC
Ultimate Practice, www.ultimatepractice.com

DO THINGS RIGHT
I would surround myself with a team of professionals including an accountant (CPA), financial planner, insurance consultant, and an estate attorney. I would streamline my office and develop staff policies and procedures to handle any situation that could arise. I would implement regular staff training and hire the right staff for the right positions.

If I were to do it again, I would build a beautiful, modern office that would be warm and inviting with fresh flowers at the front desk. I would also track my statistics each month to evaluate my performance.

 — Brett Axelrod, DC
The Masters Circle, www.themasterscircle.com

Linda Segall is editor-in-chief of Chiropractic Economics. She can be contacted by e-mail at lsegall@chiroeco.com. If you have questions for any of the management consultants, please contact them directly through their Web sites.