Resource Centers:(News, information, and tools to support your practice)
September 2007
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Dr. Joseph Teff has reinvented himself to flow with the times
Master of Reinvention
Trend-watcher Dr. Joseph Teff now focuses on nutrition to keep his patients and practice healthy.
By Todd Stumpf • Photos by Randy Grosse
If you were to stretch your imagination, you might see that Joseph Teff, DC, has something in common with Thomas Edison.
Edison was a master of invention; Teff is a master of reinvention.
Taking a sort of “what will they think of next” approach, Teff, a 27-year veteran and solo practitioner at Teff Chiropractic in Middleton, Wis., tries to stay ahead of the curve in chiropractic.
It’s a strategy that works: In the last three of four years, the practice has had billings in excess of $1 million. It collects at a 90 percent rate (thanks to being a mostly cash practice), and it treats 300 patients a week, including 40 new patients each month.
EVOLUTION OF HIS REINVENTION
In the early days, Teff’s practice focused mostly on workers’ compensation cases. When workers, who were not always in the best physical condition, were hurt on the job, their companies sent them to him to be healed.
Then companies woke up: They realized making their workplaces safer and more ergonomically oriented resulted in cost savings. Companies made safety improvements; injury rates declined; and fewer patients came to Teff from the industrial sector.
With the workplace becoming safer and subsequently healthier, Teff thought there should be a way to make his practice appeal to healthy, active people. He turned his attention to the organized athletic community.
Eventually, though, athletic teams started getting their own chiropractors. “Chiropractic made inroads and teams started taking care of their own needs,” Teff says. “People caught on and needs started to be filled.”
SUCCESS THROUGH NUTRITION
Continuing to stay a step ahead — and still aiming to keep people healthy — Teff turned toward nutrition. With about 30 percent of his current patients’ care centered on nutritional-based programs and treatment, nutrition continues to be a focus of his practice.
The practice is in between evolution revolutions, as Teff keeps a finger on the pulse of healthcare, looking for the next trend and a direction to turn. “My practice has definitely changed, but it’s gone toward what I see is the greatest need,” he says. “I look at where the biggest need is to be filled at the time. Sitting down and analyzing that constantly is where I’m at right now.”
In his early days, Teff typically focused on things from a biomechanical point of view, working in the traditional capacity of a chiropractor. He adjusted people and helped them with a variety of health issues.
Eventually, his patients became healthier. That was good news.
Except that it wasn’t.
Teff had plenty of patience, but he was running out of patients. And with those he had, he found he wasn’t having the kind of success he wanted. He started looking for better, faster ways to help people. He found his answer in nutrition, an area in which the American public was — and is — sorely in need of help.
Although it is common knowledge these days, Teff learned years ago that many health problems — and their treatments — were nutrition-based. When he focused on getting his patients on a good nutritional regimen, he was able to get them well more efficiently and effectively. Many of their problems, even old-fashioned back problems, he discovered, were caused by nutritional deficiencies.
A UNIQUE NICHE
That fact ultimately led Teff to his current tack, focusing on and implementing a comprehensive program of nutrition analysis and fitness evaluation for his patients. To equip himself for this type of practice, he trained for six months and took more than 200 hours of classes in nutritional systems.
The evaluation he gives his patients consists of a computerized fitness assessment of the nervous system.
“That, coupled with being able to incorporate nutrition, gets some balance,” Teff says. “I looked for a program that was not only workable, but affordable for patients. But not all of them; it’s a certain percentage. They come in for chiropractic care and become nutrition patients.”
Part of the allure of Teff’s practice is it can provide nutritional care that others don’t. Teff uses nutrition-response testing, a methodology he estimates only three or four other doctors in the state employ. He says patients come from Chicago and Milwaukee, driving up to four hours each way to see him.
Those patients, including about 95 percent of his flock, come via referral. That’s how it’s always been for Teff, who does not like paid marketing services. He firmly believes word of mouth is the only way to grow a practice, and feels prospective patients will believe their friends and family long before they’ll believe anyone else.
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The Teff team — Jerri Stampfli, Diane Thompson, Sophia Minnaert, Linda Grosse, Marguerite Teff, and Teff. |
“Somebody is talking about the package to a prospective patient, and they already know what they’re looking for,” Teff says. “They know what the costs are, what we expect coming in on visits. It’s kind of like prequalifying people before they come in. We give them as much information as we can before they come in. We’ll sit down with them and go over things and see if it’s a program for them.”
REFERRALS BEGET RESULTS
“People want good doctors. We want good patients,” says Teff. “We want them to understand.”
Referrals come from results. Future patients see the successes current and past patients have and want to emulate them. Results from nutrition-based care are far more evident to the naked eye. “When you have people in the nutritional program and they’ve lost weight and look five or 10 years younger and have more energy, other people want to know what they can do to look this good,” Teff says. “They come in and say, ‘Whatever you did for so-and-so, I want some of that.’”
Once he sees a patient for the first time, Teff follows a set game plan. Sometimes that means telling people he can’t help them, but he’ll always refer those patients elsewhere, then research how he might be able to help a similar patient later.
He believes the policy will pay off one way or another, be it karma or patients telling others that he is, indeed, an honest practitioner rather than someone looking to make a buck.
Even those whom he tells he can’t help refer others to him. In fact, he finds them more likely to do this based simply on his honesty. “The honesty of being able to say you maybe can’t help them the way they want,” he says, “is huge.”
Teff says all practitioners should begin to realize that biomechanical problems are no longer just biomechanical problems. They’re steeped in nutrition problems. He encourages incorporating nutrition with biomechanics, which will turn a single-minded doctor into a multiple-service provider.
From there, his other focal point is education. Teff believes educated patients ultimately make the correct decisions about their healthcare. They are more likely to follow their own instincts than directions.
As Teff’s practice continues to evolve, he looks for his next stage of reinvention. He’s not positive which way the industry will shift next, but he never is. His gut feeling, though, is it will be some variation of nutrition, because, as he says, it has to.
“All healthcare has to be geared toward that avenue,” he says. “Even people who were getting massages every month or so before are getting massages once a week. There will be variations of nutrition and the way it affects stressors on the human body. There are probably some different things, but
Patient recruitment through education Teff is taking advantage of advances in audio-visual technology to enhance his patient-education programs. Whenever he gives a biweekly patient-education program, he captures it on DVD and then makes it available to patients, who can view it in or out of the office. In the office, patients can view lectures on a big-screen TV. “I talk a lot about nutrition and whole food,” Teff says of his lectures. “They like to go over the information again.” Most of his lectures address health issues, such as allergies, stress, and fatigue. Teff’s lectures average about 17 visitors, seven to 10 of whom are new patients. Of the new patients, he estimates 90 percent sign up for some sort of nutritional consultation or care. “I’m continuing to develop that whole avenue,” Teff says. “There are so many people stopping in who aren’t even patients. There seems to be a big demand for that, so I’m pursuing that avenue.” With all the modern doodads, Teff still offers some more old-school methods for patients who might not be as tech-savvy. Patients can check out books and other literature, the same way they can DVDs. They may not be quite as cool, but the information is the same. |
No time to spare People sometimes ask friends or acquaintances what they do in their spare time. In Teff’s case, the more appropriate query might concern what he doesn’t do. The full-time chiropractor is a car enthusiast, wood carver, and classic-car collector and restorer.
Before moving to the life-sized figurine, Teff mostly worked on bird carvings, which he gave to friends. The current project will take him quite a while to finish. He estimates if he worked 12 hours a day, it would take him three months. Even if Teff had 12 spare hours a day to spend on the project (which he doesn’t), it’s likely he would not dedicate all of it to carving. He has too many other things to do. At the top of that list would be restoring cars. Teff recently finished restoring a 1955 Thunderbird and recently worked on a 1968 Mustang. Tinkering with vintage vehicles is something he’s done for as long as he can remember. “I grew up around automobiles and motorcycles,” Teff says. “I lived next to a Ford dealership. I worked with mechanics, doing oil changes, things like that. That was in the high-performance model days. In high school, I started buying old cars, fixing them up, and selling them for a large profit. My kids help me now, and they do most of the work. I just give them direction.” His kids were given a deal: Keep the cars they restore or sell them and use the money to pay for college. Since his children received scholarships, they went to college and also were able to keep the cars. Teff, meanwhile, got the satisfaction of seeing something run-down returned to its original condition, not unlike a chiropractic patient. “It ties in very closely to that,” he says, “taking patients and bringing them back to health is very similar.” Another of Teff’s pastimes is taking long motorcycle trips on his Harley-Davidson motorcycle, from as far east as Washington, D.C., to as far north and west as Minnesota and Missouri. Riding over those roads gives him a different perspective on life, he says. “You concentrate on the motorcycle itself and on road conditions. It’s almost therapeutic. You feel the breeze, smell smells, and experience temperature changes you never notice in a car. You feel everything.” He says even short trips to and from the office are refreshing. “It’s like taking a mini-vacation,” he claims. |
The beauty of a nutrition practice: Cash Much of Teff’s nutrition-based practice’s success can be attributed to one thing — cold, hard cash. Up to 78 percent of his total practice is cash, and he estimates that number creeps a little higher when nutrition-only patients are considered. “The patients that participate in the nutritional program enthusiastically pay cash, keep their appointments, and refer nonchiropractic patients to our practice,” Teff says. “I never thought I’d see it happen, but they do. They see value in it. You explain to them what the costs are and what we look at and what the program entails. Repair can take two or three months, and they understand that.” Teff says what appeals to patients is the fact that under an insured system most would pay a certain amount for a deductible anyway. In a pay-as-you-go system, a patient might not even get up to the amount of a deductible. “With the high cost of medical care and procedures these days, it looks like a great value, and it is a great value,” Teff says. “You’re not arguing about insurance. It’s like they’re going to the grocery store or anything else. Proper nutrition is something we all need.” Teff says as more and more people become educated about nutrition, his practice attracts patients in tune with the fact that cash for nutrition is akin to cash for anything else they’d likely pay for on a need basis, and, because of that, they don’t look at it in terms of insurance costs. “You’re outside the HMO box, and you’ve got a level playing field and something that everyone needs,” Teff says. “You’re getting patients from all walks of life, many of whom do not have insurance coverage.” Teff assures them they don’t need insurance. Taking the insurance factor out of the equation also reduces the stress that can add to the process of healthcare. Stress is also lessened from a practitioner’s point of view. As Teff points out, the more cash coming in, the fewer people-hours are needed to worry about deductibles and other insurance-related considerations. “That’s a huge, huge relief of stress,” he says. “You can spend your time taking care of people.” |
Success keys
MENTORS
NUTRITIONAL SYSTEMS
Vital statistics
Teff Chiropractic
6417 University Ave., Middleton, WI 53562
Tel: 608-827-2020; Fax: 608-827-2022
www.optimumfunction.com; E-mail: teff@chorus.net
HOURS OF OPERATION
M-T-W: 8 a.m. – 11:30 a.m.;
2 p.m. – 5:30 p.m.
Th: 2 p.m. – 5:30 p.m.
F: 7 a.m. – 11:30 a.m.;
2 p.m. – 4 p.m.
TEAM PLAYERS
Joseph. J. Teff, DC, proprietor;
Linda Grosse, CA and office manager;
Diane Thompson, front-desk receptionist;
Jerri Stampfli, part-time front-desk receptionist;
Marguerite Teff, CA, front-desk receptionist, and inventory manager; and
Sophia Minnaert, part-time front-desk receptionist.
| SOURCES OF PRACTICE REVENUE | |
| HMOS/PPOs/IPAs | 2% |
| Medicare | 9% |
| Cash | 78% |
| Personal injury | <1% |
| Workers’ compensation | <1% |
| Other (fee-for-service insurance) | 10% |
| PATIENT VISITS | |
| Weekly patient visits | 300 |
| Nutrition patients | 75 |
| New patients per month | 40 |
| Patient visit average | 30 |
| PATIENT RECRUITMENT | |
| Referrals from other patients | 95% |
| Health talks | 4% |
| Professional referrals | 1% |
| GROSS BILLINGS | |
| 2002 | $980,000 |
| 2003 | $1.1 million |
| 2004 | $1.1 million |
| 2005 | $1.3 million |
| 2006 | $835,000* |
| 2007 (projection) | $920,000 |
| GROSS COLLECTIONS | |
| 2002 | $940,000 |
| 2003 | $980,000 |
| 2004 | $1 million |
| 2005 | $1 million |
| 2006 | $800,000* |
| * Transition from a multidoctor, insurance-based clinic that focused on rehabilitation to a nutrition-based cash clinic. | |
| ANCILLARY PRODUCTS Nutritional products and counseling: 30% of revenues (80% of patients purchase a product during the course of their care). Products offered: Dietary supplements, cervical pillows, and orthopedic supports. | |
Todd Stumpf is an Ohio-based freelance writer and frequent contributor to Chiropractic Economics. He can be contacted at tstumpf22@gmail.com.
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Lately his activities have included carving a full-sized carousel horse from basswood, a Tilia derivative. When he’s done with it, he will put the carving on display. (It will not become part of a carousel.)
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