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More and more chiropractors are working under one roof with MDs/DOs, physical therapists, massage therapists, nutritional counselors, and other professionals. These doctors are turning to multi-discipline practice to offer patients more services and greater convenience — and to increase revenue. Whether you’ve already established an integrated, holistic practice or are just thinking about it, here are three truisms to live by.
At least 30% of your practice income should be derived from payment at the time service is rendered, instead of third-party payors. Chiropractors, as well as many medical specialties, are experiencing tremendous difficulties dealing with managed-care companies. Reimbursements have been reduced, for both fees and visits allowed. Consequently, health-care providers of all types must offer a broader variety of services, particularly elective services. Patients must be taught that they are the ones who are ultimately responsible for payment, rather than a third-party payor.
Chiropractors in many states have expanded their practices with the introduction of services such as weight management, vitamin counseling, cellulite reduction, acupuncture, and dozens of additional services. These “full-service” holistic practices offer various elective procedures, such as body aesthetics, that are not paid for by third parties, but are in high demand by the public. Anecdotally, many of these practices are experiencing at least a 30% increase in annual revenue.
You should be able to take a one-month holiday and return to a properly functioning practice. Professional practices must be organized and managed like any other type of service business. Your practice will grow commensurate to your organizational and managerial capabilities — no further. If you cannot leave your practice for a reasonable length of time without it deteriorating, you need to take steps to correct the situation.
One option is to hire a qualified business manager or consulting firm to teach you how to manage the business part of your practice. As any professional practice grows, it requires more management. Speak with a senior manager of any well-managed service business, including group health-care practices, and you will be surprised as to the number of weeks of vacation many of the principals take, with no detriment to the practice or business.
You should be able to draw a consistent salary on a regular basis. Your salary is directly dependent on your management skills. Unfortunately, many chiropractors are inefficient managers. This should not come as a surprise to you. After all, most DCs do not have MBAs and are not taught how to run a business in chiropractic school. The only way to establish a consistent salary and yearly salary increase is to expand the practice beyond critical mass. In other words, the practice needs to expand to the level at which a slow week or month will not create undercapitalization.
Your practice should be able to tolerate three to six months of slower-than-normal growth without affecting your personal income It is common for income to be erratic in a practice that limits its services, but not in a full-service integrative practice. Once a practice reaches a critical threshold of five full-time professional employees, your salary, including annual raises, should remain consistent.
