Where you can go wrong when setting rates for athletes and teams
One of the first things you learn when going into business for yourself is to price your services high enough to earn a decent living while still being low enough to attract your target market.
Yet, this is one area where many sports DCs struggle, according to Spencer Baron, DC and founder of Doctors of Chiropractic: Sports (DoCS), especially when it comes to deciding what to charge athletes and, sometimes, entire sports teams.
In fact, after spending 19 years as team chiropractor for the Miami Dolphins and treating athletes with the Miami Marlins and Florida Panthers, Baron—who is currently the DC for Nova University in Davie, Fla.—reveals there is one mistake he has seen his colleagues make over and over when it comes to setting their rates.
The critical pricing mistake
This mistake involves providing chiropractic care to certain athletes and teams without asking for any type of payment in return.
“If you think that you’re going to do treatment on a pro athlete because they’re going to endorse you, that rarely happens,” says Baron. Plus, offering your services totally free of charge can ultimately hurt your business more than help, as Baron says he’s seen firsthand that many patients don’t come back after receiving services for free.
Another problem with this approach is that it can create hard feelings if you’re giving an athlete free services, yet see them out and about and spending major amounts of cash on other things.
Then there’s the issue of liability. In the late 1990s, Baron says one of the nation’s top quarterbacks at the time wanted an adjustment. Initially, everything was going well but then he heard the player go “Ugh!” before sitting up and yelling, “You broke my rib!”
Out of the corner of his eye, Baron said he could see everybody turn toward him and the room fell totally silent. After what seemed like an eternity, the quarterback said he was just kidding, but for the couple of seconds before, all Baron could think of was a Miami Herald headline which read “Chiropractor Breaks Star Quarterback’s Ribs” and having to move to some remote country because he knew he would be blackballed for life. “That’s when I realized I needed to be paid really well for this,” he says. He had the highest level of malpractice insurance, the most sophisticated level of training in sports injuries, and advanced adjusting procedures—plus business acumen and social skills.
Know your value
In the end, if you don’t charge for your services, your patients will value you less. One way to correct this, aside from talking about how great you are, is to measure the difference in what you do. For instance, if you have an athlete who just took a cross-country flight and now has back pain, have them touch their toes, do the adjustment, and then have them touch their toes again. This highlights the value of your care instantly.
Alternatively, shoot a range of motion or gait analysis video on your patients’ phone so they can literally see what is wrong, such as if their head shifts to the right because they’re trying to avoid pain on the left. Then shoot another post-treatment to show them how chiropractic helped. Because it is on their phone, they will likely show their friends and possibly even post the video on social media, also making this a great marketing tool.
Pricing based on level of athlete
Once you realize charging for your services is a must, the next step is to determine your specific rates. Determining your rates should reflect the amount of services you provide, the value of the service, and the environment you practice in, which means where you practice and the economic environment play a role. However, your services and charges should be the same regardless of if the patient is a peewee athlete or a professional one.
Setting pro-athlete rates
Baron shares that there are two ways to get paid when working with pro athlete patients: via health insurance or workers’ compensation.
When he first started out, Baron said, “If the player was injured and carried off the field, that was workers’ comp. Anything else was health insurance.” Nowadays, the same type of rule generally applies, but it is ultimately up to the head athletic trainer to make the final call.
Treating pros also means you may sometimes be asked to see a visiting athlete or a whole team. While some sports DCs have offered this service free of charge in the past, Baron warns that this can present issues with liability while decreasing your credibility at the same time—in addition to decreasing the value of our profession.
That’s why, in instances like this, Baron suggests you itemize your charges based on travel time, the energy required to set up and take down your table, the types of services the team wants, and how many athletes they want you to treat. You can set a separate fee to cover travel time that the athlete or team is responsible for. If insurance is not used you might determine a team fee as well.
Factors to consider
It’s also important to keep in mind that their insurance may not cover your charges. That’s why Baron is always clear with visiting teams that they are responsible for any balance their policy doesn’t pay. A DC must consider
a few factors:
If you are in-network with the team’s insurance policy, it may strictly prohibit billing for any outstanding balances.
Several pro teams are self-insured and use a third-party administrator (TPA); therefore, check with the director of player health benefits for answers to the “balance billing” question.
Some pro teams have no problem with the club picking up costs per visit that are not covered by their athletes’ insurance. They may request you send in the explanation of benefits (EOB) so they can cover deductibles, copays and, possibly, other non-covered treatments.
Charging collegiate athletes
Colleges typically offer sports DCs yearly stipends. Therefore, when determining what that stipend would need to be in order to make it worth your time, Baron suggests sports DCs consider:
The distance from your home or office to the university.
How many people you’ll treat, which varies based on whether you’re treating one sports team or teams for all of their sports.
Whether you’ll be able to refer athletes to your office for follow-up, which could translate to providing other services not typically offered in the team’s training facility.
Whether treatments need to be applied daily, such as before a huge event, requiring athletes to have greater access to you.
There are insurance considerations as well, since most collegiate athletes have two separate policies: one from their parents and one from the university, the latter of which usually picks up whatever the primary insurance does not.
As far as the rates themselves, “charge the amount that is typical for you or in your area,” says Baron, who also suggests setting rates in the 90th percentile because you’re delivering a higher level of expertise and skill. Your liability is a whole lot greater when you’re treating a higher-level athlete, so consider this as well; maybe get a better malpractice policy with a minimum of $1-$3 million or higher.
Also think about why they are asking you to be their sports DC. Are you the best in the area? Did someone refer you? Use this to leverage your negotiations for a higher stipend.
For high schoolers
When it comes to working with high school athletes, the incentive is really to get referrals, says Baron, as there are very few high schools that retain chiropractors. Most hire an athletic trainer instead.
That said, if the school is in a low-income neighborhood and the star player is working hard, has talent, and is trying to get their family in a better situation, you may decide to consider hardship care and work out a nominal rate or a barter (like sharing a photo of you together on their Instagram). But beware: You cannot do this with college athletes due to extremely strict NCAA rules.
In the end, Baron warns: “Do not do anything for nothing. Period.” Instead, have value in what you do so athletes, athletic trainers, coaches, and their teams will realize your value too.
Christina DeBusk is a Chiropractic Economics staff writer who specializes in content related to natural health and wellness, personal development, and small business marketing. She can be contacted through christinamdebusk.com.