“Most people can’t understand how someone can collect an enormous sum of money and have nothing left over. But I was an example of that. I had 22 offices and was shutting them down faster than I was opening them. These are eight components I have used to become essentially debt-free. “
I set up practice in my home town of Monroe, Louisiana, which is somewhat of a no-no at least that is what I was told at school, but I hadn’t done anything wrong in my adolescent years, so I didn’t think it would be a problem. That was in 1982, shortly after I graduated from Palmer College of Chiropractic, and basically my intention was to develop a chiropractic office different from any I’d seen at that time. I established a practice in about a year and was seeing about 30-35 patients a day, which I felt was somewhat of a successful practice. Then someone invited me to a practice management seminar, which I turned down. Eventually I decided to go to a dinner where doctors talked about what they were doing in their practice they were being called up one by one to tell about their offices and what they were accomplishing. As the doctors talked, they reached the level where I was, and I thought, “Okay, that’s pretty much what I’m doing, so I really don’t need this.” The next thing I knew, they continued to go above and beyond to goals that were incomprehensible to me for example, a million dollar chiropractic office in one year.
My mind never was directly on money, my mind was always on patient care, but I am a true believer that money is the yardstick of the service we render. And if we render good service, do a good job, we will be compensated accordingly and it will last a long time. It won’t be a short term thing. As I watched these doctors, I began questioning myself and wondering what these doctors were doing that I was not.
After dinner, I talked to one of the speakers who was wearing a big cowboy hat, giant belt buckle, and whose knee was showing through his blue jeans. I thought, “Okay, Dallas, don’t be judgmental. The bottom line is, he’s doing more than you are, so let’s try to figure out what it is.” He was very open, honest and helpful. Regardless of what I asked, I was basically doing what he was. So I realized that it wasn’t the procedures it had to be something even deeper than that. I concluded later that he was very much an extrovert very outgoing. And at that time in my practice career, I felt like I was very outgoing, but I really wasn’t. His confrontational tolerance level was very high and his attitude was excellent. I started investigating further and I realized that there were two things I had to do before I could go any further in practice:
- I had to be willing to learn, and
- I had to be willing to change.
I began trying to change things and trying to model myself after certain people who were successful in practice. After about 12 months, my clinic was producing levels above and beyond what this doctor was doing.
I formed a partnership in the mid 1980’s and we opened up 22 offices. We were basically outproducing most chiropractors in the United States at that time from the standpoint of patient visits and income and so forth. However, I made an enormous number of business mistakes along the way, and those business mistakes cost me a fortune.
Most people couldn’t understand then and still can’t understand how someone can collect an enormous sum of money and have nothing left over at the end. But I was an example of that. We were collecting a high six figure income each month and having nothing left over. I made an enormous amount of mistakes. The failures that I went through in practice are basically unmatched by what a lot of people do. I had 21 offices, and I was shutting them down faster than I was opening them. I got a million dollar education, and the problem was I had to pay for it. I had a financial advisor other doctors were using and I thought he knew all there was to know about money.
To make it worse, the partnership I was in was unequally yoked. We were philosophically different and things started to fall apart as the years went on. I realized from all of the heartache I was going through that I had to change. So we split our partnership; he took several offices and I took some. I sold some of mine; he eventually closed most of his and went bankrupt. Many of his doctors called me because of the rapport that I had with them. That’s how I got started in the practice management business that I’m in now.
The financial problems I went through were horrendous. When I broke up with my partner in 1990 I had a bank account that reconciled $50,000 in the red, I had high six figure debt, and I had payables of over $200,000. I didn’t see any light at the end of the tunnel at all. I had attorneys looking me eye-to-eye, saying, “Dallas, the best thing you can do is file bankruptcy.”
However, that word wasn’t in my vocabulary, I didn’t want to do that I felt there was always an alternative. I put my nose to the grindstone, wore the knees out of my pants praying, and worked like a dog trying to get out of it. I bought every book, cassette tape and video I could find on money and I went to every seminar that I could on business finances to try to learn every last thing.
After a period of time, as I developed knowledge and continued working, we turned our whole operation around. Now by using the proper financial techniques the company is essentially debt-free and it is very liquid.
The biggest problem with doctors now is that they get out of school and they know how to adjust somebody, but they still need a lot of help with their philosophy, which comes with time, and they have no idea how to run a business. You have to run a practice just like you would run any business and the bottom line is what counts. The scary part is I see people with a big bottom line on a profit and loss statement, and they’re losing money because they’re spending it on nondeductible items and so forth.
I had an attorney ask me several years ago in Houston, “Dallas, are chiropractors just generally poor business people?” I asked her why she asked. She said, “Because last year I filed more bankruptcies for chiropractors than any other single profession.”
When I started to turn my business around, I made a business plan for every tier of my business that I was changing or setting goals towards. Today’s doctors don’t realize the importance of doing this. They get out of school with illusions of grandeur about how they need to make enormous amounts of money the first 12 months of practice because they’re worth it. They can adjust an atlas or an axis or an L-5 or whatever it may be, but that has nothing to do with their ability to be a good business person.
My own components for success are as follows:
1. Have a high confrontational tolerance level and ability to confront issues and not run away from them.
If a doctor is an introvert and he wants to be successful, he is going to have to change. At least within the practice, the doctor must get out of that shell, become an extrovert, face patients eye-to-eye and tell them what they need to hear and not what they want to hear. Stay on purpose.
2. The second component is that doctor’s have to be willing to learn and change.
I can’t tell you how many doctors have called me on a daily basis asking for information; then when I gave them the information, they were not willing to receive it. They’d make excuses such as it’s not really something they think they can implement in their own practice or work environment…
Not all change is progress, but all progress is change. Chiropractic has changed so much over the last decade; it is absolutely unreal from all of the notekeeping and paperwork and managed care. It can be mind boggling and it can cause doctors to want to get out of practice, which I see on a frequent basis as well, but it can also be exciting if you keep up with the times.
My little boy knows how to use a computer. I’ve had computers in my business for years, but I never knew how to even turn one on or turn one off. And I realized that if I didn’t learn to use computers, my son was going to leave me behind and I was going to be one of those dads who didn’t know how to do anything. And he would be one of those kids who end up talking about how old fashioned his parents are.
3. Take responsibility for your practice, and do not blame things on other people.
Don’t look at your C.A.s and say, “It’s because of the C.A.s that I’m not doing what I need to do,” or “It’s because of the town I’m in that I’m not producing the income or seeing the number of patients I need to see,” or “It’s because of where I’m located” which is another concept I call “geographical syndrome.” By that I mean saying things like, “Where I’m located, patients don’t want to come see me. They would come see me if I was in another location.”
I was visiting a doctor in California a couple years ago who had a practice with over 2000 patient visits per week with multiple doctors in the same facility. I couldn’t find a place to park. I drove all over the place to find a place to park. When I got in, I asked him about the parking situation. He told me that he never paid attention to it and that he wasn’t in the parking business his mind was on serving people so much that he didn’t let that become an issue to him. He was producing levels that other doctors only dream of producing. He was successful because he didn’t let something such as parking interfere with his focus of treating patients.
4. Doctors need to avoid “Rubber Mouth Syndrome” talking about all types of things in their practice other than what it is they’re doing.
I’ve seen doctors wanting to talk to their patients about bass fishing, deer and buffalo hunting and every other thing they could possibly think about. There are times for that. I’m not saying to shut-up and not say anything to them, but concentrate on patient care and tell the patients the information they need, and get them in and out of the office as soon as possible.
This is a fast-paced society. That’s the reason the banking business has gone computerized most people don’t even go into the bank anymore. Most people drive through to get fast food and they don’t want to spend 30 minutes or an hour in the office with their chiropractor, especially with multiple visits. Trust me, if you schedule somebody for a period of time to come in and they are going to be under your care for the next six months to a year, they’re not going to do it if they have to spend an hour and a half every visit. It’s just not going to happen.
5. Doctors have to be willing to break out of their comfort zone, which goes along with changing.
Break out of your comfort zone and do things that are different in your practice, whether it be spinal screenings or something that may make you feel uncomfortable. One exercise I do with doctors who are trying to develop confrontation skills with patients is I ask them to list the things they despise the most. And those are the things I try to get them to do. They most dislike these things because they are avoiding them due to the fact they don’t like confrontation or are trying to avoid rejection. Once past that, they end up being better doctors and are able to confront issues a lot better than what they were.
6. Establish goals and be committed to them.
A goal is something we hear about all of the time; there is nothing more important than having something to reach for. You can’t play basketball without a basketball goal, you can’t play the game of life without a goal to shoot for. You have to be constantly setting goals. The offices I personally own are always setting goals and we are continually talking about how close they are to their goal or how far they are from their goal and what they need to do to reach their goal. They set goals every month and they constantly strive to meet those goals. We have been doing that for many years and will continue for years because it’s part of the overall picture of success.
7. Another component is doctors need to learn to take control of their finances.
It may only be a small amount of money, but the bottom line is that you need to know what is happening with your money. I didn’t and I got taken to the cleaners to be quite honest. Establish good spending and savings habits, learn about how to handle money, and remember that no one is going to look after your money the way you are.
Some doctors don’t receive financial statements at all and the ones who do don’t know what they’re looking at. It looks like Chinese to them. They just review the bottom line and say, “Oh, okay, I made a profit.” There are equations that can help project what your business will be like in five years, the liquidity ratio and all other types of ratios. The financial statement is the life blood of a practice because it is like a reflection in the mirror of how a doctor is doing financially. You need to understand it, how to read it, and how to use it to the maximum benefit.
8. The last component of being successful is to be willing and prepared to work.
I see doctors who go into practice right now and try to start a practice from day one by working three days a week. Their hours may be something like 9:00 – 10:00 and perhaps 2:00 – 3:00 in the afternoon, and maybe they’ll try to pick up another hour in the evening. They get this “doctor syndrome” that the patients are going to be there when they are there and not at the patients’ convenience. You need to be there for patients at all times. Many just want to wait on people to come walking in their door, you have to continually go out and be looking. I believe that if one believes that strongly enough, they can go out and achieve it.
And those are some of the strategies of a successful doctor, and strategies that I think any doctor needs to have in order to be successful.
Dr. Humble, how have you been able to stay focused?
A lot of commitment and a lot of faith. I really believed in what I was doing. I believed that I could accomplish it, I could see myself accomplishing it. I still can with things I try to pursue. During the hard times, I confronted the worst case scenario and that helped me get through it and it helped me be more committed to my goal than I was before. It drew me a lot closer to God. If I believe in something strongly enough, I’ll pursue it to the end no matter how many times I fail.
You had a partner at one point what would you look for in a partner now?
Well, first, as a general rule, I would avoid partnerships. I think anything with two heads is a monster. If you are going to have a partnership, somebody has to be in control. I had a 50/50 partnership and that is generally a big no-no in the business world. If you are going to have a partnership, someone needs to have 51% voting power. Otherwise you get into a situation where somebody is going to have to make the decision. And if neither one can make the decision, what do you do? You have a standoff. And you end up in failure. That’s basically what happened to us.
How do you feel about group practices of multiple chiropractors?
I believe the future of our business is doctors working together rather than single practitioners. In my situation, I have several offices with one doctor in each one, but we are still a group. We share expenses and we share philosophies and ideas, we have meetings, etc. I am not saying the single practitioner will never exist, but it will exist to a much lesser extent.
What about multi-discipline practices?
I think it is wonderful for MDs and DCs to be able to work together, but if the sole purpose behind it is, “Let me bring in an MD and see if I can make more money by billing questionable procedures under a medical name than if I bill it under chiropractic,” I am against it. I have doctors calling me all the time about MD/DC relationships and I give them all the same advice. I think it’s wonderful if the reasoning behind it is right and you’re trying to serve people and just getting everybody under one roof to do that.
What are the specific areas of business and finance that need attention?
I have been astounded by the people in practice who have such horrible tax nightmares some haven’t filed in five years and have tax penalties against them. Half of them are looking down the throat of a jail sentence. So I suggest learning how to establish a financial foundation such as learning how to read financial statements, financial principles, taxes, strategies how to build up reserve accounts and how to allocate funds for taxes. I am a firm believer that until you get your tax life under control, you will never accumulate any type of wealth at all, because you never know if that dime is your dime or when the serpent is going to raise his head up and take it away from you.
What are your thoughts on retirement planning?
People think, “I just want to retire and do nothing.” I hear from doctors all of the time, “I want to retire in five years. That’s my goal.” That’s a wonderful goal for someone to retire in five years, but it’s unrealistic. They have no action steps, they have no idea what they want to do in five years they just want to retire in five years. What do they want to do? Just sit around all of the time? That’s not a goal. A goal for someone financially is to get to the point where they are able to retire, they’re financially independent, and they’re able to enjoy what they’re doing for the purpose of enjoying it and not to have to make a living out of it anymore. That’s a wonderful financial goal. To have the assets to get to that you’ve got to constantly be growing and doing things.
What do you suggest to stay motivated towards achieving goals?
I enjoy knowledge by listening to tapes, reading and I also enjoy writing. Recently I wrote a book called “How to Achieve Success in a World of Failure” and I am trying to get a publisher to publish it right now… I enjoy knowledge and expanding the mind. I think anybody you see who is successful in life at whatever it is they are doing, is constantly expanding their mind. If they’re not expanding their mind, I can assure you that they are not going to be in that success arena.s
Please contact Dr. Humble at 318-388-5744 or call 1-800-282-1947, fax: 318-388-5395 or write 2501 Ferrand Street, Monroe, LA 71201.