“I’ve seen chiropractic from a lot of different angles academic, clinical and as association officer I have never said ‘no’ when people asked me to do things. Although we have had a satellite office for 13 years, I wouldn’t recommend it. It’s possible to be busy and successful at one location. Achieving high patient satisfaction along with good clinical outcomes is really my definition of success, income is a by-product of good service.”
I graduated in 1972 from National College in Lombard, Illinois and then-president Dr. Joseph Janse asked me to teach full time while I started a small practice. I bought a practice with a one room office from a doctor who semi-retired. As the practice got busier, I had to decrease my teaching to part time while I ran my practice full time. I took in associates and kept increasing, moving three times over the next few years and eventually expanding into my own building in the same location in Arlington Heights.
I taught on and off for years. Chiropractic was my whole life at the beginning, somewhat at the expense of my personal life at first, but I spent all of my days studying, reading and learning chiropractic. At school, I was a clinician and taught the interns; I had to stay a step ahead of them and always carried a book with me so I could look things up in case they asked tough questions. Later I served as president of the Northern Illinois Chiropractic Society and am currently the president of the National College Alumni Association, the chairman of several committees in Illinois, one being the Illinois Standards of Care Committee and one is the Illinois Health Delivery Committee. I’m also a consultant for the FCER (Foundation for Chiropractic Education and Research) and do some writing and teaching at National College by giving orientation lectures for new interns before they start their clinical work. I have two full time associates, a radiologist to read the X-rays, about 10 C.A.s and two offices. My senior associate, Dr. Peter Horn, has been with me almost 15 years. Over my career, I’ve seen chiropractic from a lot of different anglesacademic, clinical, and as association officer, which gives me a good perspective of what I want to do in practice.
How did you become involved in so many organizations?
I’ve been a member of the ICS (Illinois Chiropractic Society) since I graduated 25 years ago and worked up by becoming secretary and then president of the Northern District. I felt it was a challenge I have never said no when I was asked to do things. I am a member of the ACA, as well as past-president of the ACA’s Neurology Council and I’ve always enjoyed doing those types of things. I feel it is good to try to help others, including helping those with problems in their own practice.
At what point did you get married?
While I was in school, actuallyI had a family early. My oldest daughter is 26; my next daughter is 24 and she, too, is in chiropractic college; plus I have two young boys; 11 and 13. I helped raise the family right along with my career. My wife has been my biggest supporter!
How do you effectively handle a clinic in one location yet maintain control in another one?
Well, it’s pretty tough and I probably wouldn’t recommend it. We have one main office and it takes most of my time and efforts. I’ve had the other one, a smaller satellite office for 13 years and it is tough to run it long distance. You have two sets of overhead plus it’s hard to keep a handle on a large number of staff members because we constantly have meetings with the entire staff. It’s possible to be very busy and successful at one locationtwo or more dilutes our effectiveness.
What are your principles and goals?
Well, we have staff meetings twice a week in which we discuss what we can do better to help the patients. We are going to take care of them and we want to make every patient happy that they came, even though we may not be able to cure their condition. Maybe we directed them to get care with somebody else or recommended surgery, but our patients still say “thank you.” We are always in control and offer strength for the patientsthey look up to us. Our practice’s principle or “theme” is to do the best job possible for every patient. Today there are terms for these things, such as “patient satisfaction,” which is something we tried to do before we knew these now common terms. We also try to have good “clinical outcomes,” another current concept.
Do you track patient satisfaction and outcomes?
We have patients fill out satisfaction surveys about our clinic, doctors, treatment and the staff during their treatment, anonymously if they choose, maybe every week or every other week, or at least once a month during their care.
We find out through the surveys:
- Are they satisfied with their chiropractic treatment so far?
- Are they benefitting from treatment?
- What percentage of improvement have they had?
- Do they need more time to discuss their case with their doctor?
- Any additional comments.
Do you sell products in your clinics?
We carry some orthopedic supports, low-tech rehab equipment and nutritional supplements, but it’s not our primary function. I don’t want to portray this as a retail businessI use these vitamins because I feel the products are better than what can be purchased elsewhere. We also carry some orthopedic supports such as braces and belts. We teach rehab, exercise and nutrition to patients and have some low-tech rehab equipment such as the Swiss exercise ball, some exercise tubing and equipment that can be used at home. We are careful to recommend what a patient needswe aren’t just telling them that because we want to sell that item.
How many patients do your clinics see?
About 500 per week in this office and fewer than 100 in the satellite clinic; we have one doctor there, part time.
What kind of hours do you offer?
We’re open from 9:00 am to 8:00 pm five days a week plus Saturday mornings. We have an answering service and are always on call so someone is available to answer questions in the middle of the night, because I feel that’s a responsibility we have. I’ve had patients come here because they couldn’t get to their regular chiropractor.
Does this result in patients preferring your clinic?
Sometimes, but I first send the patient back to discuss it with their doctor if they request to stay. I say, “Tell your concerns to your doctor and see what he says. Maybe there is something he can do differently.”
What kinds of marketing have you done?
We’ve done a lot of different things to a minor degree. They’ve helped us somewhat. We’ve tried low key advertising and sending out newsletters, I guess everybody does, but it’s what you do when the patient comes in that really countswhat happens after that patient is here. I learned from Dr. Jim Parker about PTC or Present Time Consciousness. That means when you are with a patient, concentrate on that patient and block out everything else. We really try to concentrate on that. Although we are busy, we try to treat each patient as if they were the only one in the office for that period of 5-10 minutes and that’s been our mission over the years. I believe a lot more in internal marketing than external marketing. I don’t like get-rich-quick schemes.
We really listen to the patient, that is extremely important. By listening, we know whether they need an adjustment or some tender loving care, a diet or reassurance. Sometimes they come in crying because of a back ache, sometimes they are crying because of a home situation. Whatever it is, we listen to that person and try to help them so they can leave in a better mood and feeling better than when they came in.
Can you give an example?
Last week, there was an 80-year-old patient who mentioned as he walked in that he had no family, nobody at home and it was his birthday. Well, as I treated him and did therapy one or two of my staff ran across the street to the bakery, bought him a cupcake, put a candle in it, ran back and gave it to him on his way out. I didn’t ask them to do that. He was very touched. This patient will feel good about our office; that we are here to help him in any way we can. He’s going to know we aren’t just here to take his $30.
How do you effectively hire staff?
I recently attended the first Disney University in Orlando, which is sponsored by the FCER. They talked about the Disney culture and brought up group interviews. I thought, “Yes, that’s an interesting idea.” We had tried it on and off and never really thought much of it. Now we schedule 10-12 applicants to come in the evening after hours. I talk to the whole group and tell them what my principles are, the culture of our office, what I believe in and what we do, but mostly our philosophy. For example, if we have to stay late, we don’t grumble about it. People come in with pain and misery and we try to soothe them and make them feel better. We talk for 5-10 minutes and I give them the opportunity to leave if this doesn’t fit their thinking. Once or twice a person has left, but overall they stick around. Then they fill out their applications and we do personal interviews, but it sets the stage from the very beginning. They know that when they are applying here, they are not going to sit around and read a book all day long. They will work and think of things to do to make the office and patients better.
How do you retain staff?
We have the normal benefits: sick days, health insurance and free health care. We also offer constant continuing education, which I pay for. We keep a bulletin board with a list of the education programs for that month and usually have 10-12 items on the list. The doctors are attending continuing education seminars, the C.A.s are attending insurance seminars at National College and we put this all up on the message board so patients can see what we are doing. We help people get their degrees; go to school and become x-ray techs, phlebotomists, etc. We don’t sit still here…we are constantly on the move. We even had three of our C.A.’s enroll at National College and graduate with DC degrees. We’re proud of our staff and we let our patients know it.
How do you educate patients about the importance of chiropractic?
We have used different videosI use one now with new patients. One resource I really believe in is the FCER; their literature is tremendous. It’s an organization I consult for on some of the brochures, so I am a little biased in their favor! They combine research, education and references with a good chiropractic philosophy and that’s very unique because we have extremes in our profession. I use almost all of the publications they have produced.
I have also used Dr. Lou Sportelli’s booklets for many yearshe did a great job on his “Introduction to Chiropractic,” and I’ve also obtained charts from a lot of different sources. However, what’s most important is what the doctor says, not necessarily the information that’s on the walls or the handoutsthose tools help reinforce, but the communication must come from the doctor.
Do you work with industry or the media?
A little bit. It hasn’t been a big thing for us, although we probably should do more. We’ve given safety workshops at construction companies. We teach how to lift and bend, precautions and so on. We’ve also worked with business people whose jobs include sitting. These seminars include topics such as the correct height for computers, how to sit, what chairs to use, the ergonomics of work areas and stress. It’s worked fairly well and I’m encouraging my associates to do more of that lately. I did a lot of outside patient lecturing when I was younger, but now I’m more involved in other things. I was recently a guest chiropractor on the local radio station’s health program.
How did you get on the program?
Well, one particular station, Health Quest Radio has invited me to talk about disc problems, nutrition and various other topics. There was also a two-hour local talk show in Arlington Heights in which patients call in with questions. I feel it is vital for chiropractors to have good communication skills.
What do you do during down times?
We don’t have a lot of down times, but when we do, we look at the patients’ files and see what other services can be done. We maintain a “problem list” of patients’ lifetime conditions. When we have more time between patients, we look through their files, compile their problem lists of things we can do to help them in addition to whatever brought them in. They might have weight problems, fatigue, insomnia, PMS or whatever. We say, “Did you know that we could look into this fatigue problem? Here are some things to try; why don’t we do blood work?” They are sometimes surprised that we can help, but are happy they can perhaps get an answer. It may be a condition another doctor was unable to help. Again, back to internal marketing. We have a gold mine with our patients right under our noses. It’s almost malpractice if we don’t tell patients what we can do to help their other health problems. I know some in our profession feel we should be only back specialists, but I believe in chiropractors being holistic doctors because we have a lot to offer. It will help help those people with problems that no other doctor could solve, as well as increase our income.
What can someone do to implement ideas after reading this interview?
The idea of starting some self appraisal is something I recommend right away. Make up a questionnaire or two about your office and patient satisfaction and start keeping some statistics on the satisfaction and retention of patients. Look at the statistics, learn from the comments and get better. These surveys will help lower malpractice claims, help doctors do a better job, improve their offices, plus it’s easy to implement.
And that helps form their culture…
That’s right. I think doctors reading this article should extract and implement the best material from these interviews and elsewhere. Each doctor should analyze his/her beliefs, create and define a culture that can then be taught to the patients and staff. Determine what you are, what you believe in, what you want to be and how you want your practice and your image to be viewed by others. After synthesizing this image and culture, then practice it and teach it to others. With your honest efforts, you will be successful in any endeavor.s
Please contact Dr. Andreoli at 1702 West Campbell Street, Arlington Heights, IL 60005-1586 or call 847-259-4493. Fax: 847-259-2242.