Todd Teller, DC, of Teller & Biddle Chiropractic, Inc., near Philadelphia, says the decision several months ago to add an MD to the already thriving practice was a logical one. “We just knew it was time,” he says. “We did it to make us stronger and to become a one-stop shopping practice.”
Teller and Craig Biddle, DC – Teller’s associate since 1997 and partner since 1999 – have always seen eye-to-eye when it comes to referring out medical cases. “Chiropractic should be the first choice for most people,” Teller says. “When we couldn’t help patients on our own, we would always send them out to the appropriate health-care practitioner.”
Teller founded the chiropractic practice in Huntington Valley, Pa., a suburb of Philadelphia, in 1993. He has worked with massage therapists as independent contractors from “day one,” and I. Richard Feldsher, DPM, has provided podiatry care as an independent contractor at the practice for the past two years. Teller began managing the business and marketing aspects of the practice full time in 1997, when an ulnar nerve injury forced him to stop treating patients.
Not long after Teller and Biddle started talking about adding a medical doctor to their practice, William H. McMicken, MD, approached Teller with the same idea. McMicken, an internal medicine specialist who has practiced for more than 40 years, was Teller’s own physician for 15 years. They had referred many patients back and forth over the years. “He has always been a mentor,” Teller says. “He is a brilliant diagnostician and has a photographic mind.”
The doctors hammered out a deal, everyone agreed, McMicken purchased some shares of the corporation, and he now serves as the practice’s medical director. Teller called on a top health-care attorney in Philadelphia to establish the multi-discipline practice in compliance with state and federal laws. McMicken has been on board since the beginning of the fourth quarter of 1999, and everyone at the practice agrees the move has dramatically improved the practice’s patient care as well as its bottom line.
McMicken says the multi-discipline set-up at Teller & Biddle provides more continuity in care and greater convenience for the patient. “They always sent some patients out for medical evaluations,” he says. “Now, instead of going to another location, the patients can just go down the hall.
“The patient benefits by getting the best of both worlds,” McMicken adds. “The combined care is good for the patient because it provides a broader perspective.”
About 20%-30% of the practice’s chiropractic patients receive medical evaluations. “We need to make sure the care is medically necessary,” Teller says. “We don’t just automatically send everyone who has limited coverage to the MD. As our attorney said, ‘That’s too ‘cute.’ If it’s too cute, don’t do it.’ ” In addition to the medical evaluations McMicken does on chiropractic cases, he sees some medical-only patients from his previous practice. He refers structural cases to Biddle.
Biddle says the changes in the practice since going multi-discipline are noticeable – and all positive. “We were always a busy practice, but now we’re even busier; there’s more energy in the office, and there are good vibes.” He adds: “We were always an open-minded office, but taking this step shows patients we work very closely with MDs.”
Teller & Biddle was already well-established financially when the partners decided to join up with an MD. In 1999, including three months with McMicken at the practice, gross billings were $1.17 million, and gross collections stood at $765,000. This year, the projected gross billings are $1.85 million, and collections should break the one-million mark at $1.15 million, Teller says.
Average patient visits per week in 1999 were 250 for chiropractic; for the fourth quarter of 1999, average MD visits started off strong, at 150 per week. In 2000, Teller estimates that DC visits per week will jump to 280, while MD visits will hit 175 per week. In addition, in 1999, including the three months McMicken was with the practice, the clinic saw about 365 new patients. This year, Teller predicts that number will hit about 550.
The potential for growth within a multi-discipline practice is incredible, Teller says. Depending on legal issues and logistics, the practice would like to add a physical therapist within the next year, along with the eventual possibility of a fully equipped gym. In addition, Teller says he is looking at bringing in a counseling psychologist within the next two years.
How does Teller & Biddle Chiropractic, Inc., recruit new patients without spending a fortune? “I’ll try anything and everything,” Teller says. “I like unique, inexpensive advertising” (see “Marketing Secrets You Can Use Now,” page 42).
The practice keeps a marketing log book to track the response from each type of marketing/advertising effort; if a particular strategy isn’t bringing in new patients, Teller moves on to a new idea.
Teller & Biddle spends about $8,000-$10,000 a year on marketing/advertising. Ongoing efforts such as print advertising and direct mail add up to about $500-$700 a month, which leaves room for some higher-priced ventures, like two patient referral contests per year; a major, well-executed open house once every year or two; occasional sponsorship of charity events; or the use of an advertising/marketing consultant here and there. Some of Teller’s favorite forms of marketing, such as health talks at area businesses, cost little more than the time invested.
The practice’s basic marketing strategies have remained consistent even after the addition of medical care. Teller says the ideas can be applied to any chiropractic or multi-discipline practice, big or small.
Teller says he has found that every patient who is happy with his or her care can generate about 10 to 15 referrals. “Marketing your current patients is the easiest and cheapest thing in the world,” he says. Therefore, Teller recommends that 75% of new patient recruitment efforts should focus on generating inside referrals.
For instance, twice a year, for four months at a time, Teller & Biddle sponsors a patient referral contest offering current patients incentives such as plane tickets, a color TV or dinner at a fine restaurant and a limousine ride. In addition, the practice places “subtle” messages throughout the office, such as “Referrals Are Welcome” signs in the waiting room and in each treatment room.
“We try to get patients to make their first referral to us within the first month they’re coming to the practice,” Teller says. “At our team meetings every morning, as we’re going through the appointment book, we’ll be discussing a particular patient and will often ask, ‘Have they sent us a referral lately?’ If they haven’t, we’ll say to them during their appointment: ‘Isn’t it great how much we’ve helped your headaches? Do you know anyone else suffering from headaches who could benefit from our care?’ “
In addition, the support staff is trained to educate patients about the importance of keeping up with their visits. Staff members are also knowledgeable about the types of health problems the practice treats, and they are encouraged to share the information with patients.
The other 25% of Teller & Biddle’s new patient recruitment efforts focus on simply keeping their name out in the community. “We just hit what we think is important,” Teller says. “We’re listed in the Yellow Pages, but we don’t have a big ad. We’ve done things like ads on deli placemats, football directories, shopping carts, professional directories for people new to the area, and a two- to three-month series of ads in the local, weekly paper once a year.”
Once your practice’s name and reputation are established, there’s no need to overdo it on advertising, Teller says. He says he marketed most heavily during the first three months his practice was open, especially because it’s located in a large professional building rather than in a free-standing building with a sign, which serves as free advertising. “Most practices should advertise heavily for the first three to six months to get their name out there,” he says. “After that, you just want to do things to remind people you’re still there.”
Creative, inexpensive marketing and advertising often work synergistically with referrals practices receive from current patients, Teller says. “When someone receives a referral to us, they’ll often say, ‘Oh yes, I’ve heard of them,’ ” he explains. “My father-in-law is a classic example of the type of consumer who is into name recognition. He’ll say, ‘Yes, Right Guard’s good; I’ve heard of it.’ “
Teller adds: “The same, basic principle applies to building the name of your practice in your community.”
Over the years, Teller & Biddle started up and sold off a couple of satellite offices in other areas of Philadelphia. Currently, Teller owns an interest in Teller & Biddle Chiropractic of Center City. Jarrad Teller, DC, Teller’s brother, opened the practice in August 1999. Although the practice carries the Teller & Biddle name for purposes of recognition, the practice is its own corporation and operates as a totally separate entity. Teller & Biddle is not involved in the day-to-day operation of the practice.
Teller says he’s come to the realization that he prefers to focus on one primary practice rather than having his hands in a lot of different pots. He relates the experience to an analogy by his mentor, Dr. Neil Leibman of New Jersey. Teller explains: “He would ask me, ‘Have you ever had a banana split, ate it, enjoyed it, and found it perfect, right down to the last bite. But if someone had offered you another one… it just wouldn’t have sounded good.’ “
Teller says, at least for now, he would rather concentrate on building – and enjoying – that one, perfect “banana split.”