Practice and management tips for success, including how to calculate cost per patient visit and more…
I’m often asked if I would have done anything differently when I first started out in practice many moons ago. And, I am 100% sure that the one thing I would have done differently was to get a mentor much earlier on. Why? You just don’t know what you don’t know! Like how to calculate cost per patient visit, scheduling and retention strategies, and more. Had I learned certain things earlier on, it likely would have allowed me to avoid some of the challenges that I faced and made my eventual success in practice come so much sooner.
Here are a few simple things that I still see that many chiropractors just don’t know.
If you don’t have time in your day, you need…
To take charge of your schedule. Not having a well-thought-out schedule will almost always lead to feeling like you’re out of control. When I finally got a handle on my schedule, it allowed me to finally enjoy practice and have a great life outside of my practice.
When it comes to scheduling, one of the most common mistakes I see is having adjusting hours that do not allow any time for your employees to train or have administrative time when patients aren’t there. This is absolutely vital if you want to have a well-oiled machine. Your team must have time every week to train and if it’s not scheduled, then it won’t happen.
Another issue is that when you don’t properly manage your appointment times, you’re setting your patients up for disappointment. Even if you’re just starting out and not that busy yet, you’ll want to plan for the day when you will be busy. If it takes you seven minutes to adjust someone but you spend 25 minutes chatting, what’s going to happen down the road when you’re busier and your schedule simply does not allow that?
Here are a few suggestions: You want to have a set time for adjusting and special times outside of adjusting hours for special appointments. Patients would have their recurring, standing appointments during the adjusting hours and they would be cluster-booked together as much as possible. Built into those blocks would be longer appointment times for re-exams.
In my practice, I would have special times set aside for our new patient appointments and the report of findings would be outside of the adjusting hours (these would all be stacked around the adjusting hours). For example, if my hours for adjusting were 3-6 p.m., my special appointment times would be 1:30, 2:15 and 5:50 p.m. The team would know to book the 5:50 or the 2:15 first so that there wouldn’t be any blocks of empty time in my schedule. If there aren’t any special appointments booked, then you’re free to leave the office!
If you don’t have success, then you need…
To implement business strategies that will bring you success. Now, this is a generalized statement. There could be many reasons that you may not have success. A method that I believe any practice type can apply to achieve long-term success is to focus on patient retention, or what I like to call patient loyalty.
Practices that focus on retention and achieving patient loyalty are not dependent on new patients and have steady recurring revenue. Not only do loyal patients lead to better success, but they also protect you when times are tough.
The doctors we work with who had successfully implemented our recommended retention principles saw less than a 3% drop in income during the first shutdown of the pandemic. Those who had not fully embraced the retention principles saw a 50% decrease in income. Read that again. A 3% drop versus a 50% drop — which would you have wanted? Having strategies that help weather storms will help the practice remain successful for years to come.
If you don’t have high retention, then you need…
To learn more about the principle of retention. In summary, to build a high-retention practice, you need to focus on a patient journey that implements the retention principle. When you do this, each patient will have a much greater chance of becoming a loyal patient.
So, what are the retention principles that need to be implemented?
- Loyal patients need Feedback
- Loyal patients need Frequent Contact
- Loyal patients need Forecasting of Care
- Loyal patients need Frictionless Payments
We refer to these retention principles as the Four F’s. Feedback, frequent contact, forecasting of care, and frictionless payments are all required if you want to truly build a practice full of loyal patients.
If you don’t have the easiest way to streamline family plans…
You need software that allows you to encourage lifetime practice members full of families. If having a practice full of families is something you want, you need to implement strategies that encourage that behavior.
We put patients on convenient, customized and compliant care plans tailored to each family member’s needs. We then make the payment experience frictionless by having one auto-debit for the entire family. By automating their monthly payment, you really remove almost all the friction in the payment process.
The software to do this should allow you to link the family members together, automatically split that one payment, and properly allocate the dollar amount amongst each family member’s ledger. This is critical in order to keep your patient ledgers accurate.
If you’re using a payment processing program or your EHR’s recurring payments feature, you want to ensure the auto-debit is being split correctly between each family member. For example, if the monthly payment is $275 for a mom, dad and one child, you want the correct portion allocated to each of their ledgers. Maybe it should be $125 for mom, $100 for dad, and $50 for the child. You would want each of those amounts posted to their respective patient ledgers — not just $250 posted to one of the ledgers.
You need to make payments easy for your patients and easy for your team members.
How to calculate cost per patient visit and plan for profit
Then you need to figure out how much on average you need to collect to be profitable. This is part of how to calculate cost per patient visit, getting to what we refer to this as your Target Collection Level.
Anytime you sell something, the first thing you need to know is, what is the cost of that “thing?” As chiropractors, our “thing” is an “office visit.” So, how to calculate cost per patient visit, and what is it? If you don’t know, that’s a real problem. That’s like trying to price T-shirts for sale and not knowing your wholesale cost.
If you don’t know how to calculate cost per patient visit, here’s how to calculate it. Take your monthly overhead expense (excluding any personal expenses you run through your company such as car payments, etc.) and divide it by the number of office visits you see in a month. For example, if your monthly overhead runs $15,000 and you see 600 visits per month, you would have a cost of $15,000 divided by 600 which equals $25 per visit.
Knowing it costs you $25 to see a patient, what do you think you should be collecting at a bare minimum to see a patient? If you want to have a 50% overhead, then you need to collect $25 divided by 50% which equals $50 minimum per visit.
Knowing this and how to calculate cost per patient visit makes it easy to build care plans where you know they will be profitable. The care plan should average at least $50 per visit. Anything less, and your profitability goes down.
And there you have it. Some of these tips may have been things you didn’t know, but now you do. Had I come to know these concepts earlier, I have no doubt I would have succeeded much sooner in my career. I certainly hope you found some insight in these tips and are now ready to upgrade your practice.
MILES BODZIN, DC, is the founder and CEO of Cash Practice Systems, “Chiropractic’s #1 Technology Platform for Creating Loyal Patients.” He can be contacted at firstname.lastname@example.org or 877-343-8950 x200.