1. What single aspect of your background/ experiences helps you in relating to chiropractor’s unique needs and practice management obstacles?
Fernandez I was lucky. I was the associate of one of chiropractic’s original consultants. He taught me how to analyze demographics, successfully start a practice, and how to run a practice by statistics. Also how to double, triple and quadruple any existing practice. These are the same principles I use today in building practices all over the country.
Gibson Twenty-nine years of highly successful practice and 23 years of helping other chiropractors to be the most that they can be and do the most they can do. Also abiding faith in the chiropractic principle and knowledge that the subluxation complex is the number one cause of disease in the world today.
Koslow Twelve years experience personally coaching thousands of chiropractors enables me to relate to chiropractors’ unique needs. Being married to a chiropractor, as well as being a business person with degrees in marketing and business administration. Practices who are attracted to me value the combination of my unique business perspectives and passion for chiropractic.
Markson Since my first seven years in practice were steeped in mediocrity, I know what it’s like to underperform. I began a long journey that explored every detail of the attitudes, actions and procedures of the achievers. As I modeled them, and changed me, from the inside out, my practice grew to be one of the largest in the country and my personal life was never better. For 20 years my work is about helping doctors figure out what is holding them back, so they can overcome those obstacles, learn newer and more efficient procedures and move on to greater accomplishment.
Singer The fact that I myself, have been a chiropractor for 26 years and have run both successful insurance and cash practices. Also, the fact that my practice averaged over 1,000 visits per week gives me complete understanding of every problem one can encounter as they expand. The fact my firm was based in Toronto for four years gives me a complete understanding of how to run cash practices in an environment of full medical reimbursements.
2. What do you do differently from other consultants?
Fernandez First, I am a specialist in starting new practices. I have written four books and four manuals on the subject and have consulted in the opening of over 1,500 practices with a 97% success rate. Secondly, I am a “nuts and bolts” consultant. I increase practices logically and systematically. In building a practice, I first determine that practice’s growth obstacles and instruct the doctor on how to get rid of them. Next, I fine tune the doctor’s office procedures. I then add one new procedure at a time to predictably and steadily increase the doctor’s practice.
Gibson We emphasize working one-on-one with all our clients. I do not believe that you can define yourself as a practice management consultant if you do not analyze your client’s practice and work on a regular basis with them one-on-one and face-to-face.
Koslow Breakthrough Coaching provides a customized success strategy for each member, which includes a specific plan of action to effectively market your practice and accelerate your growth. The most unique difference however, is that our coaching focuses on developing each member’s business skills which are not taught in the chiropractic colleges, and are necessary to be successful today.
Markson Chiropractic care is an “above-down, inside-out” process, and we at The Masters believe that success also follows this pattern. Our approach begins by helping the doctor identify any area of personality, behavior or belief that might prevent the desired growth. For example, telling a doctor to handle the issues of missed appointments or to collect delinquent receivables or that it is unnecessary to discount fees is fruitless unless any fear of confrontation or rejection is addressed first, and then teach them procedures. Our program corrects the cause and doesn’t just treat the symptoms!
Singer Our difference is four-fold. The first is concept. We emphasize the two vital components to expansion: new patients and patient management (retention). The second is our method of instruction. Our systems are comprehensive step-by-step ethical, proven methods. When we suggest a mailing, it has already been designed. If we suggest a survey, a proposal for a health spa, insurance verification form for patients, etc., they are all ready and available. The third is depth. We have over 40 full time staff. We provide seminars in eight locations, as well as advanced services both on-site at our headquarters or in your office. Fourth is price. For the services we provide, we are the least expensive program in the United States.
3. What is the most dramatic change a chiropractor can expect to see happen when utilizing a consultant’s services?
Fernandez The most dramatic change will be within the doctor himself. I typically double the number of new patients and patient visits of a chiropractic practice. If a practice is severely in debt, I will reduce the overhead approximately 20-40%. These achievements significantly decrease the doctor’s stress and allow him to move beyond the survival mode to build his practice.
Gibson The first thing that happens to many people after joining a management practice program is their commitment to grow. With that commitment brings lots of motivation. Second, a good management company should give direction, information and motivation to clients. The client should expect to get more new patients, for them to stay longer, structure the fees so that they are affordable and profitable, control the overhead and make the office highly organized, efficient, stress-free and fun.
Koslow Breakthrough Coaching members report extraordinary growth in patient volume and profit which far out-paces the general chiropractic market. Growth rates of over 100% per year are not unusual. However, success is not always measured in dollars and cents; therefore, perhaps the most important results one could expect is experiencing a greater degree of balance and fulfillment in their personal and professional lives.
Markson Many chiropractors double and triple their practice volume with the help of a consultant, but the most dramatic change we notice in our members is a shift toward balancing personal and professional lives, so that success is achieved while a quality of life is maintained. Happy chiropractors build bigger practices!
Singer The most dramatic change we try to bring about for our clients is to have them become completely in charge of their own expansion, new patients and knowing how to manage them. Our clients usually have a 100% increase in new patients through the more than 107 new patient ideas we teach. A 50% increase in patient retention is achieved through our revolutionary “Four Day Report” patient education system. Through our capacity management methods, our goal is to expand the practice, but not the overhead. Thus, most clients as they expand get a 10% reduction in overhead.
4. What should a chiropractor expect to pay a consultant? Include “hidden” costs.
Fernandez This depends on how the consultant charges for his services. If he charges a flat fee, this can range from $3,500 to $25,000 a year. Some consultants charge fees on a percentage basis. A good consultant, while earning less at the beginning of a percentage fee contract, will ultimately earn more than those of a flat rate contract. I offer my clients a choice of a flat fee or percentage fee. A percentage fee contract is ideal for doctors who are limited in investing in a flat fee contract, or have doubts about whether the consultant can help build the practice. Percentage fees can vary from 10-25% of the doctor’s practice increase. There are always additional, but optional costs. All consultants sell supplies, books, tapes, marketing systems they have developed as peripherals or enrichments to what they teach. As part of their practice building program, consultants will from time-to-time, recommend certain and appropriate practice expenditures to their clients.
Gibson In our case there are no hidden costs. Our fees are all-inclusive and is for the office not just the individual. Plus we supply every member of the office with work books, training manuals in the area of office procedure, CA training, insurance training, associate doctor relationships, etc.
Koslow Breakthrough Coaching members report extraordinary growth in patient volume and profit which far out-paces the general chiropractic market. Growth rates of over 100% per year are not unusual. However, success is not always measured in dollars and cents. Consultants have a variety of fees ranging from as little as $500 per month to several thousand. However, each consultant is different and the results that one consultant may be able to produce with one doctor could easily vary with another. Although the promise of many coach’s quotes may be similar, it is most important for each reader to interview the respective coach based on their uniqueness, chemistry and ability to make a difference with clients who have been confronted with similar circumstances and opportunities.
Markson Consulting fees in our profession range from $5 per minute for Consultant-On-Call to $25,000 plus per year, with every imaginable configuration in between. Doctors in our programs pay between $475 and $800 monthly, plus travel, food and lodging for between four and eight seminars each year, depending on which program or programs they decide to participate in.
Singer The average cost for consulting services provided by the major consulting firms is between $5,495 and $12,000 for your initial contract term. Our term is only one year and our prices go from $2,995 to $6,495 inclusive depending on your method of payment and status as independent contractor or solo practitioner.
5. What tip or secret can a chiropractor implement in their practice today, when they have finished reading this article?
Fernandez The main tip a chiropractor can implement is the ability to choose the choice of a wide range of knowledgeable consultants to build his or her practice.
Gibson Get excited about chiropractic and get excited about being a chiropractor understanding that he or she has the power in their hands to influence the health of the community far more than any other kind of doctor and if they lack direction, reach for the phone and call a good ethical practice management firm.
Koslow Most doctors procrastinate decisions, which results in limiting their possibilities. We provide an initial comprehensive questionnaire, which allows us to formulate a customized effective plan of action for each practice.
Markson The best thing a reader can do immediately is decide something right now! Decision is the initiation point in the process of success. Decide immediately that you too, with the proper coaching, can find and fix the weaker areas that have been holding you back; then, choose a coach to get you on track!
Singer My tip for you right now is to make a decision to simply ask for new patients. Let people know you have a purpose to help them and as such want them the give you a chance to see if chiropractic can improve their life as well as their health. Ask for referrals. Ask for new patients. Only by asking for them will you receive them.
6. What is the most efficient way to advertise a chiropractic practice and why?
Fernandez Direct mail is the most cost-effective way to attract new patients, usually running about $100 per new patient. This includes newspaper inserts, marriage mail (such as Val-Pak) and so on. The second is through the Yellow Pages. This typically attracts 14% of a doctor’s new patients. To determine the most effective size and design of a Yellow Pages ad requires the services of an experienced consultant Sometimes a doctor only needs an eighth of a page ad to out-draw someone running a full page. It depends on what the ad says, how it looks, graphics, etc. The third form is the newspaper. This is the chiropractor’s media. A well-designed newspaper ad, a bit larger than a dollar bill, can produce three or more patients per insertion. Newspaper ads produce new patients for approximately $150 per new patient. Radio is almost totally ineffective. TV is very effective, but almost impossible to measure, because when someone advertises on tv, referrals increase, Yellow Page ads increase, newspaper ads increase and so on. TV is very cost-effective in smaller towns, but cost-prohibitive in larger communities.
Gibson Advertising has become relatively ineffective in the chiropractic profession in most instances. Because so many chiropractors have done it in so many markets and so many times the advertisement has diluted itself. There are exceptions in this in what I call virgin or semi-virgin territory meaning areas that there has not been chiropractors advertising in the last 36 months. The single most effective way of getting new patients is spinal screening and those must be done properly. There are three elements: you must find a place where a large number of people gather with time on their hands; you must have a booth that will attract potential patients and you must know what to do with them after they come into the booth.
Koslow We normally do not recommend advertising. For the most part, the risks do not outweigh the rewards. A better choice is to invest your money in developing your business skills and creating a strategy of promotional activities with your coach. Having effective business skills can build any practice to a new level.
Markson Every other technique for new patient acquisition is dwarfed by the impact of effective and personal one-on-one communication. “Personal-touch advertising,” whether during a report of findings or when you teach a health care class, conduct an outside lecture or do a spinal screening all get better results than a Yellow Pages ad that looks like all the others, or costly one-hit newspaper advertising, or unprofessional fliers stuck under the windshield wipers of an automobile. Talking to people costs no money, provides immediate feedback, and targets the specific people you prefer to work with.
Singer The most effective method to advertise or promote a practice is through personal contact. Because only 10 – 20% of the population ever consider to use chiropractic services, such mediums as newspaper, tv, radio, etc. only reach a limited audience. However, if I had to chose a medium to advertise in, it would be the small town paper. Our ads usually cost $20 – $30 and bring a return of 40 to 1.
7. What are the hidden liabilities for chiropractors when using a consultant?
Fernandez I don’t know of any hidden liabilities, but there is one very obvious one. DCs have to understand that when they hire a consultant, they are signing a contract for services made available to them. They are expected and required to pay for the services, whether they use them or not. Some DCs join a consultant, get all his information, enjoy the seminars, private conferences with their consultant, but fail to implement what they have been taught, then decide not to pay.
Gibson The number one hidden liability to consider is does the consultant analyze your practice, do they work with you one-on-one and do they have a good track record?
Koslow The only liability in working with any coach is not implementing what they advise. You must be “coachable.” It is important for the client to empower his/her coach and trust that their only interest is in seeing you fulfill your dreams. A good coach can make the difference between your team playing in the Super-bowl or not.
Markson A doctor should make sure that the principal or principals of the company should be at each and every seminar and that he or she is personally and readily available. Doctors who are unhappy with a program, for whatever reason, should have a reasonable escape clause and not face the liability of having to pay for an iron-clad long-term contract.
The most typical problem expressed as a liability is that the chiropractor has unrealistic expectations on what to expect from a consultant. Many erroneously expect the consultant to have some magical, automatic method of transforming practices, whether the doctor makes changes and works hard or not.
Singer The liability in choosing a consultant would be if their philosophy conflicts with yours. A chiropractor who is principled will have a bad time with a medically oriented consultant.
8. What is the single key to successful implementation?
Fernandez Setting priorities is the single most important key to building a practice. I recommend doctors hire a consultant who works personally and directly with the client on a week-by-week basis. Staying focused on individual practice goals is the key. While this sounds easy, it’s not! The second most important factor is for the doctor to attend all of his consultant’s seminars, and in-between those seminars go to other practice-building seminars. This keeps the doctor positive and in a, “Yes, I can do it,” frame of mind. Success is a 99% brain game. If the doctor is successful between his ears, his practice will be a success.
Gibson The key elements for the chiropractor is to be able to translate information into action with a high rate of speed. I find that highly successful chiropractors and business people possess the same seven qualities:
- Ability to translate information into action.
- High sense of personal motivation.
- Commitment to personal excellence.
- A strong sense of character.
- Goal-oriented personality.
- Good technical skills.
- Good business sense.
Koslow Implementation largely depends on the coach’s ability to coach and the client’s ability to let go, trust and go for it. Proper chemistry and the coach’s availability are essential to the client experiencing record growth. We make sure that action is being implemented effectively by staying as close to the doctor as possible by providing each member with a personal coach offering unlimited telephone support.
Markson The key to successful implementation is not to get overwhelmed by the myriad of details faced on a daily basis. We teach our doctors a “chunking” system that identifies priorities and orchestrates step-by-step simple procedures that work with precision and efficiency. We teach members to focus, organize, execute and debrief, until your team is trained and your systems are working smoothly. Then, you get to fill the place with great new patients, knowing that they are going to be served well, every step of the way.
Singer The single key to implementation is certainty. If a doctor is certain they know how to do something, they do it. Just because you heard about in-office workshops doesn’t mean you know how to get patients to attend, bring guests and sign up their families or themselves as new patients. If you truly know you know how to do it correctly, you would be certain and successful at it.
To gain certainty on a subject you have yet to master, there are several steps. First, the subject must be laid out in it’s complete entirety. Word-for-word, step-by-step, with nothing left out. You can only learn the fine points of a procedure from one who has done it.
9. What’s the best most inexpensive secret? What’s best if money is no object?
Fernandez The most inexpensive secret is to meet people; meet people by the thousands. A doctor should tell everyone who he is, what he does, and where he is located. Nothing replaces personal contacts. The number of people who know who, what, where the doctor isand like him, directly equates to the size of practice he will have. If money is no object, the doctor should hire a consultant who is an expert in advertising and developing marketing plans. With money no object, the consultant designs and develops a new and unique marketing plan for the doctor that includes stationery, literature, direct mail, radio, television, billboards, newspaper, public relations and so on. When the doctor institutes the marketing plan, and maintains it, his practice will grow to be a huge success. Doctors who build the largest practices have great marketing plans.
Gibson To manage your patients well. The average cost (overhead per patient) in the chiropractic profession to the doctor per case is around $400. This of course varies from doctor to doctor. The average collection per chiropractor is $38.50 and also varies from doctor to doctor. Therefore, the first 10 1/2 visits covers the doctor’s costs and every visit thereafter per patient per year is profit.
Koslow The most inexpensive secret to being successful is to have a lot of reasons to be successful rather than reasons not to be. If money and risk are no object, we advise our members to explore television advertising with our marketing expertise.
Markson The best inexpensive secret is to fall in love with chiropractic and with what you do, and sell that love to the patient and community. Trite, but true! When money becomes no object, then do everything first class; the best equipment, the finest decoration, the most qualified team, the classiest marketing-and of course, be sure to invest in your own growth and development, through seminars, coaching, and educational materials, as well as inspiring and delightful leisure-time activities-and, save 10% of everything you earn!
Singer The best most inexpensive secret is how you can effectively communicate to people. To effectively communicate to people you need to simply ask them the proper questions to get them to change their viewpoint. The secret is to let people talk themselves into care by knowing what to ask them. If money was no object, I would use the money to hire the highest quality staff possible and train them to do my marketing and patient education. I would create a team that was highly motivated, on purpose, well-trained and capable of taking me to the next level.
10. As a consultant, what do you personally do to expand your knowledge and education?
Fernandez I read. I read all the books and trade journals I can find. I listen. I listen to my clients. I analyze. I am constantly gathering information and data, analyzing it to determine if it can be efficiently and effectively used to increase a chiropractic practice.
Gibson I am fortunate that I read 1100 words per minute and that I love to read. I am constantly reading material and information from within the chiropractic profession to expand my knowledge.
Koslow I get coached.
Markson I read, listen to cassettes, watch videos, meditate, exercise, commune with nature, take seminars, and master mind with other industry experts.
Singer As a consultant, I spend the majority of my time researching improved methods to get new patients and educate them.
We invited Parker School for Professional Success and Sharing to respond to your top questions.
On what sets PSPS apart…
Created by the late Dr. James W. Parker in 1951, PSPS is a system of success, developed from the knowledge and experiences of hundreds of successful DCs over the past five decades All of the speakers on the Parker program are volunteers, doctors, CAs and other practicing professionals who are on the program to share and give.
What do you do differently?
We are different in that in that PSPS is not a consulting firm. PSPS, as its name implies, is a School for Professional Success and Sharing. PSPS’s emphasis is on teaching DCs to be self-sufficient, learning the principles and procedures of success in practice. Secondly, Parker provides aid in actually implementing the practical aspects of these procedures in day-to-day practice. PSPS offers one-on-one consulting at no extra charge to attendees, provided by over 35 extremely successful, practicing DCs.
What is the most dramatic change to expect?
Most who follow a one-year program usually at least double their practice in less than a year. All who follow the PSPS program and recommendations have considerable growth in practice. All aspects of practice success are covered, so all percentages of new patients, repeat patients, collections, overhead costs and so on, improve.
What tip can a DC implement today?
Call new patients after their first adjustment. Invite the spouse in for the report. Recommend a health care plan. Make multiple appointments. Do frequent re-exams, followed by reports of findings. Read Share magazine, which is filled with success tips and is a free service of PSPS to the profession.
What is the best way to advertise a practice?
There is not one specific method that works for all DCs in all situations. Generally, doing patient lectures out-of-office and in-office, with your patients motivated to bring others, is a great and efficient way to advertise.
What is the single key to implementation?
There are a number of keys to practice success. However, the Love Concept is the most important of them all. A sense of high purpose and success attitudes which Parker calls PSHC (Practice, Success and Healing Consciousness) are essential. Another key is that DCs learn to personally involve themselves in the implementation of practice procedures so that consistency, understanding and success attitudes become ingrained in the doctor and staff, then transferred to patients and staff.
What’s the best most inexpensive secret?
Best if money is no object?
The best, least expensive secret is inspiring and attracting referrals. Best if money is no object: inspiring and attracting referrals.