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SOS. 911. Help!

Telephone calls like this one have become increasingly common as chiropractors, who have been deposited at the high tide mark of insurance, find themselves further and further away from the receding reimbursement they used to enjoy.

Before I share the gist of my phone conversation with this chiropractor, allow me to install an uncharacteristic plug for my tenth book in the Patient’s Point of View series, Adjusting, Observations of a Chiropractic Advocate During a Time of Change. Between its 240 pages and the hundreds of blog posts here (click on Musings in the “Categories” index to the left) I give more complete direction for a way out. So if you find the following suggestions wanting, realize that this is merely a quick overview.

After I called Jim back and we exchanged pleasantries, I asked him a simple question. “So tell me, why did you become a chiropractor?”

His first answer was predictable.

I say first answer because the first words out of his mouth were something like, “Well, you don’t understand Bill, I’m having to take $20,000 a month out of my retirement fund to keep this thing going. And I’m afraid that…”

“Whoa! Hold it! Hey!” I practically had to shout to derail his rant.

Having been in his situation myself, I knew the drill: try to enlist others in your plight and agree with you that things are tough. Get someone else to affirm that the situation is bad and more importantly that it’s not your fault. I wasn’t going to fall for it.

“Why did you become a chiropractor?” I repeated.

He took another run at it and his answer was spectacular.

“I wanted to help as many people as I could and by doing that, be able to enjoy a wonderful lifestyle with my family.”

Rarely do doctors connect the dots between serving others and being rewarded with a fulfilling lifestyle. Most, simply mumble something prompting an outbreak of Type 2 diabetes about helping people and making the world a better place. When these chiropractors call, we have to back track and get them congruent with the idea that making a profit is not only honorable but desirable. Thankfully, that wasn’t the case here.

“That’s great. It sounds like it’s the lifestyle part, which is a symptom, outcome or effect of serving others, isn’t in the equation now,” I volunteered.

“That’s right,” he agreed.

“So do the principles of chiropractic still work?” I asked.


“Are there people in your community who could benefit from chiropractic care?”

“Yes. With stress levels the way they are these days, the number of people who could benefit is probably greater than ever,” he added.

“Okay, so the market is still there. It’s not as though you cleaned up all the subluxations in your town during The Insurance Era and now you’re obsolete. So my guess is that what’s manifesting in your practice has more to do with the serving others part of the equation.”

I won’t give you the entire transcript of our conversation, but here are the high points of what I learned:

Still living in the 1980s. He is largely dependent upon the generosity of the insurance policies his patients have. Which these days often includes little more than token chiropractic coverage that seduces many chiropractors into thinking that better coding or electronic SOAP notes will return their incomes to pre-1995 levels. Worse, he’s still carrying $5 million in receivables on his books that he’ll never see and still not discussing money issues directly with patients. In other words, he’s practicing Reagan-era chiropractic in an Obama world.

Too coachable. His mentor passed away two years ago and ever since has been floundering. His is situation is the opposite of what I usually see; a chiropractor who hires a coach but resists implementing the recommendations. Instead, he is willing, maybe too willing to do whatever someone in authority suggests will lead to his former level of success. While I haven’t experienced his consultation or heard his report, my guess is that it’s a confusing mess, layer upon layer added by each consultant and now the beauty and simplicity of chiropractic is obscured.

No internal North Star. Now, with three or four different mentors whispering in his ear, he’s become dangerous, swerving in and out of his lane, begging to be pulled over for a DUI. Lacking an internal benchmark, he’s been on a quest to find patient education videos that would “work” and a report of findings that would “work.” Not only was he expecting someone else’s stuff to do the “work,” but by “working” he envisioned practice as it was 20 years ago. Impossible on both counts.

Sequestered in his office. Instead of getting out into his community and sharing the chiropractic message with strangers, he’s been holed up in his office waiting for patients to show up. And while his print and television ads used to produce, they no longer do, which is great since affording them is beyond his current budget. And while he has a website, I would call it a 1980s website—if the Internet had existed in the 1980s.

So, I gave him some homework to help get him up to speed quickly about what it takes to make it as a chiropractor these days. I suggested that he read the 260 posts on this blog going back to August of 2006.

“You can probably do it over the weekend if you’re in a hurry,” I observed. “My guess is that the types of questions you ask me and of yourself will radically change afterwards,” I ventured. “So be sure to call me back so we can continue this conversation, okay?”

“Sure thing. I will.”

I think he’s going to make it.

By the way it turned out to be a 48-minute call. Just another sign of underestimating what it's going to take to turn things around!

Comments (5)

Why take a part time job selling Pizza? I have a cash practice, I give away "free stuff" to those who play full out in my practice and I have created a "part time" job for myself within my own practice...people are paying cash to be healthy and investing full price for the chiropractic story. I think we are worth a little more than that....not that good people don't sell pizza.

Okay so here is my plug a few greats in the profession. 1. Patient Education - I recently upgraded my website with and it is totally worth the service and education it gives to my patients. When they understand they refer more! 2. My new "part time job" selling Foot Levelers in my own office with no extra expense....It paid for itself 5 times over in the first month.

In 12 years of practice I sold about $1,700 in Foot Levelers until I got the new foot scanner. People will pay cash for good chiropractic care and for Foot Levelers to help them get the most of that care. In the first month with the scanner I sold $5000 in Foot Levelers sales and those patients are VERY HAPPY!

Cash is king baby!....and they pay it when they understand the Chiropractic story and when I AM congruent!

Chris Wambeke:

I don't think Chiropractors have to be affected by the economy. Where else can someone regain their health for as little as it costs in our offices? Not only are we the most effective health care tool but we're also the cheapest. If you don't have the numbers you want than you have to tell the story to more people. It's as simple as that. If you're really telling the story retention and new patients will go up. If your really telling the story than you'll quickly realize that you're not telling the story to "get" more patients but b/c more people need to hear the story.


This is the first time I have heard you talk about too coachable. I was too coachable as well, and had to learn the hard way that the most important way to do things is your own way. Chiropractic will not disappear. There are too many fans of it. We are all graded on a curve, you just have to be the best (service and deliver the goods) and you will never run out of patients. Let other chiropractors go out of business. Base your lifestyle on how many patients you see X how much you average per patient (cash) minus overhead (immediately evaluate and eliminate all unnessisary overhead costs at home and in the practice). You will do fine, relax, have fun, why not?

Bob Wagner:

There's that bivocational stance again! Most chiropractors can't afford to stay in this because they spend like drunken sailors on leave but they do it 24/7/365! BJ said it would take 200 lifetimes for the general public to understand what we do and why we do it. There are better paying jobs out there but few that deliver the satisfaction of delivering chiropractic to the masses. Keep taking insurance but certainly don't depend on it to always be there. The guys doing the best in my area are box on the wall, if you can believe that! Maybe we need to change our thought on money. These guys are all cash and well, you know how that works.

The one problem everyone overlooks is supply and demand. If we create a demand for our services we all would get busier and make more. Problem is little demand and lots of freebies out there in our profession to further dilute the gene pool. Stop giving it away boys and you will be much better off in the end. It's not our job to make it affordable!

To the guy on the phone just STOP! Never risk savings in this business, NEVER EVER! It either pays for itself or it doesn't but don't throw it out the window!

Bob Wagner

Tony Russo:

You'll be getting alot more SOS's as the ebb gets into full swing. My recommendation is always to stay the course, stay focused and weather the storm. And like Dave Ramsey ( says, "Act Your Wage". Cut your lifestyle to what you make and not what insurance companies used to pay. Live below your means. Don't spend more than what you make and cut down your debt. Zero debt is the best place to be during these very challenging economic times. You'll find that you'll appreciate patients more when you're debt free. He recommends taking on a part time job, even delivering pizza's to afford you the privilege of practicing your profession. I did, figuratively. And it has evolved me and my practice to where it is today. Good luck to all of my friends. I'm here with you.

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From January 29, 2009 3:36 PM

This page contains a single entry from the blog posted on January 29, 2009 3:36 PM.

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