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Practicing Like Its 1999

1999Before Y2K (remember that?) and before the dot com bubble burst (the other most recent economic downturn) the practice of chiropractic was different. Insurance reimbursement was on the decline, and phase two, known as the post-review audit hadn’t become so widespread. (One more reason to begin the process of Converting to Cash.) It was also before chiropractic supporter Arnold Swartzenager bailed on California chiropractors by effectively cutting them out of the state’s worker’s compensation program.

A lot has changed in 10 years. Chiropractic hasn’t changed. But how it is practiced certainly has!

Yet, countless chiropractors continue to practice as if it’s still 1999 or earlier. Do you make these common “adaptability” mistakes?

I’m sure there are others, but these immediately come to mind:

Sloppy staff training. In the olden days when there were plenty of patients armed with insurance policies waiting in the wings, overlooking a reluctant patient or two who needed a bit of coaxing on the phone, to fall through the cracks was, well, just the cost of doing business. Today, you can no longer afford this type of waste. Your front line staff members must be adroit at recognizing wary prospects and be especially resourceful at snagging contact details, following up and helping assuage the fears and apprehensions of prospective new patients. Try some role-playing at your next staff meeting. See how your team responds.

Identifying lead source. These days, many chiropractors are just thankful that a new patient shows up, much less where they came from! Many neglect to ask critical questions about how the new patient came to choose the practice, who referred them and explore the decision-making process they went through before showing up. Overlooking this critical market research makes it difficult to thank referring patients and enhance the existing mechanisms that attract new patients. (Especially critical if you’re not getting the new patient volume you want.) You can no longer afford the luxury of ignoring this important source of marketing feedback.

Resisting technology. I still encounter chiropractors who refuse to learn how their computer works. They resist learning how to use simple email. Even taking the avalanche of spam, personally. By refusing to get a website, they are suggesting the Internet is merely a passing fad, or that they can avoid its influence. This shunning of technology used to be kind of endearing, even cute. Now it’s interfering with your ability to negotiate the world and respond quickly to opportunities. If you refuse to learn how your own practice management software works, or insist that emails be printed out so you can respond, you’re just not adapting and frankly, are exposing yourself to blackmail and exploitation.

Delegating financial matters. In the olden days, you could keep your precious hands clean by not attending to financial policy matters. As in, “I’m just here to help patients. If you have concerns, be sure to talk to Barbara on the way out.” If you’re still practicing this sort of “zone defense,” you’ll want to rethink it. No longer can you afford to separate the care you deliver from the price it costs. Patients don’t.

When I first got involved in chiropractic, I was taught that one of the signs of intelligence is the ability of an organism to adapt to one’s environment. From what I’m seeing, there are a whole lot of very smart chiropractors who aren’t being very intelligent!

Comments (3)

Dan Greener:

Bob is right with is comments about getting back to basics. I wish we all would do what Bob is talking about. Take care of your patients and live within your means. Then there would be no need for practice management confusions. He is also right on when he mentions this is what gives chiropractic a bad public image. Let's all do what Bob suggests and be chiropractors - you don't need a practice manager to do that.

Hello there Bill,

Never have left a message before, but I wanted to take a moment and thank you for your work, your insights, and of course your great companies, Paptient Media and Perfect Patients, both of which I am very grateful to be able to utilize.

I am an out of the media loop doctor, even the chiropractic news barely grabs my attention anymore...I had heard that Governor Schwartzeneger had cut us loose out there in Califoria, but I was hoping maybe the version I had run across was written by someone with an axe to grind?...I guess not, huh? If you say it, I believe it Bill. Just don't go flaking out like Greg Stanley did a few years ago, OK?

Yours for Chiropractic,

Dr. Leo

Bob Wagner:


It always amazes me that you understand chiropractic better than chiropractors do! Lean and mean is the key to this gig. Low overhead, personal care, and attention to detail is what pays the bills.

Practice management continues to be the fly in the perfume for this profession. Greg Stanley used to talk about the donor or the receiver practice. There is a well know practice management guy up the road from me. He is one of my main donors of new patients. People are smarter than his $6000 care plan plan. They see right though it. Too bad he doesn't see the damage to the profession and his practice. The fear of change is too great for his practice.

Back to basics is not in his deck of cards. Go up front with patients and you will never regret it. Live within your means, pay your bills, and strive for excellence and you might get a day off!

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From March 4, 2009 3:49 PM

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