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Getting Your Old Practice Back

reinvent-practiceDisoriented? In a fog? Feeling lost? Inclined to freeze and do nothing?

You may be suffering from an oppressive new pathology among chiropractors whose primary symptom includes a yearning for their (insert year here) practice from the past. They want to return to the good old days. Who knew that having your claims cut by only 30% would trigger such nostalgia?

In response, some chiropractors adopt a strategy that includes stopping. Waiting. Looking. Sizing up the situation. The thinking goes like this: If I postpone my decisions, keep my head down and a wetted finger up, I’ll avoid making a mistake. I understand this MO because for years I was the poster child for this style of decision making. (The solution? Make the best decision possible and then do everything within your power to make it the right decision.)

What these chiropractors fail to realize is that waiting and watching is a decision. And these days, an especially unhelpful-reactive-victim decision. If you find yourself in this unhappy place, look ahead, rather than over your shoulder.

First, get comfortable with the notion that you can’t have your old practice back. Attempting to return to the good old days is not only impossible, it stops you from a more resourceful response. Instead of trying to recover the past, your energy is better spent by a concerted effort to reinvent your practice.

There’s no need to reinvent chiropractic—just your delivery of it. The principles of chiropractic and its underlying philosophy are as contemporary as ever. It’s the practice of chiropractic that needs a rethink. Many chiropractic practices are operating on guidance offered up at a time when June Cleaver was a stay-at-home-mom, medical doctors endorsed cigarettes and “doctor’s orders” were not to be questioned.

If you were to do it over again, how would you set up your practice? (Perhaps more telling, would you?) If you’re inclined to remain in practice, here are a few thought-starters to fuel your creative juices:

Lower overhead. Most chiropractors carry far too much personal and professional overhead. Sure, it’s not especially inspiring to give up luxuries that you, your spouse or your children have come to think of as necessities. However, jettison some of these habits from the Insurance Era and you’ll be surprised by the new sense of freedom you’ll enjoy. Lose the “monument to chiropractic” you practice in. It’s time to go “lean and mean.”

Group practice. One way to reduce overhead is to share it with a colleague or two. If you can abandon the notion that new patients are a zero sum game, that every chiropractor is unique and must attract his or her own “tribe,” then new opportunities abound. Two heads are better than one. Gone will be the sense of isolation. Even better, team up with a chiropractor who practices radically different than you. Or put together a coalition of massage, acupuncture, naturopaths and other vitalists under one roof.

No bluffing. Use this reinventing process to rethink how you want to show up for patients. It would be a great time to abandon the parental role, the “fixer” persona and the rote, one-size-fits all “three-times-a-week, then-two-times-a-week” mantra that passes for clinical recommendations. Instead, you could bring a new level of accountability with regular progress examinations and acknowledge that there is little you can say or do to hijack a patient’s free will—other than sacrificing their future reactivation.

Mornings or afternoons. Instead of trying to milk both ends of the day, with an unsettling four-hour of rhythm-breaking inactivity in the middle of the day, pick one! Are you a morning person? Work mornings. Are you an owl? Begin at noon and serve those who share your preference. Use the rest of the day to have a life, get reacquainted with your family, conduct talks or pursue other outreach initiatives.

Avoid receivables. Many chiropractors carry thousands of dollars on their books in the form of receivables that they secretly know they’ll never see. This is a form of lying that perpetuates the illusion that they’re doing better than they actually are. As you reinvent your practice, determine whether you have a value proposition a patient would pay for, or whether you offer a specialty that only insurance companies find worthy of buying. You could institute a zero tolerance for taking assignment or billing patients.

Many of these suggestions rely on your willingness or ability to teach the principles of chiropractic in a meaningful and relevant way. You’re likely to lose some patients in the process. For some chiropractors, this will be too high a price to pay for the promise of a practice better able to adapt to changing times. That’s okay. There will be others less rigid willing to step into the opportunity.

Remember, you’re not entitled to a practice. It is merely a privilege; an opportunity. You must stay relevant and you must solve a problem that a sufficient number of people want solved—and do so at a profit. Simple really. If your practice is sending you the signal that the strategies of the past are no longer working, this would be the perfect time to question some of the assumptions on which you’ve based your practice. Chances are you have been distanced from some of the new realities of today’s marketplace. Adapt, or join the ranks of the blacksmith, ice deliveryman and telegraph operator.

Comments (1)

Rick Hasemeier D.C.:


Today chiropractic is about being able to change with our current times. Versatility, with a clearly defined compass of what your purpose is, leads us on the road to success. We determine what our purpose is, not someone or something on the outside. Thanks for clearing the smoke of confusion for the profession.

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From April 4, 2009 7:59 AM

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