Chiropractic Blogtag:www.patientmedia.com,2012:/blog//52012-01-30T13:44:12ZMovable Type 3.33Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6482012-01-30T13:00:02Z2012-01-30T13:44:12ZSell everything you have and give it to the poor. Sound like a good idea? Great. Then clearly you aren't attached to your things. Good for you. Yet, many people are. In fact, many define who they are by what...Esteb
Monday Morning Motivation.]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6472012-01-23T13:00:29Z2012-01-23T13:29:45ZHappiness is choice. Since you know the truth about health, you should be the happiest person patient's encounter. It's risky surrendering your happiness to circumstances. Yet, many of us do. Which can reduce happiness to one of those exceedingly-rare-winning-the-lottery-predicting-the-future kinds...Esteb
Monday Morning Motivation.]]>
Five Arguments Against Adding Drugs to Chiropractictag:www.patientmedia.com,2012:/blog//5.6452012-01-16T15:20:23Z2012-01-16T18:55:52Z (function(d, s, id) { var js, fjs = d.getElementsByTagName(s)[0]; if (d.getElementById(id)) return; js = d.createElement(s); js.id = id; js.src = "//connect.facebook.net/en_US/all.js#xfbml=1"; fjs.parentNode.insertBefore(js, fjs); }(document, 'script', 'facebook-jssdk'));Now that the dust has settled from the New Mexico attempt that would have...EstebNow that the dust has settled from the New Mexico attempt that would have allowed chiropractors to prescribe drugs and possibly perform surgery, it might be helpful to remind ourselves as to why this was, and is, such a bad idea. An idea that some, emboldened by last year’s close call in the Land of Enchantment, seem inclined to bring to other legislatures near you.
I’m guessing that when you see Minute Maid juice, you don’t think of apple juice. And when you think of BIC Pens you probably don’t imagine BIC pantyhose. (Yes, they tried that!) Or how about a Harley Davidson cake decorating kit? Or Lifesaver gum? Or Coca-Cola chap stick?
In marketing parlance these unsuccessful (and expensive) hallucinations are called line extensions. They rarely work. Yet a handful of chiropractors are trying to pull off something similar with the addition of drugs to the chiropractic scope of practice!]]>
1. Adding pharmacology removes one of the key distinctions separating medical practitioners from chiropractors. This may come as a shock to those who yearn to have the social proof of medical doctors, but most chiropractic patients choose chiropractic because it isn’t medicine! And those who don’t, usually choose chiropractic after an unsatisfactory experience trying a medical solution.
Adding drugs to the chiropractic scope of practice will reduce market share because it would invoke the “been there, done that, got the T-shirt, mug, mouse pad and DVD” response. Simply put, many chiropractic patients choose chiropractic because they want something different. Tried same. Don’t want same. Want different. You don’t want to lose this edge.
2. Adding pharmacology will NOT increase respect, esteem or the reputation of the chiropractic profession among those who control hospitals, insurance companies or public opinion. In fact, just the reverse will occur. Medical doctor wannabes will be seen as opportunistic short-cut-takers who didn’t pay his or her dues in favor of some weekend seminars.
3. Adding pharmacology will NOT increase a chiropractor’s income. If the motive for blurring the distinction between chiropractic and medicine is in having the increased income of adding injectables to the practice (because it is currently a reimbursable procedure insurance companies pay for), what’s the plan when this procedure is no longer covered? Or reimbursement becomes a mere fraction of that of an adjustment? Pursuing pharmacology for financial reasons is a huge gamble unlikely to remain a viable teat for confused, cash-starved chiropractors.
4. Adding pharmacology will pervert the meaning of chiropractic and confuse the public. We already have enough confusion with various “prefixed” chiropractors. As in straight chiropractors, principled chiropractors, upper cervical chiropractors, annual care plan chiropractors and the rest. Having a two-tiered chiropractic profession adds confusion, friction and uncertainty.
5. Adding pharmacology makes the simple idea of chiropractic more complex. In other words, when you add drugs to the chiropractic care protocol you confuse patients who are inclined to give the drug credit rather than the self-healing capability of their body when nervous system interferences are reduced. Actually, this is already happening in far too many chiropractic practices in which patients see repeated adjustments as drug dosing.
It’s easy to imagine a chiropractor, sitting alone in his or her practice, longing to help someone, being deceived into thinking that he or she would be more attractive by adding pharmacological agents to the practice. This, after already adding spinal decompression, cold laser, nutrition, weight loss, anti-smoking campaigns and all the rest.
We’ve tried more. How ‘bout trying less?
As for the argument that chiropractors shouldn’t be tethered to a 100 year-old philosophy and become relics of the 19th century, may I respectfully remind you that for over 100 years, chiropractic has worked when traditional methods have failed. Chiropractic has been around far longer than the more recent invention of a drug culture created out of corporate greed.
Are you going to trust man made concoctions or the wisdom of the body that can self-heal when nervous system interferences are reduced?
Choose carefully.
]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6432012-01-16T13:00:32Z2012-01-16T13:52:22ZSomeday you'll feel alone and discouraged. Or depressed and hopeless. What will make matters worse is that those around you won't share these feelings. In fact, their apparent happiness will make your feelings of separation worse. This is a common...Esteb
Vigorous exercise. I used jogging (because it was inexpensive) and found that the endorphin high lasted long enough to move beyond my personal pity party.
Serve others. The surest way to escape is to serve. And it may not be through chiropractic. Volunteer your time. Community service. Soup kitchen. The possibilities are endless.
Pray. Feelings of separation, depression and the like are often signs of spiritual oppression. It's a common scheme of the enemy. Rebuke the spirits of darkness and create a clearing by inviting in the Holy Spirit.
Subscribe to Monday Morning Motivation.]]>
“I can always find something to bill an insurance company for…”tag:www.patientmedia.com,2012:/blog//5.6422012-01-11T19:52:40Z2012-01-12T13:37:46Z (function(d, s, id) { var js, fjs = d.getElementsByTagName(s)[0]; if (d.getElementById(id)) return; js = d.createElement(s); js.id = id; js.src = "//connect.facebook.net/en_US/all.js#xfbml=1"; fjs.parentNode.insertBefore(js, fjs); }(document, 'script', 'facebook-jssdk'));This is an all too common belief held by many chiropractors who are naive,...EstebThis is an all too common belief held by many chiropractors who are naive, lazy or inclined to steal. Naturally, this lack of integrity creates far more problems in the long run than it solves in the short term.
Chiropractors who see a patient’s insurance policy as some sort of entitlement are probably the worse abusers. Either they don’t know how insurance policies work, or do, and choose to blur the boundaries for their personal gain.
In case you didn’t know, the purpose of a health insurance policy is NOT to insure the patient’s health!]]>
once-a-month Medicare visit in which an episode of care is never officially completed.
The biggest offenders are often those who have known nothing but indemnity insurance throughout their professional career. Apparently, adding reimbursable procedures is less work than developing a compelling communication strategy that transitions a percentage of patients into maintenance care which they would pay for themselves. (Which may seem impossible if you don’t believe that what you offer is valuable enough that a patient would pay for!)
At the root of this is a rationalization to steal. Yes, insurance companies don’t “get” chiropractic. True, insurance carriers have a misguided notion about the nature of health. Naturally, they should reimburse more. But they don’t. And the fact that “everybody does it” is not only a lie, but will give you little comfort when you are confronted by an insurance company audit or when asked to appear before your licensing board.
And all you wanted to do is help people.
Document what you find. Prove that what you’re doing is making a difference and that there is every reason to expect that your plan will produce further functional improvements. And document those. At the moment you’ve reached the point where their neglect, their lifestyle and the limitations of their age and interest are exhausted, dismiss them and their insurance carrier from further obligation. Make your case for continued supportive care on a cash basis. Warn of the likelihood of a relapse. Honor the patient’s choice.
And then help the next person who wants it.
]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6412012-01-09T13:00:23Z2012-01-09T12:16:47ZWhat's the greatest risk you've taken? Our relationship with risk is one of the defining aspects of our lives. What seems like a gamble of one person is a walk in the park for someone else. But is the imagined...Esteb
Monday Morning Motivation.]]>
Monday Morning Motivationtag:www.patientmedia.com,2012:/blog//5.6402012-01-02T13:00:29Z2012-01-02T13:26:54ZYou find yourself in front of 100 potential new patients. You can say anything you want for as long as you wish. Go! Are you prepared? Have you actually explained chiropractic often enough to know the key points to share?...Esteb
Monday Morning Motivation.]]>
Monday Morning Motivationtag:www.patientmedia.com,2011:/blog//5.6392011-12-26T13:05:14Z2011-12-26T13:07:45ZThis week, review the low points and highlights of this past year and set some goals for the next. Create some journal entries by addressing answers to some of these questions: What was the most significant decision I made during...Esteb
Monday Morning Motivation.]]>
Merry Christmas!tag:www.patientmedia.com,2011:/blog//5.6382011-12-19T14:24:50Z2011-12-19T15:18:39ZIt’s that time of year again. Actually it starts even before Halloween when store decorations featuring ghosts, goblins and witches are often fighting for attention from the Jingle Bells, Santa’s and nativity scenes. This post isn’t about rising above political...Esteb
It’s that time of year again. Actually it starts even before Halloween when store decorations featuring ghosts, goblins and witches are often fighting for attention from the Jingle Bells, Santa’s and nativity scenes.
This post isn’t about rising above political correctness to wish others “Merry Christmas!” This is about your practice and whether December is among its busiest month or slowest. Which is it?
If you think talking about the birth of the savior of the world is controversial, read on. Some may find the following observations about chiropractic in December even more contentious!]]>
not part of your chiropractic patient communication repertoire, or you don’t tend to attract health-conscious individuals, then December is probably pretty lonely.
Communicating Stress
Helping patients appreciate that their particular flavor of spinal dysfunction is the effect (symptom) of physical, chemical or emotional stress will require confronting one of the most prevalent patient misconceptions about chiropractic: that your adjustments treat their headaches, back pain, subluxations or anything else.
Insurance carriers, which most patients expect will cover all or some of your ministrations, are singularly uninterested in this distinction. It has seduced many chiropractors into taking the path of least resistance with their patient explanations. And thus the current state of affairs.
I’m increasingly convinced that the widespread belief among patients (and many chiropractors!) that chiropractic care treats aches and pains rather than reviving the patient’s ability to self heal is the root of many of the challenges facing chiropractors.
Okay, with clarity about what chiropractic care does and doesn’t do, the next obligation is to acquaint every patient with the three types of stress so they can recognize them and sense when their ability to accommodate them is compromised.
While our stress poster is a good start, the best strategy I know is to cover a wall in your adjusting room with white butcher paper or obtain a large dry erasable white board and divide the surface into three columns, labeling each with the headings Physical Stresses, Chemical Stresses and Emotional Stresses. Then, encourage patients to write examples of stressors that produce subluxations.
After a month or so you’ll be astonished by the result. Sure, it’s messy and so unlike what some patients expect to see on the practice walls of a licensed professional, but so what? Changing the consciousness of patients is a messy business!
Attracting the Health Conscious
Another important action step to take if you want busier Decembers is to start attracting patients who want better health.
If you neglect to explain that each patient’s inborn ability to self-heal is the hero (not a doctor, drug or adjustment) then you tend to attract patients looking for a short-term “diet” of chiropractic treatments to alleviate their spine-related ache or pain. There’s no shame in this. You can help a lot of people this way and it’s certainly better than a drug solution. However, these patients, regardless of what they say, are rarely interested in better health. Thus they tend to disappear in December when other, more pressing demands on their time and money show up.
Stabilizing your practice with more health-conscious practice members requires that you become attractive to those who value their health. Which, among other things, means you may need to become healthier physically, mentally and socially yourself. Only then does it make sense to network with other professionals who cater to a more health-conscious crowd (Pilates and yoga instructors, midwives, acupuncturists, health food store owners, etc.) and begin marketing your services more appropriately. Which means far more than adding “wellness” to your practice name! Drop the emphasis on symptoms. Become more curious about each patient’s overall life and well-being. You may even want to learn some additional skills that would better equip you to deal with the chemical and emotional subluxations you encounter.
Granted, this won’t fix your practice this December, but resolve to make the relevant changes to your practice orientation and patient communications in the New Year, and next December will be a far different experience!]]>
Monday Morning Motivationtag:www.patientmedia.com,2011:/blog//5.6372011-12-19T13:00:03Z2011-12-19T13:21:00ZWhen a patient has a health issue necessitating a visit to a chiropractor, it's often a time of confusion (why won't this resolve?), of uncertainty (can it help?) and disorientation (this is all new to me). Patients want to meet...Esteb
Monday Morning Motivation.]]>
Monday Morning Motivationtag:www.patientmedia.com,2011:/blog//5.6362011-12-12T13:00:33Z2011-12-12T13:08:19ZIt was Michael Corleone in The Godfather II who repeated his father’s admonition, “Keep your friends close and your enemies even closer.” Who is your enemy? Some think it’s the medical profession. Or the pharmaceutical industry. Or the other chiropractor...Esteb
The Godfather II who repeated his father’s admonition, “Keep your friends close and your enemies even closer.”
Who is your enemy?
Some think it’s the medical profession. Or the pharmaceutical industry. Or the other chiropractor down the street. While these may be competitors vying for the same patients, they are not your enemy. Your enemy is actually the ignorance about, and the disconnection from their own bodies, that plague the vast majority of people in your community. That’s your enemy—a formidable foe.
How many times have you or a team member wondered aloud, “How do people live without chiropractic care?”
Easy. When you’re disconnected from your body, taking a pill to fool it into not sensing pain seems perfectly normal. When you’re disconnected from your body, you’re oblivious to the early warning signs that something is amiss.
Want to grow your practice? Start here.
Subscribe to Monday Morning Motivation.]]>
Have You Been Skinny Dipping?tag:www.patientmedia.com,2011:/blog//5.6352011-12-05T13:41:33Z2011-12-11T13:39:12Z (function(d, s, id) { var js, fjs = d.getElementsByTagName(s)[0]; if (d.getElementById(id)) return; js = d.createElement(s); js.id = id; js.src = "//connect.facebook.net/en_US/all.js#xfbml=1"; fjs.parentNode.insertBefore(js, fjs); }(document, 'script', 'facebook-jssdk')); "It’s the economy, stupid" was the catch phrase used by Bill Clinton’s political...Esteb"It’s the economy, stupid" was the catch phrase used by Bill Clinton’s political campaign preventing George H. W. Bush from enjoying a second term. A similar economic theme was used by Ronald Regan (“Are you better off today than you were four years ago?”) to unseat Jimmie Carter. I’m guessing the economy is likely to play a role in next year’s presidential election also.
Which begs the question. Has the recent economic developments caused your practice to take a downturn?
I had almost completed my four-hour speaking gig at the Missouri State Chiropractors Association Saturday night when the subject of the economy came up. Apparently, some in the room were of the belief that the economic downturn was responsible for the challenges they were facing in practice. That, combined with an earlier whining from a chiropractor who felt victimized by Medicare, prompted a rant that I’ll attempt to present more constructively and with greater self-control.
Spoiler alert: if you’re allergic to the truth or prefer being a self-righteous victim please don’t read any further.]]>
every chiropractor was dipping into his or her savings to stay afloat, I might be more sympathetic. But the fact is, some chiropractors are having their best year ever. This alone causes one to question the conventional wisdom that a general economic downturn automatically means that chiropractic practices will take a nosedive as well.
Warren Buffett famously observed after the economic dip that followed 911: “You only find out who is swimming naked when the tide goes out.” In other words, a robust economy allows even marginal businesses to survive. But when times get more difficult the flaws, shortcomings and lack of a sustainable practice model are revealed. That’s what we’re seeing today among some chiropractors who find their practices exposed as the tide recedes.
They’re simply reaping what they sowed, such as neglecting their patient education duties, being too dependent on insurance reimbursement and using shame, guilt and annual care plans to get patients to continue care they didn’t want, drying up referrals and reactivations in the process.
Rule number one: when you find yourself in a hole, stop digging!
While you can’t do anything about the past, you can dramatically change the future. Here are seven suggestions. They won’t turn things around overnight, but if done consistently you can get back on track. I promise.
1. Increase your marketing overtures. Please don’t make the classic small business mistake of cutting back on your marketing when things get tough! That will practically doom your prospects. If you don’t have a website, get one. If you already have one, add some energy to it—more pictures and more compelling information of interest to new patients. Grow from within by resuming the patient newsletters you used to send, reactivation postcards, birthday greetings and New Year’s resolution reminders. Hold some patient lectures. Conduct some patient focus groups. Be proactive!
2. Find your tribe. Abandon the notion that you can appeal to anyone in a 5-10 mile radius of your practice that has a spine and is warmer than room temperature. Differentiate yourself. What types of cases do you especially enjoy helping? Find the people who have given up on traditional methods. Befriend the health food store owner, the midwives, acupuncturists, yoga instructors, Pilate studio owners, etc. Which practitioners are currently serving the constituency you’d like to serve? I promise that there are people in your vicinity who need your help and for whom money is no object. Trying to be everything to everybody is impossible.
3. Improve insurance reimbursement. Many believe that insurance money is all gone. Not true. Are carriers pickier these days? Of course. If you want to get every penny you deserve you’ll probably need to improve your documentation. (Checkout what Kathy Mills Chang and I have put together at www.ChiropracticPaperwork.com.) Use outcome measurements to show functional improvements and put an end to medical necessity denials. You’re probably leaving money on the table from down coding. Get every penny you deserve. Up your game.
4. Focus on stress and nerves. You could probably list three or four things that would improve your patient education. Now, implement them. Stop communicating to patients as you do insurance companies. Instead of bones and biomechanics, explain subluxation as a stress response. Explain their improvement as the result of simply reviving their ability to self heal, mediated by the integrity of their nervous system. Pay now or pay later. In other words, either invest in world-class patient education now, or you’ll pay later with a relentless appetite for more new patients. Enthusiastically and creatively tell the chiropractic story. No selling required. Just tell the simply, gorgeous truth.
5. Stop watching the news. Many of the chiropractors who find things slowing down can tell me what the stock market did yesterday and the latest drama showing up in the headlines. If you’re not ready for a total media fast, at least go on a strict diet! I’ve covered this elsewhere, but suffice it to say the news 1) advances a spirit of fear (unhelpful) and, 2) thrives on bad news (to attract eyeballs that can be sold to advertisers) that you can’t do anything about. Thus, the media turns consumers into powerless victims. Don’t fall for it. You’re not a victim. You know the truth. Unplug!
6. Redouble your staff training efforts. Not only is your support team the true gatekeepers of your practice, they are also your eyes and ears. Do you know how well your front desk CA is fielding questions on the phone? Can he or she recognize referral opportunities? Does every member of your team understand chiropractic principles, its nervous system focus and potential whole-body effects? Until the holes in your appointment schedule are filled, use every available moment to conduct chiropractic staff training. Use staff meetings to practice possible telephone scenarios. Role play. This is the “practice” of practice.
7. Focus on self-development. Your practice will grow only as you do. Look for opportunities to stretch and force yourself out of your comfort zone. Have the difficult conversation you’ve been putting off. Acquire public speaking skills. Tour some practices that are helping more people than you are. Ask for help. Ask more questions. Journal. Put words to your feelings, worries and challenges and notice solutions appear. Humble yourself and show up more curious and less judgmental. List, and then question your assumptions about patients and practice.
When I was growing up in Olympia, Washington, there was an old saying that “When Boeing sneezes, Seattle catches cold.” Same thing here. All of us at Patient Media are deeply committed to your success. We only thrive when you do. How may we help?
Atchoo!
]]>
Monday Morning Motivationtag:www.patientmedia.com,2011:/blog//5.6342011-12-05T13:00:52Z2011-12-05T13:17:20ZRemember, you have little control over how patients respond to your application of energy at opportune times and places along their spine. Imagining that you do, suggests that you see yourself as the hero instead of the patient's ability to...Esteb
they're the hero. It's far more accurate of them and attractive of you.
Subscribe to Monday Morning Motivation.]]>
Dear Billtag:www.patientmedia.com,2011:/blog//5.6332011-12-01T01:21:24Z2011-12-01T01:26:05ZQ: Do you have any archived articles or a Monday Morning Motivation about the importance of a chiropractor arriving on time for the first scheduled appointments of the day? I work for a DC who consistently strolls in 10-15 minutes...Esteb
Q: Do you have any archived articles or a Monday Morning Motivation about the importance of a chiropractor arriving on time for the first scheduled appointments of the day? I work for a DC who consistently strolls in 10-15 minutes late. His self-sabotage not only affects my income but I resent having to entertain patients who have shown up for a specific appointment time. What can I do?
A: I don’t recall a specific Monday Morning Motivation on this topic, however I’ve certainly addressed this subject many times at speaking gigs and Connecting the Dots. (Spin down to the heading ‘Working for Efficient Managers’ in the chapter “Inspired Teams.”)]]>
Sounds like you may be working for a chiropractor suffering from a case of low self-esteem. Making patients wait is often a strategy designed to increase one’s feelings of importance and control. It’s one thing to ask for a patient’s indulgence after a grueling morning of emergencies and serving the unexpected needs of patients. It’s far different when one doesn’t respect patients enough to show up for the day’s “first fruits.”
First fruits are the best. The first of the harvest. The most important. In ancient Israel, it’s a form of tithe. Showing up without any “warm up,” or worse, showing up late, may also suggest that your doctor isn’t fully invested in the practice, potentially putting your job at risk.
Reminds me of those prideful NBA basketball players who are “too good” to do the practice sessions, wind sprints and free-throw drills. Instead, they just want to play basketball.
You may not be able to directly change this attitude. (In fact, it’s highly unlikely, since a disrespect of patients probably means an even greater minimization of you!) However, leaving to work for a more appreciative chiropractor might.
Monday Morning Motivationtag:www.patientmedia.com,2011:/blog//5.6322011-11-28T13:00:17Z2011-11-28T13:15:51ZAre you a control freak? It's nothing to be especially proud of, since it's often a sign of insecurity, indecisiveness, low self-esteem or all three. Through the insecurity lens, control is a strategy to get our way, minimizing the contributions...Esteb
Subscribe to Monday Morning Motivation.]]>
Now that the dust has settled from the New Mexico attempt that would have allowed chiropractors to prescribe drugs and possibly perform surgery, it might be helpful to remind ourselves as to why this was, and is, such a bad idea. An idea that some, emboldened by last year’s close call in the Land of Enchantment, seem inclined to bring to other legislatures near you.
I’m guessing that when you see Minute Maid juice, you don’t think of apple juice. And when you think of BIC Pens you probably don’t imagine BIC pantyhose. (Yes, they tried that!) Or how about a Harley Davidson cake decorating kit? Or Lifesaver gum? Or Coca-Cola chap stick?
In marketing parlance these unsuccessful (and expensive) hallucinations are called line extensions. They rarely work. Yet a handful of chiropractors are trying to pull off something similar with the addition of drugs to the chiropractic scope of practice!]]>
1. Adding pharmacology removes one of the key distinctions separating medical practitioners from chiropractors. This may come as a shock to those who yearn to have the social proof of medical doctors, but most chiropractic patients choose chiropractic because it isn’t medicine! And those who don’t, usually choose chiropractic after an unsatisfactory experience trying a medical solution.
Adding drugs to the chiropractic scope of practice will reduce market share because it would invoke the “been there, done that, got the T-shirt, mug, mouse pad and DVD” response. Simply put, many chiropractic patients choose chiropractic because they want something different. Tried same. Don’t want same. Want different. You don’t want to lose this edge.
2. Adding pharmacology will NOT increase respect, esteem or the reputation of the chiropractic profession among those who control hospitals, insurance companies or public opinion. In fact, just the reverse will occur. Medical doctor wannabes will be seen as opportunistic short-cut-takers who didn’t pay his or her dues in favor of some weekend seminars.
3. Adding pharmacology will NOT increase a chiropractor’s income. If the motive for blurring the distinction between chiropractic and medicine is in having the increased income of adding injectables to the practice (because it is currently a reimbursable procedure insurance companies pay for), what’s the plan when this procedure is no longer covered? Or reimbursement becomes a mere fraction of that of an adjustment? Pursuing pharmacology for financial reasons is a huge gamble unlikely to remain a viable teat for confused, cash-starved chiropractors.
4. Adding pharmacology will pervert the meaning of chiropractic and confuse the public. We already have enough confusion with various “prefixed” chiropractors. As in straight chiropractors, principled chiropractors, upper cervical chiropractors, annual care plan chiropractors and the rest. Having a two-tiered chiropractic profession adds confusion, friction and uncertainty.
5. Adding pharmacology makes the simple idea of chiropractic more complex. In other words, when you add drugs to the chiropractic care protocol you confuse patients who are inclined to give the drug credit rather than the self-healing capability of their body when nervous system interferences are reduced. Actually, this is already happening in far too many chiropractic practices in which patients see repeated adjustments as drug dosing.
It’s easy to imagine a chiropractor, sitting alone in his or her practice, longing to help someone, being deceived into thinking that he or she would be more attractive by adding pharmacological agents to the practice. This, after already adding spinal decompression, cold laser, nutrition, weight loss, anti-smoking campaigns and all the rest.
We’ve tried more. How ‘bout trying less?
As for the argument that chiropractors shouldn’t be tethered to a 100 year-old philosophy and become relics of the 19th century, may I respectfully remind you that for over 100 years, chiropractic has worked when traditional methods have failed. Chiropractic has been around far longer than the more recent invention of a drug culture created out of corporate greed.
Are you going to trust man made concoctions or the wisdom of the body that can self-heal when nervous system interferences are reduced?
Choose carefully.
]]>
This is an all too common belief held by many chiropractors who are naive, lazy or inclined to steal. Naturally, this lack of integrity creates far more problems in the long run than it solves in the short term.
Chiropractors who see a patient’s insurance policy as some sort of entitlement are probably the worse abusers. Either they don’t know how insurance policies work, or do, and choose to blur the boundaries for their personal gain.
In case you didn’t know, the purpose of a health insurance policy is NOT to insure the patient’s health!]]>
once-a-month Medicare visit in which an episode of care is never officially completed.
The biggest offenders are often those who have known nothing but indemnity insurance throughout their professional career. Apparently, adding reimbursable procedures is less work than developing a compelling communication strategy that transitions a percentage of patients into maintenance care which they would pay for themselves. (Which may seem impossible if you don’t believe that what you offer is valuable enough that a patient would pay for!)
At the root of this is a rationalization to steal. Yes, insurance companies don’t “get” chiropractic. True, insurance carriers have a misguided notion about the nature of health. Naturally, they should reimburse more. But they don’t. And the fact that “everybody does it” is not only a lie, but will give you little comfort when you are confronted by an insurance company audit or when asked to appear before your licensing board.
And all you wanted to do is help people.
Document what you find. Prove that what you’re doing is making a difference and that there is every reason to expect that your plan will produce further functional improvements. And document those. At the moment you’ve reached the point where their neglect, their lifestyle and the limitations of their age and interest are exhausted, dismiss them and their insurance carrier from further obligation. Make your case for continued supportive care on a cash basis. Warn of the likelihood of a relapse. Honor the patient’s choice.
And then help the next person who wants it.
]]>
"It’s the economy, stupid" was the catch phrase used by Bill Clinton’s political campaign preventing George H. W. Bush from enjoying a second term. A similar economic theme was used by Ronald Regan (“Are you better off today than you were four years ago?”) to unseat Jimmie Carter. I’m guessing the economy is likely to play a role in next year’s presidential election also.
Which begs the question. Has the recent economic developments caused your practice to take a downturn?
I had almost completed my four-hour speaking gig at the Missouri State Chiropractors Association Saturday night when the subject of the economy came up. Apparently, some in the room were of the belief that the economic downturn was responsible for the challenges they were facing in practice. That, combined with an earlier whining from a chiropractor who felt victimized by Medicare, prompted a rant that I’ll attempt to present more constructively and with greater self-control.
Spoiler alert: if you’re allergic to the truth or prefer being a self-righteous victim please don’t read any further.]]>
every chiropractor was dipping into his or her savings to stay afloat, I might be more sympathetic. But the fact is, some chiropractors are having their best year ever. This alone causes one to question the conventional wisdom that a general economic downturn automatically means that chiropractic practices will take a nosedive as well.
Warren Buffett famously observed after the economic dip that followed 911: “You only find out who is swimming naked when the tide goes out.” In other words, a robust economy allows even marginal businesses to survive. But when times get more difficult the flaws, shortcomings and lack of a sustainable practice model are revealed. That’s what we’re seeing today among some chiropractors who find their practices exposed as the tide recedes.
They’re simply reaping what they sowed, such as neglecting their patient education duties, being too dependent on insurance reimbursement and using shame, guilt and annual care plans to get patients to continue care they didn’t want, drying up referrals and reactivations in the process.
Rule number one: when you find yourself in a hole, stop digging!
While you can’t do anything about the past, you can dramatically change the future. Here are seven suggestions. They won’t turn things around overnight, but if done consistently you can get back on track. I promise.
1. Increase your marketing overtures. Please don’t make the classic small business mistake of cutting back on your marketing when things get tough! That will practically doom your prospects. If you don’t have a website, get one. If you already have one, add some energy to it—more pictures and more compelling information of interest to new patients. Grow from within by resuming the patient newsletters you used to send, reactivation postcards, birthday greetings and New Year’s resolution reminders. Hold some patient lectures. Conduct some patient focus groups. Be proactive!
2. Find your tribe. Abandon the notion that you can appeal to anyone in a 5-10 mile radius of your practice that has a spine and is warmer than room temperature. Differentiate yourself. What types of cases do you especially enjoy helping? Find the people who have given up on traditional methods. Befriend the health food store owner, the midwives, acupuncturists, yoga instructors, Pilate studio owners, etc. Which practitioners are currently serving the constituency you’d like to serve? I promise that there are people in your vicinity who need your help and for whom money is no object. Trying to be everything to everybody is impossible.
3. Improve insurance reimbursement. Many believe that insurance money is all gone. Not true. Are carriers pickier these days? Of course. If you want to get every penny you deserve you’ll probably need to improve your documentation. (Checkout what Kathy Mills Chang and I have put together at www.ChiropracticPaperwork.com.) Use outcome measurements to show functional improvements and put an end to medical necessity denials. You’re probably leaving money on the table from down coding. Get every penny you deserve. Up your game.
4. Focus on stress and nerves. You could probably list three or four things that would improve your patient education. Now, implement them. Stop communicating to patients as you do insurance companies. Instead of bones and biomechanics, explain subluxation as a stress response. Explain their improvement as the result of simply reviving their ability to self heal, mediated by the integrity of their nervous system. Pay now or pay later. In other words, either invest in world-class patient education now, or you’ll pay later with a relentless appetite for more new patients. Enthusiastically and creatively tell the chiropractic story. No selling required. Just tell the simply, gorgeous truth.
5. Stop watching the news. Many of the chiropractors who find things slowing down can tell me what the stock market did yesterday and the latest drama showing up in the headlines. If you’re not ready for a total media fast, at least go on a strict diet! I’ve covered this elsewhere, but suffice it to say the news 1) advances a spirit of fear (unhelpful) and, 2) thrives on bad news (to attract eyeballs that can be sold to advertisers) that you can’t do anything about. Thus, the media turns consumers into powerless victims. Don’t fall for it. You’re not a victim. You know the truth. Unplug!
6. Redouble your staff training efforts. Not only is your support team the true gatekeepers of your practice, they are also your eyes and ears. Do you know how well your front desk CA is fielding questions on the phone? Can he or she recognize referral opportunities? Does every member of your team understand chiropractic principles, its nervous system focus and potential whole-body effects? Until the holes in your appointment schedule are filled, use every available moment to conduct chiropractic staff training. Use staff meetings to practice possible telephone scenarios. Role play. This is the “practice” of practice.
7. Focus on self-development. Your practice will grow only as you do. Look for opportunities to stretch and force yourself out of your comfort zone. Have the difficult conversation you’ve been putting off. Acquire public speaking skills. Tour some practices that are helping more people than you are. Ask for help. Ask more questions. Journal. Put words to your feelings, worries and challenges and notice solutions appear. Humble yourself and show up more curious and less judgmental. List, and then question your assumptions about patients and practice.
When I was growing up in Olympia, Washington, there was an old saying that “When Boeing sneezes, Seattle catches cold.” Same thing here. All of us at Patient Media are deeply committed to your success. We only thrive when you do. How may we help?
Atchoo!
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