About Edward Petty

Consultant with Petty, Michel & Associates, Author of Marketing Manager System, the Goal Driven Business www.GoalDriven.com. Father and grandfather, husband, student, active in athletics, and in health and environmental causes.

Humor in Practice Development

Always laugh when you can. It is cheap medicine.
Lord Byron

You probably don’t laugh enough.

And, just probably, there could be more humor in your clinic.

Sometimes offices can be downright grim. Stressed insurance staff, doctors working with an emergency case, patients running late… the list goes on and on. You may not notice it from the inside, but your patients do. Have you ever walked into a doctor’s office that seemed less than happy or friendly? How about a dentist’s office?  You don’t really want to return to an office that is stressful and tense.

Laughter is good medicine, or rather, good therapy. It is good for patients, employees, and doctors.  It helps make the work day go smoother, tasks seem easier, and goals more obtainable. And more fun to achieve.

Even if you are not good at telling jokes or making them up, you can work on it. And that can be funny too! At least for others!!

ACTION STEP

Start each staff meeting, or your morning case management meetings with a joke. Have your staff take turns.  (No mean or off-color jokes.)

Telling jokes can help you to take the gravity and stress out of your work. Successful practices, and people, tend to be lighter hearted than those that are worried and very very serious.

Sometimes when you start laughing you can find more things to laugh about. Try it sometime.  You can always check out our “Breakroom” for a joke or two. They may be a little corny, but that is funny too.

P.S. April is National Humor Month. Click here to learn more.

Letter to Patients From the Doctor: Write Your Successes

Good News Is A Wonderful Thing

Dear Patients and Friends,

We get hit with bad news all the time. From what the newspapers and TV serve up, you would think we are gluttons for negativity.

But the fact is, there is always so much more good news happening than bad. It is probably true that we overlook the many daily events and experiences for which we can be grateful and happy.

For health reasons, it is important to get more good news than bad. Stories about calamities can add to your level of stress and bring about physical tension and mental anxiety.  This stress can help create subluxations that can lead to back problems, headaches, stomach conditions, and many other dis-eases.

Chiropractic care can relieve back pain, headaches, and the effects of subluxations and stress. To support your health efforts, we also offer regular classes on Yoga, nutrition and medication.

As additional support, I suggest you try to limit the amount of negative news you  get assaulted with each day. Instead, look for the good news events. Find reasons for which you can show gratitude.

This is one of the reasons we invite our patients to fill out a survey at some point during their active care.  We call these “Success Stories.”  It is a time to reflect on your health progress and achievements and write them down.

We love hearing about your success. Part of getting and staying healthy is staying positive, and nothing is more positive than celebrating the successes we all share in.

See you soon,
Dr. John

PS  We invite you to read what other patients have said in our reception room.  We have also recently posted a number of these patient successes on our web site and you can read them there at www._____ .com

Change or Be Left Behind

Change happens.  And you either are making the change happen and evolving your business, or the change will happen to you and to your practice. It is a matter of either being proactive or unresponsive.

Too many offices seem to be changing, but they are actually caught in a kind of neurosis: compulsively putting out fires, and like a dog chasing its own tail, never getting anywhere.

Other offices go to the seminars and read the books, and talk about improvements, but never really change. They stay stuck and hide in their comfort zones, doing business the way they did back last century.

You have to change. All you have to do is look at other business models for examples. We have a McDonalds a few miles from our office (who doesn’t?). It has been there for many years. A new Panera moved in near to it. It is a beautiful and convenient restaurant with all the things people want now: upgraded coffee, salads with chicken, and some no-fat bread. Oh yes, with Wi-Fi (wireless fidelity).  And it is very busy.  So what is McDonalds doing? About two weeks ago heavy equipment moved in and started demolishing the building. Today, it is completely destroyed and plans are underway for building a new McDonalds with a new design and improved features. I assume with Wi-Fi and fancy coffee.

Peter Drucker, one of the world’s foremost management consultants who recently passed away, said that “business has only two functions — marketing and innovation.”

You have to change, or to put it better, you have to innovate.  And you have to market.

We have recently talked about the process of Continuous Improvement. The Japanese call it Kaizen. We have begun implementing a process called Continuous Improvement Reviews (C.I.R.), which is an adaptation of some of our basic consulting procedures that have been so effective. The CIR looks to be a vital tool for improving practice innovation and marketing. We will be posting more information on how to do the process in the future.

A new month is coming and it is time for a change. Time to innovate and market and grow your practice.

These are my health care successes:

(Directions: Please write a few sentences regarding your condition before treatment, and then a few sentences regarding your condition now after receiving the health care we provided.)
Name ________________________

1. Describe your condition. How long had you been suffering?  How did it start?
2. What previous unsuccessful steps had you taken to try to solve your problem?

3. How did you find out about Dr. _____________?

4. Describe what Dr. _______________  did to help you. ( Examination, x-ray, treatment program, etc.)

5. What did Dr. _______ tell you your problem was?

6. Describe your progress, your results , and the benefits you received.
7. How has your life been improved since coming to our office? What can you do now that you could not do before?
8. Words of encouragement for others who have similar problems.
Signature _____________________________ Date_________
I hereby give my permission to publish my success story in whole or in part: (initial) _______


Procedure for
Success Story
Questionnaire Form


When the patient is ready to write their “success story”, have her or him fill out this survey.

Then, you can re-type it and have them sign the new version. Type the following on the bottom of the newly retyped story. When you display the patient’s story, you can mention: “(Individual results vary. These accounts were obtained without remuneration and within HIPAA guidelines.)”  You may also want to check with your state association if you have any questions.

I hereby give my permission to publish my success story in whole or in part:
Signature _________________________________   Date:______________________

Actual Recent Patient Testimonial

NO OPERATION FOR ME!

February 2006

I have spinal stenosis, which is a narrowing of the spinal column that causes lower back pain along with some arthritis.  I also have spondylolisthesis recently diagnosed early in 2005.  This is the term for a slipped vertebrae compressing on a nerve.  This added to my lower back pain, including right leg and foot pain.  I have been dealing with the discomfort through pain management, epidural steroid injections, orthotics, massages, ibuprofen and chiropractic treatments.  This was all done in my hometown.  After moving to Smithville [name of town changed] two years ago these treatments ceased and the pain worsened.

I then saw a neurosurgeon in Smithville. The surgeon said I needed a lumbar spinal fusion which would be done in a seven hour procedure.  Recovery would take 6 months, sometimes as much as 18 months before fusion is complete.  She told me I did not have much of a choice.  Was she wrong!  I sought a second opinion and was told I did not need an invasive surgery as she suggested.

I met Dr. A at the Women’s Expo in the fall of 2005.  I told him my tale of woe.  He did a computerized spinal exam, which showed my right side from neck to lower back was unbalanced.  He was very encouraging and seemed to know exactly what was giving me back pain.  I have been receiving treatments from him ever since until January 2006.  I am now on monthly maintenance treatments which I feel is very important to maintain my road to recovery.

I can now sleep through the night.  Being fairly active senior citizen.  I can resume most of the activities I enjoy doing, which improves my mental attitude. I am looking forward to summer gardening, playing with my grandchildren, golfing, hiking and more, all with less pain than before.

Thank you Dr. A for helping to improve my lifestyle and to enjoy life to the fullest.  Yoga, meditation, healthy eating and a positive mental attitude professed by you has influenced my life.  Your friendly and professional staff, A & K are a plus to your practice.  I am always greeted with a smile and genuine concern for my well being. Chiropractic is the way to go!
J. M.

(Individual results vary. These accounts were obtained without remuneration and within HIPAA guidelines.)

Chiropractic Business Development: Go Before You Know

As a chiropractor, you always have to know before you go. However, successful business leadership sometimes needs to act first and figure it out later. It all depends on which role needs to be fulfilled.

There are times when you should leap before you look.

As a chiropractor, you have a number of different roles. And for each role, there is a certain but different mindset that is most effective.

Your first role is that of doctor. The mindset and motto for this role is: Know Before You Go.

Each time you start a new case, you do your diagnosis to find what the best treatment program should be. You want to know what to do before you go with the treatment program.  And, at each visit, you briefly reassess the patient’s condition before you go ahead with that day’s treatment.

In your role of senior manager, you have a similar mindset. You assess the business situation, make plans to improve it, and then execute the action steps. Again: Know Before You Go.

The opposite seems to be true with entrepreneurial doctors that have successfully built their businesses. The lesson seems to be that, as a business owner, you need to have the inclination to GO before you KNOW.

Why is this?  Because we are all faced with degrees of procrastination, of fear, of “paralysis by analysis.”  Given any opportunity, many of us can find reasons to wait, do more planning, get more information, talk to more people, and just think about it some more.

Pretty soon, other issues come up and our planning gets bumped to handle new issues. In time, we have a garage full of uncompleted or never started practice building projects.  An attitude of going for it, without waiting for all conditions to be perfect, gets us out there promoting our services, telling our story, and serving more people.

Too many of us get ready, then aim, get more ready, aim some more, and never fire. On the other extreme, the successful entrepreneur often just fires. This can result in wasted money and time, but it does get the office moving and this is what leadership is all about. Hence, the sequence of fire, ready, aim.

Many chiropractic practices and businesses do suffer because the entrepreneur has never adopted systems of good management that stabilize the business so that it can grow. Their growth is stunted because of poor organization. We see this all the time.  But, that is the role of managing.

We also see the opposite: wonderful, skilled doctors, well organized, and broke. Or nearly so.

Successful business owners and entrepreneurs have a bias for action. This especially applies to marketing activities, but can apply to anything that improves your business. Marketing is a very broad category and covers everything from the services you provide to the way you promote them.

For example,  you can always improve the brochures and letters you send to your patients and community. And you should improve them. But no matter the quality, you need to get them out and distributed, not lying around in stacks on the top self in the storage closet.

When was the last time you painted your office, gave a lecture, did a screening, wrote a letter to the editor, set up a referral relationship with an MD, dentist, or car repair shop? The color of the paint, the content of your lecture, the location of your screening, the grammar in your letter, or what you say to the MD or business owner is secondary to just doing it.

As a doctor your have to know before you go. In practice management, you have to develop strategies based upon set policies and procedures. But as the business owner and leader, sometimes you need to just get going, and figure it out later.

Starting firing!

Health Observance Dates

The following dates are listed by various web sites as special times to observe a particular health related subject. Trade associations will designate a date where they can showcase their services. There may be other reasons for these “observances”, but promotion is certainly one of them.

These dates give you many new avenues in which you can promote your services. But, they won’t work by themselves. They are opportunities for creative, bright, and energetic health care promoters.

  • Give a workshop in your office on the theme. Do this workshop alone, or in conjunction with a local professional related to the subject.
  • Promote a special screening for the condition or theme.
  • Work with local related professionals or associates and schedule workshop or screenings outside of the office. You can do this with them, or for them.
  • Set up a donation program in conjunction with a particular theme.
  • Set up your own dates to observe a health condition, as many office that we work with do.

February

1-28 Heart Month
www.americanheart.org Participate in the local “Heart Walk.” Give your patients a free cap if they participate in the walk and bring in a friend for an exam and or massage. Donate the money paid to the local Heart Foundation.
1–28 AMD/Low Vision Awareness Month
www.preventblindness.org Set up a health fair with a local optometrist.

1– 28 Kids E.N.T. (Ears, Nose, Throat) Health Month
www.entnet.org/KidsENT Give a workshop on “Kid’s Care” with a nurse or M.D.

5 – 11 National Burn Awareness Week
www.shrinershq.org

7 – 14 Congenital Heart Defect Awareness Week
www.tchin.org/aware

14 VALENTINE’S DAY

11 – 18 Cardiac Rehabilitation Week
American Association of Cardiovascular and Pulmonary Rehabilitation
www.aacvpr.org

12 – 18 Children of Alcoholics Week
www.nacoa.org

17 National Women’s Heart Day
www.womansheartday.org

26 – March 4 National Eating Disorders Awareness Week
www.nationaleatingdisorders.org

March

1 – 31 National Nutrition Month
www.eatright.org

1 – 31 Workplace Eye Health and Safety Month
www.preventblindness.org

1 – 31 Save Your Vision Month
www.aoa.org

1 – 31 National Brain Injury Awareness Month
www.biausa.org

1 – 31 National Multiple Sclerosis Education and Awareness Month
www.msfocus.org

6 – 10 National School Breakfast Week
www.schoolnutrition.org

13 – 20 Multiple Sclerosis Awareness Week
www.nationalmssociety.org

13 – 19 Brain Awareness Week
www.dana.org/brainweek

17 St. Patrick’s Day
April

1 – 30 National Occupational Therapy Month
www.aota.org

1 – 30 National Humor Month
http://www.larrywilde.com/month.htm

1 – 30 National Youth Sports Safety Month
www.nyssf.org

1 – 30 Sports Eye Safety Month
www.aao.org

1 – 30 National Child Abuse Prevention Month
nccanch.acf.hhs.gov/topics/prevention/index.cfm

1 – 30 Foot Health Awareness Month
www.apma.org

3 – 7 National Youth Violence Prevention Week
National Association of Students Against Violence Everywhere
www.violencepreventionweek.org

7 World Health Day
www.who.int/world-health-day/

22 Earth Day
http://www.earthday.net/
22 – 29 National Infant Immunization Week
www.cdc.gov/nip/events/niiw/

29 – 30 2006 WalkAmerica
March of Dimes Birth Defects Foundation
www.walkamerica.org

30 – May 6 North American Occupational Safety and Health Week
www.asse.org/naosh

May

1-31 National Correct Posture Month
http://www.amerchiro.org/membership/cpm/index.shtml

1 – 31 National Osteoporosis Awareness and Prevention Month
www.nof.org

1 – 31 Older Americans Month
U.S. Administration on Aging
www.aoa.gov

1 – 31 Asthma and Allergy Awareness Month
www.aafa.org

1 – 31 Better Sleep Month
www.bettersleep.org

1 – 31 Healthy Vision Month
www.healthyvision2010.org/hvm/

1 – 31 National Physical Fitness and Sports Month
www.fitness.gov

1 – 31 National Bike Month
www.bikemonth.com

5 Cinco de Mayo
http://www.cincodemayo.net/english/other.shtml

May 1-7 Teacher Appreciation Week
http://www.nea.org/teacherday/index.html

6 – 13 National SAFE KIDS Week
www.safekids.org

12 Fibromyalgia Awareness Day
fmaware.org/may12.htm

14 Mother’s Day
14 – 20 National Women’s Health Week
www.womenshealth.gov

14 – 20 National Running and Fitness Week
American Running Association and American Medical Athletic Association
www.americanrunning.org

15 – 19 Bike to Work Week
www.biketoworkweek.com

15 National Women’s Check-up Day
www.womenshealth.gov

17 National Employee Health and Fitness Day
National Association for Health and Fitness
www.physicalfitness.org

25 National Missing Children’s Day
www.childfindofamerica.org

29 Memorial Day
http://www.usmemorialday.org/

31 World No Tobacco Day
www.wntd.org

June
June National Outdoors Month  http://www.greatoutdoorsmonth.org/

3-11 National Fishing Week

4 – 10 National Headache Awareness Week
National Headache Foundation
www.headaches.org

12 – 18 National Men’s Health Week
www.menshealthweek.org

18 Father’s Day

21 National ASK Day
PAX/Real Solutions to Gun Violence
www.AskingSavesKids.com

25 – July 1 Helen Keller Deaf – Blind Awareness Week
Helen Keller National Center for Deaf-Blind Youth and Adults
www.hknc.org

Improvement Goals Worksheet

You can use this worksheet to help you implement a process of continuous improvement in your clinic.

Today’s Date: Person in charge of meeting: Date of Next Meeting in 3 Months:
Clinic Areas for Possible Improvement Grade: 1- 10 Improvement Goals
Front Desk
Billing & Collections
Case Management
Internal Marketing
External Marketing
Staff Training & Education
Patient Education
Office/Clinic Appearance
Patient Service (Extraordinary, fast, friendly, etc.)
Wellness Practice
Office Volume
Speed of Service
Paperwork, Documentation
Clinical Enhancement
Other
Personal Areas for Possible Improvement Grade: 1- 10 Improvement Goals
Professional, Technical, or Job Skills
Health Care Education
Personal Health Program
Other areas:
Recreation
Family
Relationships
Savings
Study
Hobby
Spiritual
Other

Improvement Goals

It is not enough just to have goals.

It is a good start, but there is more.  In fact, just setting goals does not work. You have a staff meeting and decide that in the New Year you are going to see 400 Visits per week average and 30 new patients average.  Then you go back to work. That’s great, but it’s just not enough.  Plus, you have probably done this before so it becomes boring at best, or at worst, brings to mind past failures.

Just setting goals is lazy management. Like General Motors.

You have heard of them. They make cars, like Chevrolet, Cadillac, Buick, Pontiac, and the Hummer, to name a few.  Each year they set production quotas and they once dominated the world.   Over the years their market share has been shrinking, their stock has been shriveling, and they continue to close plants and lay off workers.

Toyota, on the other hand has been growing for decades and  is now predicted to overtake General Motors  as the number one car manufacturer in the world.

Kaizen

Toyota sets goals and quota’s, sure.  But they do something more. They set improvement goals and implement a process to reach these goals.  They call this process KAIZEN. It translates roughly as continuous improvement.

As a business, you either continue to improve, or you eventually die.  It is not enough to improve once every five years. It has to be continuous. You are either improving your clinic this year, or your patients may be drawn to an office that is. That is the way the market works.  You should review the level of your efficiency, patient care and service, promotion and public relations, patient education, and staff training and see if there is room for improvement.

You don’t have to make big improvements, but you have to constantly work on it.  It has to be a process or system of improvement, with incremental tweaks here and  there,  working out the bugs as you continue to grow.

Real business improvement also requires that each team member work on improving themselves personally.  Better health, greater fitness, more education, new hobbies, better relationships, etc., all add up to an improved team and an improved office.

Chiropractic is the improvement profession. This is an added benefit for anyone working in chiropractic because it supports constant professional and personal improvement.

There are many benefits that come from a process of constant improvement. And the consequences of not setting and working improvement goals? Ask a recently unemployed GM worker or stock holder.

Make the 2006 your Year of Improvement.

ACTION STEP. Have a staff meeting and make a list of at least 5 areas in your clinic that you want to improve on over the next three months. You can download a worksheet to help you do this (click here) .  Discuss each area with your staff, and assign each one a grade on a scale of 1-10. Set a goal to improve this part of your clinic in the next three months. Next, have each staff member and doctor do the same for 5 areas of their lives. Have them grade each area, and set an improvement goal for the next three months. The last step of the meeting would be to set a date for the next meeting, three months later.

Repeat this drill every three months for a twelve month period.

Get Outside to Promote in the Summer

It’s Summer. Get Outside!

Summer is a great time to promote your services.

Get a list of upcoming community events from the Chamber of Commerce and schedule a screening, talk, an information booth, your own participation, or just a visit. Be neighborly.

For example, local fairs or county fairs have been very good for special health screenings.  There is often a run or walk as part of a donation program during the summer months which you and your staff can participate in it. We have seen offices proudly wear their office t-shirts, and recruit many patients to do the same.

Screenings still work, but they have to be well organized. Most importantly, the people doing the screenings have to want to be there and have fun doing them.  Whether you do a screening, or run,  or just show up with your friendly conversation and cards, there are many summer events for you to get out and do some networking.

Here are just some of the benefits:

  • Meet new people who can eventually become new patients or new referral sources.
  • Meet active patients and strengthen your relationship with them in a different setting.
  • See inactive patients and reactive them, or encourage referrals from them.
  • Get out get some sun and have some fun!

Overcoming The Challenges of Chiropractic Patient Education in the Pharmaceutical Environment

You may not know the extent to which your patients are being influenced to subscribe to the pharmaceutical model of symptom relief, but it is enormous. This short article gives some tips on how and why to combat it with effective chiropractic patient education.

Every now and then we send out information about our colossal health care system and the vested interests that profit most from it.

Why? Because it is within this macro-system that your patients, and their M.D.’s, are being bombarded by a constant stream of propaganda about “health” care solutions.  It is good to know, and be reminded of,  what you are up against in promoting your own services.

Our health care system and culture are under an all out assault by drug companies to sell their products.  In 2003, roughly 15.7 billion was spent marketing drugs in the US, and this has been estimated to be increasing annually about 20% each year.1  Also in 2003, 4.8 billion dollars were spent in “detailing” physicians, which includes dropping off free samples at the doctor’s office, taking them to lunch, etc.  Drug reps meet with individual M.D.’s  an average of four times per month.2  Then, there is the estimated $750 million dollars drug companies have spent on lobbyists in the last 7 years to in influence Congress and Administration officials. 3

Why do they spend so much on marketing and lobbying? It pays. The pharmaceutical industry continues to be the most profitable US industry, with profit margins in the year 2000 nearly four times the average of Fortune 500 Companies.4

Driven by such marketing, “the value of the US pharmaceutical market is expected to top $330 billion in 2006…” “The US market will thus account for over 60% of the total Market Prognosis International market, up from 56% in 2001. US per capita expenditure on drugs will reach well over $1,000, which will be double the expenditure in Japan and three times that in the UK.” 5

Medical students, not yet caught up in the Medical-Pharmaceutical Complex, are protesting this kind of advertising.   The American Medical Student Association (AMSA), the nation’s largest, independent medical student organization adopted, a policy at its annual meeting condemning drug industry-sponsored advertising and supporting medical school curriculum that prohibits pharmaceutical industry representatives from marketing to medical students. 6

Excellent service and care to your patients is the first step to successful practice. Good internal organization that supports this comes next. And effective marketing, both internally and externally comes third.

We consider patient education part of your marketing efforts, though it also has its clinical role as well.   Marketing is especially important in chiropractic offices because of the leadership role you play in the health care system.  Chiropractors and their staffs have been at the vanguard in natural health care for over 100 years.

Patient education is most effective, we feel, if it comes from a larger understanding of the health care system your patients are in.  It works best when its mission is more than just to educate the patient, but to enlighten and motivate them into action. It has to counter the dominance of the medical-pharmaceutical forces bearing down on them.

The doctors we have seen who do the best at patient education have taken it on as a personal issue, as the medical students who protest drug reps. You and your staff have many opportunities to educate your patients: “table talk” in your adjusting rooms, in the reception area, during therapy, back care classes, report of findings, group report of findings, spinal care classes, newsletters, to name just a few. Pamphlets will help, but for it to be effective, it has to be personally driven by your passion and sense of leadership.

Once a month or so, we also recommend that you read an article or book relating to the this subject. The references below may be helpful in this regard.
1,2,3. New England Journal of Medicine, Meredith Rosenthal (www.therubins.com) 4. “Off the Charts: Pay, Profits and Spending by the Drug Companies”, a 38 page article found at  www.FamiliesUSA.org Click here to go to article.  5. IMS HEALTH is a supplier of market research to the global pharmaceutical industry. www.ims-global.com/index.html Click here to go to article.  6. American Medical Students Association (www.amsa.org/news/release2.cfm?id=223

Form For Collecting “Med Pay” From Auto Insurance Carrier For Chiropractic Services

IRREVOCABLE ASSIGNMENT AND INSTRUCTION
FOR DIRECT PAYMENT TO DOCTOR
PRIVATE AND AUTO ACCIDENT AND HEALTH INSURANCE

Date:
To: (Insurance Agent)
Street Address
City, State Zip

Cc: Twin Palms Chiropractic Office
333 Oren Avenue
So. Grover’s Corners, WI 12345

From: (Patient Name)
(Patient Home Address)                                                                   Cc: (Name of Attorney)
City, State Zip                                                                                     Attorney-at-Law
Street Address
City, State  Zip

Re: Auto Policy (Policy Number)

DOI: (Date of Injury)                                                                       Claim (Claim Number)

Attached Claims for Medical Services rendered by Twin Palms Chiropractic Office
To (Name of Insurance Agent) and (Name of Insurance Company),

I hereby direct and authorize you, as my Wisconsin automobile insurance carrier, to open a claim against the “medical payment” portion of my auto policy as I am entitled and to pay the reasonable medical claims incurred as a result of the accident of  (date of accident or injury).

As per my policy and Wisconsin Statute, I direct you to pay medical payments for me as the policy owner, passengers of the vehicle I was driving and members of my immediate household This extends to those involved in the accident of (date of accident) including myself and : ________________________________________________

I hereby instruct and direct my insurance company to pay by check made out and mailed to:

Twin Palms Chiropractic Office
333 Oren Avenue
So. Grover’s Corners, WI 12345

for the professional or medical expense benefits allowable, and otherwise payable to me under my current insurance policy as payment toward the total charges for professional services rendered. THIS IS A DIRECT ASSIGN-MENT OF MY RIGHTS AND BENEFITS UNDER THIS POLICY. This payment will not exceed my indebtedness to Twin Palms Chiropractic Office or John Smith, DC, and I have agreed to pay, in a current manner, any balance for professional service charges over and above this insurance payment. In consideration forTwin Palms Chiropractic Office billing for services and not collecting from me at time of service, I understand that this authorization and direction is irrevocable for the accident of (date of accident). A photocopy of this Assignment shall be considered as effective and valid as the original.

I am aware that there may be other liable parties or insurers involved with this accident. Under Wisconsin Statute Ins 6.11, Section (3) Unfair Claims Settlement Practices, Subsection (a) 9, I am using the available medical payments portion of my auto insurance policy to pay for medically necessary care rendered by this clinic.

I also authorize the release of any information pertinent to my case to any insurance company, adjuster, or attorney involved in this case.

_________________________________________________  ____________________________________
Patient’s Signature       Date

Patient Retention: Form for Determining Percent of New Patients Still Active After 3 Months

Percent of NP’s Still Active After 3 Months

Number of NPs NPs from three months ago still active Percentage
October January
November February
December March
January April
February May
March June
April July
May August
June September
July October
August November
September December
Total Total

EXAMPLE:

Percentage: NPs Still Active/NPs from three months ago = x 100.
Example: March 25 NPs still active from Dec. / December there were 30 NPs = 25/30= .833.
.833x 100 = 83.3%

Percent of NPs Still Active After 3 Months

Number of NPs NPs from three months ago still active Percentage
October January
November February
December 30 March 25 83%
January April
February May
March June
April July
May August
June September
July October
August November
September December
Total Total

The Future of Chiropractic and What You Should You Do About It

THE FUTURE OF CHIROPRACTIC AND WHAT YOU SHOULD DO ABOUT IT NOW

Forecasted Supply of Selected Chiropractic Competitors

2002 2012 Percent Change

2002 2012 Percent Change
Doctors of Chiropractic 61,000 70,000 15%
Physical Therapists 137,000 185,000 35%
Massage Therapists 92,000 117,000 27%
Acupuncturists 15,000 27,000 77%

Sources: Physical massage therapist numbers from the Bureau of Labor Statistics: Occupational Employment Projections to 2012. DC numbers and projects based on active non-redundant licenses. For further reference, BLS projections for chiropractors are 49,000 in 2002 and 60,000 in 2012. Projections for Acupuncturists are derived from Richard Cooper’s projections for acupuncturists from 2002 to 2015.

The above table was part of a new report predicting the future of chiropractic. Just published by the Institute for Alternative Futures, it offers 4 different scenarios by the year 2015, and recommends strategies doctors can take now to be prepared for the opportunities and challenges that await.

Their recommendations include the following:

  • Continue to strive for high standards of practice. “Empowered consumers and managed care plans will want to know more about what results to expect from your office.”

Some Marketing Action Steps: Provide Extra-ordinary service, and promote the results from outcome studies and patient surveys.

  • Develop greater integration with mainstream health care.

Some Marketing Action Steps: Work on and set up referrals sources, or alliances, with other doctors. Take advantage of recent opportunities with the VA and DoD. Provide pro-bono care in free clinics with other providers.

  • Anticipate and engage in consumer-directed care.

Some Marketing Action Steps: Look at your clinic as a retail business. Promote and advertise your good and effective work.

  • Prepare for the Future of Prevention & Wellness. One of the projected scenarios forecasts a “healthy life doctor”. “No aspect of health care has invented the business model for prevention and wellness. Chiropractors argue that they are closer to it than others and some (but only some) chiropractors do practice prevention.”

Some Marketing Action Steps:  This is called “positioning” in marketing, and is a topic we will take up in more detail in upcoming newsletters. Medical doctors are NOT “Healthy Life Doctors”. People want health; just look at the number of books on the subject in any bookstore. This is the niche that chiropractors are in, and the sooner and more completely you own this area, the better. We believe that this is part of the new model for chiropractic, one that incorporates fitness, nutrition, and works with medicine as needed, yet retains its heritage, core services and principles. Do not make the mistake of abandoning “pain relief” as a major benefit of your services, just incorporate it into this model. Promote yourself as a “Health Doctor”, and provide services that are consistent with this concept.

  • Develop Geriatric Chiropractic. “One of the largest growth areas in healthcare will be geriatrics. The retiring Baby Boomers will look for alternative medicine that can help them to remain active and healthy.”

Some Marketing Action Steps: Promote yourself as a “Health Doctor”. Provide classes specifically for your elderly. For example: “Weekend Warriors: How To Maintain Your Knees And Shoulders Past The Age Of  50 Without Using Drugs Or Surgery.” Provide classes outside of your office to the elderly.

  • A Group Practice. Though not specifically recommended, this subject is referred to in their report. Most chiropractors are still solo. By practicing in a group you have more opportunities to fulfill the above recommendations and action steps. Associate doctor programs, partnership programs, multi-doctor, location, and discipline, we specialize in building and helping to susatain a prosperous group practice.

For help on implementing any of these recommendations, please drop us an email.

A very interesting article which you can find in full at: http://www.altfutures.com./

Spring Flower Seed Promotion

Flower Seed Promotion

A fun internal promotion is the Flower Seed Promotion used to generate patient referrals.

Spring is a happy time of year. Flowers bloom, life is renewed, and the activities of summer await.

Using this theme, you can encourage your patients to help their family and friends get in shape for summer recreation.

Attach a coupon to a package of flower seeds. You can attach the coupon with glue, a stapler, or plastic tape. Then, attach about 5 of these seed packages a poster. An example is below.

Spring Flower Seed Promotion

The coupon offers a free consultation, and exam, or screening, and or initial x-rays, and or 10 minute massage, and or flexibility testing, etc. Whatever you want to offer as a free health oriented service to the families and friends of your patients.

You may also want to place some of these posters around town, such as in laundromats, bookstores, etc. An example of the text for the coupon is below.

Valuable Coupon

To help you get healthier we are giving you a complete health examination and consultation all at NO-CHARGE!

(Please pass this offer along to a friend or family member if you are unable to use this valuable coupon.)

Please call us at (123) 456-7890 to schedule your appointment.

Offer good for anyone who hasn’t been in since 1/1/99 – Expires 5/14/99

name of office
location

(For active clients and member’s, a customizable version of this poster is available on  your  Member’s site.)

For more information about the Marketing Manager System interactive computer CD, click here.

(As with all promotions, be sure that you are in compliance with federal and state statutes.)

Monthly Marketing Managment Duties

Monthly Marketing Management and Coordinating Duties
[Note: This article has a special introduction from Marge, the practice marketing manager and coordinator who is featured in the Marketing Manager System Interanctive CD. For more information about this powerful marketing tool for chiropractors and their staff, click here.]

Marge, your Practice Marketing Manager

Greetings!  Good job for making it through the month! I am sure that you and the entire team accomplished a great deal.

Here are your monthly duties. They include limited planning, and mostly coordinating ongoing activities. The planning we will do will be mostly special promotions, direct marketing projects that need specific scheduling. We won’t even question the recurring activities until the 3-month meeting. So, let’s take a look at how we did.

___1. Statistics. Get month ending statistics for “new patients” and “office visits”, and any other statistics that you are using.

___2. Sources. If available, determine the source of the new patients, which should be logged in your computer, or on the “New Patient Log” and “New Patient Tracker.”

___3. Planner/Calendar. Review the marketing planner or calendar, and check how each scheduled project for the past month did. Note if it was done, and if so, how effective the project was. Get the numbers if you can.

___4. Proposal and Plan. Work out a tentative plan of future scheduled activities as a proposal in preparation to the meeting with your doctor.

___5. Coordination Meeting. Meet with the clinic director and go over with him or her: a) what you have discovered about how the past marketing has been working and b) your proposed plan for the future. Incorporate her or his ideas and add to, revise, and or continue scheduled activities on your planner/calendar.  This is a brief planning for the next 3-6 months and should last about an hour.

___6.  Next Meetings. Reconfirm your next month’s meeting and your 3-month meeting.

___7. Goals. Set monthly goals for total new patients and visits at a staff meeting or with your doctor at this meeting.

___8. Coordination. Spend time to ensure that all projects are coordinated with all areas of the office, and any outside vendors or contacts.

____9. Publish Calendar. Print the calendar and post it on a bulletin board for the rest of the staff to review.

Fast Tips V: The Road To Wellness, Personal Demand, Patient Referrals

Getting Patients to Wellness You will get more of your patients on to Wellness Care if you ensure that each step of their treatment program is executed completely.  Here is a simple exercise that can help improve the number of patients you have on Wellness Care, increase referrals, and enhance teamwork:Make a list of all the important procedures by you and your staff on key patient visits, such as Day 1, Day 2,  Re-Evaluation Visit, Regular Visit, Transition to Wellness Care Visit, Wellness Visit,  etc.   This would include a thorough report of findings, a financial consultation, patient education during each visit, possibly a 6th visit micro-report, re-eval. after 12th visit, etc. Review and adjust this checklist regularly with doctors and staff against every 10th patient for quality case management.Many of your retention problems can be traced back to shortcutting of your own successful procedures. Making a list of all of your patient procedures from acute care to wellness care, and then ensuring that you and your staff actually DO each procedure, will greatly improve the number of patients you can get to wellness.  For more information, click here.

Demand. A vital element to practice success is the use of “demand.” This is such an obvious ingredient that it is easily overlooked.What is demand? Webster defines it as: “to ask or call for with authority:…or insistently”.   Having a dream, a goal, or a promotional plan is useless without the self-discipline to activate it. You have to demand action – from yourself, your staff, and your patients.  And it has to be positive. Set short term and realistic goals and practical plans. Then, be unrelenting and insistent, accepting no excuse until you achieve your objectives.Interestingly enough, done correctly, your staff and patients will respect you more for it.

Don’t Ask Your Patients For Referrals. Don’t ask your patients for referrals. Tell them. Don’t beat around the bush and ask for permission.  You don’t need approval to do this, or a license: you already have one. You are the doctor, and you have a responsibility and a  mission. Most people just don’t know about chiropractic, or your specialized services.Timing, however, is important. Ensure the patient is appreciative of your care. Ideally, the she or he has mentioned something about a relative or friend, but this is not necessarily.  Example:  “Mrs. Jones, I would like you to bring your husband in so I could check his back.” Be direct and friendly.  Done correctly, patients interpret your directness as honesty and genuine care, and often comply.

On the Road to Wellness. Retaining Patients by Using a Patient Progress Sheet

On the Road to Wellness.

Patient Retention: How to use the Patient Progress Sheet

The patient progress sheet is a checklist of basic administrative and clinical actions that need to occur for every patient to ensure that each patient receives complete care. On occasion, unimportant activities can be dropped out which can negatively effect the total quality of patient care, resulting in patients dropping out of care.  By following this patient progress sheet, the doctor can ensure that all of the necessary actions on each patient occur.

The patient progress sheet should be kept in the patient folder, either as a full sheet of paper, or as sticky pad attached on the inside front cover. Each doctor’s office can determine what is most appropriate for his or her particular situation. A staff member can be assigned this duty to make sure that each Patient Progress sheet gets completed.

Example

Date                               Initial Procedure

__________ ____ Initial Paperwork
__________ ____ Pre-Consultation Video
__________ ____ Pre-Consultation
__________ ____ Consultation
__________ ____ Initial Exam
__________ ____ First Financial Consultation
__________ ____ X-Ray
__________ ____ Other Diagnostic Tests
__________ ____ Initial Payment
__________ ____ Scheduled for Second Visit

__________ ____ Pre-Report Video
__________ ____ Second Visit Report of Findings
__________ ____ Written Report of Findings
__________ ____ Second Financial Consultation
__________ ____ New Patient Orientation/Spinal Care Class
__________ ____ Multiple Appointment Plan Scheduled in Appointment Book
__________ ____ Scheduled for New Patient Workshop
__________ ____ Attended New Patient Workshop

__________ ____ Received Pamphlets During Care on visits:
__________ ____  4.   __________ ____ 8.   __________ ____ 14.
__________ ____ 16.  __________ ____ 20.  __________ ____ 24.
__________ ____ Was Educated by Doctor
__________ ____ First Re-Exam
__________ ____ First Re-Report
__________ ____ Follow Up Financial Consultation
__________ ____ Second Re-Exam
__________ ____ Second Re-Report
__________ ____ Second FC-3
__________ ____ Third Re-Exam
__________ ____ Third Re-Report
__________ ____ Third FC-3
__________ ____ Fourth Re-Exam
__________ ____ Fourth Re-Report
__________ ____ Fourth FC-3
__________ ____ Re-Exam
__________ ____ Transitional Report of Findings
__________ ____ Transitional Financial Consultation
__________ ____ Released from Active Care
__________ ____ Started Wellness Program

Patient Birthday Cards

Sending birthday cards to your patients is a nice thing to do. You probably like to receive them on your birthday day.

But besides being a nice thing to do, the birthday card helps maintain the relationship with your patient.  It can also be used to reactivate inactive patients, as well as help generate referrals.

Procedure

  1. Order the birthday cards. These can be postcards, or, preferably, real birthday cards from the store or from a chiropractic supplier. See if you can get your office name embossed on the card.  Post cards do not have the same impact as a real card, but are less expensive, fast, and nearly as effective.
  2. The List.  On the 15th of each month, generate a list of all upcoming birthdays for the following month.
  3. Review. Review this list and delete any names that you do not want to send a card to.
  4. Address. Have one of your staff address all the envelopes and place them in your room with the cards included.
  5. Sign Each Card. Sign each card personally in blue ink, and add a note where appropriate.
  6. Optional Certificate: Add a coupon for a free adjustment, or a discount on a service or product, but only if they come in during the next two weeks. If you offer a free adjustment, you may want to mention that they may need an updated exam and x-ray that is not part of the offer. However, you can also make it part of the offer if you want. You can also include a “Guest Pass” a friend or relative.
    You may want to mention that this offer is good for all patients and their friends, but due to Medicare restrictions, Medicare patients may only receive the free massage.
  7. Offers. Here are some examples of offers:
    Free adjustment
    Free adjustment and 10 minute massage
    15 minute massage and examination (for guest or patient)
  8. When the Patient Comes In. When the patient comes in for their service, you should do an initial consultation to ensure that they have not had any new injuries, etc.
  9. After the Service. After the patient receives the service, provide them with a mini-report of findings and give them your recommendation for continued care.
  10. Delegate. Delegate this program to one staff member. She should keep monthly stats and report these to you, including:
    # BD cards sent
    # Patients in off of BD cards
    # Patients reactivating from BD visits
    # Patient referrals from BD “Guess Passes”