Category Archives: Doctor Procedures

The Chiropractor Versus the Chiropractic CEO

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There is a constant struggle in your office.

It is a battle between you as the doctor and you as the CEO.

As the CEO, you want to grow your business. You want it to be profitable, smooth running, and systematized.  You want it to be efficient and providing excellent service.

As the doctor, you want to focus on each patient and their unique treatment program. You really could care less about administrative concerns as these are usually just distractions to your patient care.

Who wins this war between the doctor and the executive manager?

Unfortunately, in most cases, no one.  Usually, the doctor’s duties blend in with the executive duties and the services get watered down and the growth of the office never reaches its full potential.

Without a doubt, the biggest dilemma in practice management is just this:

How can you be the best doctor you can be
and also run your office?
If you had the time (and perhaps the training, but that too just takes more time!) you could take your business to the next level.  But there just isn’t the time. You are too busy as it is.

This was the theme of Gerber’s book, the E-Myth, wasn’t it?

You know you should “systematize” your office procedures, but that still takes time. And maybe this systematizing stuff hasn’t worked all that well for you.

It comes down to roles: how can you be a compassionate and dedicated doctor while at the same time being the CEO of a growing small business?

This Thursday, October 18, 12:30 pm Central to 1:20, we will show you how –

Learn how you can, in 5 hours or less each month:

*  Drive your business to the next level
*  Improve communication with team members
*  Help each staff member be more goal oriented
*  Help create a stronger team that is more goal oriented
*  Have more fun in practice
*  Achieve more of your clinic goals

As the doctor, you are taught patient management procedures. You need them and patients benefit from them.

But as a business owner, you also need practice management procedures. Done properly done, your business will benefit.

We will show you how to do it in just over 1 hour per week, on average.

You won’t find this anywhere else. (Hype alert.) This is a culmination of our Marketing Manager System (2001), 3 Goals Management System (2008), and three other management systems which we have incorporated into our consulting over the last 25 years.

Because we feel this process is so important for your practice, we are waiving the fee for this webinar.

That’s right, this is one is FREE. It should be three times the usual price but we want to get it out to you now and fast. We want to help you get a head start on 2013.

But you have to register, so go HERE to do so.

Best regards,
Ed

PS This webinar is for doctor owners only and the office manager or administrative/office coordinator.

 

Chiropractor to Chiropractor: Reclaim the Joy of Practice

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Being a chiropractor can be a lonely job.

Who knows what it is like to adjust patients late in the afternoon while one patient is going on and on and the next one is dirty from work and smells?  And yet another just called in who has been under care for two weeks and is in pain and wants to be seen right away – who knows what that is like?

Someone who has been there and done that – another doctor.

You aren’t looking for advice, that can wait. You don’t need a lecture.  It would just be good to talk with someone who has been there before and survived, or better, thrived.

Let me introduce Dr. Tom Potisk.  He is not the overbearing charming salesman type of a doctor that you often see in consulting programs.   Actually, not too many doctors are really like that.  In fact, most doctors are very similar to Dr. Tom.

Dr. Tom and Dave, Phyllis and myself have been discussing an additional ingredient to practice success that that we feel doctors need. Simply, another doctor to talk to.  They have us, of course. But we are managers and marketers and practice builders.  That is our specialty.  And we too have been there and done that, since the 1980’s.  But as managers – not as doctors.

We feel doctors need both for practice success: a professional manager to help build a profitable and self sustaining business AND the support and perspective of a professional, experienced chiropractor.

So we are very happy to partner with Dr. Tom Potisk in providing services to our wonderful wonderful clients.

We are pleased to announce that Dr. Tom will be giving a number of presentations at our upcoming seminars this year.  One of the classes will be on Doctor to Doctor: Reclaiming the Joy of Practice.  This is his basic theme: how, as a doctor, you can truly enjoy each day doing what you do as a doctor.  His approach is simply – doctor to doctor. Not as a coach, but as a fellow doctor who has been through what you are going through and made it to the other side – very successfully.

Listen to this his first teleclass you – you will find it very motivating and reassuring.

Hope to “see” you there,

Ed

Here is what others have said who have listed to his full presentation:

“Dr. Tom’s program was fantastic! I laughed, I cried, and I went back to my practice with a new, deeper sense of dedication and confidence. All DCs need to hear his message!” – Dr. Donna Stackpool, Lake Geneva WI

“Reclaim the Joy of Practice was an amazing presentation!  Dr. Potisk made the evening fun and enlightening with great tips on how to stay happy and truly enjoy Chiropractic.  I loved the history references with BJ.  It was a great reminder of how generations past fought for Chiropractic and how we need to honor them and the profession AND continue the passion.  Thanks Dr. Potisk for lighting the fire again!” – Tara Gill DC, Delevan WI

“After nearly 40 years of practice, I thought I heard the last of the great, authentic, and sincere chiropractic programs years ago; then along comes Dr. Tom Potisk with his Reclaim the Joy of Practice presentation. He brought me right back to what I remembered as the good-ole-days with an adjustment between my ears. High pi Dr. Tom !”  – Jerry Zelm DC, Oconomowoc WI

And you can read more about Dr. Tom Potisk here.

Asking Permission, Gaining Respect

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By Dr. Tom Potisk

Doctors of chiropractic appreciate respect as do patients. When a doctor acknowledges and recognizes that the patient may have limited time and money, a mutual respect develops and the situation becomes win-win. For example, when making a recommendation to a patient, ask “May I explain the tests that need to be performed today?”, and then “These will take approximately ____ minutes. Do you have time today?”

After explaining the results, a good follow up is: “Are you ready to start treatment today?” Then explain the treatment.

Far too often doctors get into a routine and they begin to assume that the patient wants what you’re about to perform. Asking their permission to proceed not only relaxes the patient but lowers your liability because you’ve gotten their consent.

Never assume that permission has already been obtained by staff. Ask “Has the receptionist explained our procedures and policies?”

For gaining referrals, avoid the harsh “Bring in your spouse and child for a spinal exam.” Instead ask, “Many of my patients bring their family here for preventive check-ups. Would you be interested in how that works?” The best time to ask this is when the patient has praised your treatment. As Doctor Sid Williams says, “Breed them while they’re in heat!”

For building a wellness care practice, a great question is “If there were a way of preventing this problem from reoccurring and avoiding new problems would you be interested?”

At the end of your practice day, reflect upon it and take notice of how many times you asked questions versus issued advice and orders. The ratio should be about 50:50. Don’t be afraid to ask your staff for their perspective of your performance. They are your best source of input and will feel honored by your inquiry.

In this era of managed health care and busy lifestyles, asking for the patient’s permission goes a long way in gaining their respect and building a joy filled successful practice.

Dr. Tom Potisk has been a client of PM&A for nearly all of his 25 year multi-doctor practice. He now works with PM&A and is soon publishing a book titled Reclaim The Joy Of Practice.

Chiropractor: Are You a D.C. or a D. S.?

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Whether you are a D.C. or a D.S. makes a big difference in your patient retention and patient referrals.

Many years ago we were working with a chiropractor who, while he had a great practice, couldn’t manage it worth a damn.  Even so, because his patient retention and patient referrals were exceptional, he had a high volume practice.

As we worked with him to improve and expand his business structure, his volume continued to increase. This was a while back; when note taking was very simple, but I think he got up to seeing around 500 visits a week, with peak weeks over 600. We helped with marketing and associate doctors, and he continued to grow. He had all kinds of marketing programs, plenty of associates, and made a great name for chiropractic.  But at the heart of his growth was a special secret he often related.

What was his secret?

Well, one of them was the way he started each case.  On his initial consultation with each patient he would say:

“Before I tell you what chiropractic does, let me tell you what it doesn’t do. As doctors of chiropractic, we do not prescribe drugs.  (Pause.) We also do not perform surgery. (Pause.) Lastly, we do not treat symptoms.” (Long pause.)

He would let that sink in for a few moments. He would then briefly explain what chiropractors were really after.  Namely, subluxations. And while there may be other terms for this condition, from a marketing point of view, this has worked. It fixes in the mind of the patient that there is an underlying cause or a basic contributing factor that resulted in, or at least affected their current complaint(s).

Over the years of consulting, we routinely see doctors “going shallow”, treating only the superficial symptoms that patients come in with. “Hey doc., I must got a crick in my back. Can you just give me a crack here (points) and fix it?”  Horror of horrors!

It is easy to focus only on the symptoms.  First, it is the reason why the majority of your patients come to see you.  They have pain, stiffness, or discomfort and want it fixed.  Second, it is what your insurance company requires in your documentation.  Third, it is the path of least resistance. Give the patient some relief and then move on.  Fourth, chiropractic is usually SO effective with symptoms relatively quickly, that we often are just happy with that.

I am certainly not advocating any particularly type of treatment guideline.  I am just pointing out that many successful chiropractors look for earlier traumas in their consultation and history and maybe spend just a bit more time on the general diagnostic process, if only a minute more.

This is from a marketing point of view, not from a clinical perspective. In these times of higher deductibles, you have to put the value into your service.  If a patient comes to you for a pain in the “keister”, and you only address that, not only is the patient being the doctor, but also you are relegated to “therapist.”

Another doctor David and I worked with had a practice “melt down” one winter day. (By the way, we see these “melt-downs” every now and then! Too much insurance B.S., mid-life burnout, staff problems, etc. Please call us if you feel one coming on!)  He was mostly a “straight” doctor, but had purchased a very inexpensive, used EMS (muscle stim.) unit for patients.  One day, one of his patients came for his adjustment. He told the doctor that he didn’t want adjustments anymore, just wanted some of that electronic muscle stimulation.   Our doctor blew a fuse. “Fine”, he said. “Here, take the dang machine and go home. You can have it.” And he actually gave it to him.

A bit extreme, but it was probably good to get it out of his system. The doctor was feeling that he had become only a band-aid therapist for his patients because of the therapy unit. It took a while, but we got him to see that it was not the patient’s fault. The patient simply did not understand the purpose of the doctor’s treatment program.

D.C. could be called Doctor of “Chronicity.” I was reminded of this recently by one of our clients.  D.S. could be “Doctor of Symptoms.”

We suggest the following:

1.    Be a D.C. Doctors who emphasize the chronic nature of the patient’s symptoms seem to have busier practices.  We suggest that you should do both:  definitely help patients get what they want – pain relief.  But, as appropriate, work with them to get what they really need.

As a side note, some doctors can become so philosophical that they loose touch with the fact that “the Customer is King.” (In Japan, I have read they say that the “Customer is God.”) Philosophy, principles, and emphasizing the chronic nature, as indicated, is fine.  So is “Wellness.” Just remember that you have to also give the patients what they want and keep them happy.

2.    Integrity. Needless to say, in all things you have to call it like you see it and maintain your integrity. If there are no chronic conditions, then so be it. But at least, take the time to look.  Be curious, investigate, and don’t let the insurance company or the patient’s desire for fast results compromise your clinical integrity.

3.    Interest. Traumas may have occurred many years earlier, or accumulated over the years.  Be genuinely interested and focused on their case. Even intense about what you discover in their exam and x-ray and how you explain it. “Would you look at this, Mrs. Jones”, pointing to a spot on the x-ray as if this was the first x-ray you had seen of this kind before. (And it is.)  This will increase the patient’s confidence in you and acceptance of your treatment plan.

4.    Time, Repetition, Effort. It may take time to correct the condition. It may take repetitive visits (like an orthodontist), and it will take effort on the patient’s part as well as yours.

Go over the factors of time, repetition, and effort with the patient. You can also ask the patient how long do they think it will take to correct the condition.   If you have educated them on the true nature of the condition, you might be surprised to hear that they often offer a longer period of time than you were ready to present to them in your treatment program. (A very successful doctor recently reminded me of this.)

5.    You Are, And Have Been, A Leader. And finally, don’t sell yourself short. As a chiropractor, you are an active member in a profession that, no doubt, has led the way in real health care over the last 100 years.  Certainly, it will continue to do so in the future, provided that you stick to your guns, while always adapting to the ever-changing market.

By looking for and working to correct the long term causes of spinal related symptoms, you will inspire trust and confidence in your patients as their doctor of chiropractic, coach, and friend. As such, your patients will be loyal and refer their friends because of your care. And, as such, you will be a D.C.

Ed Petty

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

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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