Why You Shouldn’t Have Promotions

Posted on September 25, 2012 by Edward Petty

As a chiropractor, there are many reasons why you shouldn’t have practice promotions.

Hundreds. You can come up with 10 right now. Your staff could think of more. So could your family!

Most of them would have something to do with not enough time to do them, or too much of a hassle, or it might cost too much. Then, there is also: not sure if they would work, or what do we do and how do we do it? Maybe you are really too frightened, embarrassed, or burned out to promote.

Now, you could say: “Hey, I already have more patients than I can see.”

Yes, maybe you could. But then you would have to ask yourself: “is everyone in my town getting proper chiropractic and natural health care?” “Is anyone in my neighborhood receiving unnecessary drugs, surgery?”

On the other hand there are only a few reasons you would want to have practice promotions. These would include:

Help more people
Fill up your office
Make more money
Make your services and those of chiropractic more popular

In terms of traffic lights, promotions are GREEN.

In your office, what light is flashing? Yellow, red, or green?

Green means GO! Promotion = pro + motion. The word comes from “forward motion.”

Ultimately, there are three basic reasons for not promoting:

3. Not knowing what or how
2. Lacking the motivation
1. Lacking the organization

In our upcoming webinar, we cover the what and the how and the why to get your promotions going, fill up your office, increase your revenue, and make your services more popular.

Hope to see you there.

Best regards,

10 Strategies for Improving Patient Retention

Posted on September 13, 2012 by Edward Petty

In our recent webinar on patient retention, we reviewed basic procedures that can be used to decrease patient drop outs.

More significantly, we looked at a new or model for practice retention that many businesses are now using successfully.

If your visit average is less than 60, then you can benefit from the material we covered.

The old approach to patient retention is focused around patient control procedures designed to “plug up” the “leaky bucket.” These still work and we covered some of the more effective procedures.

But this approach tends to address the symptoms more than the causes. A more effective approach is focuses on teamwork.

Patients, like customers, want two things: results and a “good feeling.” The “good feeling” is a product of how much each doctor and staff member genuinely cares about that patient at the time he or she is interacting with that patient. Patients will even tend to stay with a doctor and a practice if their results are not satisfying IF the service is extraordinary.

An effective method of improving patient retention includes role playing the “moments of truth” each team member has with patients. These include phone and walk-in greetings from the front desk, patient encounters with the doctor, therapist, and with the billing department for financial consultations.

Here are ten strategies you can put into place to keep your chiropractic patients coming back.

10 Strategies To Improve Patient Retention

__1. Love The Services You Provide. If you don’t love what you do, how can you expect your patients to? People buy based upon confidence – and if don’t have faith, confidence and love for your services, your patients won’t either and they won’t come back. (They won’t refer either.)

__2. Love Your Patients. People can tell if you are being real, or just reading a script. You see it when you go to the chain stores and the checkout clerk says “hello”, or “have a nice day.” They say the words, but it isn’t genuine. They just don’t care. Practice and improve these “moments of truth.”

__3. Their Goals. Be goal oriented with your patients. Get them to set and commit to a goal for improving their health. Keep them recommitting.

__4. Coaching Patients. Once you have their commitment, you now can use your patient control techniques. The webinar included a short presentation on an effective patient recall system used many years by Linda Skiles, former Chiropractic Assistant of the year in WI. The forms discussed in the webinar are located on our PM&A members site.

__5. Education to Make Your Patients Self-Motivated. Would you as a chiropractor, or experienced chiropractic team member, stop getting adjusted? Of course not. And why not? Because you know it how important adjustments are to maintaining your health. You have been educated.

__6. Help With Finances. Third party pay is confusing. Financial concerns can be embarrassing for your patients. Providing friendly and easy access to personal help in working out paying for their services can assist keeping your patients coming back.

__7. Stand for Something. Your mission has to extend beyond relieving pain, just like Apple goes beyond computers or Starbucks beyond coffee. If you honestly embrace a greater purpose, your patients will see why you do what you do, not just how you do it. They will want to support that purpose as well by getting adjusted regularly

__8. Family. People like to belong to communities. We like to have friends. Some offices call their patients “Practice Members”, while others have “wellness clubs”, and advisory committees. However you do it, your patients should feel like they are part of your inside circle.

__9. Measure, review, improve. Constantly work on improving your service. That which you don’t improve upon eventually atrophies.

__10. Take care of each other. We spent a lot of time on this one, but need to spend more. One of our webinars later this year will zero in on how this action helps create a winning team.

As it turns out, the way you treat each other is the way you will treat your patients.

The webinar is located on our PM&A members site now. PM&A Members: Marketing Training/ Patient Retention

[Download version of this file for your staff meetings and reference: 10 Strategies for Patient Retention. ]

Chiropractic Spinal Screenings as an Educational Process

Posted on May 7, 2012 by Edward Petty

How to Generate New Patients from Chiropractic Health Screenings

For health and marketing purposes, a screening is a step by step process of first discovering if a person might have a problem or condition that may need further looking in to. If there any indication of a possible spinal related problem or condition, the screening is there to also help the person become more aware of their health condition so that they want to do something about it.

It can be done at any type of a venue, from a health fair to a casual meeting.

It is a sequence of actions that that ultimately ends in the “screenee” making an appointment to come in for no risk introductory service, such as further testing or a workshop.

The example below, taken from our PM&A webinar on screenings from 2012, shows the steps taken during a screening. It is important that each step is taken sufficiently in order for an appointment to be made.

Screening Steps

The actual screening itself is a process of enlightening a person so that they see that they might have a spinal related condition, if indicated, and if so, realize how it might affect them. Also, if left untreated, what the long term affects might be.

They are now ready to be encouraged that they really should do something to address the problem, no matter what! Offering them an introductory service as a no risk beginning solution now helps them “solve” their ethical dilemma of just what should they do about their condition. This could be a service at your office, or with another provider at another location. Your professional integrity should always be maintained.

There are three general types of “screenees”: roughly 80% or so are not ready to get help with any health conditions, 15% or so are almost ready, and about 5% are ready to do something. Your target is to work with the 5% that are ready. You may be able to influence some of the 15% that are almost ready, depending on your skill in screening. And with your professional and friendly presence, in the long term, you can also influence some of the 80% that are not and may never be ready to see you, but do have families and friends that they are now more likely to support seeing you because of their good experience with you at the screening.

Below are 6 simple steps that can be remembered and used. It is also a good idea to practice these to improve your skill and to train new Screening Technicians.

For more information, please watch or listen to the Fundamentals of Effective Screening Procedures on our PMA Members site from April 19, 2012.

The Art of the “Screen”

Find Out More – about the condition.
Find Out the Affects – of the condition.
Look at the Future – of the condition.
Do something — about the condition.
Offer a something to do – about the condition
Appointment for something to do – for the condition.

More
Affects
Future

Do
Offer
Appointment

*Screenings are always the responsibility of the doctor and conducted in accordance with local statutes and professional standards.

He Fired the Office Manager

Posted on April 18, 2012 by Edward Petty

A few months ago a chiropractic office manager called me. She said that her doctor had fired her.

Her primary role had been that of Billing and Collections Coordinator, but she was also the office manager part time. I had worked with the office for a few months and knew the doctor and Dorothy (not necessarily her real name.) I had gone over the role of the Office Manager with her and the doctor. They both felt that they understood the situation and would let me know if they ever needed any help. I was pretty certain they didn’t know what their roles were, or how to execute them, but their minds were made up.

Months went by and then late one Monday morning I got a call from Dorothy. She told me she had been fired. I asked her why? (Knowing her and the doctor, I had a pretty good idea.) She told me that the number of new patients had been dropping for some months and that the doctor was not happy about this.

She said that she couldn’t believe it. “He fired me for that? I am not even in charge of new patients?” She was upset and went on about how new patients weren’t her responsibility.

What do you think? Was she right? Or, was the doctor right?

Let’s look at this: the doctor is ultimately in charge of marketing. As the Chief Executive Officer for the business, marketing is a key component of his or her job. But since he is also so busy as a doctor, he needs to delegate most of the marketing activities. But to whom?

First, to all of the staff. It is each team member’s responsibility to “sell health.”
Then, a staff member could help coordinate all the marketing activities as a Marketing Coordinator or Marketing Manager.
You might also delegate different marketing activities to different staff: someone for external events and screenings, someone for the internet, etc.

But behind it all, is the Office Manager’s role to make sure everything is running smoothly.

Actually, no one should have been fired. Instead, they all should have been trained on marketing and especially on MARKETING MANAGEMENT.

This is one of the reasons for our monthly webinars. We just completed a very informative webinar on the key duties of the office manager (now posted on our members site) which can help clarify the role of the office manager.

The purpose of business is to create a customer, patient, and practice member. I didn’t say that. Peter Drucker did. You should know about Peter Drucker as he is the granddaddy of all management consultants.

“Because it is the purpose to create a customer, any business enterprise has two – and only two – basic functions: marketing and innovation. These are the entrepreneurial functions. Marketing is the distinguishing, the unique function of the business.” Peter Drucker

Doctor, you are busy. Your #1 focus should be on quality patient care. But as the CEO of your business, you HAVE to drive the marketing. To do this effectively, you can and should delegate the marketing activities to others. The office manager is responsible for making sure all office activities are being done effectively, and this of course, includes marketing.

Whatever your office mission states, it has to include the concept of marketing. It is your job, and everyone’s job, to tell the chiropractic story – and to communicate the value of your services in such a way and often enough that thousands of people come in to get better.

Don’t get fired. Get fired up!

A Short History of How Everything Else Has Cost You Hundreds of Thousands of Dollars and (nearly) Killed Your Dreams as a Chiropractor

Posted on April 8, 2012 by Edward Petty

When you started your chiropractic practice, you took on 2 roles: “Doctor” and “Everything Else.” As your practice grew, you became busier in your role of doctor. That is what you wanted. That was good.

But as your practice grew, your role of “Everything Else” also got busier. This was a distraction from your role of doctor, so you delegated front desk, billing and therapy duties. You still kept the role of “Everything Else.”

As your practice continued to grow with more staff – your role of “Everything Else” expanded geometrically. This concerned you.

You didn’t think about it much because you enjoyed being a chiropractor and loved your patients, but when you were very busy, you made more money. You could take a vacation with your family, put money aside for your kid’s education, and pay off debts. Sometimes, you could see yourself producing even more, helping more people, and being even more prosperous.

These dreams didn’t last long. Your role of “Everything Else” became more demanding. There were more “everything else’s” crying for attention. There was too much to do and soon you saw your patient volume dropping. Patients were dropping out of care and new patients became scarce. You had lost control.

Other doctors who were experiencing lowered income blamed insurance companies. Or the economy. Or the modern culture. All you knew was that it wasn’t fun anymore and there was just too much work to do. Work that wasn’t chiropractic.

The fact is, you were never too sure of this role of “Everything Else” and never really liked it all that much. You didn’t have any training in it like you did as a doctor. And when all of the “everything else’s” starting coming at you, you felt like things were getting beyond your command.

You experienced some staff turnover and now with patient volume down, you didn’t need as many staff. Gradually there was less to do in your role of “Everything Else.”

This cycle may have occurred to you a few times: numbers up, then more stress, then back down. A roller coaster.

MONTHLY OFFICE VISITS And here is where you may be now.

If you were to add up the amount of revenue you could have made had you stayed at your highest level, or been able to go even higher were it not for your role of “Everything Else”, you might be surprised how much this “Everything Else” role cost you. Hundreds of thousands of dollars.

= = = = = = =

If this is your story so far, don’t go away. The last chapter hasn’t been written. In fact, your next one might be completely different. Here is an introduction to it:

You read about the chiropractic Executive Freedom Package and started it.

You discover that the “Everything Else” role is really the role of the business executive. It is the role of the CEO.

You realize that all major businesses have an executive and that there are certain skills and tools as a CEO to be learned. These skills have to do with leadership, management, and marketing.

So you learn these skills and get coached on them. In time, you get better and better at applying them.

You find a staff member and give her the role of chiropractic office manager. You get her continuously trained and give her lots of your less important CEO duties. As she gets better, you give her more.

You get someone to help you coordinate all the marketing. You give him continuous training.

You have staff meetings and get the team on board with managing the office.

All the “everything else’s” are organized into systematized procedures and delegated to your team.

Numbers go up. Your team continues to improve. They are happy about this as they are sharing in the management of the office and its success. Now that all the “everything elses” are packaged up into nice neat systems, you have time to focus more on patient care, future planning, personal studies, and other pursuits.

You are now a better leader, better manager, and a better marketer, and your business continues to grow. Your team is happier, more people are getting served, and you make more money.

If someone had only told you about the role “Everything Else” and what it really was all about years ago you would have avoided losing so much money and wasted time.

On the other hand, now that you know what the secret is, you are on your way out of the rut you have been in and on your way to greater freedom.

You can learn more about the “Everything Else” role and how to create the business structure that puts you in command with our new chiropractic business Freedom Package here.

Your Chiropractic Brand

Posted on April 2, 2012 by Edward Petty

A brand is the representation of you in the marketplace. Well defined, it can cut through the thousands of health messages people hear each day so that your message is heard distinct from all others.

We have said this over and over, but you have the opportunity to make and improve your own brand. And the way you principally do this is through an active and continuous conversation that you have with each of your patients, vendors, staff, and local businesses.

You start your conversation usually on your patient’s first visit. Then you continue it on the second and on successive visits thereafter. Also through newsletters. Also while doing a community event, letters, or even while shopping: “Hi Bob. How did your wife do at the 5K run?”

The conversation has to be two way. You have to listen as well as communicate. Facebook fits right into this, but you have to post more than what you copy and paste from the American Chiropractic Association or from Mercola. Pictures of babies, puppies, recipes from a patient with photos, and anything you feel genuinely passionate about. Anything endearing: “Aw, look at the cute baby.” Even a bulletin board with local stories of your patients let’s others know that you are paying attention.

Your brand is based upon how you converse with your select community, your own tribe.

Here is a great quote from Seth Godin’s book, Small is the New Big.

“Markets engage in conversations, but marketing often doesn’t. The reality is that most brands are actually monologues, not dialogues. A conversation might create a better, more robust, more useful brand but, alas, most organizations can’t handle that truth. So they do their best to do it the old way.

Big brands are dying. Little brands are doing great.”

Improving Team Performance and Developing Community Services for a Chiropractic Office

Posted on March 5, 2012 by Edward Petty

This month we cover a couple of import topics, both of which can bring you more income if managed correctly: Chiropractic Staff Performance and Community Relations Marketing.

TEAM PERFORMANCE

How well does your staff perform their duties?

Studies show that there are 3 primary methods to improve performance:

Deliberate Practice
Expert Coaching
Family and social support.

Natural talent is a factor, but is never enough by itself and is often overrated.

So, how well does each member of your team perform? Are they experts? Are they ready to teach their own seminars?

And how about your how team? How well do all of you work as a team? Will they go to the Super Bowl or World Series this year?

Your office responds to training like any athletic team or musical group. If the scoreboard shows that the numbers aren’t where they should be, then individual performance or team performance is a likely reason why.

What is the fast and economical solution? Training. Coaching. This is something you and your office manager, and each team member can learn.

Team training is not done by just one person; it is done by the team. One member helps the other member, and back and forth until both improve.

Our webinar this week covers just this topic.

10 Tips on How to Be An Effective Team Trainer

Tools and Tips for Fast Team Training That Pay Off

Thursday, March 8^th, 12:30 CT

Don’t miss it. Excellent for Clinic Owners (CEO’s) and Office Managers.

===============

COMMUNITY SERVICES: External Marketing

We all live in caves.

We live in a cave house. Then we get into our cave car and drive to our cave office and stay in our cave rooms.

Meanwhile, there is a whole world out there with thousands of people that need your care, but don’t know it. And the main thing you have to do is to just … SHOW UP and do something.

What’s so hard about that?

You all have done screenings and you all have done some kind of external events: workshops, school presentations, visiting medical offices. The hard part is not the presentation. The most difficult (and it is not difficult) is getting these events scheduled.

Ideally, you should have your community services calendar scheduled with a few external events of one kind or another every month.

This is the subject of our next marketing webinar.

Scheduling Effective External Events and Generating External Referrals

Learn how to schedule effective events in this short webinar.

Thursday, March 15^th, 12:30 Central Time.

How to Register

For guests, you may register for all of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

For all active PMA clients register immediately for these classes at: Active Client Registration. (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK

The 5 Levels of Chiropractic Business Leadership

Posted on February 21, 2012 by Edward Petty

What level of leader are you?

Join us for a unique webinar on chiropractic executive leadership. This webinar goes over the levels of leadership skills you need to be a successful chiropractic CEO in your practice.

We will reference the work by John Maxwell and his book on the levels of leadership. Maxwell states:”… everything rises and falls on leadership.”

Chiropractic does not fail you. Tens of thousands of chiropractors and millions of patients over the last 115 years can attest to its effectiveness.

But just because chiropractic delivers, or just because you are a skilled doctor, does not mean that you are a skilled CEO. Lack of small business executive leadership training has stunted the growth of so many otherwise prosperous doctors.

Starting in 2012, we have begun a new program focused on freeing the doctor from practice drudgery and high stress roller coasters by beginning an executive training program. We are calling it the Freedom Package.

In this webinar, we will also review an actual consulting case, complete with stats and personnel profiles (all anonymous) demonstrating a level of chiropractic business leadership.

On our panel will be a successful chiropractic CEO of a multiple doctor office for 25 years, Dr. Tom Potisk.

Date: Thursday, February 23

Time: 12:30 Central Time

Prerequisite: Doctors must have been in practice for 4 years or more, and own their own business.

How to Register:

For guests, you may register for this webinar for $65 which includes “5 Levels of Leadership” by John Maxwell mailed to you. Go to the Registration Page below.

For all active PM&A clients, you can register immediately at the Registration Page link below.

Once you register, you will automatically receive your special log-in access number where you can participate via computer, or by telephone only.

Registration Page

If you’d like more information visit our website HERE.

February Freedom Webinars

Posted on February 4, 2012 by Edward Petty

Freedom Package This is an invitation to get your motor running — and to head out on the Freedom Highway…

We have three webinars this month designed to help you get free from financial and staff stresses, and free to follow your own dreams.

You know…as long as you provide good clinical care, then all you need is effective marketing, a motivated team, and good leadership. Just three – to be free.

So many of our offices have been surging forward over these last several years and recent months — because they have provided better leadership, team building, and marketing.

Hop on the Freedom Highway with us… and take your patients with you as well. They too want to be free … free of pain and poor health.

FEBRUARY WEBINAR SCHEDULE

**February 9th, Thursday, at 12:30CT, we start off with a training webinar on management and team development. We will be discussing how to hire the right team member.

How To Hire The Right Team Member

How do you know if you really need more help?
How do you promote for another staff member?
What traits are best for what position?
What about different personality types?
Screening and the interview
The first 30 days

The presentation is approximately 30 minutes followed by a 30 minute panel discussion with two long time professional C.A. office managers.

**February 16th, Thursday, 12:30CT, we focus on tools and tips for marketing your services.

“Marketing Tools and Tips”

How to make Earth Day your Day
Powerful internal marketing scripts
Report of findings trick
Setting up Community Events (Next Month -Lots more on this subject, including screenings)

The presentation is approximately 30 minutes followed by a 30 minute panel discussion.

**February 23rd, Thursday, 12:30 CT, a special Executive Briefing

just for clinic owners.

Executive Briefing: Case Study of one doctor’s attempt to grow his business. What he did right, wrong and what you can learn from his journey.

We will show the graphs, report on the personnel, clinical and marketing changes, and tell you what happened and why. An inside look.
Learn from others mistakes and success.

The presentation is approximately 30 minutes followed by a 30 minute panel discussion with other doctors.

How to Register

For guests, you may register for all three of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK

Hope to see you at our trainings and briefing.

Freedom Package Webinars for 2012

Posted on January 2, 2012 by Edward Petty

INTRODUCTION

For 2012, we will be offering an ongoing program of training and support for chiropractic marketing managers, office managers, and chiropractic doctors as CEO’s.

We are calling this the Practice Freedom Package. Its purpose is to help free the office from financial concerns, day to day managements worries, and give it the freedom to follow its greater purposes.

Over the years we have observed that the key barriers to achieving practice success are organizational. The barriers do not lie with chiropractic. It is not a matter of chiropractic failing the office, but the office failing chiropractic.

These failings occur as a practice grows beyond its ability to effectively manage itself. The capacity restraint ultimately stems from the doctor who is too busy doctoring to run her growing business.

This package of webinars and services is designed to help the doctor and the office overcome these organizational limits. More information about how and why this program works can be found on by following the link below.

FREEDOM PACKAGE WEBINARS: COURSE DESCRIPTIONS

♦♦♦♦♦ Chiropractic Practice Marketing Webinar♦♦♦♦♦

When. The 3rd Thursday of each month at 12:30 Central Time.

Description. You will learn principles and accompanying action steps which will help you generate new patients from other patients, from external sources, as well as reactivate former patients and better retain the ones you have.

Each webinar will cover at least 4 practical marketing procedures that are effective in generating more patients.

Who should attend. Designed particularly for chiropractic marketing coordinators and managers, doctors and office managers.

♦♦♦♦♦ Chiropractic Practice Management Webinar♦♦♦♦♦

When. The 2nd Thursday of each month, 12:30 Central Time.

Description. You will learn fundamental principles of management with specific applications to managing a chiropractic practice and business.

Each webinar will cover at least 3 practical action steps to improve individual and group performance, efficiency, and productivity. Also, tips on working with your doctor and how to provide more support for her or him as a doctor and as the CEO.

Who should attend. Designed for office managers, practice managers, and doctor owners

♦♦♦♦♦ Executive Management Webinar♦♦♦♦♦
The Doctor as a CEO

When. Starting in February, the 4th Thursday of every other month, 12:30 Central Time.

Description. Using actual case studies for examples, we will see what worked and what didn’t for doctors and their teams. We will uncover the basic principles of effective leadership and management in case and see how to translate this to your business.

This is training on how to be a prosperous CEO.

Who should attend. This is only for doctors who own their own business.

♦♦♦♦♦ Discussion Group/Share Session♦♦♦♦♦

After the presentation is over, we will open up the group for those who want to stay to ask questions and also to offer their experiences and advice to share with others.

This is often the most popular part of the program as other professionals really want to hear your stories and ideas. So, hang around and share and get to know your fellow teammates from other areas of the country. (Must be ready to contribute and share a successful procedure.)

♦♦♦♦♦ Follow Up Materials♦♦♦♦♦

After the presentation is over, you will receive an email with a link to a private vault of marketing materials referred to in the most recent webinar. There will also be a short summary of our discussion. Additionally, attendees will have access to our private Practice Marketing and Management Library of information and customizable tools for practice building which you can use in your practice.

♦♦Calendar of Classes [Link]

♦♦More information about how and why the Chiropractic Practice Freedom Package (Lots more info here, though not complete.) . Link

Cal Jam Special Offer for Chiropractors

Posted on December 30, 2011 by Linda

Come on down to Cal Jam 2012!

Our great consultant and coach, Ms. Phyllis Frase, will be speaking at the 5th Annual California Jam, presented by the Dead Chiropractic Society in Costa Mesa California. Register before January 15th and mention the Promo Code of FRASE for the special discount mentioned in the flier below.

All registration is handled through Cal Jam by calling the number below.

Call Today 949-250-0600

for more information: http://www.caljam.org/

Chiropractic Prepayment Plans in South Dakota? Think Again!

Posted on December 29, 2011 by Dave

If you’re a chiropractor in South Dakota and you believe patients benefit from ongoing regular chiropractic care, or you think that you know what an appropriate treatment plan might be for your patient, AND you want to offer your patient a prepayment plan, guess again. You’ll find yourself before your State Chiropractic Board for unethical behavior.

That’s what happened to Dr. Josh Biberdorf, who has a few clinics in that State and also is the president of the South Dakota state chiropractic organization. Here’s a great article: http://rapidcityjournal.com/news/state-board-reprimands-chiropractor-for-billing-practice/article_e3b0eb8e-2f4d-11e1-815e-0019bb2963f4.html.

This is yet another example of State Chiropractic Examining Boards going after local DC’s for practicing their business within their scope of practice. Wisconsin and Minnesota continue to do this.

This begs the question of what the role of the state chiropractic board is. They are created to protect the public – that’s what the State law says. But more and more it seems that the State Boards like to determine what chiropractic is – whether patients, the public or chiropractors agree.

This is bad for patients, bad for the public, bad for chiropractic. No other profession does this to itself.

When, we ask, are chiropractors going to stop going after one another? It seems the biggest crime a chiropractor can commit within his or her own profession is to be successful. If you are, some piss-ant DC is going to report you to the board.

It’s time for the National Board of Chiropractic Examiners to make a clear statement on this and ensure that local Boards are doing what they are supposed to – protect the public. Not protect unhappy chiropractors.

Chiropractic Promotions for the New Year

Posted on December 14, 2011 by Edward Petty

Seems like every office we talk to or visit these days is busy – crazy busy – with patients and computers and Christmas.

But the New Year is approaching – fast. 2012 only has 12 months and the first one starts in just about two weeks. And then, before you know it, it’s February and you are wondering what you should be doing for marketing and getting the word out about your services.

So as not to be left behind, you should begin the New Year with a strong marketing strategy.

Below are some fast tips to help get you started:

But first… PROJECT X-3. We are finishing adding the final components into our new 2012 program, temporarily called the Project X-3. This is just the working title and we will be announcing the new program soon with all the details. It is designed to help lift you and your practice onto and into a whole new level of prosperity and fulfillment in the New Year.

**Schedule Patients Now. Health Never Takes a Holiday. Poster. If you are active with PM&A, you can also find a customizable version on our Members site, along with other promotions under “monthly promotions.”

**External Referral Sources and Event Locations. Make a list of every location where you participated in a promotional type of event. Include any business or professional that sent you a referral or helped you in some way. Then, make sure you send each a card or a gift, or just stop by and wish them well and that you look forward to continued relationship with them in the New Year.

**Marketing Meeting. Schedule a thorough marketing meeting soon, maybe right after Christmas. Spend a couple of hours making a list of what has worked and what you want to do and then schedule these things over the next several months. One example we recommend is:

**Be an Authority and Educate. People want health care information. This is proven by the fact that 80% of Internet users search for health information on line, according to PEW Research. 8 out of every 10 people at some time are looking for health information when they go to the Internet. That is significant.

…2 ways to do this is to schedule workshops and health “awareness weeks” for the New Year. People want to know the latest. This gives you an opportunity to teach. Yes, you do have to do your homework and it takes time. But it is time well spent because as you study and prepare, you will find that you will become motivated about your subject. Besides, at least 1/3 of your presentation can be your spinal care class, so this saves you time. These types of community education programs or services not only help you generate direct new patients, but give you an excuse to promote your office and services. Sample Poster Clients can find many more customizable posters and fliers on the Members site under: Marketing Materials/ Community Education.

You can find more ideas about upcoming promotions to start your New Year here. Link

Best wishes for a high volume 2012!

“Thank You” to All of You Who Work in the Chiropractic Profession

Posted on November 23, 2011 by Edward Petty

It is that time of year when we take a moment to give thanks and in so doing, we want to say “Thank You” to you.

Thank You Very “Doggone” Much as a matter of fact. Thank you for all you do to care for and help your patients.

You all are part of a great profession that helps millions of people each day. And because of you, chiropractic and the chiropractic way of life has persisted and grown and is now more accepted than ever before.

You are braver than most, work harder than most and genuinely care more for your patients than perhaps other care professionals are allowed to. It could be said that you are the best defense against a drugged zombied society, but it is definitely true that your loving care helps much more than you have been recognized for.

So, just a note to say that we are grateful for all you do.

“THANKS”

Handling Insurance Company Refund Requests of Chiropractic Patients

Posted on November 16, 2011 by Dave

More and more, insurance companies are doing post payment audits or hiring outside firms to conduct payment reviews and requesting money back from your chiropractic office.

Refunds should never be automatically sent out based on a request from an insurance company. Each request needs to be individually reviewed and processed and the patient’s account should be audited to determine if a refund is actually due and to whom.

Sometimes, a refund is due. Examples may be when an insurance company has double paid dates of service, or when two insurance companies both pay on the same date of service. These are legitimate refunds – ie: you have been paid more than you billed or were due for services rendered. These should be refunded.

Often however, a refund is NOT due and should be disputed. Examples might be when an insurance company or third party does a “post payment review” and determines that the care was not medically necessary, or when insurance pays but later determines that work comp or PI were primary, or when an insurance company decides that the patient did not have a particular benefit or coverage for what they already paid.

Essentially, when you have delivered quality services to a patient that were medically necessary and in the best interest of the patient, and the insurance company pays for those services, you have NOT been overpaid and no refund is due. Even if the insurance company later decides they overpaid or paid in error. These refund requests should always be disputed.

Legally, you are not obligated to repay the insurance company when you have been paid in good faith for services rendered and they paid in error. These should always be disputed.

This will not stop some insurance companies from ‘recouping’ the payment, but you should still attempt to dispute the refund request first. Our experience is that by disputing the refund you will avoid 85% of all refund requests. It is well worth the time and effort to do so.

The exception to the above involves government programs such as Medicare and Medicaid. We generally advise refunding these right away and THEN disputing the request. Remember that you must use the approved Medicare refund form and mailing address (check on line with yur local Medicare carrier for the latest form and address).

Points that can and should be used whenever disputing a refund include these (use any and all reasons that are applicable to each case):

– All services were medically necessary for the health of the patient. Our review indicated that the care was medically necessary; therefore no refund will be issued.

– This request is for a patient no longer active with our office. We have no alternative methods of collecting on these accounts. Because of a supposed error on your part, you are asking us to refund monies to you for services rendered to your insured without a foreseeable ability to collect for said services.

– We called/verified benefits on line with (Insurance Company) on each of these patients prior to the delivery of care and verified coverage for services rendered by our office. Had we been informed, we or the patient could have made a more informed decision regarding the delivery and payment for care.

– It is our understanding that (Insurance Company) has maintained a policy of not reimbursing for services if they are submitted for payment one year or longer after delivery. You are requested a refund for services over two years after their delivery and payment. It would seem that the policy should apply both ways.

– Your letter mentions that 98940 and 97140 are mutually exclusive. This is not the case when they are performed in different regions of the body as defined by the AMA. You also state that manual traction and mechanical traction are mutually exclusive. Again, this is not stated in the AMA CPT codebook and the services were performed by different providers, as our chart records show.

– The time and effort to have our office pull charts and research services from 2009 and 2010 is considerable and cannot be done without prior reimbursement, nor can these records be forwarded to (Insurance Company) without prior consent from the patient.

– We would also like to know if you have informed this patient, in writing, that due to the error on your part, that they are now liable for their medical bill from 2009?

– Our feeling is that the following court cases concluded that the insurance company is responsible for knowing their policy limits prior to paying and therefore must bear the responsibility for their own mistakes.

City of Hope National Center vs. Western Life Insurance Company, 92 Daily Journal D.A.R. 10728, Decided July 31, 1992. (In this case the hospital obtained standard assignment of benefits from the patient and submitted claims, which were paid by the carrier. The insurance company later decided the treatment was experimental and requested the money back. The California Court of Appeals stated that if it’s your mistake you have to pay for it.
In Federated Mutual Insurance Company vs. Good Samaritan Hospital (Neb. 1974) 214 N.W.2d 493. (The carrier contended that it mistakenly paid claims beyond the policy limits. The court held that the insurance company could not recover the money as it places an undue burden on the providers of service to subject them to retroliability.)
Lincoln Nat Life Ins vs. Brown Schools (Ct.App. Tex 1988) 757 S.W. 2d 41 1. (In this case the carrier mistakenly paid claims after its policy had expired. The court denied recovery stating “Here the insurer knew it’s own policy payment provisions, but failed to notify the health care providers as to these provisions and the insurer alone made the mistake of paying beyond its responsibility . . . in the normal course of such business, the hospital has no responsibility to determine if an insurance carrier is properly tending to its business.”)
National Ben. Administrators Vs. MMHRC (S.D. Miss. 1990). (Similar case as #3 with same conclusion.)

– Our office made no misrepresentations in filing claims for your insured. We extended valuable services based on preverification of benefits and assignment of payment by the insured. We were not unjustly enriched, and simply had no reason to suspect that any of the payments for services rendered were in error. Refunding the monies at this time would place an undue burden on our office.

As always, send a copy of your letter to the patients involved. The insurance company will send a letter to the patient (if we don’t send them a check) saying that “we are not cooperating and therefore the patient may be responsible”. So, strike first by presenting our side and preparing the patient.

Situation: The insurance company paid twice on one date of service and missed payments on another. They are now requesting repayment on the double payment.

Solution: Send them a letter explaining that the payments were posted to the unpaid dates and no refund will be made.

Situation: The insurance company claims that the work comp carrier is responsible for payment and is asking for all their money back.

Solution: Send them a letter explaining that you will bill the work comp carrier and if and when payment is received, you will refund any duplicate payment.

Situation: The insurance company paid for the first eight visits, then denied the next five and now wants a refund on what they paid.

Solution: Dispute the refund as per the above points and request immediate payment on the five denied visits.

Situation: The insurance company paid for care, but then came back and stated the patient didn’t have an active policy or coverage.

Solution: Dispute the refund as per the above points. It is the insurance company’s job to pay within the limits of their plan; you have been paid for services rendered.

If you have questions, feel free to contact me.

David Michel

Your Chiropractic Root System and Patient Retention, Referrals, and ROI

Posted on October 3, 2011 by Edward Petty

Updated: April 2016

When people go to the grocery store for produce they are mostly just interested in their plump cucumbers, zucchinis, or other vegetables. They don’t much care about the garden that actually produced these nutritious wonders of nature.

But a lot of work goes into a well managed garden. If you don’t take good care of your garden, you won’t have its fruits and vegetables. It’s that simple. And a good part of a garden takes place underground in a network of roots. Roots provide water and minerals to the plant, and keep it in place when the wind blows. The top part of the plant, its stem, can get mowed under by a lawn mower (I have done this) and the plant comes back to life – because of its strong root structure.

Your office is kind of like a garden.

It produces healthier people. You take care of your team, polish up your systems, do some training, and you will continue to have a productive “health garden” that produces healthier people.

And the roots?

In this analogy, the root system is the loyalty and good will of your patients. Here’s how:

Many offices struggle to get new patients. Even offices that have been in business for years and years.

Why? No roots.

If some doctors spent the same time and attention – and money, on giving extra care and service to their existing patients as they did on trying to hustle up new patients, they would have more patient visits than they would know what to do with.

Why? First, because the service and care was SO extraordinary, patients would refer their family and acquaintances because they would want them to receive similar treatment as they had.

But more obviously, existing patients would never drop out of care. (Some would, of course.) They would continue to come back for wellness visits. How busy would your office be now if all the new patients you ever started still came in for services? You couldn’t handle…there would just be too many patients!

Over the years, there have been many studies to support the fact that it is more expensive to chase after new patients than it is to keep the ones you have.

“A common rule of thumb is that the marketing costs of landing a new customer runs three to five times the costs of retaining an old one.” (Total Customer Service, Davidow)

Some articles talk about it costing 10 times the amount to get a new customer as to keep the ones you have.

I am all for getting new patients, but do you also keep your existing patients? And do they refer family and friends and work associates? And why do your patients leave? An interesting survey pointed out that most companies believed it was because of price, or that the needs of the customer changed. However, from the point of view of the customer, they left because of poor service. (The Loyalty Connection: Secrets To Customer Retention And Increased Profits By Bob Thompson, CEO, CustomerThink Corporation Founder, CRMGuru.com, March 2005)

There are a number of procedures to improve your services to patients – to help generate stronger and more productive “roots”, or healthy patient relationships. Let’s focus on the most fundamental: Communication. To put it more accurately, let’s call it “conversation.”

BEGINNING THE CONVERSATION

A conversation is a dialogue, a giving and receiving of communication back and forth. It is an interactive exchange of thoughts. It shows that you respect the other person and that you are interested in them and what they have to say.

Many patient conversations are one-way, from the staff and doctor to the patient. They are also rote, robotic, and too scripted to be genuine. Do an audio recording of how the front desk answers the phone or how you do a consultation and you might be able to see room for improvement.

The conversation usually starts with the first phone call. Does the prospective patient feel that the front desk is listening – really? Is she interested, or just reading her script and trying to get to her next task and hang up the phone? Does she introduce herself and show interest and even gratitude for the call?

It is these little things that make such a big difference. Think about how you like to be treated when you contact a business…

In the consultation, do you really listen and seek to understand the patient, even though it is like the 5 millionth time you heard about someone’s low back pain?

In your report, do you have a conversation with the patient, or do you just rehearse your script to the patient while they are nodding in appeasement?

You see so many patients… and have so many tasks… that real conversations are too often sidelined. You don’t have much time, usually. But in the time that you do have, you have to be present. You have to be THERE, with all of your attention on the patient, and not on your next task. That moment with that one patient will never happen again. It is its own time that just you and that person share. The Japanese have a saying for this: “Ichego Iche.” One time, one moment. This is a plaque that is often found in tea rooms in Japan.

You have started to create a relationship. Now, you have to continue to nurture it. This is done by continuing the conversation – and of course, great clinical and administrative service and care.

With each patient encounter, you have to be interested, attempting to understand and then get understood. Improve this and you are well on your way to better patient retention and referrals.

CONTINUING THE CONVERSATION

But when your patients are not with you, you have to find ways to continue the conversation.

How?

Your Newsletter.
You can easily set up an email newsletter with an a provider such as Constant Contact or Mailchimp. Send these out monthly or even twice per month. The most important aspect of these letters is to keep them real, personal, as if you were writing to a friend. It could simply be a few paragraphs from the doctor relating a recent case success, or a home health tip. You can also include patient testimonials and a review of a recipe.

But we are inundated each day with hundreds of emails so keep in mind that old fashion snail mail still works, and in fact, works better. It does cost, of course, but the return on investment makes it worth it. A hard copy newsletter will have “shelf life,” and can be read and reread. Most emails are overlooked -there are just too many of them. Send out a hard copy newsletter every 4-6 months. It can even just be a one page foldover, self-mailer.

Other Mail.
Cards are very considerate. Just think about the few you receive. You may still have them! A system can be set up to send out birthday cards, welcome cards, humorous reactivation cards, bereavement cards, and congratulation on starting your “wellness program” cards, as well as other cards each month. These all help keep the conversation going.

Social Media.
Facebook is your primary social media with your patients. This can be similar to your newsletter. Like email, it has become glutted with ads and “content” information. Ask your patients to “LIKE” your page so that they can stay in touch with the office and receive new information about health and upcoming office events. Some offices even hold special contests only for their Facebook “friends.” Then, post regularly fun and education information. For example:

“Our patient, Burt, just got accepted back into his hockey league thanks to chiropractic. Here is a photo of Burt and Dr. Smith and his new puppy eating apple pie made by Rose, a long time patient who can’t stop bringing us apple pies!” (Of course always get patient approval to post their picture.)

Upload patient testimonials, in writing or even videos. If they are interesting, other patients can comment, or even share. And if anyone does comment, make sure that you comment back.

Delegate these types of communication to your team, but you have to be the one to ensure that the conversation continues.

If you have good roots, there is nothing to fear. Insurance reimbursement can decrease even more, the economy can decline, staff changes can occur, but if you have taken good care of your patients, they will take good care of you. Conversations with your patients will help nurture a strong “root system” that will keep your office productive, no matter the storms that may come.

SUMMARY – TAKE AWAY:

When the patient is on the phone or in the office:

Be present and attentive. (Present Time Consciousness “PTC” as Jimmy Parker would say.) Be genuinely interested.
Seek to understand the patient.
Get your point understood and have a conversation.

When the patient is out of the office – continue the conversation:

Snail mail real newsletters and cards mailed.
Emailed newsletters.
Get Facebook “fans” and post local/personal news.

Billy DeMoss Shakes Up Appleton Wisconsin at Petty Michel Seminar

Posted on August 22, 2011 by Edward Petty

Billy DeMoss, ChiropracTOR

Dr. Billy DeMoss gave a heated and edgy presentation for 3 hours to chiropractors and their staff in Appleton, Wisconsin, Friday night, Aug. 19^th. Full of anecdotes from his own practice, along with statistics, slides and videos, “Billy D” reminded everyone what chiropractic and natural health care is all about.

He talked about how providing chiropractic care is actually fun and how you should have fun in your office. He stated that patients want to come to a place that is enjoyable, where staff and doctors are having a good time in a positive atmosphere.

But he also explained that it takes a great deal of work to have a successful office. He recounted the days that he had to do manual odd jobs just to make it through school. He works hard at his office but keeps it fun. “If you want a more successful and profitable practice you are going to have to work for it.”

“The days of the $200 dollar office visit are fading,” he said. Workers Compensation reimbursement in California has been cut back and some money motivated chiropractors have abused the system. But money is not the goal, and never has been, he said. Serving people will always be rewarded financially, but that is not our primary objective.

He emphasized that our main goal should be to teach and adjust. Some doctors complain about doing screenings or lectures, but Billy asks the audience: who do we do it for? Are we worried about inconviencing ourselves or do we want to help people get healthier?

He discussed issues such as vaccinations, diet, United States health statistics relative to other countries, and said that the chiropractors were the ones best poised to take a leadership role in the health care of the U.S.

After 3 hours of Billy’s high energy, the mesmerized and energized crowd gave him two standing ovations.

One member of the audience who owns a small farm and who was not a doctor or staff member, said he wished there were more people speaking out like Dr. Billy DeMoss. He said it was one of the best presentations he had ever seen.

The next morning, Phyllis Frase spoke to staff and doctors about how to be a “Rock Star” C.A. Phyllis also gave a dynamic talk and will be speaking at the Cal Jam in California, February 24-26.

PM&A encourages all who can make it to Cal Jam to do so. I attended 2 years ago and it was absolutely the most unique and refreshing chiropractic seminars I’ve attended in 20 plus years. Well worth the time and money. More info about CAL JAM.

Dave Michel, Billy DeMoss, Dana Pittner, Phyllis Frase, Ed Petty

CATCH DR. BILLY DeMOSS SPEAKING MONDAY NIGHT, AUGUST 22 AT LAKE GENEVA, WI. FOR MORE INFO, CALL: 262-275-5005

Video here

Photos here

Electronic Health Records and Chiropractic

Posted on July 18, 2011 by Edward Petty

There is more and more attention being placed on the topic of Electronic Health Records. For those of you who are not familiar with this subject, you can find basic information on the web sites of CMS (Centers for Medicare and Medicaid Services) and of course, Wikipedia. There are other sources, but reader beware: many have ties to software companies (and their advertising and promotional distributors) that are trying to make a case for buying expensive software now.

Here is a Q&A with Dave Michel and one of our clients regarding this subject which may be helpful in understanding what is going on:

===============

Dear Dave,

Dr. H wanted me to e-mail you with some of our questions and concerns. We are hearing a lot of different things the more people we talk to about it. We are hoping that you can shed some light on the situation. Here are some of our questions:

Is the deadline for reimbursement this October 2011? Or do we have until October 2012?
There is no deadline at this point. It is not a requirement and, even if it is, there will be an exemption for small offices (usually less than 10 FTEs).

Is there a checklist of things that need to be completed in order to be compliant? Do we need to have digital x-ray in order to be compliant?
Yes, there is a checklist. If you google CMS EHR Incentive you will find a couple on the CMS website (skip software vendor websites …). Digital x-ray is NOT a requirement.

Is it a tax credit or would we receive a reimbursement check? Will it just cover the EHR software or will it cover equipment upgrades/replacement as well?
Beginning May 2012, you would be possibly eligible for up to $18,000 per year in incentives paid as a check to each provider. The limit would be based on 75% of your prior year’s Medicare reimbursment. IF you are “an eligable provder” and you have demonstrated “meaningful use”.

How much should we expect to spend on this process? And how much will we get reimbursed? Is it a percentage or the exact amount? And is it a guarantee?
Great questions. EHR software for chiros ranges between $2.5 – $27k. Add to that the cost of conversion in your office (thousands) and the reduced efficiency (eg if the new program adds 2-3 minutes to each patient encounter). This is going to be a big process.

Dr. H wants to know “what happens if we don’t become compliant?”.
Nothing. Yet …

Thank you so much for taking the time to answer our questions.
No problem! Bottom line (if you haven’t picked up on this so far …): I am not a fan of any of the EHR programs currently out there. They either add too much time to each patient visit or they produce a SOAP note that would not pass an audit / records review. There is NO guarentee that Big Government is going to be mailing out $44k checks to each provider for doing something that will really not improve the heath care delivery system

Most of what you have seen are from companies marketing their products (seminars, EHR software, etc). There is NO mandatory deadline (yet) to convert to EHR and so far, I have not received confirmation from CMS that chiropractors will receive any money or incentives to convert to EHR. I do have a letter in to CMS to get an official word and will let you know. It does not make sense to me that CMS will give each chiropractor $44,000 to convert to EHRs when the CMS program is going broke. But I will let you know.

For questions about EHR, feel free to contact Dave at Dave@PMAworks.com

Dr. Brian Kelly Scheduled for a Live Teleseminar Interview

Posted on June 16, 2011 by Edward Petty

Dr. Brian Kelly

Dr. Brian Kelly will be our guest in this months teleseminar interview on Tuesday, June 28, at 12:30 Central Time.

Dr. Kelly is the new president of Life Chiropractic College West. He is from New Zealand, where he completed his professional education and training in chiropractic at the Phillip Institute of Technology (PIT) now the Royal Melbourne Institute of Technology (RMIT), Melbourne, Australia.

After successfully owning and operating multiple clinics, Dr. Kelly became the President of the New Zealand Chiropractic college where he has served for the last eight years.

He is the second president of Life West, succeeding Dr. Gerry Clum, who retired earlier this year after 30 years as College president.

Dr. Kelly will be discussing how he sees chiropractic applied in the U.S. compared to New Zealand and Australia. From this perspective, he will also offer insight on how doctors here can improve both the quantity and the quality of their services.

Don’t miss this special seminar.

–>To Register<–

And, we should also tell you about a power packed line-up of speakers for a 2 day seminar in the San Fransisco Bay Area at Life West, August 5th and 6th.

This two-day event is all about information, motivation, and inspiration! Hear from over 35 chiropractic super stars! ‘The WAVE’ offers three tracks including a full-day chiropractic assistant program on Friday, and a day-long series of short, bold presentations on Saturday.

Purposely constructed to make you think and stir your soul, attend this event and you’ll never be the same!

Click the image below to see the full size poster for more info. Or visit their web-site at: Life West Wave

The Wave Email Flyer 3

“Highway to Health Summer” Tour 2011 with Dr. Billy DeMoss, Founder of the Dead Chiropractor Society

Posted on June 2, 2011 by Edward Petty

It’s summer. Time to get away… and spend the weekend getting high on chiropractic and just relaxing.

Join us Friday evening, August 19th, in Appleton WI as we celebrate chiropractic with Dr. Billy DeMoss, founder of the Dead Chiropractic Society and CALJAM, the yearly music festival and seminar program that is lighting up the chiropractic profession.

Billy D will rock your world with a rip roaring presentation Friday evening, August 19 at the Paper Valley Hotel in Appleton, WI.

Saturday morning there will be a special presentation for staff (and doctors) with Phyllis Frase, Internationally renown staff trainer and practice development coach.

Later, you can go for a walk to the local farmers market, catch a free concert, or just walk by the Fox River and enjoy a beautiful summer day in Wisconsin – all while inspired again about chiropractic.

The Apple Valley Hotel is a deluxe resort on the north side of Lake Winnebago in Central WI, located next to the beautiful Fox River. With many amenities, it is a great family destination as well as nice for those who just want to get away from it all.

Date, Time, Location
Friday, August 19, 7-10pm
Dr. Billy DeMoss: “Highway to Health Tour”

Saturday, August 20, 8-10am
Phyllis Frase: “How to Be A Rock Star C.A.”

Paper Valley Hotel — LINK
333 W. College Avenue, Appleton WI 54911
Hotel Reservations: 1-800-394-7046 US/Canada Toll-free
Telephone (920) 733-8000

—Hotel Information…. Special room rate of $99.00. Will be extended for the weekend if you wish.

Price of Admission – and Registration

Fees double at the door. Space limited so register now.

Dr. Billy DeMoss:
PM&A Client: $25 Per person, doctors and staff
Not an active PM&A client, just $35 – Per Person, doctors and staff

Ms. Phyllis Frase:
PM&A client – no charge – Just let us know who is coming by sending us an email at services@pmaworks.com or faxing us at 1-877-868-0909
Not a PM&A client: $25 per person

To register, click the registration form, open the file, print it, complete it and fax it back to us at: 1-877-868-0909 Registration form.

Observations

observations from our travels in the world of chiropractic

Tag Archives: chiropractic