“We are all concerned about the future of American education. But as I tell my students, you do not enter the future – you create the future. The future is created through hard work.” -Jaime Escalante – Teacher
For a printable copy of this tent poster email us.
Over the last few months, I have been noticing a particular phenomenon in offices that I don’t think I have seen before… maybe ever. It is like noticing a slight hand tremor that you never knew you had or a buzzing sound from outside that has become increasingly loud and annoying.
2020 was a long year, a stressful one. And you all have been in the thick of it. Daily, seeing more people in one day than most providers see in a week – or more.
My old football coach, Johnny Pappa from Davis, made a big impression on me as a young freshman when he said: “When the going gets tough, the tough get going.” In my then youthful life, I had never heard such profound words. They still apply – especially to you. You are tough!
But stoicism has its limits. The cognitive dissonance can finally get to you.
One doctor expressed to me extreme frustration about two young and very healthy patients, who exercised, got adjusted, ate well, took their vitamins, but decided to discontinue taking their outdoor walks for fear of COVID.
Another doctor, venting his dismay, told me that he couldn’t bear to watch the medical bureaucrats talk about masking and vaccinations as the only remedies to COVID when he knew of so many methods that have been demonstrated to ameliorate the virus. “People are frightened and told to stay at home, don’t socialize, wear a mask if you go out, and wait for the vaccine. That’s it? That’s all you got for people? This really shuts people down.”
One doctor I talked to who, after dealing with depressed and suicidal patients, many of them vets, has become depressed himself. Another wonders what the hell is happening to our chiropractic colleges – have they all been taken over by medical bureaucrats? Is chiropractic finally squashed?
Your good nature can become frayed, your patience worn thin, and regardless of your professional composure and your disciplined countenance, the stresses can have an affect. I mention this because most of you are tough as nails – you have successfully dealt with many types of stressful situations in the past, as a doctor, professional, and for many of you, a business owner.
So if you are feeling a bit off, recognize that you might be affected by a contagious “Morale Virus.” The Morale Virus is what I call the social sickness that occurs as an emotional response to continual fear-baiting. Frightened, your patients are told they can’t do this and shouldn’t do that.
The Morale Virus is not caused by hardship itself. It is caused when you are pushed into a corner and given no way to fight back. You tend to give up. (Or go stark raving mad!) (Reminds me of the movie, One Flew over the Cuckoo’s Nest when the star, McMurphy (Jack Nicholson), says: “You guys complain how much you hate it here, and then don’t even have the guts to leave! You’re all crazy!”)
There has been a constant assault of bad news emanating from officials and authorities. Yes, and I know the media plays a part — it is mostly owned and controlled by just a few rich people and corporations who have their own agenda — namely, more money. But still – no one buys boring newspapers. Sensation sells the news, and we, the consumers, buy it. We listen and read the “news” that riles us up and confirms our bias. Social media does the same, times ten.
I make my living off the evening news
Just give me something, something I can use
People love it when you lose. They love dirty laundry
We got the bubble-headed bleach-blonde who comes on at five
She can tell you about the plane crash with a gleam in her eye
It’s interesting when people die, give us dirty laundry
Here are some ideas on how you can fight back, disinfect your office from this disease, and better help your patients regain their spirit of hope, kindness, and free enterprise. And yours as well.
One doctor we work with likes to anchor her practice around a yearly theme. For 2021, she is calling 2021 the year of Good Vibes and has events planned to support this philosophy. And just to reinforce the idea, she has T-Shirts made that say Good Vibes. (And by the way, she has a bustling two-doctor office.)
Fear is often a byproduct of lack of knowledge – so arm yourself with the facts.
For example: Roommate 1: “Oh my god! (A panic shout is heard.) The television isn’t working and the game is on. What will we do?” (Drama ensues.) Roommate 2:(Calmly) “Check the remote for new batteries.” Roommate 1: “Ah, that fixed it, thanks.”
Study, use critical thinking, avoid bias – your own and others. Go to the sources – research studies and from people who are actually working on what you are studying. Then, please educate your patients and clients on how to be happier and healthier. And educate your team, help them increase their knowledge. Arm them as well. Doctor comes from the Latin to docere – “to show, teach, cause to know.”
What area in your office, if changed, will produce the most significant effect?
Obviously, first and foremost is the doctor. Each day should be a trip to the playground, the ski slope, the baseball field, the dance floor. Ideally, each day is a fresh opportunity to accept the privilege of helping as many people from suffering as possible, to teach them, and have fun doing so.
In most offices, I would also say it is your front desk. The front desk’s power is so poorly recognized in most offices that at least 20% or more production is lost. A vibrant, aggressively friendly, caring, mission and goal-oriented front desk can and will boost your volume – this week. Front Desk team members may need more support and less admin (billing) duties. They may need a better understanding of the mission and how your office is helping people.
During cultural upheavals and shifts, entrepreneur businesses remain and often thrive. New opportunities open up. More established and larger companies are weighed down by dogmatic rituals, have high overhead and many vice presidents, and vast networks of suppliers. Change is difficult. But not for the entrepreneur. Most entrepreneurs are all too “change-happy.” You can adapt, innovate, and overcome quicker than companies who are afraid to or can’t. So what if in-person care classes are out for now? Get everyone on a Zoom class, give them a secret word. Test them when they come in again and if they answer correctly, give them a gift – a bottle of Vitamin D or a lunch at another patient’s business.
One doctor told me that her solution was to “stay out of the weeds.” To stay in her lane and just keep helping people and not get caught up in the storms of controversy. I suggest that this is the best course of action. You want news? Sensational news…? Just listen to your patients and staff and community. But stay on the fairway and don’t get sidetracked, mentally or in real life.
Stay with your goals. Goals are agreements that you made with yourself, and usually others. If you stay true to them, they will lead you out of the den of the morale sickness. Staying true to your goals is a point of integrity. Your goals are not in the weeds – they are straight ahead. Figure out new and better ways to get there or resurrect old ways that worked. Fall down 7 times, get up 8. Each day and each week — begin with the end in mind.
Your goals are in three categories:
We have seen harsher times. The past is easily forgotten, and we think we are in the worst of times. Well, the 1918 flu was much worse than COVID. Plus, we were sending our young boys to suffer in horror and die in the trenches in Europe in the Great War. But society prevailed and soon ushered in the Roaring 20’s, a time of economic growth and cultural freedom.
Prepare to roar!
Carpe Deum (Seize the Day)
Ed
This is such an important subject, I encourage you to share it with your team and colleagues: To print out a hard copy
As we leave the crazy year of 2020 and enter a fresh 2021, here is a summary of Coding changes taking place that impacts your clinic operations and bottom line:
I. CPT Code 99201 is being deleted effective 1/1/2021
A. Documentation for CPT Codes 99202 through 99205 will be required using criteria of Medical Decision Making OR Time element to determine the level of coding.
o Medicare requirements remain the same for medical decision-making criteria using P.A.R.T. (Pain, Asymmetry/misalignment, ROM decrease, Tissue tone changes) OR diagnostic imaging with documented report of objective findings.
B. CPT 99211 (re-exam) is not being deleted but not used very frequently, and some payers do not pay chiros for this code. You may still bill 99211 when a CT licensed in history-taking and exams performs a re-exam.
C. The 2021 treatment plan model will be the same as 2020:
o Number 1 documentation priority Medicare is looking for: Goals (time or distance element, for example ADLs or specific exercise)
o Number 2 element = duration of care (for example 24 visits)
o Number 3 element = frequency of care (Example – 2X/week for 12 weeks)
II. Changes to ICD-10 codes relevant in chiropractic
1. The following codes have been Added:
A. Arthritis of temporomandibular joint
i. M26.641 right
ii. M26.642 left
iii. M26.643 bilateral
iv. M26.649 unspecified
B. Arthropathy of temporomandibular joint
i. M26.651 right
ii. M26.652 left
iii. M26.653 bilateral
iv. M26.659 unspecified
2. Deleted ICD-10 Codes:
A. M92.50, M92.51, and M92.52 deleted. (Juvenile osteochondrosis). Use M92.8 or M92.9 instead
B. R51 (this headache code deleted). Here are two specific codes added, to use instead:
i. R51.0 Headache with orthostatic component, not elsewhere classified
ii. R51.9 Headache, unspecified
III. Medicare 2021 Reimbursement on covered CMT
Please note a significant reduction in reimbursement across the board for select specialty physicians and surgeons. Here is the chiropractic fee schedule:
Referring back to the exam discussion above, you may want to consider raising your E/M code fees. However, be advised insurances will not reimburse at your full fee, and Medicare as well as most Part C plans as of this writing do not pay for exams performed by Doctors of Chiropractic. These charges are patient responsibility.
Questions? We’re here to help!
Call 920-334-4561 or email lisa@pmaworks.com
Cheers!
~Lisa Barnett
Increasing your collections through better billing and documentation.
References:
Medicare has released a new ABN which will be implemented starting January 1, 2021. There are two versions, an English and Spanish version. Click the link to download now.
Remember . . .
The ABN is required for your Medicare patients to sign when:
They transition from Active Treatment to Maintenance or Wellness Care.
The ABN is voluntary when:
It functions as your financial policy, and the patient is still on Active Treatment.
GUIDELINES:
Questions? I am here to help! Contact me at lisa@pmaworks.com, or call 920-334-4561
Lisa
“Increasing your collections through better billing and documentation”
REMINDER: Wisconsin License Renewal Credentialing Requirements
*Please Note: Due to the pandemic, usual and customary continuing education requirements are waived this biennium. However, even if you did not complete your hours, you still need to renew your license.
A review of the usual requirements follow:
Doctors of Chiropractic (DCs):
Starting now and prior to December 14th, renew online: https://online.drl.wi.gov/UserLogin.aspx
Chiropractic Technicians (CTs):
Starting now and prior to December 14th, renew online: https://dsps.wi.gov/Pages/Professions/ChiropracticTechnician/CE.aspx
Chiropractic Radiological Technicians (CRTs):
Starting now prior to December 14, renew online: https://dsps.wi.gov/Pages/Professions/ChiropracticRadiologicalTechnician/CE.aspx
TIP: Keep your transcripts and file them safely, in the event of a continuing education audit.
Approved course listings can be found here:
https://dsps.wi.gov/Pages/Professions/Chiropractor/CE.aspx
All licenses (DC, CT, CRT) expire on December 14, 2020, at midnight.
Questions?
Contact Lisa Barnett
PM&A Consultant
920-334-4561
Time to prepare for the New Year’s marketing.
But before we leave 2020, here are a few tips to help you round out this crazy year and lay the groundwork for a fresh, New 2021.
For December, work “internally” with your existing network, including your active and inactive patients and your external referral sources. But prepare for external marketing for the New Year now.
INTERNAL
The Team – Your First Line of Marketing
Every member of your office is a marketer – everyone sells health. 2020 has been one heck of a year. Why not acknowledge your staff as Health Hero’s with a pin, a certificate, or plaque, perhaps with a bonus if there are any funds available? You all deserve many “thank you’s.”
Holiday Cards and Letters to your Patients
Send cards and letters to both active and inactive patients. Recognize their good efforts to improve their health during this peculiar year and tell them that you look forward to helping them and their family stay healthy in 2021.
Health Never Takes a Holiday
Post a sign in your office in December that “Health Never Takes a Holiday” and schedule patients through December to January. We have a customizable poster on our Member’s site, and sample posters here.
Keep the Conversation Going.
Send out regular emails to patients. Email is more effective than social media, according to many studies, but social media has its place too. Assign email and social media posting to someone. A simple four-paragraph informal health tip from the doctor shows that you care and help improve your patient’s health. It is better that your patients hear from you than from the local chain store pharmacist.
Poinsettia Giveaway
Some offices have done well by giving away free poinsettias, or another holiday plant, one per family. Include a gift certificate with the plant for family members or friends. (See Member’s site for gift card samples.) Make a special arrangement with your local florist for a discount.
Patient Education
Now, more than ever, provide health tips for your patients to combat the heavy advertising of COVID-related reports. Stress is amplified by a lack of knowledge. Good education can help lessen the fear and help keep your patients stay healthier and happier. Plus, educated patients remain with you longer and refer more. There are many approaches that work, including: table talk, newsletters, whiteboards with “Patient Education Prompters,” and short five-minute weekly video health tips. The more you teach, the more you reach.
Donation Drives
Holiday time always brings an increased demand for helping those less fortunate. Within your office set up a collection area for any of the following programs and promote it in your newsletter. There are also other times of the year where donations are welcomed and needed. These can be scheduled throughout the year. Here are some sample donations:
Also, you can support drives at local churches or gyms. EG “Free first-day services for every donation a member of YMCA makes to the homeless fund.”
Giving Tree/Angel Tree
The Giving Tree/Angel Tree Project is a great way to bring community awareness to your office. It is a simple project that can assist your patients to help others where they might not otherwise have the opportunity to do so.
EXTERNAL
Show Appreciation to External Referral Sources
Send a Holiday Card to any business or individual outside of your office who referred a patient to you or helped you with your marketing. Make sure you include a card of thanks and perhaps a fruit basket or other small gift. Let them know that you are looking forward to another year working together for better health.
Internet
Review your website with your Internet company. Set up a consultation with someone to review how well it is drawing new visitors. Make plans for improving traffic and conversion for the first three months of 2021.
Sample Plan for Special Events
January. Video series about improving the immune system: 10 Proven Shortcuts to Improving Your Immune System: 15-minute video every Friday. Include guest providers. PROMOTE these.
February. Valentines. Have a Heart gift certificate. Donation Drives.
March. Saint Patrick’s Day – Leprechaun Appreciation Day – A special kid’s day.
April. Earth Day. Community Clean-up Drive. Include external alliances to help.
100’s More Marketing Ideas
For 100’s more marketing ideas that have worked, if you are active with PM&A, go to our Member’s site, www.pmamembers.com. If not, we still have many effective marketing procedures right here on this blog.
Meet with Your Consultant
All offices are different. Some need fast action direct marketing — others benefit most from long term development of their external network. Meet with your consultant to make plans for the first part of 2021.
MARKETING MANAGEMENT
Someone to Coordinate
It is essential that you delegate someone to coordinate your marketing as a project manager. Too often, marketing does not get done because, well, no one person is responsible. This is a major cause of the Practice Roller Coaster. While your entire office and everyone in it, staff and doctors, have marketing roles, one person aside from the doctor needs to ensure each project and procedure is implemented.
Goals and Attitude
Commitment to your goals and the right attitude undercuts everything. How strong is your desire to fulfill the mission of your office? Does the WHY? of your business enliven you each day, and are you happy about it? (Yahoo! Can’t wait to get to the office to see my next patient!!)
Of all the projects and procedures mentioned and the hundreds not mentioned, your drive to your goals and your attitude about achieving them is the most fundamental component to marketing success. Work and improve on this each day.
Ed Petty
Bonus Article: Health Tips from Mercola.com
1
[Link to a checklist of patient education procedures below.]
Educate your patients!
There are so many reasons why — let’s look at a few of them. Then, I will show you how your team can implement your patient education procedures.
1. Selling the Invisible. Unlike buying a refrigerator, your patients are purchasing something they can’t see.
They are receiving a service for which there are no concrete, tangible references for them to judge whether the services were excellent, complete, or long-lasting. Outside of immediate relief from their symptoms, they may wonder if you provided a great service, shortchanged them, or are recommending more than they need.
On the other hand, you know the length, breadth, and depth of what you provide. Virtually, you can see the outcomes, know the measurements, understand the symptoms and know what they point to. But to your patients… it’s all an illusion. They have to trust you and what you say.
Typically, once the symptoms are relieved, many patients believe that the condition is resolved. But through education, your patients can understand how your treatment recommendations are a pathway to fully resolving their condition.
2. Beyond Your Services – Your Patient’s Optimal Health. Beyond your services and the treatment program you suggest, your patients will benefit from general health knowledge. Health is a lifestyle, including exercise and nutrition, but the healthy way of living is distorted by unrelenting drug advertising and propaganda.
Low-fat diets, diet soda, statins and other drugs are still an accepted part of the conventional health model. Pharma is increasingly pouring billions into advertising — $328.6 billion in 2016 from $116 billion in 1997.(1 ) In addition, there are untold sums spent on lobbying your elected officials and paying for their election expenses.
Health reality is being manufactured for corporate profits rather than for personal and family health and longevity. Your patients and neighbors in your community don’t have a chance without your calm teaching of the facts on how to achieve a healthy and long life.
3. Customer Education — From a strictly commercial point of view, other businesses are seeing the advantages of customer education. According to learning industry analyst John Leh, “In a world where customer success increasingly determines overall business success, customer education has become an imperative.”(2)
Studies support the idea that customer education pays off. According to studies by ThinkJar, a customer strategy consultancy, “Customers are thirsty for more information and knowledge.”(3) And a study by Eisingerich and Bell conclude that customer education improves the trust in the company.(4)
Major businesses are investing large sums in educating their customers, and a leading customer education platform, Skilljar announced it has raised $33 million in funding. That is a significant investment! Their goal is to provide tools to companies to better onboard, engage, and retain customers at a large scale.
So if you want healthier patients and a healthier community, and if you would like to generate more profit, simply spend more time educating your patients. It is not that expensive! But as with most value-added programs in a practice, projects rarely start, and when they do, they are abandoned almost as soon as they begin.
To avoid this, use a checklist!!
Download the Patient Education Checklist for some ideas on what you can do to educate your patients. Assign a team member this checklist and give them 1-3 hours per week to work on selected projects and report on them at your meetings. They can take on the role of Patient Education Coordinator and help everyone on your team up their game in patient education.
The more your patients know, the further they (and you) will go.
Ed Petty
1. Consumer Reports, January 14, 2019 2. Avramescu, Adam. Customer Education: Why Smart Companies Profit by Making Customers Smarter. 3. Interview with Kolsky, Foundoer of ThinkJar. Huffpost, 10/15/2015 4. Andreas B. Eisingerich, Simon J. Bell, February 1, 2008 Photo from UCLA
Selling the Invisible – a favorite book of mine by Harry Beckwith
“You will never reach your destination if you stop and throw stones at every dog that barks.”
Winston S. Churchill
For a printable copy of this tent poster download: Reach Your Destination – Churchill
“Feelings of anger, bitterness, and hate are negative. If I kept those inside me, they would spoil my body and my health.
They are of no use.”
For a printable copy of this tent poster email services@pmaworks.com
“Everyday courage has few witnesses.
But yours is no less noble because no drum beats for you and no crowds shout your name.”
~Robert Louis Stevenson
For a printable copy of this tent poster visit: Everyday Courage-Stevenson
Here is some new information from our insurance expert Lisa.
Th AMA just released CPT Code 99072 which is relevant to chiros for the reimbursement for cleaning supplies, hand sanitizers, wipes, sprays. ect.
To read the article of the recent release please click here CPT Assistant Guide Coronavirus Sept 2020
What we know:
99072 is a special services billing code, used for additional supplies, materials, and clinical staff time over and above those usually included in an office visit or service. The code captures practice expenses during a Public Health Emergency such as:
FAQ
Q: What is the reimbursement for this code?
A: Reimbursement information is not available at this time. We will continue monitoring future communications regarding reimbursement.
Q: When is this effective?
A: Immediately.
Q: How much should I charge?
A: This all depends on what you paid for the supplies, what you pay your staff per hour, and taking into account how much time you spend on the additional activities. Our estimated calculation comes out to around $4-$5 per billing encounter, but this is an example estimate.
Again, we will post more information relevant to chiros as it becomes available.
Questions in the meantime? Email Lisa at lisa@pmaworks.com.
Sincerely,
Your Allies and Advocates at PM&A
Around the year 2000, I published the Marketing Manager System. It was initially a series of binders (3) to help chiropractors with their marketing. I received many compliments and positive reviews from both doctors and staff on how it helped them. Palmer Chiropractic College ordered a few hundred of the binders.
A couple of years later, I converted it into a software program and sold it as a CD package you could install on your computer. After a couple of years, I had to shelve the product. I was not set up to stay current with the constant changes in both software and the Internet.
Still, the information is sound, and it continues to work. Much of it is on our PM&A Member’s site, and though the graphics are somewhat outdated, the fundamentals still apply.
One of the motivations for publishing the Marketing Manager System was to solve a simple marketing challenge almost every practice we worked with had. In fact, the problem was so simple that it is almost embarrassing to explain.
We would get a call from an office requesting “something” to “get their new patients up.” “Got an ad that is working?” would be a typical request. And we would often hear this after working out an effective marketing plan that had been working for months at generating more new patients.
“What happened to your new patients? They were doing very well, even increasing,” we would ask. But when we checked if they were still implementing the marketing plan we had worked on, the usual answer was “no.”
We would go over the action steps on the marketing plan with them. “Are you still doing X?” “Umm, no, guess we forgot about that.” “Are you still doing Y?” “Oh yea, well, the staff member in charge of that took on another role so she couldn’t do Y anymore.”
You get the idea. What worked gradually gets abandoned.
So, I came up with the Marketing Checklists. These were a comprehensive list of marketing procedures, several hundred all told. They were a compilation of marketing procedures that we had used or had seen others use effectively. The idea was that by using the Marketing Manager System, the office would put together its own customized marketing checklists using ours as a template and reference.
This brings up the subject of checklists. In 2009, a surgeon named Atul Gawande wrote a book about checklists called The Checklist Manifesto. Here is a relevant section from his book:
“What is needed… is discipline. Discipline is hard — harder than trustworthiness and skill and perhaps even than selflessness.
We are by nature flawed and inconstant creatures. We can’t even keep from snacking between meals. We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.
Good checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything–a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps–the ones that even the highly skilled professional using them could miss.
Good checklists are, above all, practical.”
By the way, I cover this in my new book, the Goal Driven Business scheduled to come out in early 2021. I have learned how to make these checklists more practical and, well, Goal Driven! (I plan to update all of the Marketing Checklists into their new Goal Driven version next year.)
So, from the archives stored away since 2000, enclosed is one of the 13 marketing checklists from the Marketing Manager System. This one is on Patient Referrals. It lists just a few procedures you can use to help generate more patient referrals. Of course, there are many more, and I recommend you make your own checklist and review it every 3 – 4 months.
And that is the key: keep marketing procedures that are working – working.
To help you do this, list them on a checklist and review the checklist regularly to ensure that they are still occurring. Use the checklist like an assessment. Look at each successful marketing action and ask: “Did this get done all the time, some of the time, or oops! Hardly at all.” Make sure all marketing duties are assigned. Then, where needed, improve them.
Stay Goal Driven and help your patients do the same!
Ed
Download the The Marketing Checklist on Patient Referrals.
Over the last few months, we have noticed that offices have continued to grow – some even breaking their previous records!
Why is this?
I have heard from doctors and office managers that patients may be hesitant to visit medical offices and prefer seeing chiropractors, acupuncturists, and other health-oriented offices instead. Are they just afraid of the COVID at medical centers, or are they truly seeking to improve their health and immune systems?
What have you heard?
I am going to guess that your practice is filling back up as well. What should you do to augment your growth, sustain it, and even increase it?
You want to think about retention and then generating more referrals – from patients and from community members. Consider the following:
As a more aggressive approach, you may want to be more vocal in promoting better health in all its aspects, from what we eat, breathe, to the kind of health care we seek. In this regard you could take on the role of Health Rebel, or even Health Outlaw!
Your unique selling principle (USP) should include your noble purposes that sets you apart from comparable alternatives. Consumers are looking for businesses that take responsibility for social and environmental issues. And, according to several studies*, this is especially true for the younger generation – Generation X – those born in the 1990s. Speaking out for better health in your community and against toxic pollutants, for example, is not only a noble purpose but – if genuine, has practical marketing benefits.
There really are two sides in our health culture – one for optimal natural health of the planet and of our bodies, and the other as advertised by corporations.
Your community is bombarded with thousands of advertising messages each day, many of them promoting drugs and COVID hysteria fears. Advertising is a form of population control, which is an advanced science, and which may be used increasingly to motivate your community to consume more vaccines, including for COVID. Yale University, as reported by Mercola, is testing advertising messages to shame, embarrass, anger, and otherwise motivate people to take the vaccines.
And the campaign has already started. According to USA today, it is patriotic to get vaccinated.
And it is not just the push for vaccines. Corporate medicine has been discrediting natural health remedies, including chiropractic, nutritional supplements, and certain medical practices such as chelation for years. And outside of health care, we can see advertisements for the cancer-causing Roundup (with glyphosate), “foods” with toxic ingredients (e.g. aspartame), and the suppression of information about mercury, hexavalent chromium (as in the movie Erin Brockovich), and other toxins currently in our drinking water.
This is really your time. This is a contest for health independence from corporate tyrants that have set up laws to escape liability for their actions. But those of you in the chiropractic profession are used to the fray. Now, you are not alone. Other doctors are also experiencing suppression and personal and professional retaliation and are joining the fight.
The sales of organic food and supplements continue to increase. And based upon your practice returning to pre-COVID levels, the tide just may be shifting towards true health.
But only with all of our help.
Helping you to help more people,
Ed Petty, and all of us at Petty, Michel, and Associates
“I learned this, at least, by my experiment: that if one advances confidently in the direction of his dreams, and endeavors to live the life which he has imagined, he will meet with a success unexpected in common hours. … If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them.”
Henry David Thoreau Walden
For a printable version of this tent poster click: Castles in the Air-Walden
I’ll do whatever it takes to win games, whether it’s sitting on a bench waving a towel, handling a cup of water to a teammate, or hitting the game-winner shot.”
– Kobe Bryant
For a printable copy of this tent poster click: What it Takes to Win – Bryant
The Centers for Medicare and Medicaid Services(CMS) recently released a new ABN Form.
The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 06/30/2023 will be mandatory on 8/31/2020. We are including the links to the forms for your convenience and they can also be viewed at the CMS Web-site.
In addition to the expiration date on the form, there are a few other minor changes. If you have further questions please feel free to contact Lisa at 920-334-4561.
I try to visit Facebook at least once a week. When I do, I sometimes see posts by others labeling the behavior of the public as “sheeple.” The term, I guess, refers to people acting obediently like sheep. The context usually includes those who believe that COVID-19 is a scam and view people who wear facemasks and observe CDC rules for quarantining as weak and stupid, and easily manipulated.
There certainly are indications, as well as precedents, that can support this view. The promotion of potential threats to generate fear has often been used to motivate people. Think of all the weapons of mass destruction that we were told Iraq had – which they didn’t have — that justified a 3 trillion-dollar war (estimated, Wikipedia) to the U.S. alone—not counting up to 400,000 killed. Someone made money off that scam.
There are over 100 cataloged types of biases, and we all have our own odd fears and weird ideas. Included with this is our basic “I-am-right” mechanism that makes others wrong and emboldens our ego.
Recently, I was talking to someone on their speakerphone while they drove in their car. They were wearing a mask and their voice was slightly muffled. I thought to myself that it was odd to talk to someone who was wearing a mask while in their car. Then, I was reminded that the person I was talking with has unselfishly devoted his entire life to taking care of his severely health-compromised daughter.
We all have our own stories and fight our own battles – with the best knowledge we have.
Another method to control people is to dissuade them from education and from learning to think critically and question authority.
So, I invite you to consider this as your #1 duty as a doctor – and as support staff — to educate your patients and community. Doctor, after all, means teacher.
People do not know what you know.
Perhaps they don’t want to know, are too tired, or seem too lazy to make an effort to learn. Maybe they have already made up their mind, and their view reinforces their own identity. But don’t give up on people — they are part of your family. They are your brothers and sisters.
Use newsletters, social media (even Facebook!), webinars, and especially Table Talk.
Educate because you care for people. Market your services from an attitude of compassion.
We are not sheep. We just don’t know. And regardless of what we say, privately, we look to you and your integrity — for your wisdom, your help, and your friendship.
Ed
The Story of Selling Yourself by B.J. Palmer
A tree withstands storms but continues with its systems.
Just a note here about procedures:
Keep the structure of your business – its policies and procedures — in place. As much as you can, stick to your usual routines.
Certainly, you want to integrate needed changes to prevent the spreading of the virus. And obviously, for many of you, patient volume has changed, so you may have to adjust your work hours and staff hours.
You do need to be flexible. Improvise — where needed, adapt, and overcome! (Paraphrase of Marine slogan!)
But do not let the virus be the tail that wags the dog!
Keep the recalls going. Keep the billing going. Hold staff meetings, if only by Zoom. Rally the team! Review numbers and SET GOALS. Give staff study assignments. If anything, increase your patient communication 5 times – or more.
Strengthen your network.
I bring this up as I have seen a few offices start to slack off on their procedures, and while this is understandable in many situations, it can be a slippery slope. This can set a precedent for neglecting other procedures. This is what leads to office anarchy and what I call “Procedural Atrophy.”
Procedural Atrophy is the gradual dropping out of procedures. For example, you used to call every new patient after their first adjustment and send out birthday cards. Then, you became so busy that you “didn’t have time” to do the calls or to makes sure the staff sent out birthday cards. Two years later, you wonder what happened to all your patients.
We are NOT victims. We will respond positively and use this opportunity to strengthen our resolve and our health network.
Hold true to time tested procedures during unusual conditions.
Stability breeds confidence. Your patients are looking to you to be the rock that they can count on.
Management’s job is to hold the structure of the organization in place. (And then improve upon it.) It may have to be abbreviated, economy of time, effort and money come into play, but … do the usual. Set your goals and stick to your successful procedures to reach them.
Do this, and after this storm passes — your business will be busier than ever.
Working now for the future,
Ed
(image from the movie Troy, with Brad Pitt playing Achilles, a Greek warrior. Reddit)
You and your team may not recognize this, and the word hero is overused, but in our book, this is what you are. Heroes.
Caught up with dealing with the urgencies of the times, you and your team may overlook the crucial and significant role you all play in raising the level of physical and emotional health of your community.
Without you, people in acute pain might tax critical and urgent care resources. Without you, patients on corrective or maintenance care might fall back into acute care.
You help alleviate our pain and improve our health – including our immune system. You calm our concerns with your well-informed insight and give us action steps to improve our health.
Health, as we know, is dependent upon mechanical, chemical, and emotional factors. Besides your adjustments and therapy, you provide education – and reassurance that this pandemic will pass.
I hear about it every day. You risk your health to help others, both physically and mentally.
Let your team know the vital role that they are playing.
Years from now, when asked what they did during 2020 Pandemic, they will be able to say that they were Essential Health Care Workers — and didn’t flinch.
And we just wanted to tell you – very sincerely – THANKS!
From all of us at Petty Michel and Associates.
I am sure that all of you are trying to stay up with unfolding events regarding the virus and the governmental recommendations – and enforcement — to deal with it.
We are, as well.
I am sending this email out to encourage you to watch an informative video by Del Bigtree, who reviews the facts and numbers of the virus pandemic. It is a bit long, so I am sending this out this weekend in case you have more time to watch it.
I have also included an article by Bruce Lipton. Dr. Lipton is a cellular biologist who taught medical students at the University of WI medical college and often speaks at chiropractic seminars.
Plus, an article that states 99% of those who died from the virus had other illnesses.
(Links below.)
We must watch out for the GENERALITY of the virus. For example: “COVID-19 could kill us all!” “Who says?” “They do.” “Who is “they.”” “The authorities.” “Who are the authorities?” “Those who are in charge.” You have to break it down and be as logical as you can.
I recommend that you review these sources, add to it what you are learning, and using your best judgment, continue educating your team members and patients/members/clients!
Be the lighthouse in your community.
Education and knowledge displace fear and uncertainty.
Let’s eradicate what Dr. Lipton calls the “nocebo” effect — the opposite of a placebo.
And let’s continue our fight to help people get healthier!
Keep educating,
Ed
By the way, no one is saying you must close your office. Even in California where San Francisco has a “Shelter in Place” or strict quarantine. For example, the California Chiropractic Board of Examiners, on their website, states:
YOUR SERVICES ARE VITAL!
The Exec. Director of the Kansas Chiropractic Association, in a letter to their state Governor (March 20, 2020), stated:
“We understand that with the severity of the current pandemic hospital emergency rooms may soon be filled with patients complaining of pulmonary symptoms. We offer our services in diagnosis and treatment of musculoskeletal complaints presenting to emergency rooms. Many Doctors of Chiropractic have arranged to be a referral point for their local emergency rooms on these conditions.
“We are prepared to see these patients in our offices that are already taking every precaution available to prevent the transmission of COVID-19.”
REFERENCES
Del Bigtree Coronavirus Quarantine March 19
Bruce Lipton Cornonvrus 2019-Covid-19 UPDATE
Bloomberg News March 18, 2020 99% of those who Died From Virus Had Other Illness, Italy Says