I am certain spiritual or not you have heard of the 7 Deadly Sins. Well for many practices there are numerous sins committed in business each day. The reason for these sin is simple: a)lack of knowledge, b) lack of time and c) lack of awareness of the issue.

It is so important that practice managers pay particular attention to the business. What typically is forgotten is that nothing happen unless a patient pays. Doctors and staff must create business efficiency and organization if the practice is to survive. Here are the 7 sins of practice management that negatively impact the practice:

Marketing – The doctor and staff must actively engage in the marketing business. Everything they do must act to ensure there is acquisition and retention. This includes activities that engage patient around brand.
Sales – Nothing happens without a sale. Selling happens when patients exchange value for dollars. The problem here I know of too many doctors that are afraid to ask for money. Patrick has an front desk person that requests payment before individuals walk into a treatment room. Being meek does not pay the bills.
Service – So many practices ignore customer service. The greatest asset of any business is your patient. The difference between a profitable firm and one that isn’t is customer service. Don’t believe me then visit an office with a full waiting room and one that is empty – the difference, customer service. Patients are not an interruption of the business they are the purpose of it!
Hiring – People make a difference. Staff is the first and last people patients see. When your staff treats patients like yesterday’s garbage, they find another physician. When they take pride and illustrate purpose, patients remain. Ensure you hire right. Hire for talent not behavior.
Benchmarking – The problem with many practices is that they do just that – they practice. In fact, some are so good at practicing they do not compete. If you want to take your business from the practice field to the competitive field then you must have key performance indicators that measure success. When it is measured, it is repeated.
Accounting – Ron loves to travel and have nice vacations. However, he is so busy spending he is not reinvesting into the practice. Material items are great but they do nothing for business expansion, reinvestment, and retirement.
Strategy – Too many doctors are so busy on working on tactical things that nothing gets done. Doctors need to think strategically because this is what the business is to become not how.

Did you know that every doctor has the same 17 Business Frustrations? Want to know what they are?

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

All chiropractic practices to service patients and they exist because they are a business. This is where many miss the mark since many chiropractic practices forget that they are actually a business. Chiropractors today must think in terms patient care efficiency and profitability. To help the chiropractor and his or her staff must think daily about the five things that actually influence their business side of their practice.

The five areas of a successful practice review:

Time
Talent
Money
Systems
Processes

All five must be focused on daily in order to operate an efficient practice. My work with hundreds of chiropractors and businesses suggests that the lack of attention and focus will throw any practice into panic and survival. Focusing on the five concepts can mean the difference between thriving and barely surviving. Over the course of the next several days will share with best practices so that you can implement them into your own firm.

First a brief explanation of each:

Time – Most chiropractors are so busy attempting to see as many patients as possible they lose focus on items that are equally as important such as 1) creating awareness and community, 2) staff development and communication, 3) building alliances to aid the practice, 4) reviewing the systems for key performance measurements.

Talent – In the crazy busy world in which we live it is essential to focus on those people that can make a difference in the practice. From the front desk staff and first impressions to billing and coding. Dismissing the benefits of good staff can make or break your practice.

Money – It is unfortunate how many chiropractors pay little heed to numbers and metrics. When recently asked a chiropractor I spoke with did not know what his accounts receivables were. When there is little knowledge of those things that keep the practice afloat as well as few benchmarks that denote the status of the practice – there is a recipe for future issues.

Systems – I find that building your practice is similar to building a residential home. Before the framework is being installed, the foundation is built. Similar to a home or commercial building, the foundation vital for the home remaining for years. Without proper systems such as a business model, a business plan which are your systems, the business cannot operate towards future success.

Processes – Processes are those items that operate the systems. They are the pathways to indicate how patients are acquired, how they are treated when they enter the practice and just as important how to get them to remain.

While there are more items and more procedural methods that I will introduce in my forthcoming book “Practice Acceleration”, do note that these five are the foundations for operating an efficient practice.

Over the course of the next few posts, I will separate each one and help explore how you can implement some best practices into your practice. Stay tuned when I provide information on how to implement best practices in time but more important where the doctors time is best spent.

Did you know that every business owner has the same 17 Frustrations? Want to know what they are? Find out now!

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

Janet Jones works 95 hours a week seeing patients, trying to provide the level of medical care she has always wanted to provide. Her passion even during her undergraduate days was caring for individuals and ensuring their health. She opened a small practice and like many other physicians uses insurance to fund her practice. Eventually she could not keep up. Billing, coding, denials and constant changes left her with much to do, so much so that she missed anniversaries, birthdays, and many other special events.

With the notion of trying to keep pace with healthcare rules and regulations, she was actually beginning to lose money. Between stress, increasing expenses, a family to feed and patients to see she was running low on tolerance and high on anxiety until… the doctor needed a doctor. In the midst of an exam – she collapsed.

One must remember that when you decided to attend professional school for chiropractic you gave up a lot. You may have delayed getting married, having children, taking vacations and even spending time alone. Then as your desire increased so did the bills and the pressure to succeed. You carried on with your path attempting to become the best-darned physician that you physically can be… that is until you found out what was needed to run the practice. The DaVinci Code of Chiropractic was revealed, and the standard business model is accepting payment from a third party.

As is often discovered this is not the best method for operating a practice simply because when you operate a model with the third party concept the following happens:

You lost control
You are beholden to payment dates and rates
You have no other source of income
You limit your exposure to your patients. They can tell you how often to see them and when to end your relationship.

To stop feeling alienated and like a victim, physicians need to develop a business model. One that is most suitable to you, your personality, and your working habits. This requires sitting down and sketching out on a piece of paper:

The perfect patients you desire to work with
The type of insurance companies you desire to work with
The type of care you desire to provide i.e. sports injury, geriatrics, pediatric, hypothyroidism, etc.
Methods and activities required bringing new patients to the practice
Key benchmarks that ensure success

Over 54% of physicians surveyed do not have a business plan or even a business model. The issues associated with this are dysfunction, disillusion, and dissatisfaction. The road to a successful chiropractic need not be long or stressful if mapped out and planned. However, the lack of planning and modeling could eventually harm you personally and professionally. Run the practice with the same skills you desire of your patients – healthy and maintenance free.

Did you know that every business owner has the same 17 Frustrations? Want to know what they are? Find out now!

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

When it comes to chiropractic there are no statistics that illustrate how many do well and how many fail. Yet it is safe to say that those entering the field after exams without the proper coaching and guidance will suffer. This happens in one of 2 ways: a) venturing out by yourself and not having clear guidance on how to set up a practice or b) working with someone as an associate and they’re not illustrating to you the proper practice protocols. Why is this so important simply because not gaining the proper advice can get you into much hot water.

While there are many things that are required to help operate a successful practice one of the most is benchmarking or the use of key performance metrics. Simply put what gets measured often gets repeated as well as creating a level of practice achievement. Now there are many pundits that will inform you of what to measure but suffice to say they key items correlate to the following:

- Patient Visits – Ladies and Gentlemen you cannot operate a successful practice if you are not measuring the number of new patients coming to the practice. Think of it this way nothing happens unless there is a new patient coming to your practice.

- Patient Cancellations/Reschedules – True people have busy schedules, however if appointments are cancelled or missed similar to above you do not get paid. When you have hungry children or a landlord, cancellations are no excuse for non payment.

- Revenue – It is vital for you to keep track of monthly revenue as well as the expenses that offset any revenue. I highly recommend the use of patient forecasting as well as monthly profit and loss statements.

- Debtor Days – This information concerns the amount owed to you in terms of both reimbursements and patients that have not paid their co –pays.

- Patient Attrition – why are patients leaving you and why are they only remaining for immediate care and not maintenance. There is value you are missing out on.

- Bad Collections – this includes those patients that forget, run out of money, are running from the law, or just ducking you. However when they have your money, you have nothing but bills.

There are several more items that can be included but you need to have a roadmap that guides you towards the success of your practice. There are too many physicians that do not pay heed to the numbers or let others do it for them. However the practice is yours and yours alone, do not leave important revenue and profits in the hands of others or the unknown. When you keep track of the numbers you keep pace with competition.

Did you know that every business owner has the same 17 Frustrations? Want to know what they are? Find out now!

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

A large struggle for many chiropractors is not necessarily acquiring a patient it is retaining them. As physicians you have three methods of care 1) determine how to mitigate the immediate pain, 2) treat that immediate pain and get them back to where they were prior and 3) after initial treatment help them maintain the triad of health body, mind and biochemical.

When conducting chiropractic coaching I typically need to help the chiropractor convince the patient to maintain good help. If you are like many that struggle here there is a good reason – failure to articulate your value.

Doctors you need to understand that there are too many choices today. Patients have options they never had before they can a) self treat, b) find another physician due to the prowess of the Internet or c) do nothing. Many choose the latter because they are too busy and cannot find the reason to do so. The true reason no value.

Therefore if you want to increase your revenue, lower your labor and retain more of your patients for the long haul you will focus on the three things patients seek: a) identification of their wants and needs b) the ability to build a trusting relationship and c) conversations based on benefits and value. Your conversations have got to stop being “me” oriented or “fact” oriented and focused on the results the output and the relief patients will gain from this care.

Additionally, you need to speak in terms of case study and proof. Patients want to know what you have done for others in a similar situation. Case studies are much better than testimonials because they illustrate the issue, your treatment and the resolution.

So the next time you have a patient that only wants immediate care, keep building the relationship and speak in terms of value. Doing so will stop them from saying, “Frankly I just don’t give a (care).

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

Every healthcare organization has had to deal with patients who either don’t show up for appointments or are more than 30 minutes late. Missed appointments mean missed revenue for practices and other healthcare organizations, while significantly late patients can throw off your entire day’s schedule and force your other patients to wait for you – something that could potentially anger them enough to consider leaving your practice. (See MOT’s article “Reducing Missed Appointments”)

Clearly, you need a policy for managing no-shows so they don’t derail your practice. One solution that some healthcare providers have chosen: charging patients no-show fees for missed appointments or significantly late arrivals.

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You have choices and it is the path you take that determines your future. Take Roy for example a former abused child. Roy had three choices growing up a) have children and beat on them, b) use drugs or alcohol to fend off the post traumatic affects of the beating or c) mature into a fine business man and never look back. He took the most plausible road possible.

Without sounding trite, our forefathers met tremendous challenges to secure freedom; in some cases your ancestors fought adversity coming to America. And even today, your friends, parents and children fight war, tremendous economic issues and career defeats. But, it is the choices they make.

The choice is yours, which path is right for you, right now?

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

I conduct many seminars especially for new chiropractic graduates and it always surprises me how cocky some get about working hours. There are times when I ask many graduates how many hours they intend on working or the hours once beginning practice – 2.5 days per week and over $100K in the first year!

Ladies and Gentlemen, chiropractic is a business just like any other; printing, restaurant, shoes, anything. Chiropractic requires structure, processes and chiropractic marketing. In addition, ask any chiropractor who has been at it for a while – it requires you to bust your hump. You need visibility while you are also treating patients! This cannot be done in 2.5 days! And there is no way that you will reach 100k in the first year unless you play the lottery!

What got you into chiropractic is only the beginning of the road. The boards are only the doors to the kingdom. As Lao Tso once said, “The journey of 1000 miles begins with the first step.” Not only do you have to take the step but you gotta keep walking. Work hard now, toil away and depending how hard you work, you reward will be future days off.

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

Each day will require that chiropractors hustle to ensure patients are interested in care. This requires a never-ending battle to achieve visibility and create community both within the local and regional areas. Similar to the manner in which many organizations brand products and services, the chiropractor must ensure that they are known so that patients can be attracted to their work. To that end there are several factors at play to ensure patients become attracted to someone’s practice.

Networking – Truth be told the only way to make a splash in the community is being known and available. Patients will choose you when they know you and know of you. The point here then is to become the mayor of your local communities. This requires quite a bit of activity. And it requires a daily dose of meeting and greeting individuals. I typically tell clients that if they are in the office not seeing patients then they are to be out meeting with prospective ones. Time in the office is meant to heal, and time out of the office is required for your meal! And networking requires constant interaction and follow up which I will cover in a future chapter but suffice to say if there is little commitment and follow-up there will be lethargic patient visits.
Advertising – In my experience advertising is not the most conducive method for gaining patient volume. One needs to understand that there is much noise in the market today. Most patients like you are multi-tasking and it requires a large effort to ensure their attention. This requires multiple methods and quite a bit of money. It also requires differentiation. Advertisements must create emotional connections, value and differentiation from the other chiropractor down the street. While in some markets it does work attracting patients, it is important to understand how advertising will create a return on investment in your area.
Promotion – A form of advertising, promotions are methods to help conduct two things 1) traffic or 2) move inventory. Some chiropractors will conduct promotions to help move vitamins, pillows, dietary products and numerous others items for passive income. And some will produce a series of promotions to bring traffic to the practice such as massage, free initial treatment, screenings etc. Similar to advertising, promotions can work as long as they are specific, time based and researched effectively.
Community and Professional Affiliations – People conduct business with whom they know and trust. One chiropractor I work with is very active on his local Fire Department Board and Chamber of Commerce. As such a good inflow of his business stems from these affiliations. Part of networking is becoming affiliated with as many organizations as possible so that people get to know you.
Website – When I was a child I remember the two times per year we would get the Yellow Pages© delivered to our home. When I got my first telephone I could not wait to see my name and number listed. However, it was a very cumbersome book to review. Now in the age of Internet and online searching most consumers research the Internet before they call you. In fact, I recall some research that states there are over one billion searches on Google™ each day. With that type of power it is important to have a website much like signage in a strip mall or kiosk in a shopping center. Chiropractors need a method for others to find you.
Personal Interactions and Referrals – Another form of networking, personal interactions and referrals will be the best form of business. if your parent or immediate family member were ill, would it be more useful to look up a position in the Yellow Pages, conduct an Internet search, or simply call someone you trust? In addition, with the increased use of social networks, patients are speaking positively and negatively about vendors they have done business with. Therefore it is imperative that your name and brand are in good standing so that you can obtain third-party endorsements from those who trust you.
Buzz Marketing/Word of Mouth – The best method of referrals is getting your patients to talk about you. When you create patient centered relationships, use proper customer service and truly have patient care top of mind your patients become pundits for your practice. They will shout from the rooftops to tell others of your passion, professionalism and persistence to help. Studies truly show that in most instances, patients avoid promotions, advertisements and other media and do business that others tell them about.

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

My client John called me the other day very upset that he was spending infinite amounts of time on billing and invoicing and could not seem to rise from the paper. When I asked him how many patients he saw he stated that he was too busy to see any because he was stuck with invoicing. In fact he mentioned that it took him over 10 hours to resolve one issue.

Time my friends can be your best friend or your worst nightmare. The reason- there are instances when you go down one road and before you know it the project that appeared to be a five-minute thing now lasts hours. Your children are married by the time you finish! However the biggest problem is that you allowed time to control you.

If there is one issue I see from office to office it is the incredible amounts of time wasted by not on the DC but also sometimes the CA.

When it comes to getting things done in your office there are several things to consider:

Delegation – Too many chiropractors even those that are solo will tell me that they need to do everything. They will fester for hours trying to print invoices when paper jams in a machine or they will become frustrated trying to make copies of brochures that are not printing correctly? Truthfully where is your time best spent? There is only one answer to this question – in front of patients. You need to think like an airline. When planes do not fly they do not make money. When you are not meeting patients you are not making money! When possible get someone else to print the invoice for you and definitely visit a printing store that can make copies for you. Your time (approximately $160/hour assuming 4 patients/hour) in front of patients than making $.045 brochure copies.
Resources – Start investing in those things that will help you. If you do not have a computer in the electronic age then you need to buy one. If you need assistance but cannot afford full time then seek out a part time CA. And if you need better methods for scheduling and billing then invest in a software program. You need to invest in those items that will help you even if you are not in a thriving office. One item will advance you a hundred fold.
Prioritize – For heaven sake the largest time waster for any chiropractor or assistant is simply prioritization. Too many of you will work on nebulous items or avoid certain things because they take too long. Work in blocks of time and do not allow one thing to take more than 30 minutes. First and foremost patients come first so scheduling, rescheduling and cancellations will be your first priority. Reviewing the new codes for insurance will be last especially if only one of your patients is on that plan and lamenting over the color of a PowerPoint slide for 45 minutes for an upcoming seminar is not even close to important. Start the day with only 6 things that need to be completed and rate them in order for example 1) patients, 2) call backs, 3) billing 4) networking at chamber meeting 5) reading a magazine about recent holistic trends, 6) reviewing the brochure to be sent to prospective patients. When you align your day with what is most important you work from an urgency perspective and get things off the plate – for good!

Drew Stevens Ph.D. is a world-renowned marketing mentor for chiropractors. Drew is one of those very rare chiropractic-marketing experts with not only 30 years of true experience but advanced degrees in marketing productivity. Not many can make such as claim. Drew works with chiropractors and professional services firms who struggle like crazy to create customer centric relationships that create new revenue. Dr. Drew has aided professionals to reach billions of dollars in new revenue by strategically implementing processes and methods that develop new relationships and new revenue.

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