Written by Kent Greenawalt   
Wednesday, 30 June 2004 20:46

TAC: Tell us a little bit about the history of Foot Levelers, Inc.

Greenawalt:  Foot Levelers is the world’s largest custom-made Spinal Pelvic Stabilizer company.  We use the term Stabilizer instead of orthotic, because our products stabilize the pelvis and spine by correcting imbalances in the feet.  They are custom-made and scientifically designed to address the patient’s unique postural problems.  They are not the same as a product that can be bought off the shelf.  My father, Dr. Monte Greenawalt, founded the company in Dubuque, Iowa, in 1952.  He is a chiropractor who learned that, by supporting the feet, you can make adjustments hold longer. We have been perfecting Stabilizers ever since.  In fact, we have had many patents awarded to us for our unique designs.  In 1988, Foot Levelers moved to Roanoke, Virginia.  Foot Levelers is over 50 years old, and we’re just getting started.

TAC: How are you giving back to the chiropractic profession?

OrthoticsGreenawalt: Foot Levelers has supported chiropractic from the beginning, because my father believed in giving back to the profession.  At Foot Levelers, we do our best to support all levels of chiropractic.  We give financial support to all of the chiropractic colleges, the Congress of Chiropractic State Associations (COCSA), The Foundation for Chiropractic Research & Education (FCER), as well as state and national associations.  We believe in education and, as a result, we have funded scholarship programs and also enhanced chiropractic colleges with libraries, research chairs, and laboratories.  In addition to supporting chiropractic on a large scale, we also support the individual chiropractors, because they are the heart and soul of the profession.  We have held hundreds of license-renewal seminars over the past twenty-plus years, and we also publish professional manuals to help chiropractors get appropriate compensation from insurance companies.  But it has always been a pleasure and an honor to give back to a profession that does so much good for so many people.

TAC: Being an insider on the "vendor" side of the profession, what advice do you have for our readers to help them make the best buying decisions?

Greenawalt:  I advise your readers to do their research, and make sure that the vendor can prove that their products will help patients.  Any worthwhile company should be able to support their claims with research.  At Foot Levelers, we want the doctors to know that our Stabilizers are custom-made and backed up by over 50 years of research which documents their performance.  We want the doctors to be confident that our products can help their patients.  I know as well as anybody that chiropractors want to be doctors, not salespeople.  But if an adjunct product can truly benefit the patient and improve their health, then I believe that it is the doctor’s responsibility to get that product to the patient.

TAC: What are Foot Levelers' plans for the future?

Greenawalt:  I want to help chiropractic grow as a profession.  In light of this goal, I have organized the United Chiropractic Public Relations Campaign.  The goal is simple—bring more patients into chiropractic offices.   The chiropractic leaders who support this PR campaign have agreed not to start any public relations efforts on their own and to support one unified message: to get the general public to go see a chiropractor.  The fighting within chiropractic hurts us in every way—with the government, with insurance companies, and worst of all, with potential patients.  Only one-in-ten Americans sees a chiropractor.  We need to change that for the sake of the patients.  But we can only accomplish growth and change if we work together.

TAC: Any closing remarks or advice for our readers?

Greenawalt:  I encourage your readers to get involved in every way they can.  Become a member of your local Chamber of Commerce.  Be active as an area expert in your field.  Give time or money to help your alma mater improve and grow.  Get involved in your college’s alumni association and recruiting efforts.  Support the United Chiropractic Public Relations Campaign.  Become a member of state and/or national chiropractic associations, if you haven’t already.  Chiropractic needs you now more than ever. Without dedicated, involved chiropractors, there is no profession. TAC

MILLION DOLLAR CHIROPRACTIC Interview with Dr. Steven Windwer, D.C.
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Written by Dr. Steven Windwer   
Tuesday, 08 June 2004 20:27

 Originally from New York, Dr. Steven M. Windwer, began working as a physical therapist the Boston area before moving back to Long Island and attending New York in Chiropractic College. He has played competitive basketball and soccer and now is the official chiropractor at Northeastern University, where he works with the athletic trainers and cares for athletes in all sports.  

Having practiced in Massachusetts for the past thirteen years, Dr. Windwer has 4 offices that all offer chiropractic and physical therapy care.  In his main office, Dr. Windwer has a family practice with an emphasis on sports medicine and trauma.  He is the past president of the South Shore chiropractic Society and is very involved in the community.  He is married with 3 children and coaches all of them in basketball and soccer. Dr. Windwer has recently lectured nationwide on The Business of Chiropractic and has developed a product called Systems for Success.  This CD contains downloadable forms such as organizational charts, employee handbook, policy and procedure manual and position contracts and performance review tools.

In an interview with The American Chiropractor (TAC), Dr. Steven M. Windwer answers our Million Dollar Chiropractic (M$C:) questions about running his multioffice / multidisciplinary practice while maintaining the chiropractic philosophy throughout his offices.



to wife, Joan for 13 years and has 3 children (Taylor, 12; Alexandra, 9; and Nicholas, 7).
Recreation and Leisure:  "I exercise everyday, either running, weight lifting, playing basketball, spinning or cycling. I love to spend as much time as possible with my family and enjoy coaching my kids in basketball and soccer."
Professional Affiliations:  American Chiropractic Association, Massachusetts Chiropractic Society, American Physical Therapy Association.
Seminar Attendance:  The Masters Circle.
Vacations:  "We love Martha’s Vineyard and Cape Cod, Waterville Valley for skiing and, the Caribbean."

  "We are located next to Home Depot on a main Street in Quincy, MA. This office has approximately 4000 square feet.  We have 3 other offices in Massachusetts."
Office Hours:  The Clinic is open from 8:30 AM until 12 PM and then reopens from 3 PM until 7 PM, Monday, Wednesday and Friday; 3 PM to 7 PM on Tuesday and Thursday; and 8:30 to 12:00 PM on Saturday.  “However, someone is always here to answer your questions from 7:00 AM to 7:00 PM Monday through Friday and 8 AM to 12 PM on Saturday.”  
Techniques:  Diversified, SOT, Nimmo, Flexion/distraction.
Staff:  Dr. Windwer’s office has approximately 22 employees.  The professional staff includes 5 DC’s, 4 PT’s, 2 massage therapists, an accupunturist and a podiatrist.  The office also has administrative staff in management, reception and billing.


M$C: What influenced you to become a chiropractor?
  When I was in high school and was injured playing sports, my dad took me to his athletic trainer, who took great care of me and got me interested in the medical field.  He later went on to become a chiropractor.  I had decided to become a physical therapist and, midway through my training, my dad called me at Boston University and told me of this great experience he had had with a chiropractor and suggested I really consider becoming one myself.  I finished PT school and began working in the field, but I was moderately unfulfilled and decided to go back to school.  And, from day one in chiropractic college, I knew I had made the right decision.

M$C: What type of practice do you have?
  Our practice is a “multi-disciplinary” practice.  We have integrated chiropractors, physical therapists and massage therapists into our clinic.  The chiropractic philosophy is the common theme and culture in our office among all therapists, doctors and staff.  We have a general practice with an emphasis on sports medicine and trauma. 

M$C: Give us a physical description of your office facility.
I started with a 1200-square-foot space located in an old school building that had been redone as an office condo.  The office consisted of a reception area, three adjusting rooms, an exam room and a billing area.  Over time, I acquired another office down the hall of 1200 square feet that housed our physical therapy center.  We later added another condo with 900 square feet,  which became our central billing area.  Staff meetings, and patient education  classes are presented here.  Finally we obtained another condo down the hall. This one has 900 square feet and houses our massage therapists and acupuncturists, as well as a podiatrist to whom we rent space.

Our front desk was designed by Davlen & Asociates. We offer our patients nutritional products and supports.

M$C: What’s the income service level that you provide annually?
  Our income service level has consistently risen in practice; however we had our biggest increase when we added our physical therapy services.   Utilizing economies of scale and having several offices has increased profits.  In our main office we have been able to collect $1,000,000-plus for the past three years.

M$C: Do you have a set profit-standard or margin formula for the business? 
This is a great question and difficult to answer.  For a single office, we would want to be as close to 50% of our overhead as possible.  With a multiple office scenario, you are looking for around 25-27% margin.  This can fluctuate greatly, depending on the maturity of all of the practices.  We have benchmarks and standards that we look at monthly, quarterly and yearly.  Goal setting, incentives and continual coaching and mentoring are the keys to our success.

Our exam room is fully equipped with a high frequency low intensity unit by Bennett, surface EMG and thermogrphy as well as other diagnostic equipment.All our adjusting rooms are equipped with muscle stimulation, hot packs, ultrasound as well as patient education materials.Our exam room is fully equipped with a high frequency low intensity unit by Bennett, surface EMG and thermography as well as other diagnostic equipment.
All our adjusting rooms are equipped with muscle stimulation, hot packs, ultrasound as well as patient education materials.

M$C: Is there anyone in particular to whom you attribute your professional success?
  Firstly, my mom has blessed me with an incredible work ethic and value system.  My dad is one of the healthiest guys I know and has been a great example of the importance of proper nutrition, exercise and personal development.  My professional mentors include Dr. Richard Vincent, who taught me to always do the right thing the first time.  Also, Drs. Dennis Perman, Robert Hoffman, and Larry Markson of The Masters Circle have taught me so much about communication, personal growth and relationship building, as well as the importance of being a leader, and being committed to ongoing patient education. 

M$C: What marketing strategies do you use to attract new patients, and to keep current patients? 
  We track where all our new patients come from.  I think that is the first key.  If you are not tracking, you don’t know.  Our number one referral source is patient referrals.  We ask our patients for referrals regularly and it is part of our expectation that they will refer in new patients. We do a lot of lectures in the community and invite prospective patients to come in and get their spines checked.  We visit health clubs regularly and do screenings.  We also have our ads in the Yellow Pages and local penny saver. 

During our report of findings, we educate our patients on the benefits of chiropractic and the three phases.  We then explain to them why it is important to go through initial intensive, corrective and, finally, begin the benefits of wellness care.  We believe firmly in telling our patients what is best for them and helping them make the best decisions for themselves.

M$C: How do you handle problems with patient retention? 
  We believe it is all about the relationship with the patient.  Each staff member and doctor in our office realizes that people have choices.  We want patients to choose us because we are clinically excellent, nice, attentive and caring.  We work on quickly building rapport with patients and continually educating them and asking them good questions. 

M$C: We all know that an efficient staff is a crucial component of a successful practice.  Tell us what you look for in a staff member.
  The first thing I look for in a staff member is  energy.  How do I feel in their presence?  Do they have good energy?  Do I feel comfortable with this person?  I then want to know what enneagram (personality) type they are, so that I match the right personality with the correct job for them.  I also am very sensitive to team chemistry.  I love harmony.  Once I have decided I think someone may fit our team, I have him or her interview with other team members to get feedback.

Dr. Steve Windwer & Dr. David Smith are very fortunate to have an empowered and professional support staff that understands and implements the mission of the office. They embody the team

Dr. Steve Windwer & Dr. David Smith are very fortunate to have an empowered and professional support staff that understands and implements the mission of the office. They embody the term "team"

M$C: Do you enjoy your work? 
I love what I do.  I get to go to work every day to help people naturally change their lives and lifestyles, motivate my team and be in an energetic, healthy, loving environment. I can get adjusted, get some PT for any injuries, and go for a massage.  Who has it better than me?

M$C: Having a multi-disciplinary practice, what advice can you offer our readers about setting up and maintaining such a practice in today’s healthcare system? 
  First of all, multi-discipline practices are not for everyone.  There are many more managerial and administrative demands in running a bigger practice that may not be what everyone is looking for. You will need to have great systems in place to allow  you to take on a different role in your practice.

Our physical therapy office is fully equipped with a full line of Nautilus, treadmill, bikes, upper body ergometer as well as various exercise equipment. the office is staffed with 2 full time therapists treating patients for a variety of neuromusculoskeletal issues.

M$C: Other than traditional chiropractic care, do you include any other type of services or products in your clinic which further help your patients as well as bring in additional revenue to your practice?
  We offer physical therapy, massage therapy, acupuncture, podiatry as well as nutritional supplements.  We also have cervical and lumbar pillows, as well as backpacks for kids.

M$C: Any final words for our readers? 
  I am honored to be interviewed by your publication.  I would remind anyone reading that success in any endeavor starts with you.  Make a commitment to work on yourself and develop yourself in all areas:  personally, clinically, business-wise, financially, in communication skills, etc.  I would also encourage you to get a coach.  Get a team of professionals who are interested in growing you and your practice.

You may contact Dr. Windwer at 617- 471- 4491 or
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Our sincere thanks to Dr. Windwer and his staff at Milton Chiropractic & Rehabilitation, located at 111 Willard Street Quincy, MA 02169. TAC


Editor’s Note: Do you have a million dollar practice that you’d like TAC to highlight in our Million Dollar Chiropractic column? We want your inspiring story.  Contact us today. You can reach TAC’s editor Jaclyn Busch Touzard on our US direct line:
1-305-716-9212, or by email at:
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Million Dollar Chiropractic features Dr. Rick Markson
Written by Rick Markson, D.C.   
Saturday, 03 April 2004 17:35

Each article in the MILLION DOLLAR CHIROPRACTIC series (M$C) focuses on the top surveyed issues facing chiropractors today.  Recruiting new patients, retention, profitability, marketing and staffing are each a determining factor in the growth, potential and success of the practice.

The subject of this issue’s profile is Dr. Rick Markson, an extremely successful chiropractor who has practiced in Florida for the past 9 years.

Originally from Long Island, New York, Rick Markson began his chiropractic journey in early childhood.  The son of Dr. Larry Markson, a 23-year veteran of success coaching and one of the founders of The Masters Circle, he literally grew up with a love of chiropractic and is “thrilled” to be able to offer his wife, Robyn, and eight month old son, Pryce, the same experience of living a healthy, drug free life.

One of only twelve chiropractors in the country certified to teach the Thompson Adjusting Technique, Dr. Markson also lectures at chiropractic associations and colleges throughout the country on practice building, office procedure and personal growth.  He  received the 2003 International Chiropractor of the Year award given by The Masters Circle, and has acted as President of the Broward County Chiropractic Society for the past two years.

In an interview with The American Chiropractor, Dr. Rick Markson answers our Million Dollar Chiropractic (M$C) questions about what he describes as his “good old fashioned family practice” where the focus is always on chiropractic care.

M$C: What influenced you to become a chiropractor?
  I recall knowing that I was going to be a chiropractor since the age of six.  Having a father who was so successful and well respected in the profession fueled my desire to follow in his footsteps.  I have been adjusted my entire life and chiropractic care has always been the mode of health care for our family.  So, it wasn’t a far stretch to imagine myself sharing what I have learned over a lifetime.  I majored in sociology at Syracuse University.  I chose that field, because I knew that the more I understood what makes people make the decisions that they make, the better able I’d be to assist them in making the proper health care decisions.   

M$C: What type of practice do you have?
  Our practice is a good, old-fashioned family practice.  Before I started, nine years ago, my vision was to see fifty percent general practice, twenty-five percent personal injury and twenty-five percent pediatrics.  That felt like a perfect balance to me, and that is almost exactly what we see in the practice.  As I stated earlier, I grew up as a chiropractic kid. Therefore, we make sure we educate every patient on the benefits of lifetime chiropractic care for every member of their family.  I am very strong with my patients on understanding the subluxation concept and I believe that has a huge impact on our success.
I have one associate doctor and another one in the works.  They are instrumental in being able to provide the quality of care that we pride ourselves on.  We have two massage therapists on staff at all times and I see a huge benefit in having the massage therapy on premises.  

M$C: Give us a physical description of your office facility.
  We started in a 1600-square-foot office with four adjusting rooms and one massage therapy room.  We began to see some capacity limitations, so I purchased the massage therapy company that occupied a 750-square-foot space in the same strip center.  We moved the massage over to the new space to give us another adjusting room and were able to have two massage rooms as well as rent-ing space for acupuncture and Chinese medicine.
Two-and-a-half years ago, we moved down the road to a magnificent freestanding building in a professional plaza.  It is a 2700 square foot space and houses everything under one roof.  I believe it to be the dream office.  We have decorated it in a very warm, welcoming way and it suits all our needs.  We now have the capacity to see a virtually unlimited volume.  Not a day goes by that a patient doesn’t comment about how beautiful our office is.  Needless to say, I’m very proud of it.

M$C: What’s the income service level that you provide annually?
  Our goal has always been to grow financially by twenty percent each year.  I have been fortunate enough to be surrounded by a team that understands that goal and helps me to fulfill it year after year.  As the practice has grown, our income has followed as well, and we continue to see the twenty percent increase every year.  Also, this past year, I purchased another practice with a partner and that has created another income stream for me.  

M$C: Do you have a set profit-standard or margin formula for the business? 
I believe that setting very specific goals is of the utmost importance in running the practice effectively.  Second in importance is to make sure that your team knows each goal and that continuous training is done to ensure the achievement of each one.  Due to the nature of our practice, our overhead tends to be a little high at approximately 55-57%.  This is due to the multiple associates and the multiple massage therapists.  Employing professionals may have a higher price tag, but I believe that their value makes it worthwhile.  Additionally, thanks to our insurance and collections team, our accounts receivable is actually lower now than it was three years ago.  Our goal is to collect 90% of services rendered, and we get closer to that goal every year.   

M$C: Is there anyone in particular to whom you attribute your professional success?
  On a personal note, my mother taught me to always do the right thing, regardless of what the cost.  I strive to accomplish that task in every facet of my life. 
On the business side, I was fortunate enough to have a father who revolutionized much of how chiropractic is now practiced around the country and the world.  I learned early on that the practice of chiropractic follows a triad of personality, procedural efficiency, and clinical competence.  I have been listening to my dad’s Markson Management Services cassette albums since I was a kid and I follow his procedures to the letter.  The chiropractors that I know who try to “reinvent the wheel” end up struggling needlessly. 
Now, as I have become involved with the The Masters Circle, the success philosophy has taken center stage.  I follow their manual and CD albums lesson by lesson.  With Bob Hoffman and Dennis Perman helping me work on my own weaker areas, I have become a better boss, a more confident leader, and the kind of person who can create the life and practice of my dreams.
M$C: What marketing strategies do you use to attract new patients, and to keep current patients?  
  I have always loved public speaking, so I have built the practice predominantly on doing outside lectures in our community.  I have spoken at various companies, schools, support groups, and municipalities on the topics of stress management, back safety, raising a healthy, drug-free family and, of course, the benefits of chiropractic care.  I have used Michelle Geller Vino of MGV Marketing since the day I opened my practice.  She has been responsible for opening countless doors for us to educate our community and I would never practice without her in my corner.
For patient retention, we do a mandatory new patient orientation in our office that all new patients are required to attend.  This has translated into a very high patient visit average and decreased our reliance on new patient volume.  All patients receive a detailed report of findings, which further educates them on the three phases of chiropractic care.  This eliminates the patients’ desire for the “quick fix”. 

M$C: How do you handle problems with patient retention? 
  We work very hard on understanding the personality type of each patient.  Depending on who they are, we will cater our communication skills and our procedures to the fulfillment of their needs.  This translates into each and every patient feeling as though we understand them.  I believe very strongly in relationship building and we work diligently, as a team, on our rapport building skills.  Confrontational tolerance is something that every successful person in every field has mastered.  We are able to confront patients about u  ukeeping up with their appointment schedules and financial responsibilities so that they understand that it is in their best interest to do so.

M$C: We all know that an efficient staff is a crucial component of a successful practice.  Tell us what you look for in a staff member.
  I used to hire people out of desperation.  I sounded like everyone else.  “Good help is impossible to find.”  Through the teachings of The Masters Circle, I have learned that attracting the right team members is no different than attracting new patients, or the perfect mate.  You must work on goals, affirmations, and visualizations to manifest whatever it is you want.  In this instance, I am very specific on hiring my teammates by their personality type.  I believe that almost any task can be taught, but you can’t train someone to be the type of person you need for each position. 

 Our associate doctors are fully empowered to take the patient through consultation, examination, Report of Findings, and all aspects of care. 

M$C: Do you enjoy your work? 
How many people do you know who knew what they were going to do with their life since the age of six and then actually made it happen?  When someone asks me what my purpose in life is, I believe it is primarily to become the best husband and father   I can possibly be.  Then, it is to help get chiropractic to the mountaintop…where it belongs.  I really am living a dream.

M$C: Any final words for our readers? 
I am flattered by the fact that I have other chiropractors visiting my office on a weekly basis.  They ask many of the same questions that I have answered here.  The advice I have for them and for the readers is simple.  First and foremost, start having more fun.  Chiropractic is an amazing healing art…enjoy it.  Our patients love us.  If you fuel your passion for chiropractic, patients will flock to you.  Second, you must have a coach.  If Tiger Woods, Michael Jackson, and every other superstar in any field have  coaches, you should to…if you want to be a superstar!  I am also flattered that you asked for my inclusion in your publication.  I love chiropractic and I am honored to share what I have learned with each and every one of you.

You may contact Dr.Markson at (954) 472-7975.

Our sincere thanks to Dr.Markson and his staff at Markson Chiropractic, Plantation, Florida.

Million Dollar Chiropractic features Dr. George Michalopoulos
Written by George Michalopoulos, D.C.   
Saturday, 28 February 2004 00:00

Each article in the MILLION DOLLAR CHIROPRACTIC series () focuses on the top surveyed issues facing chiropractors today.  Recruiting new patients, retention, profitability, marketing and staffing are each a determining factor in the growth, potential and success of the practice.

The subject of this issue’s profile is Dr. George Michalopoulos an extremely successful chiropractor who has practiced in Illinois, for the past fourteen years.

Originally from Toronto, Ontario, Canada, George Michalopoulos began working for his parents in their family owned fast food business in Napanee, Ontario.  He played competitive hockey and was a member of the Ontario Provincial Softball Championship Team, representing Ontario in the Canadian National Softball Championships.  He is a “huge” Toronto Maple Leafs hockey fan. 

Dr. Michalopoulos still plays hockey and is a Member of the Chicago Blackhawks Alumni Association.  He treats a number of the ex-Chicago Blackhawks and participates in their fundraising auctions and golf tournaments.  An avid golfer, he treats a professional caddy of one of the top 10 golfers in the world, as well as top ranked high school and NCAA athletes.

In an interview with The American Chiropractor, Dr. George Michalopoulos answers our Million Dollar Chiropractic (M$C) questions about his successful multidisciplinary and physical therapy center.

M$C: Dr. Michalopoulos, what influenced you to become a chiropractor?
  Ever since I was 8 years old, I wanted to be a doctor.  I remember walking down the halls of Toronto General Hospital going to visit an aunt in the hospital and thinking how much these doctors and nurses had helped her.  From that day, I knew I wanted to help people but I did not know what type of doctor I wanted to be until 1981.
In 1981, I hurt myself playing high school football.  Prior to this injury, I had always had some mid back pain and I used to have my little sisters “walk on my back”.  Finally, a friend of mine told me to go the local chiropractor in Napanee, Ontario, Dr. Larry Shaw.  From the first time he adjusted me, I had instant relief.  He proceeded to explain what chiropractic was  and also the benefits of supplements, all—amazingly—without drugs.  I thought, what a great way to help people and do it without medication.  
After high school, I went to Queen’s University in Kingston, Ontario, and then, in 1986, started at the National College of Chiropractic.  I completed the 5 academic years in less than 3-and-a-half, and was on my way.

 What type of practice do you have?
  Our practice is a “multidisciplinary” practice.  We have integrated medical doctors, chiropractors, physical therapists and massage therapists into our clinic.  We quickly realized that, to be successful, to be able to grow your practice and to cater to a large number of patients, you need a great network of doctors to work together.  We had a number of patients that needed chiropractic care, but needed some type of medical care at the same time.  There have been many times when patients have come in that were in excruciating pain who truly need medication to at least “take the edge off”.  Initially, we would refer the patients out and not hear back from them.  At this point, we decided that we needed go get our own medical team assembled.  This is where the expertise of Practice Perfect and Dr. Daniel Dahan came in.  They made this new marriage of medicine, chiropractic, physical therapy and massage work together legally, ethically and honestly to accomplish the patient goals we wanted as an outcome. 

M$C: Give us a physical description of your office facility.
  Our clinic is on the second busiest street in Addison, Illinois.  We initially started out with about 600 sq. ft. of treating area down the road and quickly graduated to a new 2,000 sq. ft. facility that I thought I would never grow out of.  We are still at this 2000 sq. ft. facility, but have knocked down walls to incorporate our growing physical therapy department. 
We have a beautiful office with a therapy suite that has our interferential electrical stimulation, ultrasound and micro stimulation units.  A front office and insurance department combined; and 3 treatment rooms as well as a physical therapy room for active aggressive physical therapy and strengthening.  Beyond the physical therapy room is our X-Ray and dark room facility. 
We have great visibility on a busy street in a town of 37,000 next to a locally famous pizzeria.  When new patients ask for directions, we tell them, next to Nardi’s pizzeria.  They know exactly where to go. 
M$C: What’s the income service level that you provide annually?
  Our income service level has consistently risen every single year in practice; however we seemed to plateau just prior to our office becoming multidiscipline.  We were seeing more patients, working harder and longer hours, but  had become limited in income growth because we were running out of room.
Dr. Dahan of Practice Perfect taught us how to cut overhead, increase the practice and even cut my hours all at the same time.  Within one year, I was astonished at how receptive my patients were to our new medical doctor and the extraordinary service and knowledge our office was providing.  Our patients’ response was, “It’s about time MD’s and Chiro’s started working together.”

M$C: Do you have a set profit-standard or margin formula for the business? 
  Our practice runs on goal setting.  We set our goals at the u u beginning of the year and revisit them every quarter.  Our objective is always to do better than the year before, and we have a bonus system for all of our staff and doctors.  We all strive to give the best quality care, from the front desk and insurance department to the doctors and therapists in the back.  We have weekly staff meetings and get all questions answered at that time.  If patients have questions, comments, complaints or compliments, we want to hear them.  The personal profit margin formula for the business is to decrease unnecessary expenses and to have a blow out Christmas party with bonuses at the end of the year. 
M$C: Is there anyone in particular to whom you attribute your professional success?
  My parents with their strict work ethic and honesty have undoubtedly contributed to my professional success.  When I was going to school in the US, the Canadian government didn’t offer student loans to go to a US school, so my parents and younger sisters worked many hours and weekends to pay for my tuition, which was almost  7 times more than it would have cost had I gone to a Canadian school.  For this I am very grateful.  
My wife, Kathy, not only believed in me but also trusted that I would do the right thing for us and our family.  She is the love of my life and we are cut from the same cloth. 
There are several other people that have changed my life personally and professionally.  First of all, Anthony Robbins has helped me set my goals by having an ultimate vision for my life.
Secondly is my consultant, and dear friend Dr. Daniel Dahan.  He has outlined for us a program that is honest and ethical with continual updates to stay on top of the rules and regulations that are constantly changing in our profession.  He discusses ethics and honesty in detail at every one of his mastermind seminars, and I consider him a true friend and great person.
Thirdly, my priest, Fr. Chris Kerhulas, was very instrumental in changing the direction of my life.  His determination and foresight are second to none.
Lastly, and most importantly, my partner, Dr. Ralph DeStephano.  In the almost 10 years that we have been partners and 15 years I have known him, we have laughed—no exaggeration—every single day and we could count the number of disagreements we have had on one hand.  He is a partner’s dream and a true friend.

M$C: What marketing strategies do you use to attract new patients, and to keep current patients? 
  We outline our marketing strategies at the beginning of every New Year.  We use a wonderful newsletter from L. K. Graphics that we send direct mail to 50,000 homes several times per year. We also have internal marketing, of course.  This is the most effective, I believe, because when a patient comes in that was referred from another patient, this tells you, your staff, and the new patient what an effective job you have done.  We have had several food drives for Thanksgiving and toy drives for Christmas.  We have even done spinal screening in malls and seminars at local and big businesses in the area. 
The most fun of the year comes when our wonderful staff has a Patient Appreciation Day.  On this day, we get local businesses to donate bagels, donuts, coffee and numerous other things to give away.  The patients come in, get their adjustments and massages at no charge, and all new patients come in and get consultations and examinations at no charge.  There is so much energy in the office that day, how couldn’t you have fun.

M$C: How do you handle problems with patient retention? 
  Our patient retention is monitored carefully by the doctors and, even more so, the front desk.  The importance of the patient keeping up with their scheduled appointments is stated to them right from the get go.  We explain to the patients how important their care is and that every treatment and physical therapy session builds on the next.  When they come in, they are taking 3 steps forward; however, every time they miss, they are taking steps back.  We explain that we want to continually make progress and not “tread water”.  It is also explained that there is a high probability that their problem did not occur yesterday when they took the trash out, but over years of some type of abuse to their body.  With this in mind and explained in an easy to understand manner, the new patient realizes that several years of problems will not go away in 3 or 4 visits.  We are very strict with our appointments.  Our front desk, who I call our quarterback, knows the importance of keeping the patient schedules and does a spectacular job doing that.  Missed appointments jeopardize care and potentially our practice.
We have a staff meeting every Wednesday to discuss the status of our patients and what needs to be addressed, and with which patients, before the next staff meeting.
Our patients can feel the energy in our office.  The patients love to come and to send others to get better.

  We all know that an efficient staff is a crucial component of a successful practice.  Tell us what you look for in a staff member.
Michalopoulos:  Organization is the key to any staff member.  Every single one of our staff members is extremely organized and knows what to do.  I have been in Addison for 12 years and I still have one of my original staff members, who is the organizer for all supplies and in charge of getting us the best deals.  She also does physiotherapy and is in charge of filing our note documentation, which, in any practice—especially a multidisciplinary practice—is crucial.  As I mentioned before, the front desk is our quarterback.  My belief is, “As the front desk goes, so goes the practice.”  The insurance u udepartment needs somebody with great knowledge and expertise of the insurance business, and we have a 20-plus year veteran that keeps up with all the changes.  Our physical therapist’s, massage therapist’s, therapy assistant’s and associate doctor’s work ethics are unmatched.
The whole office is closely involved with getting the patient better.  I look for not only organized people but also friendly and empathetic people when hiring.
We have an outstanding team, and most of the staff participates in hiring new staff members.  Once we get the approval from the staff, the new staffer is put on a probationary period.  If they fit within our mold, they are a keeper.  The majority of our staff has been with us for at least 7 years so, as you can see, there is little turnover.

 Do you enjoy your work?  How do you feel about going to work in the morning? 
Michalopoulos:  Enjoying my work is an understatement.  Our office is a very dynamic place.  It is filled with love and energy. This, along with outstanding doctors and staff are key ingredients to this wonderful healing profession.

M$C: Having a multidisciplinary practice, what advice can you offer our readers about setting up and maintaining such a practice in today’s healthcare system? 
  First of all, multi-discipline practices are not for everyone.  It takes a tremendous amount of work and constant preparation to achieve your ultimate outcome.  Second, you cannot do it alone.  You need someone with a tremendous amount of knowledge and a person that has access to knowledge of this type of practice.  Our consultants, lawyers, and other professionals help us, almost on a daily basis.  If you want to go this route, you must find a consultant and healthcare attorney who can answer all of your questions.  The more knowledge people have about this business, the easier it is for you to succeed. 

  Other than traditional chiropractic care, do you include any other type of services or products in your clinic which further help your patients, as well as bring in additional revenue to your practice?
Michalopoulos:  One of our associate doctors provides nutritional counseling, and counseling for fibromyalgia.  Our MD occasionally gives trigger point injections.  We do offer our time for outside industrial lectures for carpal tunnel syndrome, low back pain and headaches, and are also preparing to do manipulation under anaesthesia.
M$C: Any final words for our readers? 
  I will say that my office is a ball of revitalizing energy.  It didn’t just happen overnight.  There have been many long days and questions that have come up while building this practice.  There are many transformations that have taken place.  You need to be a leader, to lead yourself and your team; innovative, to not be afraid to take a chance and experiment with new products and new technology; enthusiastic, because enthusiasm is the battery for healing; and, especially, be honest, open and ethical with your patients.  If you apply these simple techniques, not only to your professional life but also your home and personal life, with everything you do, you will have the recipe for success.  Get an ultimate vision for yourself, and never lose sight of that vision.  Have a purpose and mission statement, not only for your business but your family life also.  Balance, balance and more balance is essential to true success.

You may contact Dr.Michalopoulos at 630-833-1552.

Our sincere thanks to Dr. Michalopoulos and his staff at Addison Physical Medicine and Rehabilitation, LTD., Addison, Illinois.

Editor’s Note:  Do you have a million dollar practice that you’d like TAC to highlight in our Million Dollar Chiropractic column?  Contact TAC’s editor Jaclyn Busch Touzard by phone/fax: 1-305-716-9212, or email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .  We want your inspiring story.  Contact us today.

Million Dollar Chiropractic featuring Dr. Mitch Mally
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Written by Dr. Mitch Mally   
Sunday, 30 November 2003 00:00

Each article in the MILLION DOLLAR CHIROPRACTIC series (M$C) focuses on the top surveyed issues facing chiropractors today.  Recruiting new patients, retention, profitability, marketing and staffing are each a determining factor in the growth, potential and success of the practice.

The subject of this issue’s profile is Dr. Mitch Mally, a 1981 graduate of Palmer College of Chiropractic who has practiced for the last twenty-two years in chiropractic’s fountainhead city, Davenport, Iowa.
Originally from Detroit, Michigan, Dr. Mally began his Pre-Medical Training (1974) at Wayne State University in the heart of Detroit. Not only did he carry a heavy class load, but also played football for the Great Lakes Intercollegiate Athletic Conference (GLIAC) Division III Champion, assisted in biochemistry research, electron microscopy, surgical pathology, cytology and observed many autopsies at William Beaumont Hospital Pathology Department. Additionally, an avid martial artist, sprinter and weight lifter, Mally found his niche in sports chiropractic subsequent to nonsurgical (chiropractic) treatment of his traumatically injured left knee.

In an interview with The American Chiropractor, Dr. Mitch Mally answers our Million Dollar Chiropractic (M$C) questions about his incredibly successful sports and occupational injury rehab center.

M$C: Dr. Mally, what influenced you to become a chiropractor?
  In retrospect, my path has always been directed. Just three courses prior to entering medical school or embarking on a career in pro football, an injury to my left knee sidelined me, resulting in a personal or non-surgery?
Chiropractor, Alan Kash, and his young associate, Rick Dybowski, whose conservative treatments and rehabilitation resulted in my dramatic recovery, opened my eyes to an alternative form of health care, although my family and friends referred to it as quackery, a cult, etc.  Much to the dismay of all who learned of my career plans change and against the odds, the head spinning, rapid matriculation and immediate acceptance to Palmer College in 1978 resulted in an exciting opportunity for me to experience a tremendous practice, become an author, inventor, academician and world-wide lecturer in the field of Sports and Occupational Injuries.

M$C: What type of practice do you have?
  My practice is mulifaceted and highly specialized in sports and occupational injuries, workers compensation and personal injury, with an emphasis on extremity injuries, syndromes and conditions.  A high volume of referrals come from chiropractors, MD’s, DO’s, dentists, attorneys and factory safety personnel for treatment of extremities including, most commonly, shoulder, elbow, TMJ, carpal tunnel syndrome and cumulative trauma disorders.  Also, frequent and numerous depositions as an expert witness for the above noted specialty add to an exciting and lucrative practice.

M$C: Describe your workplace for us.
 The Mally Chiropractic Clinic and Rehabilitation Center, currently undergoing a multidisciplinary practice transformation, is operating under the auspices of the newly named clinic, TRI-MED Health and Wellness Center, P.C., in Davenport, Iowa.
The spacious, contemporary, open format 4500-square-foot state-of-the-art facility is equipped with an efficient floor plan and a design that comfortably incorporates various departments, including: examination, diagnostics, radiology and videofluoroscopy, treatment rooms, physical therapy, low tech and high tech rehabilitation, massage therapy, and patient orientation and education viewing area with two large flat screen TV/DVD players, administrative area and a seventy-doctor lecture hall.

M$C: What’s the income service level that you provide annually?
  Our office production volume for a Davenport, Iowa, high end, expensive practice surprises many, due to what others term “competition”.  My attitude is the only competition is between me, my patient and sickness/disease.  I also feel that competition is healthy, in that it prevents mediocrity and practice complacency, spawning interest in continued education and practice enhancement.  I have often said, if I can have one of the largest practices in a two state region (Iowa and Illinois), namely Davenport, Iowa, with the largest number of DC’s per populous, then others can be successful anywhere else on the planet.

M$C: Do you have a set profit-standard or margin formula for the business?
 I believe in setting goals to achieve goals.  Based on a 22-year practice and the results of quality care, I expect certain conditions to respond within an approximate timeframe.  I utilize an initial twelve-visit Intensive Care Treatment Plan, followed by a re-evaluation and a prescribed Condition Specific 4-week Prehab/Rehab Program, with a subsequent re-exam and additional treatment recommendations to follow.  Therefore, mandatory management by daily, weekly, monthly and yearly statistics is simplified.  Interdepartmental and total office goals are plotted and appropriate stats reviewed at regular weekly staff meetings. 
Practice analysis is as critical to a successful business as early detection of cancer or subluxation is to the patient’s ability to recover.  Early detect...early correct!!!  Day-to-day in-office motivation among doctor, staff and patients is contagious;  and what a great way for each to profit, with a smile and the care that is so worthwhile!

M$C: Is there someone in particular to whom you attribute your success? 
  My greatest inspiration was, and still is, my father, who passed away at 49-years-young, from a medical malpractice issue following a “routine” gall  bladder surgery, when I was only eighteen.  Dad had an incredible and enviable work ethic others would jealously term “workaholic”.  He had a genuine passion, a love for whatever he attempted—no task too difficult or menial, always giving 100% effort, even if it meant personal sacrifices.  He always said, “Son, treat others the way you want to be treated, and work with that same conviction.”
My energy and leadership skills definitely stem from my mother, Nora, who, when under pressure and despair after my father’s death, raised three successful boys by herself. I will always value her dedication and belief that through any circumstances, success  can be accomplished! Thank-you Mom, for making me the man I am today!
My two older brothers, supposed to be the brains (and I, the brawn) also inspired me, although with a different twist (no pun intended).  Being the youngest of three boys, always one of the last picked for sports among their friends, motivated me to try harder, eventually running faster, throwing harder and lifting more; later, being the one choosing the teams for pick-up games.
There’s motivation in telling someone like me NO, or YOU CAN’T, DON’T, or YOU’LL NEVER; those are words that do not register in my gray matter.  In fact, they are, rather, interpreted as entirely the opposite, motivating me as YES, I CAN, I WILL, and I’LL ALWAYS.
These people and experiences I credit with paving the way for my success as a positive, benevolent person, a chiropractor with a great practice, and they motivated me, subliminally, to be a pioneer, inventor, author, and national/international lecturer.
Incidentally, my family eventually accepted me as a Doctor of Chiropractic, upon graduation, but, in the next breath, said I could never make it (a good practice) in Davenport, Iowa, with all the practicing chiropractors there.  The rest is history.

M$C: Tell us about your family?
 My family is my inspiration and fuels my passion for life!  I am a divorced father with three beautiful daughters, Alissa (19), Genna (16) and Shailyn (7), plus, my adorable new granddaughter, Aaliyah.  But, with change comes reward, and I currently also share my life with my partner and fiancée, Jules Johanson, and her children Jacob (9), Breanna (8) and Ashleigh (7).

M$C: What marketing strategies do you use to attract new patients and to keep current patients?
 We use the strategies of my twenty-two years of trial and error experiences coupled with the genius marketing campaign of marketing director, Jules Johanson, whose experience and skills in marketing are unparalleled.  However, the best marketing comes from three words that I preach:  RESULTS, RESULTS, RESULTS.
In-office marketing begins with the smile and positive energy from you and your staff.  Telephone rule #1:  Let the person on the phone hear your smile.  Happiness is contagious. Remember, if disease and negativity spread quickly, why can’t health and positive attitude.
We offer patients bottled water while they’re waiting in the lobby or treatment rooms, staff assist new patients with form completion, doctors call patients the evening of the first treatment, or for any special reasons or concerns.  Paperwork is often sent out and completed prior to the patient’s first visit, with an accompanying reminder-call the evening prior to the first appointment.  The chiropractic patient miracle book of testimonials circulates in the lobby and staff encourage patients to interact about their positive treatment experiences.  Of course, greeting, reminder, condolence and congratulation cards are sent accordingly, with doctor and staff personal signatures.  The finer touches in life always impress, and keeping the patients happy is our motivating methodology.
All new patients attend Monday night one-hour health classes within the first month of care.  We encourage patients and the community to attend, as we have various topics, speakers and/or vendors present.  Our lobby has seating for sixteen, arranged conversationally and directed toward two flat screen TV’s recessed into the wall, providing current, flashy, eye-catching, outstanding patient educational DVD’s.
External Marketing is via newspaper, radio and cable TV.  Regular newsworthy press releases and media hype are leaked strategically in an artistic fashion, utilizing Jules’ skills and experience.  Banquets, screenings, event sponsors, cocktail parties, meet-the-pro, lunch-and-learn and many other secret tools of the trade have proven incredibly effective at generating outside referrals. 

M$C: Obviously, every doctor, at some time or other in his practice, experiences problems with patient retention.  How do you recommend handling such problems?
 Ongoing in-office motivational events, gift certificates, and other marketing tools work well for patient retention, as does a good report of findings, explanation for care and, most importantly, achieving the best results in the fewest number of treatments.  Confucius says, “Do, not efficiently, that which need not be done.”  This implies brevity is brilliance, verbosity is ignorance.  Recall my earlier philosophy, to treat others the way you want to be treated.  It has worked well for me and my practice.  That and the old u  u  cliché, If you love something, set it free and, if it was meant to be, it will return to thee.  Use your verbiage wisely and timely (once the patient is responding) in promoting within your practice to those patients who are most compliant, and give them five business cards each and other referral items, requesting that they distribute them to family, friends and co-workers and not be selfish about their care or their doctor.

M$C: What are your ideas on selecting and maintaining an efficient staff?
 We all know that staff are very powerful, in that they can make or break a practice.  Therefore, I always look for multi-taskers, waitresses and sales personnel.  The Five Love Languages, by Gary Chapman, should be required reading for staff.  In short, the book summarizes that people (apply theory to spouse, family, children, co-workers, and patients) are different, interact differently, have different desires and needs.  Failure to recognize these differences will lead to certainty of failure to fulfill the needs of others.  For example, if a little old man or woman presents to your office for treatment and you are a high volume, fast-talking, in-and-out doctor that doesn’t recognize that the patient needs time with you, the patient will likely discontinue care.
I also recommend that—weekly, monthly and quarterly—doctors motivate their staffs with various perks, be it picnics, boat outings, staff lunches, gift certificates, etc.  A happy and healthy staff promotes a happy and healthy practice.  It starts from within:  Are you happy?

M$C: Do you enjoy your work?
 Two words that best exemplify my work ethic, twenty-four/seven.  I work well in the mornings, so I begin my day at 5:00 AM at Gold’s Gym, and I train until 6:30 AM.  I see patients Mondays, Wednesdays and Fridays, 8:00 AM-6:00 PM;  Tuesdays and Thursdays, patient hours are 8:00 AM-12:00 PM, because I also teach private one-on-one extremity adjusting seminars for doctors from 1:00 PM-5:00 PM, and student seminars from 6:00 PM-9:00 PM.  No weekend patient hours for me, as I travel to teach seminars worldwide, approximately forty weekends of the year. 
I love what I do and it is my passion. 

M$C: With your practice being multi-disciplinary, can you give our readers some advice about setting up and maintaining such a practice in today’s health-care system?
 Practice makes perfect is not a good cliché for a multidisciplinary practice.  Not to know is to guess and, in the eyes of the public, the high profile offices are under scrutiny.  Therefore, they must have all the “I’s” dotted and the “T’s” crossed.  This is why I chose Dr. Mark Sanna and Breakthrough Coaching to mentor my practice transformation.
The admirable, unique, private coaching from Dr. Sanna and his Breakthrough Coaching staff, namely Dr. Charlie Schuster, is preparing me and, my staff for the exciting changes forthcoming in our quest to becoming a legitimate, true multidisciplinary practice.  Medico-legal issues, Stark Laws, contracts, compliance, structure, billing, treatment and interdisciplinary protocols, as well as standards of practice, etc., are among the 300-400 on-line power point and audio training modules that are required to be completed, tested and implemented by the doctors, PT’s and all staff.  Individualized weekly coaching, constant analysis of practice statistics, teleconferences, chat rooms for the doctors and staff, regular national meetings and special seminars enhance the growth of the practice.

M$C: Any final words for our readers?
 We’ve discussed communication and business management skills, practice styles, beliefs, attitudes, opinions, marketing strategies and various success ingredients; however, the skill level and expertise of the clinician is key to the success of the practice.  Consistency and Continuity of Care are the 3-C’s I promote in my 5-Star Extremity Adjusting Seminars on Sports and Occupational Injuries, a must for the practitioner that wants documented, scientifically validated techniques supported by the medical journals, as well.  Also, attend extensive hands-on technique seminars offered weekdays, weekends, one-on-one, or group, and inquire with your state board for state sponsored license renewal courses and/or conventions in your area.
Enjoy the fruits of your hard work and put your money where your mouth is and hands are…invest in yourself.  Remember the 4H’s:  Use your HEAD; have a compassionate HEART; sharpen the skills of your HANDS; and with balance of the HEAD, HEART and HANDS, touch the patient and watch them HEAL.
Good luck and God bless!!!

You may contact Dr. Mally  at 1-800-779-4263. Visit him at or  e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Our sincere thanks to Dr. Mally and his staff at TRI-MED Health and Wellness Center, P.C., in Davenport, Iowa.


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