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The Magic Wand Question
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Written by Chiropractic Gateway   
Saturday, 03 April 2004 17:08

“If you had a magic wand in your hand with the ability to change one thing that chiropractors do that would have an enormously positive impact on their practices come Monday morning, what would be the one thing you would change?”

Answer by:  Dr. Larry Markson, The Masters Circle

I love the “magic wand” question because after 23 years of coaching chiropractors on how to build larger and more profitable practices, while becoming more personally fulfilled, I believe there is a definite answer to this question.

While the answer I am about to give may seem trite or trivial to some, trust me when I say that it is anything but that. 

The answer is “Attitude.”  You see, attitude is the single most important ingredient that makes the most significant difference in practice and in all of life.  Member doctors who have been thoroughly questioned and debriefed after a seminar often say to us things such as, “I can’t understand it, because I haven’t had the time yet to institute any of the action steps we learned, but somehow, as if by magic, there is an excitement, a healing energy, and a happiness that has seemed to open the doors.  New patients are coming in, former patients are calling for appointments, my staff is charged up and today IS a great day.”

Time and time again we receive testimonials based upon the results of those wonderful Mondays.  Why? Because over the two days at our seminar, our doctors and their CA’s learn that it’s their attitude, not their aptitude, that determines their altitude in their practice and in their lives.

So, unleash your magic wand.  Get positive Right Now!  Stand taller, walk faster, speak louder and more enthusiastically, put a twinkle in your eyes and use an attitude of hope and expectation.  Then, watch as the “magic wand” creates the difference in your life!

For more information, call 1-800-451-4514 or visit www.themasterscircle.com.

Answer by: Dr. Mark Sanna, Breakthrough Coaching.

mark_sannaCommit to practice with passion.  Rarely does someone excel at something that he or she is not passionate about.  Planning for passion includes planning your office procedures.  Take a serious look at your practice; see what your office looks like.  Sit where your patients sit, lie where your patients lie.  Ask yourself, “If I were a prospective patient, would I come to this practice and trust my health to these people?

If you’ve lost your passion for practice, it may be that practice has become routine for you.  You’ve gotten tired of “the same old thing”.  Add excitement by adding new services or profit centers.  Stress is a major passion drain.  This results in your goals becoming unrealistic and unfulfilled.  Your life begins to run you.  You stop exercising and you become tired and unhealthy.  You can better manage stress by adhering to a schedule that allows time for planning.  Adhere to a daily regimen that takes practice building into account.  Get up early and, for a minimum of fifteen minutes a day, write your goals and read your affirmations.  Remember to plan for family times and vacations in advance as well.  Compose and review a “love list” of your favorite things, people, and places and set a goal to increase their presence in your life.  Most importantly, get involved in something bigger than yourself.  Create a purpose for your practice that includes more than just earning a living.  You will eagerly put your heart and soul into a purpose that you love and believe in.

For more information, call 1-800-723 or visit  www.mybreakthrough.com.

Answer by: Dr. Sig Miller, Chiropractic Gateway.

As editor of Chiropractic Gateway, I communicate with hundreds of doctors all week long.  Regarding the “magic wand” question, I can make two observations, both representing opposite ends of the spectrum.

At one end, I listen to chiropractors describing extraordinary strategies and opportunities on ways to effectively grow their practices.  Rather than getting to work, they procrastinate so, a year later, that idea is still in the box.  Simply stated, I want doctors to develop a mindset where they begin ripping open those boxes so they can get to work on those things they believe will work.  I want them to get rid of the “what if I did this,” or “I should have done that” way of thinking.

At the other end, I see many with great ideas who get right to work.  Often times, they expect an immediate return on investment, as though their idea was to be THE magic bullet in turning their practice around.  Unfortunately, many times, they simply don’t have the conviction to stick with it and to see the project through to the end.  In my own personal experience, I’ve learned to deal with speed bumps head on.  After making some minor changes, I was able to turn things around.  In my successes, I don’t usually end up where I initially thought I would.  Remember, we’re on a journey.  Enjoy the ride.

For more information, call 908-237-2727 or visit  www.chiropracticgateway.com.

 
Diagnostics A Practice Management Tool
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Written by Suzi Plank   
Saturday, 03 April 2004 17:06

Diagnostic procedures are a part of almost every clinic operation today, from those as basic and standard as the physical examination of the patient and X-rays, to specific and higher levels of diagnostics.  These can include blood work, nutritional analysis, functional capacity evaluations, musculoskeletal ultrasound, digital analysis of X-ray films, MRI/CT scans, videofluoroscopy, neurological studies and many other procedures. 

The general goal of management is to deliver services effectively, efficiently and profitably.  Health care is a service business, your patients are your clients, and the treatment and care you provide is your core product.  You share common issues with many business: Selling your product (treatment and care), acquiring, maintaining and increasing your client (patient) base, while creating efficiencies within the business (your practice) to increase your profit. 

There are two ways to increase profit—decrease expenses or increase revenue.  Economy and efficiency help a business decrease expenses, even in a growth mode.  Business revenue can be increased by providing services to more clients or by providing more necessary services to existing clients.  Diagnostic procedures are another tool, when used appropriately, that can help you accomplish this.

Some factors in the determination of diagnostic services you can provide and how you deliver them within your practice are the specialty and patient volume of your practice, the type of practice structure you have—straight chiropractic, holistic or integrated multi-disciplinary, for example—as well as scope of practice limitations within your state for your specialty or structure.  These form the basis of a cost versus benefit analysis for implementation within a practice of a diagnostic procedure or service. 

Many practices obtain X-ray films on their patients and can utilize services, at no cost to the clinic, to perform a digital analysis of those films.  A service that includes comprehensive biomechanical and pathology reports with AMA Guide Impairment Ratings by Board Certified Radiologists can provide you the documentation to justify additional treatment and, ultimately, better care for your patient.  No additional equipment, staff, training or costs are necessary for almost any chiropractor to use this diagnostic procedure.      

Blood work and/or nutritional analysis are diagnostic procedures that can be provided within many practices to help uncover hidden systemic problems or imbalances within patients.  Many of these, once identified, can be addressed through treatment or supplementation to restore health to the patient.   Some additional equipment, training and/or certification may be involved when offering these procedures. 

Functional capacity evaluations, musculoskeletal ultrasound studies and neurological testing (nerve conduction studies, Evoked Potentials) are services that are necessary to document patients’ conditions and justify treatment and can be offered within many practices.  Testing interpreted by an independent specialist often provides the best benefit and most objective documentation.  Necessary equipment falls within the affordability range for many chiropractors; however, extensive training and consistent use are required to maintain proficiency.  Additionally, some procedures are time consuming and not an efficient use of time for the chiropractor as technician.  Leased equipment, trained technicians and interpretive services are cost-effective solutions available in most areas of the country.       

Dedicated facilities offering MRI scans certainly fall on the high end of the cost scale and there are practices and clinic groups that can support such a facility.  There would be a reasonable expectation that, for the same patient volume, more patients would be indicated for MRI studies from a practice specializing in accident and injury cases than from a family wellness practice.  There are options available in many areas of the country, mobile units and leased time, for example, that would allow a chiropractor to provide MRI services.   

Medical necessity should be well substantiated for any diagnostic service you recommend for your patient.  This is crucial if you expect to be reimbursed for diagnostic services performed within your practice.  Also, beware of any situations that may be construed as kickbacks or payments to you for the referral of your patient.   

You can ethically and legally add revenue with diagnostics, improve patient care and provide services to more patients. These are just a few of the diagnostic services you could employ within the management of your practice to obtain that goal.

Ms. Plank has an extensive background in medical and facilities management.  Before making the transition to healthcare, for over 10 years she was the Practice Manager for a large veterinary hospital and a “first of its kind” commercial veterinary blood analysis laboratory.  During the past 15 years, Ms. Plank has provided technical and management services to healthcare providers, specializing in radiology and neurology.  She is currently the Vice President of Corporate Services for Practice Perfect.  Contact her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 
Upcoming Seminars
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Written by TAC Staff: Upcoming Seminars   
Saturday, 28 February 2004 00:00

Anabolic Laboratories:
May 22–23, Levittown, NY; June 24–25, Allentown, PA. For more information, call 1-800-445-6849 or visit
www.anaboliclabs.com

Breakthrough Coaching
May 20–22, Crowne Plaza Times Square, New York, NY; August 19-21, San Diego, CA. For more information, call 1-800-723-8423 or visit
www.mybreakthrough.com.

Chiropractic Leadership Alliance
May 21–23, Puerto Rico; June 17–20, Minneapolis, MN. For more information, call 1-800-285-2001 or visit
www.subluxation.com.

David Singer Enterprises
May 1–2, San Francisco, CA; June 19, Atlanta, GA. For more information, call 1-800-326-1797 or visit 
www.davidsingerenterprises.com.

Dallas Humble
May 14-15, Dallas, TX. For more information, call 1-800-282-1947 or visit
www.dallashumble.com

DMX Works
May 28–29, Cayman Islands. For more information, call 1-800-839-6757 or visit
www.dmxworks.com.

Footlevelers
May 15-16, Des Moines, IA; June 5, Va Beach, VA.For more information, call 1-800-553-4860 or visit
www.footlevelers.com.

Fred Van Liew’s  Water & Air Essentials
April 24, Dallas, TX. For more information, call 1-800-964-4303 9-6 CST or email
This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

ICPA
April 29–May 2, Long Branch, NJ. For more information, call 1-610 565-2360 or visit
www.icpa4kids.com/chiropractic_pediatric_seminars.htm.

Integrated Expo
May 13-16, Chicago, IL. DC/MD/PT Seminar. For more information, call 1-888-67-DAHAN or visit
www.dahan.com.

Loomis Institute of Enzyme Nutrition
June 12-13, Dallas, TX. For more information, call 1-800-662-2630 or visit
www.loomisenzymes.com.
  
The Masters Circle
May 14-15, Los Angeles, CA; June 4-5, East Rutherford, NJ. For more information, call 1-800-451-4514 or visit
www.themasterscircle.com.

Nutri-West
May 1–2, Denver, CO; June 26–27, Reno, NV. For more information, call 1-800-443-3333 or visit
www.nutriwest.com.

Parker Seminars
June 17-20, Minneapolis, MN. For more information, call 1-888-727-5338 or visit
www.parkerseminars.com.

 
Create a Safe Place to Fail
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Written by William D. Esteb   
Saturday, 28 February 2004 00:00

Most patients don’t “get” chiropractic on their first exposure to it.  So, if you’d like to increase the likelihood of subsequent reactivations, even referrals, create a safe place for new patients to “fail.”

Failing, is when a patient begins chiropractic care, enjoys symptomatic relief, discontinues their care and suffers a relapse months or years later.  Failure is an essential ingredient of true patient “education.”

Failure is underrated in our culture.  Yet, it’s how we really learn.  Most of us were “taught” not to touch the hot stove, and were “educated” when we did.  While the painful burn might have been seen as a failure by your parents, it was all part of the plan.  That’s why, these days, you don’t have to be told not to touch a hot stove.  You and I have learned much more from our failures than our successes.

If a patient must fail on their first (and probably their second or third!) exposure to chiropractic, then consider creating an environment in which a patient can receive chiropractic care, discover its implications and discontinue without shame or fear of judgment.  (Something difficult for many chiropractors who care about a patient’s health more than the patient does.)

What would a “successful” patient failure look like?  A patient who has a positive chiropractic experience discontinues care, has a relapse, knows not to blame you or chiropractic, returns to your office without an “I-told-you-so,” resumes care and after a couple of these episodes (possibly spanning years!), comes to accept regular chiropractic care as they do bathing, teeth brushing, eating healthy foods and other healthy habits. 

Ready to play the “long game” and plant the seeds necessary to perhaps, possibly, maybe, someday enjoy a harvest of appreciative, stable, cash-paying patients who see chiropractic as a way of life?  Then create a safe place for patients to fail.

Begin by assuming a healthy detachment about how much chiropractic care patients opt to receive.  Acknowledge their sovereignty and appreciate the fact that they have the freedom to abuse their bodies, reject your suggestions and value other things more than their health.

Second, make sure patients understand that they are likely to feel better before muscles and soft tissues supporting their spine are fully healed.  Set the stage during your report of findings to “future pace” each patient:  “We had a patient in here a couple of months ago who got great results and then dropped out of care as soon as she felt better and later suffered a relapse.  Fortunately, I had explained that she would be susceptible to a relapse and she didn’t blame chiropractic or me, and came back in.  Of course, how long you benefit from chiropractic care is always up to you.”

Make sure every patient knows that you’re genuinely interested in serving and honoring their health goals.  (Remember, they have to fail first.)  Help each patient see that they won’t be “letting you down” or disappointing you by discontinuing their care early or won’t be judged for not doing what “good” patients do.  (That’s the hard part!)
Even more daring, at your report of findings, while the relationship is still being established, discuss the “office disengagement process” when they’ve had enough chiropractic care.

“We have a little ceremony my staff and I like to conduct when patients reach their health goals, so please let us know when you’ve had enough so we can celebrate.”  It may seem counterintuitive to celebrate when the patient is seemingly sabotaging their health, but, remember, they still have to have a relapse or two before they’re likely to appreciate the lifestyle benefits of periodic chiropractic care.

Some might criticize this as actually putting the “premature dismissal seed” into a patient’s brain.  Hardly.  Most patients have heard that “once-you-go-you-have-to-go-for-the-rest-of-your-life” anyway, so most patients are plotting their escape from the first visit!

Take a quick inventory of those wonderful “once-a-monthers” who are a delight to serve.  You rarely have to force-feed them chiropractic.  In fact, on most visits you rarely even talk about health!  How did these individuals acquire their healthy habit?  Many observe that these special patients have usually had a couple of previous chiropractic experiences—often in someone else’s office!

Yours? TAC

William Esteb is the president and creative director of Patient Media, Inc.  His new company provides state-of-the-art, visually-based patient communication tools from a patient’s-point-of-view.  Request a free copy of his 64-page catalog and subscribe to Monday Morning Motivation, his free, weekly emailed practice tip or patient communication idea by visiting www.patientmedia.com or calling (800) 486-2337.

 
National Associations News Update
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Written by TAC Staff: National Association News   
Saturday, 28 February 2004 00:00

American Chiropractic Association

ACA Ranked High Among Washington’s Elite Lobbying Groups

The ACA runs one of the most influential advocacy operations in Washington, DC, according to a new listing of the 25 “most effective grassroots lobbying organizations for health care in the United States.”  The ACA is number 19 in a ranking compiled by an official of the American Political Science Association and reported in the Washington Times on November 26, 2003. 

Out of thousands of groups that lobby Congress on health care issues, the ACA and just 24 other organizations are singled out for their effectiveness in communicating with Capitol Hill and recognized for being “highly successful in building connections between their members and Congress on a wide geographic basis.” 

“This ranking confirms that the ACA and the chiropractic profession have a place at the table when health care policy decisions are made in Washington, DC,” said ACA President Donald Krippendorf, DC.  “Very simply, elected officials know that the ACA is a force to be reckoned with.  When our members speak out on health care issues, they’re listened to and heeded.”

Michael T. Heaney, a research fellow with the American Political Science Association and the author of the ranking, conducted anonymous interviews with 77 health care aides to U.S. senators and congressmen/women between April and July 2003.  The result has been several significant legislative victories for the chiropractic profession in recent years, the most recent being the inclusion of a Medicare Chiropractic Demonstration Project in the newly signed Medicare reform bill.  


International Chiropractic Association

Continued Coverage of Discredited “Stroke” Article Raises Serious Questions of Journalistic Responsibility

The re-appearance of a news report on WNBC New York, based on a thoroughly discredited article that appeared months ago in the medical journal Neurology, has raised serious questions about the motives of the broadcast agency carrying the story.  Entitled “Study: Chiropractic Adjustments May Increase Risk of Stroke,” the piece appeared on November 6, 2003.  Presented by the station’s “health” reporter David Marks, MD, the issue of chiropractic safety was once again raised, but offered no additional evidence, no credible data and no new perspective, other than the opinion of a medical neurologist, whose experience on the issue of chiropractic procedures is completely unknown.

ICA Board Calls for Profession-Wide Dialogue on Chiropractic Education and Accreditation
The Board of Directors of the International Chiropractors Association (ICA) has issued a call for a serious profession wide dialogue on the challenges and needs of chiropractic education, in light of the current intense controversy surrounding the educational accreditation process. During their Mid-Year Board meeting on February 25, 2003, the ICA Board adopted a statement that expressed concern over the state of chiropractic accreditation and called for a national dialogue on how this process might be improved. This resolution is meant to voice the concerns of the many thousands of individual doctors of chiropractic and the dozens of chiropractic organizations that have contacted the ICA regarding the nature and direction of the operations of the Council on Chiropractic Education (CCE).

For more information, go to www.chiropractic.org.

World Chiropractic Association

WCA Announces Annual Awards

The World Chiropractic Alliance is proud to announce the following recipients of its annual Chiropractic Awards to be presented during the WCA International Summit in Washington, D.C., April 29-May 1, 2004:

  • Chiropractor of the Year:  Leona Fischer, D.C.  A member of the WCA International Board of Governors, Dr. Fischer served as a U.S. Navy Special Operations medic assigned to the Explosive Ordnance Disposal unit.  She showed true courage under fire in 2003 as one of only two members of the Veterans Affairs Chiropractic Advisory Committee to vote in favor of direct access for chiropractic.
  • Outstanding Service:  Jerry Hardee, Ed.D., president of Sherman College of Straight Chiropractic.  After the Association of Chiropractic Colleges (ACC) passed a statement on diagnosis that all but gutted the "Chiropractic Paradigm" that had won nearly unanimous applause from the profession, Dr. Hardee was the first college president to stand up to the group in opposition.
  • Researcher of the Year:  Madeline Behrendt, D.C.  By countering the medical and drug industry propaganda with hard scientific evidence, Dr. Behrendt has been able to gain attention and respect for chiropractic.  In 2002, she was named Associate Editor of the Journal of Vertebral Subluxation Research.
  • Humanitarian of the Year:  Bobby Doscher, D.C.  For 26 years, Dr. Doscher has dedicated herself to providing service to severely sick and handicapped children at Oklahaven Children’s Chiropractic Center.  Expanded under her leadership, the Center’s current home allows room for future expansion to serve even more children, to conduct research and to educate people about the benefits of a natural, drug-free health care and the chiropractic way of life.

For more information, see

www.worldchiropracticalliance.org.

 
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