The answer is simply yes.  The key is to provide more services, not bill more for the same old services.  The future of our profession is bright.  Technology is adding a new paradigm to the 21^st century.  Professional athletes are getting results and honoring chiropractic like never before.  Often, this is done by adding new technologies to your clinic.  How old is Ultrasound, Electric Muscle Stimulation?  Recently, one of my clients and, now, my partner, Dr. Gerald Mattia, was featured in The Orlando Sentinel.  Why?  Because of his treatment of athletes and the technology he has utilized.  The key to getting reimbursed is not “doing the same thing the same way and expecting a different result.”  We must grow and improve our practice with the times.  This is one way to avoid the insurance trap.  I have watched doctors flock to cash practices.  Why?  You need to have a hybrid, an insurance and cash component to your practice.  What this means is simple:  In a time of declining insurance reimbursements, your practice does not have to decline.

One Way to Fight Declining Reimbursement

There are three basic ways your practice can generate more revenue.

1. Deliver more of the same services.
2. Expand to deliver new services.
3. Charge more for the same services.

Granted, charging more is largely a theoretical option in today’s reimbursement environment. But there are different ways to charge more for essentially the same service–without triggering a fraud investigation. Just ask the “manufacturers” of bottled water.

The technique is called “value-added marketing”. Simply put, it capitalizes on consumers’ willingness to pay more for an enhanced level of goods or services. In certain situations, doctors can apply it to their practices.

Going First Class

Many people–especially baby boomers and subsequent generations–love the perception that they’re getting a better product or service than other folks. More importantly, they’re willing to pay more for such enhancements. People stand in line to pay three or four times more for a cup of coffee similar to the one they’d buy at Dunkin’ Donuts. Starbucks absolutely sells top-of-the-line coffee, but the product’s cache allows the company to charge higher prices–and operate with a fatter margin–than a donut chain that’s simply been selling a first-rate cup of Java with its crullers for many years.

You might be able to take advantage of this concept by discovering what your patients want and are willing to pay for. Begin, by looking at your specialty’s core services. Consider what life events bring patients into your practice–and how you can add value to what you already provide.  The world is leaning toward alternative health care. Starbucks brought a better line of coffee; we need to provide the better paradigm of healthcare.

Clinical Standards

Value-added marketing is not about different levels of clinical quality. It’s about added features. The passengers in the first-class cabin pay for added amenities, not added safety. Harvey Mackay, author of How to Swim with the Sharks without Getting Eaten Alive, says, “Provide your customer with everything you promise and then a little more.” All your patients deserve the same quality of care. You must also make certain your commercial insurance contracts don’t prohibit providing extra services by interpreting them as a different level of care. And, of course, Medicare and Medicaid require equal treatment for all patients. If you see many self-pay patients, you have a freer hand to implement a value-added services program with them.

Even if what you do is perfectly legal and in accordance with your contracts, you must consider the perception that you’re offering two levels of care. In a sensitive area like health care, a patient could sue you over that perception. So consider that risk management aspect before proceeding.  Review this with your healthcare consultant or attorney.  Know your state laws; don’t hesitate to contact your state board.

Become a Specialist

Flight attendants draw a curtain between cabins to divert coach passengers’ attention away from what they’re missing. You might accomplish the same by opening a second practice catering to upscale clientele. For example, a Diplomat in orthopedics or acupuncture might develop an “elite athlete” sports medicine practice under a different practice name right next door.

Declining reimbursement has pushed many offices to shorter, limited visits for routine cases. The patient may not even see the physician at each visit. But, by offering an enhanced option like Endermologie for an additional $1500 or more, you can add a new line of treatment to your practice.  Yes, this can be done with massage, rehabilitation, laser treatment, etc. And, if your insurance contracts permit, you might be able to offer longer visits, more access to the doctor and enhanced office visits.

Apply this principle to your own specialty. Figure out how you can provide–or partner with other businesses to provide–services that your typical patient needs or wants. Create an optional program, and charge for it. Learn from other businesses, like the airlines. It costs less than $50 more to fly a passenger first class, but airlines can charge hundreds more for a first-class ticket.

A Huge Opportunity

Surprisingly, Americans spend more out-of-pocket dollars on medical care than Medicare and Medicaid pay combined, according to the Eisenberg study. That amount is growing, from $203 billion in 1995 to approximately $300 billion in 2000. Numerous patients willingly go beyond their health plans, into their own wallets, to get the medical care they want.  Now, add in the world of Anti-Aging, and this number will continue to escalate.  People will pay to feel good, people will pay to look good, people will pay to be healthier and more energetic.  A Wellness office is the office of the future, a one-stop shop for health.  Now is your time.

Given the downward pressure on traditional reimbursement, it makes sense to consider establishing this new revenue stream.  Many of my clients go to the MD/DC approach, however 50% stay just a DC practice.  Now the hot topic is DC/PT, but be careful; the same Stark rules apply.  There is no right way to do the wrong thing.  Don’t cut corners. If you do it, do it right and consult with experts in this arena.  The key is same store growth.  Now is our time. The world is looking for a better model of healthcare.  Chiropractic is not a Philosophy, Art and Science.  Chiropractic is a Science, with an Art and a Philosophy.  The key is chiropractic is a Science, documented by research; we are more than bone movers.  We live in the world of Healthcare, a trillion dollar industry.  Fortunately, our specialty is chiropractic.  We can do a lot under the scope of our license.  Expand your knowledge, work to the extent of your license, follow all state and federal laws, and watch your practice grow. TAC

Dr. Eric S. Kaplan is CEO of Multidisciplinary Business Applications, Inc. (MBA), a comprehensive coaching firm with a successful, documented history of creating profitable multidisciplinary practices nationwide.  For more information, call (561) 626-3004.

In today’s society, image is everything.  Public perception of a service or product can actually make or break a business.  Lets face it…chiropractic has had a less than positive public perception for over 100 years.  Do you ever contemplate your image?  What does the public perceive when they are introduced to you and to your practice?  What do they notice and remember about your office?  It goes without saying that everyone has a first impression of an individual or a business.  As a profession, we know that we have a good quality service to offer to the public.  Chiropractors are very highly educated doctors with powerful abilities for healing as well as for promoting wellness and healthy lifestyles.  What can you do as an individual to help change the public awareness of chiropractic?  Now that chiropractic is gaining recognition as a viable alternative to medical care, it is more important than ever to emphasize the high quality of care that our profession provides.  In other words, our profession must pull together and put ourselves out there in the public eye as the high quality health care providers that we are!  Our time has come.

You cannot just be a good chiropractor and automatically have a successful practice….  The public desires a high quality health care provider.  In this age of technology, people have the ability to choose their health care providers and, as a rule, they want the doctors who are the most current and progressive in their approaches to patient care.  People tend to be ruthless in the pursuit of finding “the best” doctors.  How do they find the “best doctors?”  The answer is not just by word of mouth, but also through personal recommendations.  Today, people are doing their own research via the Internet, which means they are using technology to help them to decide which healthcare provider to use.

How exactly does a chiropractor acquire and utilize a quality image both personally and for the practice?  Projecting a high quality image can start with simply evaluating your personal appearance.  It can be as simple as wearing quality clothing that fits well, and making sure your shoes are shined.  Is your “look” as professional as you think it is?  Also, is your staff dressed and groomed professionally?  Are they practicing their smiles on a minute-to-minute basis?  Your staff is an asset to your practice.  Whether they are assisting with patient care or handling the bookkeeping, they are always projecting an image.  Make sure it is the image you desire your patients to perceive.

The next thing to look at is the quality of your office surroundings.  Is your landscaping neat?  Does your front door work properly?  Is the waiting room inviting and clean?  Is your equipment up to date and working properly?  It can be very helpful for the owner of a chiropractic practice to walk through his or her own front door at least weekly, to just have a look at the place through the eyes of a patient.  Each office should have a monthly checklist that is inserted into the office calendar.  An “image audit” may just catch some shortcoming that you or your staff would have otherwise missed.

Are you using up to date printed material?  Are your intake forms poorly reproduced photocopies?  Is your HIPAA notification readable?  Are your brochures current?  The expense of printing and graphic design is not insignificant; however remember, image is everything, and each and everything you give to or say to a patient reflects upon the perception of you as the doctor.  The public wants high quality, colorful, easy to understand information given to them.  How will you effectively deliver this?

One way to deliver the message of chiropractic in a high quality manner is with the new chiropractic magazines, such as Chiropractic Wellness and Fitness Magazine or Pro-Solutions for Healthy Living.  These quality magazines allow your patients to receive a wealth of positive information in a format that will reflect positively upon you and the entire profession.  These magazines are full of colorful photographs and articles that will educate and enlighten the readers, as well as encourage the readers (your patients) to share the information with others (potential new patients.)

The entire profession of chiropractic is currently undergoing a major transformation.  The public perception of chiropractic has never been more positive and, therefore, it is critical that each and every chiropractor does his or her part in order to continue the momentum.  As technological advancements continue, as research continues, as results continue, so does the enhancement of the profession.  As the image of chiropractic improves, so, then, does the number of people who seek our care.  Don’t be a spectator….  JOIN THE GAME! TAC

Dr. Maurice A. Pisciottano, CEO and founder of Pro-Solutions for Chiropractic, is a practicing chiropractor, noted lecturer, author, producer and research and development technologist.  He is well known for his practice management expertise, as well as new patient development programs.  He has devoted the past twelve years to the development of the instrumentation and the computerization of chiropractic treatment and documentation.  Dr. Pisciottano regularly lectures at Palmer College of Chiropractic in Davenport, IA, and at Logan College of Chiropractic in St. Louis, MO.  He can be reached at Pro-Solutions for Chiropractic in Pittsburgh, PA, at 1-877-942-4284.