Practice Management


Design Your Own Drip-Education System One of the Simple Secrets to 300+Visit Patients
Practice Management
Written by Dr. Miles Bodzin, D.C.   
Friday, 25 September 2009 16:53

I always say it is better to keep a patient for lifetime than it is to keep getting new ones. This is one of the techniques I have used for nearly fifteen years, to build a practice full of 300+visit patients. After all, if you are really seeing people for lifetime wellness care, you should have tons of people with hundreds of visits over the course of many years.

When you went to chiropractic school, how long was it before you REALLY understood chiropractic? When I ask docs this question, I typically hear some number of years as the answer: "It wasn't until I graduated and practiced a few years before I really understood chiropractic."

If it took you years to understand chiropractic, how in the world do you expect your patients to understand chiropractic in such a short time? Do you really think they get it by hearing you tell the chiropractic story or reading a brochure or coming to a new patient orientation?

Patient-Ed

Although all these methods are tried and true for generating new patients, they don’t change a person’s long-term behavior. Ultimately, the reason you educate a patient is so they will change their behavior for the better and that involves using chiropractic instead of dangerous drugs and medical care.

Look at how every other big company teaches people about their product: McDonald’s, Coca Cola, the Drug Companies, etc. What do they all have in common? They deliver a short, to the point message over and over and over again.

People learn something new by hearing the SAME MESSAGE over and over. People don’t change their behavior by seeing one big advertisement. People are creatures of habit and a message has to be delivered many times before they get it.

The philosophy behind the patient education I teach can be summarized by a term I coined, Drip-Education. How are plants best watered in the most efficient and cost-effective way? Drip-Irrigation. How are patients best educated in the most efficient and cost-effective way? Drip-Education!

 

Designing your own

Drip-Education System is easy.

Step 1:

Define the SIMPLE benefit message you want your patients to know. I say simple, because they don’t need to know chiropractic like you need to know. They just have to know it benefits them. For example, "You get adjusted to stay healthy." Or, "Getting adjusted keeps your immune system strong."


If the patient understands that, when you get adjusted, you will have a stronger immune system, would you need any further information as to why you should get adjusted? In today’s world of super bugs and infectious disease, do you need to know any more? People just know, strong immune system equals good health. What do people think when you say "nerve system"? Health? Or do they think pain, numbness, paralysis? I’m not saying to ignore the nerve system; I’m just saying it does not convey a simple message. Stay healthier with adjustments. See what happens if you start sharing the "immunity" concept with your patients.

Do you drive a car? Do you really care how all the mechanics work? Will you not drive the car unless you know how all the components work? If you like the car, will you tell your friends about how it works or just that you like the car? People choose a particular car for reasons, such as prestige, make, safety, etc; however, they still use the car to get from point A to point B.

What’s my point? In your messages, don’t get too caught up in the "how." Give them a big "why" and lots of "benefits to taking action."

As a general rule, people do not care about how chiropractic works. People choose chiropractic, because it makes them healthier (and feel better).

Now that you have a simple message to share, you’ve got to get the message out.  

Step 2:

Have a predetermined plan for getting that message to your established patients as often as possible and in as many ways as possible.

Examples:

1. Give out a weekly handout. The handout could simply be a photocopy of an article attesting to the benefits of chiropractic. "Ear infections treated by chiropractic!"

2. Send your patients an email based newsletter at least once a month. This is a no-brainer and is FREE to do. Just be sure you have their permission.

3. Send your patients a snail-mail newsletter. Keep it simple and hire a company to print and mail them for you.

4. Explain to a patient who comes in with a cold or flu how they will "feel worse" after the adjustment. That the adjustment stimulates their immune system and that a lot of people feel worse as a result, but then get better faster.

5. Explain to the mother of a child you just adjusted how that child may spike a fever, or fill their diaper on the way home, or get really energetic or sleepy afterwards. In other words, tell the patient what they should expect to occur with regard to a "healing experience." Healing can sometimes be very uncomfortable.

 

Do You Educate New Patients?

Extensive patient education is not something to be invested in new patients. New patients only get the information they need in order to make a decision as to whether or not they will choose to be your patient (i.e., they have a problem that I can help them with is all they need to know). I will not invest more in a new patient’s health than they are willing to invest in themselves. So they have to hire me first.

Patient education is a privilege they earn by choosing to be my patient. I (like you) spent nine years and over $100k to get my education. I don’t take an investment like that lightly. If they want a piece of it, they need to choose to become a part of my practice and invest in their health first. In other words, do not invest a ton of energy trying to educate new patients. Simply have a Drip-Education system in place that produces very predictable outcomes—people who stay under your care for the benefits you tell them.

In summary, choose a simple message that you want your patients to know. Then come up with as many different ways as you can to deliver that message repetitively.

Dr.-Miles-BodzinDr. Miles Bodzin is Founder & CEO of Cash Practice® Inc., a web-based service company providing the Cash Plan Calculator®, Auto-Debit System® & Drip-Education® Email Marketing System. To learn more about how the Cash Practice® Systems can help you grow your practice, visit www.CashPractice.com. Dr. Bodzin can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or 877-FIFTY-50.

 
The Sky Isn’t Falling, but the Economy May Well Be!
Practice Management
Written by Evan Zang   
Friday, 25 September 2009 16:50

 

These days, consumers, feeling the rising squeeze of lost jobs, stale investments, and eroding assets, have made it a challenge for physicians to stay afloat. Even seasoned health care practitioners, across the country, are seeing up to 20% fewer patients than just 2 years ago. Billings are down for many physicians, as much as 50% in some cases, as existing patients elect to stay at home and save money rather than visit their medical providers. It appears today’s consumers are definitely watching their medical expenses more closely than ever. The news isn’t too positive for graduating medical students either, as they face the challenges of a tough and competitive marketplace on top of rigorous student loan payments.

But it isn’t all gloom. The encouraging news is that there are several viable tactics that both veteran healthcare practitioners and recent medical school graduates can execute right now.

 1. GET YOUR COSTS UNDER CONTROL NOW.

One of the most critical survival steps you can accomplish is to immediately lower your costs. You may think you’ve already done this. But, check again. It pays to be observant. I often encounter medical office buildings that are virtually deserted. Is the current lack of paying tenants your next opportunity? If so, perhaps the timing is right to have an affable discussion with your landlord about the renegotiation of your current lease, or to inquire about some reasonable tenant improvements!

In this unyielding economy, cash is king. Recommendation: Make it mandatory that all patients pay for services rendered at the time of service. No exceptions. Allow your patients to use their credit cards at checkout if they prefer. And, even if you must pay a small percent to the credit card companies, 3 percent, say, on a $15 bill, this would equal a mere 45 cents (about the cost of a postage stamp), and well worth the investment to save your staff time and energy!

 2. GET YOUR STAFF UNDER CONTROL NOW.

If you did not conduct at least 6 in-depth interviews, then you probably inadvertently hired at least one staff member that is causing you some form of problem. Now would be a perfect time to eloquently "invite" your bad hire to look for another job somewhere else. When ending someone’s employment, be genuine, be professional, and make certain your dismissed employee leaves with their dignity. Be sure you document, in writing, everything that occurs in order to limit potential post-employment problems.

Hiring productive and honest people, and removing dead weight, is probably the single most important thing you can do to help yourself survive a tough economy.

 3. GET YOUR MARKETING PLAN UNDER CONTROL NOW. It is time to pull out all stops when it comes to marketing your practice.

It might actually be the little things that ultimately count. For example, try calling the patient you saw that morning around dinner time. Your call should be short, such as, "How are you feeling?" Or, "Did you have any questions about today’s visit?" The level of service you create with this marketing/customer service activity may far exceed the benefits of that costly remodel you were considering before the economy began to collapse around you.

It’s also a great idea to always ask your patients for referrals. Patient referrals continue to provide some of the most economically feasible results for building your practice quickly. The patients whom you’ve successfully healed trust you, and may even subconsciously feel somewhat obligated to thank you. It would be a small matter for a happy patient to refer a friend to you. Referrals are FREE, unless of course you wish to provide an incentive program for this purpose.

4. GET YOUR DISPENSARY OPERATIONS UNDER CONTROL NOW. The nutritional supplement industry is a multi-billion dollar business. Your patients are already purchasing nutritional supplements, if not from you, then from someplace else.

Setting up a small supplement dispensary in your office may well be your best financial strategy for surviving these tough times. You may want to carry only the supplements you need to support your type of practice and to help treat your acute care patients. You may also wish to always have a good supply of men’s and women’s multivitamins, plus, some effective immune enhancing products (like a great Vitamin C), and perhaps some joint support products. Lastly, many Americans have some thoughts towards "weight loss" on their minds. So, perhaps a good meal replacement/detoxification product might also fit into your operation.

In the end, it’s all about improving the quality of life for your patients. And, if you have a successful practice, you will have given yourself a fighting chance to survive these challenging times, and accomplish all of the above.


Evan Zang, Healthcare and Protocol for Life Balance consultant, is the CEO of Jump Start, Inc., based in Scottsdale, AZ. Mr. Evan-ZangZang has more than 20 years of chain retail and distribution experience. Many recognized colleges and universities have benefited from his business lectures. These schools include Arizona State University, The University of Arizona, Southwest College of Naturopathic Medicine, National College of Naturopathic Medicine, University of Bridgeport, Logan College of Chiropractic, and Pacific College of OrientalMedicine. He can be reached at 1-602-717-1173

 
Rules of Time
Practice Management
Written by Dr. Eric Kaplan, D.C., F.I.A.M.A.   
Friday, 21 August 2009 11:30

In this time of an economic downtrend, I see so many of my peers depressed. If money is your key to happiness, your life, like Wall Street, will have continual ups and downs. The most valuable commodity in your life is time. Time is more valuable than money. Ask any dying person how much they would pay for one more day, one more year. Value your time and you will value your life. You can always get more money in life, but you cannot get more time.

 There are primarily four rules of time:

The first is that time is perishable. This means, that it cannot be saved. In fact, time can only be spent. Because time is perishable, the only thing you can do with it is to spend it differently, to reallocate your time away from activities of low value and toward activities of higher value. But once it is gone, it is gone forever. Invest your time wisely, in your family, your friends your patients and, of course, in yourself.

The second rule of time is that time is indispensable. All work requires time. No matter what it is you want to do in life, even looking out a window or sleeping in for a few extra minutes, it requires a certain amount of time. And according to the 20/80 principle, the 20% of time that you take to plan your activities carefully in advance will save you 80% of the effort involved in achieving your goals later. The very act of thinking through and planning your work in advance will dramatically reduce the amount of time that it takes you to do the actual job.

One of the keys to a successful office is time efficiency. Are your notes automated? Is your practice congruent with the times? I have many offices with more than one decompression table. The doctors enjoy making $200 per visit and not having to be face to face with the patient the entire time. The patient, whose visit ranges 30 minutes, feels ample value for time spent. We live in a world of technology; this technology can save each of us time to do the things we love to do. Make your office time quality time; enjoy the moment and make the minutes productive.

The third rule of time is that time is irreplaceable. Nothing else will do, especially in relationships. Time is the only currency that means anything in your relationships with the members of your family, your friends, colleagues, customers and coworkers. Truly effective people give a lot of thought to creating blocks of time that they can then spend, without interruption, with the important people in their lives. I miss the times I spent with my dad, he was such a positive influence on me. As much as I loved and appreciated him, I wish I would have spent more time with him. Treasure your time, your moments, by dedicating quality time with your friends and family. Invest your time in creating great memories.

The fourth rule is that time is essential for accomplishment. Every goal you want to achieve, everything you want to accomplish, requires time. My father used to say, "God's delays, are not God's denials." All good things take time, all plants need time to grow, all farms need time to harvest their crops. All goals need time to prosper.

It takes time to set goals and time for your goals to come to fruition. One of the smartest things you can ever do when you set a goal is to sit down and allocate the exact amount of time that you are going to have to invest to achieve that goal. The failure to do this almost always leaves the goal unaccomplished.

 

Time Perspective

Begin to see that everything that you are doing today is part of a long-time continuum, at the end of which you are going to be happy, healthy, financially independent or financially unfortunate. People with short-time perspective, those in the "Now Generation" think only about fun and pleasure in the short term. The "Live For the Moment" attitude can cause mistakes that will last your entire life. They have what economists call, "The inability to delay gratification." They have an irresistible tendency to spend every single penny they earn and everything that they can borrow. The time you invest in your practice and family today will give you rewards worth waiting for. Sacrifice short term pleasure for long term rewards. How long does it take to eat that piece of chocolate cake? How long does it take to lose that pound?

When you develop long-time perspective, you develop the discipline to delay gratification and to save your time rather than spending it all in one place at one time. The time you spend keeping yourself healthy saves you time from being sick. The combination of long-time perspective and delayed gratification puts you on the high road to success and independence.

Dr.-Eric-S.-KaplanDr. 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. Dr. Kaplan is the best selling author of Dying to be Young, and Lifestyle of the Fit and Famous and Co -developer and President of Discforce, the next Generation on Spinal decompression. For more information, call 1-561-626-3004.

 
Streamlining Your Data
Practice Management
Written by Michael Failla, D.C.   
Friday, 21 August 2009 11:25

Recently I have talked to a number of doctors about the types of software that they are using in their offices and it has become apparent to me that many of them have taken a piecemeal approach to creating a paperless office. They are using one program for billing, another for scheduling and yet another for doctors notes. Often these programs were purchased at different times and different stages of practice growth or as the need presented itself and not with a specific plan in mind. Sadly, these offices can be missing out on many of the benefits that an integrated practice management system can provide, as well as incurring hidden expenses that may not have been envisioned.

System-Provide

 

Some of the issues that are most commonly
experienced by these offices are:

Repeated data entryInputting each client’s information in multiple programs may seem trivial for an office that is seeing a lower volume but can become quite time consuming and expensive as a practice gets increasingly busier. Since payroll and staff hours are an important aspect of managing any business, this function can’t be overlooked as an avoidable expense.

Costly upkeep of multiple licenses and feesEach software license comes with tech support and up-date fees. When you are maintaining your agreements with 2-3 companies, these fees can add up when purchased individually rather than together.

Prolonged trainingDoctor and staff have to acclimate themselves to a number of different screens as well as command buttons. This only adds to the increased amount of time needed when training new staff and associate doctors.


 Poor integration of programsAs technology changes, some companies are moving faster than others in keeping up with the times. If one software company decides to move to a format that is not compatible with the others, you may have problems with how they interface.

Difficulty running reports and statisticsInformation from different departments cannot be quickly exchanged from one system to another so that aspects of the practice can be managed. Information about missed appointments, outstanding balances, updated records all has to be transferred manually and can delay responsiveness to problems in an office.

Slow interoffice communicationEach staff member would have to keep tabs on multiple programs to be aware of changes that were occurring in real time within the practice. For example, the staff being informed that the doctor would like to do a re-exam on the next visit or that patient should be thanked for a referral that was given to the office.

While these programs may have served you as you were growing and reshaping your practice, there will be a point where the expenses out weigh the benefits. At that point, it would be wise to begin the process of researching systems that perform all as one network. These are often easier to use and are more efficient and reliable in managing your database and collections.

Dr.-Michael-FaillaDr. Michael Failla is the President and Co-owner of Integrated Practice Solutions, the makers of ChiroTouch. Dr. Failla graduated from Life University College of Chiropractic in Atlanta, GA, and went on to run a highly successful chiropractic office in Seattle, WA, for 25 years. Dr. Failla sold his practice in 2007 and continues to promote health and wellness by helping chiropractors run streamlined and successful practices with more time for their patients and less time with their paperwork

 
Electronic Health Record Identification and Incentive Payments
Practice Management
Written by Dr. Steven J. Kraus, D.C., D.I.B.C.N., C.C.S.P., F.A.S.A.   
Tuesday, 21 July 2009 15:37

In all my recent meetings with government officials, including several trips to Washington, D.C., and participation in numerous reform initiatives, like the regional White House Forum on Health Care Reform, major buzz surrounds the electronic health records portion of the economic stimulus plan. To date, much has been discussed about the American Recovery and Reinvestment Act (ARRA) of 2009 and its impact on healthcare and, with more than $19 billion of the economic stimulus package dedicated to the implementation of electronic health records across the nation, the attention is warranted. Though the rules and standards related to implementation have not been fully established, some key elements have been confirmed that influence decision-making today.

 

How to get $44,000 for your EHR investment

Let me first emphasize that the Electronic Health Record (EHR) package is directed at physicians, and doctors of chiropractic are included because the ARRA of 2009 adopted the definition for physicians for this program from the Social Security code. This is an important note, as not all healthcare professionals will be eligible for incentive payments, but chiropractic physicians are an approved group.

In order to fully understand the incentive payment requirements, you must ask yourself two integral questions to determine eligibility. Do you have a qualified EHR product? And are you using it meaningfully in practice?

To be qualified, the EHR system must have the capacity to handle patient demographics and clinical health information. It must also have clinic management capabilities, as outlined by the entity that certifies qualified EHR’s. Only certified EHR’s will be considered for incentive payments, and the certification body has yet to be named. However, most insiders predict that the Certification Commission for Healthcare Information Technology (CCHIT) will be selected, as it is the only entity currently approved by Medicare for EHR certification.

So, if you have a qualified EHR, are you using it meaningfully? "Meaningful use" is defined by three key measures: (1) Connectivity to health information exchanges (HIE’s) and other EHR’s; (2) Regular reporting of quality measures to the Centers for Medicare Services (CMS), including outcome assessment scores and pain assessments; and (3) e-prescribing capability (Note: because chiropractic physicians do not have prescribing privileges, it is unknown whether this will remain a requirement for DC’s.). The framework that has been introduced suggests that reporting quality measures to CMS will likely be managed by PQRI, the Physicians’ Quality Reporting Initiative, a standardized mechanism that already exists. More rules regarding reporting requirements are expected to come at a later date.

A.R.R.A. 

Once you answer "yes" to the above questions, as much as $44,000 is available as a post-adoption incentive for implementing EHR. What’s more, for clinics with multiple physicians, each physician can qualify for an incentive payment, as long as a qualified system is being used and each physician is using it meaningfully, as the terms outline.

To qualify for the full incentive payment of $44,000, your EHR system has to meet the aforementioned qualifications, no later than 2010, to begin earning incentive payments in 2011. If you’ve already adopted a system that meets these guidelines, then you automatically qualify for the incentive payment.

And, while we know that the Department of Health and Human Services and the Center for Medicare Services will be involved, their specific roles are still being evaluated with regard to reporting and eligibility requirements for doctors participating in the incentive program. For example, minimum billing thresholds, such as an annual $25,000 in covered services to CMS, are being considered in order to be eligible for the incentive payments. However, there is some discussion on consideration for proportionate payments if the threshold is not met. So, if you average 16 Medicare patient visits a week, you would likely qualify.

The chart included with this column outlines the incentive payment schedule in simple terms.

 

The ideal timeline for implementation

Typically, it takes 90 days to six months to plan, train, and implement the new EHR system. PQRI currently states that you have to report on 80 percent of your patients. Assuming PQRI is a requirement for demonstrating meaningful use, it stands to reason that you would have to use the system for the better part of 2010 to begin receiving your first incentive payment in 2011.

Implement in 2009, use the system in 2010, and begin receiving incentive payments through Medicare in 2011. If you opt not to transition to an electronic health record system, you will be penalized beginning in 2015 through 2018. These penalties will be assessed against your normal reimbursement for services from Medicare.

So far, only 15 to 20 percent of DC’s have moved to EHR. With enormous financial incentives to support the move, there is no longer an excuse to wait. There are just too many good reasons to adopt!

 

Dr. Steven J. KrausDr. Steven J. Kraus is CEO of Future Health, Inc., a company that partners with chiropractors to deliver a comprehensive clinic management solution, including fully-integrated EHR. Dr. Kraus is a recognized expert in building successful clinics, having developed and sold 18 practices of his own and provided strategic consulting services to more than 400 healthcare businesses. He offers leadership to numerous industry associations and currently serves as the Chairman of the Iowa Board of Chiropractic. Contact Dr. Kraus at This e-mail address is being protected from spambots. You need JavaScript enabled to view it for more information.

 
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