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Practice Management
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Practice Management
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Written by Jay S. Greenstein, DC, CCSP, CGFI-L1, CKTP
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Saturday, 28 January 2012 03:31 |
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T hroughout my travels I have had the opportunity to meet lots of great people in our profession. Many have been in practice for years, but some are in school, getting ready to graduate or just getting started. I’m often asked by these folks what it takes to build a sports chiropractic practice. The answer essentially revolves around three key ingredients. They are (1) education and training; (2) building strong internal and external relationships; and (3) hard work. So let’s jump right in and discuss each of these ingredients in detail.
Education and Training
 When I graduated National, I decided I was going to do whatever it took to work for a great sports chiropractor. I was fortunate enough to be hired by Dr. Jan Corwin, who was the official US Olympic Team Chiropractor in Seoul in 1988. I spent a year with Jan learning each day about what a high quality sports chiropractic practice looked like and the importance of having great relationships with people both inside and outside the profession – more on that later. When I decided to return home to my roots in Washington, DC and start my own practice, I realized I had a lot more to learn – clinically. Immediately I enrolled in my CCSP course. In that course, I was trained by some of the world’s best sports chiropractors – Drs. Marianne Gengenbach, Tom Hyde, Bill Moreau and more. Once you begin to go down the road of postgraduate training, my advice would be to never get off. Continuous education to pursue a Diplomate, an ICSSD, a masters in sports, and/or certifications in great programs such as Functional Movement Screen®, Active Release Technique®, Graston Technique®, Kinesiology taping, FAKTR®, and more, can be extremely beneficial. These degrees and certifications are not about the letters after your name – they’re about tools in the toolbox. The more tools you have the more you can correctly apply those tools to the athlete you are treating and their goals and needs. Dr. Tom Hyde, DC, DACBSP, co-founder of Functional and Kinetic Treatment with Rehabilitation, Provocation and Motion (www.faktr.com), and one of the world’s preeminent sports chiropractors, emphasizes never stop learning, saying, “It’s amazing how far sports chiropractic has come in the last two decades. Dedication to learning has turned into a process whereby now we are teaching some of the most advanced techniques in managing the athletic chiropractic patient. Continuous focus on education and evidence-based practice will propel the sports chiropractor to new levels in the future.” Further attending interdisciplinary conferences can be extremely beneficial. Dr. Angela Salcedo, Past President of the International Sports Chiropractic Association and now a member of Federation of International Chiropractic Sport, states, "Attending other sports medicine conferences outside of chiropractic has afforded me the opportunity to build multi-disciplinary relationships. Over the years, these relationships in turn have given me additional opportunities to build my sports chiropractic practice as the team sports chiropractor for the British Virgin Islands Olympic Committee and Track and Field team and support my leadership role in the International Sports Chiropractic Association and the Federation of International Chiropractic Sport."
Thus, investment and commitment to education and training will pay off in spades when it comes to…
Building Strong Internal and External Relationships
This second ingredient is not necessarily a “second step”. Building strong relationships can happen congruently as you build your sports chiropractic skill set. I always recommend that any doctor wanting to be a great sports chiropractor join the American Chiropractic Association Council on Sports Injuries and Physical Fitness (ACASC). Dr. Corwin took me to my first ACASC convention in Santa Barbara, California. Dr. Corwin emphasizes the importance of intra-professional meetings… “Having a network of other DCs around the country to share your trials and tribulations with, knowing they are also involved in sports chiropractic can be extremely beneficial because the knowledge sharing is so strong.” Certainly for my first ACASC convention, it became abundantly clear that not only was I surrounded by phenomenal sports chiropractors, I was surrounded by phenomenal people. Every person I met was (and still is) completely engaged and committed to bringing chiropractic to the forefront of sports. Not only that, they were, and still are, committed to helping others grow sports chiropractic. I met Dr. Hyde for the first time at this convention and he literally changed my life. He took me under his wing and helped me, and continues to help me to this day, increase my involvement in sports chiropractic. The lesson to be learned here is that had I never gone to our national association’s convention, I would have never met these people who have had such an impact on my life. And, as great as the professional opportunities that came about because of building these internal-to-chiropractic relationships, it’s actually the personal connections that I’ve made with these great folks that are the most rewarding. In addition, being part of the national association provides tremendous resources to the budding sports chiropractor. Local, regional and national events that require staffing, educational meetings and vendor resources are just a few of the many reasons to join.
The message that was reiterated over and over again in speaking with the world’s best sports chiropractors was that in order to be successful as a sports chiropractor, you had to be humble. Even though we leave school with a passion to literally change the world with our hands, we have to be respectful of the other healthcare providers on the healthcare team. I remember hearing stories of Dr. Phil Santiago, who was the official chiropractor for the 1992 US Olympic team in Barcelona, Spain, cleaning up the training room because there were no patients that day and he wanted to do something to begin to make a contribution. Those sports chiropractors who think cleaning, or helping in any way, is below them will find the road to gaining acceptance long and hard. Those sports chiropractors who are willing to roll up their sleeves and do whatever it takes to make a positive contribution, listen and respect others, and clearly communicate how they can be an integral part of the healthcare team in a manner that is humble, but confident, will excel. Dr. Alan Sokoloff, Chiropractor for the Baltimore Ravens, adds, “Most chiropractors do well to get involved with sports teams, but many of their struggles come with staying involved. I have found good communication to be the key. 1. Communication with your team supervisor (Physician, athletic trainer, etc.) about what you recommend for the player. 2. Communication with the player and making sure your message is consistent with that of the rest of the medical staff. 3. Communication with your office and family, so they know your time commitments. The goal is to not just get involved, it’s to stay involved.”
What’s the best way to go about building these relationships? If you are already in practice, have inquisitive conversations with your existing patients about themselves, their kids, their friends and family that are participating in sports and offer your services – in your office, on the field, and/or in the company lunchroom for a lecture. Do they know coaches and athletic directors? Do they know of community groups that are bound by a particular sport – running, skiing, bowling??? For those of you who are starting a brand new sports chiropractic practice and don’t have a patient base to leverage, use my favorite tool…Google…think about the sports you want to serve, and Google “youth football league, your town” and see what comes up. Also spend some time out of the office introducing yourself to local coaches, trainers and owners of health clubs. Dr. Peter Garbutt, President of Sports Chiropractic Australia, states, “I would say that one of the things that I found most beneficial with building relationships with other professionals was to join a sports medicine association and participate in the interests of the organization, not yourself and not chiropractic. Throughout our training and general socialization we tend to become a part of the chiropractic community automatically. We don't have that luxury within the sports medicine community, so we have to show that we are a part of that community and not an opportunist or pariah in their organization.”
There are infinite possibilities…Of course, if you’re going to be a great sports chiropractor and you’re going to have all these potential opportunities, you better get used to…
Hard work
We’re all tasked with working hard to have successful practices. But the great sports chiropractors take hard work to another level. Working in their practices during the week and then working on the weekends doing community sports events, treating patients on the sidelines or on the court, providing sports injury treatment and prevention lectures, are all critical elements to building your brand as a top sports chiropractor. It takes hard work to raise your level of education, it takes hard work to spend time building new relationships with the outside sports world – coaches, athletic trainers, parents, personal trainers, other physicians.
Most highly successful sports chiropractors work a lot more hours, and they do it not because it’s going to get them another new patient, but for the love of service. They know they can help that athlete recover from an injury faster, prevent an injury and/or provide information and feedback that will change the game in the positive direction for the athlete. It’s that commitment to service that shines through, and when intent is altruistic, great things happen.
Dr. Greenstein is the CEO of the Sport and Spine Companies, a multi-location, multi-disciplinary, evidenced-based practice in the Washington DC Metro region. He is also the President and Founder of the Sport and Spine Rehab Clinical Research Foundation, a non-profit dedicated to high quality, clinical research. He is a member of the scientific advisory board for Thera-band®. He serves on the CCGPP as the Vice Chair and represents CCGPP on the Chiropractic Summit and the Government Relations Committee.
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Practice Management
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Written by Tom Owen III
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Sunday, 18 December 2011 00:32 |
O ne subject that tends to get overlooked when it comes to the overall management of a chiropractic practice is simple appointment book control. A lot of doctors haven’t learned that there needs to be a certain rhyme and reason to every minute that is controlled by the appointment book for the practice. Because really, when it boils down to it, there’s only so much time in a day. If that time is not managed properly then it’s going to lead to frustration, distress, and ultimately, failure.
 Don’t allow patients to come and go as they please. Schedule them. When you allow the patients to control your schedule, you’ll have a day like this: You’ve got four regular people that show up for their regular care, and then a new patient shows up and waits for an hour and a half to be processed because you weren’t expecting two of the four regular patients, and both the new patient, the regular patients, and the doctor just end up being stressed and frustrated. It just leads to a big break down in efficiency and stress that doesn’t need to occur.
One way to fix that would be something as simple as cluster booking. Cluster booking is essentially blocking time throughout the day where the CA, the chiropractic assistant, and/or the staff know they can’t book any new patients. That two and a half hours or hour and a half or whatever it may be is only to see patient visits for regular care.
Then there will be blocks of time where you’re only going to see report of findings. So if you need to fit in your report of findings, it helps you get into a groove. Also, you’re not bouncing around. You’re able to focus on the patients at hand. It really helps with the efficiency and the effectiveness of what you’re trying to communicate to the patients.
Here’s another point that’s often overlooked. This helps reduce missed appointments. If someone calls and cancels, are they rescheduled for the appointment that was missed? In other words, if they were on some type of care plan where they were scheduled to be seen three times that week but they call on Monday and cancel do you just say, “Okay, we’ll see you on Wednesday.” If so, you’ve just missed that appointment that was originally scheduled in the care plan. So that’s not a rescheduled, that’s just a missed appointment.
A lot of doctors think, well, I had 25 visits scheduled today and 24 of them showed, so we did pretty good. Well, if that was the case, in most chiropractic offices that’s not too bad. However, if they have 25 scheduled, had four missed appointments, and had five drop-ins there is a good indication that there is a problem with appointment book control.
Just on the missed appointments, forget the drop-ins for a moment, just on the missed appointments alone, do you know that if you have one missed appointment a day and you do that for a year’s time that’s over $10,000 you’ve lost? So when the appointment book is mismanaged, and even down to one missed appointment a day, that’s going to lead to dramatic loss of profits and productivity.
When I ask doctors how many additional patient visits they would like to be able to see in a day, effectively and efficiently, with low stress, most doctors will say somewhere around 20 more patients a day.
However, if it takes you 20 minutes to see a patient visit, 30 minutes to do a report of findings, a full hour to process a new patient, then you’re taking up the time in that day that you could be seeing additional patients. There is only so much time in a day, and if you keep running your practice in an inefficient manner, how are you ever going to squeeze 20 more people into your schedule?
Until you can better manage your schedule, the day that you’re going to squeeze 20 more people in is never going to come. Because that’s a stress point. And you cannot outgrow a stress point. It can’t be done until you address it. All of those inefficiencies lead to a “friendship practice” that so many doctors have. Friendship practices are those that allow the patients to come and go when they what to. Patients dictate the care, not the doctor. There’s no respect.
Until you learn to manage the business that you already have, you’re going to be constantly looking for new business. Think about that for a second. If we’re losing business, the very business that we’ve already spent a certain amount of money and time to get into our office, if we mismanage that, then we’re going to be seeking out new business before we really need it. Pay attention to the appointment book and determine to become more effective and efficient in your practice.
by Tom Owen III, and Todd Osborne, D.C.
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Practice Management
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Written by Kathy Mills Chang, MCS-P
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Wednesday, 26 October 2011 20:40 |
D o you ever sit at your desk, look around at the stacks of requests, letters, and charts and ask yourself, “What do insurance companies really want from me, anyway?” The volume of new regulations and rules are raining down at a fast and furious pace, and may feel like an out of control, runaway train. We just master one new policy and they change the rules. Keeping up with the modifications can make our heads spin, but it is vitally important to stay on top of everything. Usually, staying connected to your State and National Association, a trusted advisor, or consultant can keep you in the loop and up-to-date on regulatory changes. But what about the day-to-day inner workings of your practice? With all that you manage, what are the handful of most important things to keep track of to steer your practice out of the danger zone, and operating on all cylinders? Make sure that among all the stacks, rules, regulations, and forms to fill out, you master these five basics to keep your show on the road to success.
Understand Their Definition of Medical Necessity
There is a clear difference between most chiropractors’ definitions of what is clinically appropriate and what a carrier may define as medically necessary. When you are a third party to the relationship between your patient and their contracted insurance carrier, it’s important that you follow their rules. If you happen to be a contracted provider in their network, then you have your own rules to follow as well. It’s my opinion that if you try to find out medical necessity definitions from the carriers you deal with, you will be well on your way to better documentation and an unmistakable showing of an effort toward compliance.
Remember that medically necessary care is that which the carrier can justify as payable through the insurance. It is usually tied to certain diagnosis codes and based on medical review policy. They will not dictate what you recommend to a patient as needed treatment, but will dictate that portion which they will pay for. You can treat as you wish, but be sure you only submit for reimbursement that segment that your documentation shows will align with the medical review policy for that diagnosis. The remainder is the part the carrier expects the patient to pay. And the doctor is the link between the two. It’s based on your interpretation of the review policy, and your documentation of medical necessity is the lynchpin.
Medical review policy is usually found on a carrier’s website, in the physician area, sometimes requiring a password. You can search using their search tools, or navigate to the appropriate section and use key words such as “chiropractic” or a specific CPT code like 98940. For example, many carriers will pay for orthotics. They will tell you upon verification that they are a covered service. But if you failed to read the medical review policy for orthotics, you may have missed the fact that orthotics are only covered if the diagnosis is “Diabetes”. If you didn’t know that, you may be frustrated when your bill is denied for your diagnosis of “Plantar Fasciitis”.
Be Proactive with Compliance
In 2000, the Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) encouraged the voluntary implementation of compliance programs in healthcare offices, particularly those that served the Medicare or Medicaid beneficiaries. In March 2010, as part of the Patient Protection and Affordable Care Act (PPACA), also known as “ObamaCare”, these compliance programs were made mandatory. While there has been no specific deadline by when they must be implemented, it’s likely going to be very soon. The majority of chiropractic offices do not have a compliance program in place. Those that do likely have a program that they bought years ago, thinking it made them compliant, and it has an inch of dust on it from sitting on the shelf.
But if you failed to read the medical review policy for orthotics, you may have missed the fact that orthotics are only covered if the diagnosis is “Diabetes”.
Think of a compliance program as a self-policing program, where you proactively state that “this is how we do it here” and then keep to it. A Code of Conduct for your office sets the tone of compliance for your team as well. It involves voluntarily auditing yourself for coding, documentation and billing errors, and reporting them and paying back overpayments if necessary. When these standards are stated, implemented, and managed, a third party looking in from the outside can see that you are not part of the problem, but part of the solution. A well organized office with a compliance program is less prone to simple mistakes. And if they make errors, they catch them early, and deal with the fall out quickly. An office writing in to a carrier with an overpayment caught by the self-auditing process will be set apart as a stunning example of the way it should be. And you can imagine that if an error was found on a carrier’s audit, the fact that you routinely self-police is a strong, mitigating factor in your favor, trumpeting that you are not doing something fraudulent, which implies intent.
A doctor I work with called recently with what they thought was the end of practice as they knew it….a team member had been falsifying billing for quite some time, and then stealing the extra money that came in. The numbers were staggering once we started digging and auditing. The amount that would need to be repaid was more than they could fathom. Some of it was from Medicare, which layered on another series of deadlines and regulations. But trust me when I say that this doctor coming forward to the several carriers involved, showing that “we found this as we audited” was a huge mitigating factor in their favor when the carrier began extending payment plans and other considerations. Just think of what would have happened if a carrier began an audit for another reason and found it before the doctor did. Setting up a compliance program is a simple process with an uncomplicated structure. Don’t be caught without one.
Code and Bill Correctly
If you have a compliance program in place, then you probably will do your coding and billing appropriately. The CPT and ICD numbers reported on your patient’s billing is the language used to communicate your services to the third party payer. Simple auditing techniques will make sure that errors are minimized. But, if you use codes that are not a clear and obvious description of the work you’re doing, you could run into trouble. Make sure that you clearly understand the parameters for the use of every code you bill. Some codes require particular modifiers, and others require certain pieces of documentation to be present in your notes for use of the code. When you report a code, and it’s paid, don’t assume that because they paid it all is well. Usually, errors are found on post payment audit, and “I didn’t know” is not an excuse that will hold water. Repayments of erroneously billed codes still have to be refunded. The great news is that coding and billing correctly in chiropractic is pretty easy. Diagnosis codes are straightforward, and there are a small handful of CPT codes that apply to our services. Even with the implementation of ICD-10 in 2013, it’s an area of your practice that must be exactly correct. You can’t afford to take the risk of erroneous coding and billing. It will cost you time and money when you may have precious little of both.
Be Aware of Documentation Requirements
Federal and state reports on the audit of chiropractic documentation indicate that chiropractors don’t have a good handle on proper case management and documentation requirements. Some jump to purchase EMR software thinking it will solve all documentation problems, but end up with an unhappy experience. You must learn the requirements on your own and master the documentation of your care. The best way to do this if you find your documentation lacking is to use a good paperwork system that will prompt you along the way with appropriate requirements so you don’t miss a thing. It’s a great bridge from the travel card you may be using now to EMR software that may be required in the future. Using appropriate forms will guide you and teach you the nuances of documentation that you must learn. The Medicare documentation requirements are easily found in your Medicare carrier’s Local Coverage Document (LCD). Read it! And implement those requirements.
Don’t Charge the Carrier Significantly More Than You Charge Your Patient
Offices that routinely offer cash discounts to patients under the guise of “time of service” pricing are usually in violation of a myriad of inducement and compliance rules. It usually goes like this: An insured patient’s carrier gets a bill for a manipulation, traction, and exercise at the doctor’s actual fee schedule, which comes to $120. Meanwhile, a patient who has no insurance comes in and is quoted the “time of service” fee of $40. Can you see why a carrier may have a beef with being “overcharged”? It’s a violation pure and simple, unless you’re following the OIG’s guidance of no more than a 5-15% prompt payment discount. Would an average of $12 savings (10% of the $120 actual fee) really help that cash patient? This is why most doctors are discounting far more than the allowed 5-15%. The easiest fix is to join a reputable Discount Medical Plan Organization (DMPO) like ChiroHealthUSA. This allows you to set a network fee schedule for your cash paying patients too, and this keeps insurers from feeling like you’re gouging just because someone has third party coverage.
Focus on these five areas should strengthen your relationships with the third party payers you deal with. It’s important to keep them healthy and strong, so you can continue helping your patients be the best they can be, without worries of third party payer interference. It’s possible! And it starts with you!
Kathy Mills Chang is a Certified Medical Compliance Specialist (MCS-P) and, since 1983, has been providing chiropractors with hands-on training, advice and tools to improve the financial performance of their practices. A well-known and sought-after speaker, Kathy has served in national and state level chiropractic organizations, sits on diverse boards and advisory councils related to the profession, and is frequently invited to address chiropractors in important conferences and seminars around the country. In 2007, KMC University was created to streamline, develop and offer a broader range of chiropractic solutions in the areas of coding, insurance, patient financial procedures, Medicare and compliance. She can be reached at 888-659-8777 or
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Practice Management
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Written by Tom Owen III
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Sunday, 25 September 2011 21:40 |
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T alk to just about anyone, in any profession these days, and a similar theme weaves itself throughout the conversation; our nation’s poor economy has left few untouched. Many chiropractors have certainly felt the sting of this unfortunate downturn. We’ve had numerous conversations with several practicing chiropractors in recent months and no doubt, times are tough out there. However, we’ve noticed that while many stories started out with the same details– lower collections, few patient visits, a few of these doctors have ended the conversation by saying their practices are healthier than they have been in a long time and their outlook is optimistic for the future. The circumstances started out the same, why were the outcomes different? It may surprise you to know it had nothing to do with the market, their staff, or a magical newspaper ad. The difference was in the doctor’s response to the adversity he or she faced.
While some doctors lament their falling collections and hopelessly describe their uncertain future, others, in the same circumstances, tell us a different story. They say when their practice started hitting bottom; they knew they had to do something different. Let’s take a time-out right here. That sounds simple, doesn’t it? Something isn’t going the way we need it to go, so we decide to do something different. Simple logic. However, we never cease to be amazed at the powerful results of acting on this simple thought, and we also never cease to be amazed at the number of doctors who don’t think this way.
We tell clients who find themselves in troubling situations that if they don’t do anything about their current situation, they’re insane. That may sound cruel until you understand our definition of insanity, which is, “continuing to do the same thing while expecting different results.”
If something isn’t going right, it may be time to do something different. This is the blessing of adversity. Adversity forces us to acknowledge that our current way of doing things isn’t working. It forces us to consider change and do things we may have otherwise never done. This was the common thread in the different outcomes of stories we’ve heard from doctors all over the country. Some of them do nothing, and watch their practices shrivel up and die, while the adversity our economy has brought has stirred others out of their comfort zones and forced them to make changes within their practices. Those changes, albeit uncomfortable or risky, brought about the success they needed to survive the perils of the economic downturn. For many of them, the change they made was calling us and asking for our help. Most admit, they would have never sought out our help had it not been for the desperation they felt as a result of this horrid economy. The adversity they encountered was a blessing in disguise because of their proactive response.
The current situations of many chiropractors remind us of a true store that happened over a century ago in Enterprise, Alabama. This small town’s commerce was all but wiped out, but the same culprit that almost destroyed it, is now the town’s hero. What is on the monument that now stands at the center of Enterprise, Alabama’s town square? A boll weevil.
The monument honoring the boll weevil is a robed, Statue of Liberty look-alike, holding the enormous black bug over its head. The statue’s head is bowed in somber respect.
The boll weevil ravaged 60 percent of the region’s cotton crop in 1915, and even more the next year, decimating livelihoods and towns. Yet, the inscription on the monument’s base says, “In Profound Appreciation of the Boll Weevil and What It Has Done as the Herald of Prosperity.” The herald of prosperity? The boll weevil?
In 1917, with their economy and society almost destroyed, the down-and-out farmers of South Alabama faced tremendous adversity, much like many in our profession are facing today. However, the adversity the boll weevil caused, forced these farmers to do something different. They had no choice; they couldn’t grow cotton any longer. They were either going to die into extinction or they were going to have to adjust and innovate. Over the next few years, they began diversifying into peanuts and other crops and no longer depended so heavily on cotton. This forced change helped the farmers of Enterprise thrive, even when other areas of the South, primarily dependent on cotton, continued to suffer. Take note, the other areas of the South didn’t suffer under the destruction of the boll weevil, their adversity wasn’t as severe, therefore, they were not forced to make the needed changes and diversify their crops. For the farmers of Enterprise, the enormity and severity of their adversity, and their response to it, saved their economy and birthed their prosperity.
What changes is your adversity forcing you to make? Consider the cotton farmers of Enterprise, Alabama and consider making those changes to save your future. What you are suffering through right now may be just what you need to propel you into the changes that will bring the prosperity you’ve been waiting for.
by Tom Owen III, and Todd Osborne, D.C.
Dr. Todd Osborne, a 1989 graduate of Palmer College, ran a successful high volume multiple doctor practice, and is currently Vice President of AMC, Inc., as well as an author and lecturer. Visit www.amcfamily.com or call (877) AMC-7117 for more information.
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Practice Management
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Written by Peter G. Fernandez, D.C.
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Sunday, 25 September 2011 18:44 |
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I n my previous articles, I described the types of associateships that are, and are not, successful. Now that you know the type of associateship you should look for—here’s how to find that “needle-in-a-haystack associateship from Heaven.”
A potential associate should search for an established doctor who is earning $500,000 or more per year. Do not associate with a doctor practicing below this level, as one of your associateship goals should be to learn how to run a large, successful practice. You can only learn this by either hiring an experienced consultant, or by associating with a doctor who is already doing it. The established doctor must also be able to comfortably give the associate doctor 20 to 25 new patients a month, without a financial worry if any are lost. Only a very successful doctor with a large volume of new patients can match these criteria. Don't settle for less when you're looking for a great associate position.
Looking for a Successful Associate Doctor Practice
Your first step is to talk to the president of the county chiropractic society of the area in which you're interested. Ask him who the area's most successful and ethical practitioners are that hire associates. Your association president will know. Then, speak with those doctors and ask if they need an associate. If they do, apply for the position. If not, ask them who the most successful practitioners are in the state who operate good associate practices. They'll know. When you ask three or four doctors the same question, you'll find the same names cropping up.
Go to these doctors and ask them for a job. If they don't have a position available, ask them to refer you to other super-successful, ethical doctors who are good trainers of associates. If you appear to be good associate material, they'll be happy to do so.
By following these steps, you will find the super-successful associate practices. The doctors who run these practices are networked by mutual interests and concerns, and are openly supportive of each other.
Your next step is to contact the practice consultants that have clients in the area you are interested in practicing. Ask them about large successful associate practices. They’ll know and will be happy to guide you to a successful practitioner. If the successful practitioner has a full complement of associates and is not hiring at the time, ask him for a referral to other successful associate practices. He’ll be happy to help you.
Another method of finding a successful practitioner is to ask vitamin and chiropractic equipment vendors in your state. These people know everyone. They will be happy to steer you in the right direction because the more successful they make the established doctor by referring a good associate (YOU) to them, the more vitamins, orthopedic supplies, or equipment they will sell the established doctor and, thereby, the more successful the vendor will become. Everybody wins.
Look for “Associate Wanted” ads in the classified ad section of the local chiropractic society newsletter, your state association journal, and our national journals. Call these doctors and follow the previously described recommendations.
Another fruitful source of associate positions is through the profession’s employment agencies, vacation doctor companies, etc.
Finally, if the previous methods of finding an associate position are not successful, write a letter to all the practicing DC’s in the area of the state in which you’d like to practice. In this letter, state you are looking for an associate position, your qualifications and your willingness to work hard. You’ll be pleasantly surprised by the response.
Best of luck in finding a great associateship. I did and it was one of the most rewarding experiences of my life. I had the best teacher and, because of the training he generously provided me with, I became a success. Forty years later, I still follow the principles and guidelines he taught me. I've had a dozen associates, who I trained the same way and I'm extremely proud of their subsequent successes.
Doctors, I hope you follow the guidelines of this article. Identify and avoid the types of associateships that will only trap and hurt you. Find a good associate position…become a great associate! When you become a great associate, you'll become a great doctor. And, when you learn what the successful practitioner knows, you'll be able to duplicate the established doctor’s success after you have successfully opened your own practice.
More information on becoming an associate and the specific responsibilities of the established and associate doctors in an associate and independent contractor practice is available online at www.practicestarters.com.
When you're through being an associate and are ready to start your own practice, hire a consultant who specializes in starting practices to guide you. Don’t think that you now have the experience necessary to start and build a new practice…you don’t! Yes, you’ve gained the experience of caring for patients and learned some good office procedures, but that’s not enough knowledge to start a successful new practice. You still have to learn how to find a great office location, effective bank negotiating strategies, cost-cutting remodeling negotiations, how to market a new practice, etc. It’s the lack of this specialized knowledge that dooms new practices, not the lack of knowledge regarding patient care.
Dr. Peter G. Fernandez is the world’s authority on starting a practice. He has 30 years’ experience in starting new practices, has written four books and numerous articles on the subject, and has consulted in the opening of over 3,000 new practices. Please contact Dr. Fernandez at 10733 57th Avenue North, Seminole, Florida, 33772; 1-800-882-4476;
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or visit www.drfernandez.com
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