The following are traps that many doctors, as business owners, fall into and, if you can avoid them, you could make a lasting change in your business.
Most doctors are very proud of being true to their philosophy of healthcare and being a chiropractor, but doctors aren’t trained or naturally talented in all aspects of business, although, the amount of money many owe in student loans could fund a startup business. However, a very good doctor may not invest in the time, funding and implementation of important aspects of his or her business. As doctors, we have to be business people, out of necessity. Just take a quick assessment of your own office and see if you can give yourself a good grade for avoiding the following business traps:
1. Slipshod Accounting: Correct accounting can diagnose what is right and wrong with your business. You can produce an income statement in a matter of minutes from any accounting software. That is, if you have input the data. This shows if your formula for making money is working. Do you understand your ratios of expenses to sales? Yes, as doctor, you have sales. This is what makes you profitable. You must have an understanding that you must gross X$ amount to see X$ amount of net profit. It is not going to work to say, I hope I can make $300,000 this year. Slipshod accounting will get you into trouble and worse is having no accounting at all. You must have a grasp on all your costs, including components such as computer upgrades and other orphan costs. Then you can fine tune profits. Accurate accounting can correct aimless direction. A doctor doesn’t have to know all the answers to all the questions, but he or she does need to know all the questions and employ someone who can help achieve the answers, i.e., a good accountant and bookkeeper.
2. Fear of Fees: Discounts on fees really increases your “Cost of Sales”, and you must keep that in mind. Free offers for examinations, X-rays and first adjustments have costs associated with them. There are the costs of the doctor’s time, patient confidence and income lost from “free offers.” And you are acquiring additional liability for which you have not been compensated. You need to truly understand your costs, and pricing your fees too low is a significant sign of your own feeling of value and can transfer into patients’ lack of confidence in the doctor.
3. Ignorance in Hiring: It is valuable to have a prospective employee interview with someone else in addition to the doctor. The additional interviews can even be done via telephone or Skype. It is amazing what others may detect while interviewing. Busy doctors may want to hire someone pre-trained from another doctor’s clinic. Key question, “Why aren’t you still with Dr. Bob?” You need to take the time to call their references and learn how to ask the right questions. We all want to hear that the prospective employee is wonderful and could return to their previous job, if they wished. However, do we really want an employee from another doctor’s office? Are we taking on another doctor’s bad habits and preconceived ideas that may not click with ours? I believe an employee must have some fundamental qualifications, but I do not want to hire from another doctor’s office. I want to indoctrinate my own employees. I have found that personality testing can provide great insight into what motivates a person and makes an employee tick.
4. Hanging onto Employees: No one wants to let an employee go and, unless you are the only one left to do the job, delegate it to a reliable employee or even a spouse, if available. Along with the delegation to another should be instructions of exactly what to do and say. The simpler the better and just saying while handing the employee a short, nice severance letter, “This was a decision recommended by the accountant or management” could be the best approach. Keeping an employee because of your own fear—fear of time it takes to advertise and interview and the fear of the time it takes to train—can hold you hostage. If you have even a “gut feeling” about an employee, you should monitor this feeling closely. It can be amazing how statistics can improve when the wrong employee is out of your office.
5. No Standards or Controls: How much deviation from your standards can you tolerate and how do you know? Chiropractors offer healthcare services; so where do standards come into play? You, personally, are a well-trained doctor and your care and reports are fine and up to standards. Yet, how about standards in your paperwork? Do all your forms that are given to a patient look crisp and clean with your logo, address, telephone number and website address? Is your website up to standard? So many people now research using the internet and, if a page of your website is “Under Construction” or there are major misspellings and grammatical errors—let alone just darn hard to navigate—all this turns people away. Make and meet standards in your office appearance and employee appearance. If you don’t have any standards, how can you have any control? Implement what you want to see in your office and, of utmost importance is to be clean, orderly and consistent from room to room and employee to employee. The doctor must appear well-groomed and look like a doctor. I believe in wearing a lab coat, dress shirt and a tie. This is a topic that merits much more dedicated interest by many doctors.
6. Poor messaging: This applies to the way both you and your staff communicate with your patients. Messaging starts with the first telephone call from the patient to the Report of Findings and then on to communicating with patients all the way through care. You need to trim out the fluff and have a message that is focused and easily understood. Poor messaging also means not anticipating what information a patient needs to know. As an example, during the first telephone inquiry, the majority of a patient’s questions should be answered prior to being asked. Another way to message poorly is not distinctly branding yourself and your clinic as an expert. What you need to remember is, whether it is good or bad, we are marketing and branding ourselves every day in multiple ways.
7. Confusion about who you work for: Do you work for your patients or the insurance company? Are you afraid to offer best healthcare practices rather than best insurance practices? Why not work for the patient and place payment responsibility on the patient by having a cash-only practice. This will do away with third-party billing and waiting for reimbursement of a discounted, contracted rate. The cash-only model allows the doctor to receive fair and reasonable reimbursement, and it emphasizes that the contract is between patients and their insurance companies and not between their insurance companies and the doctor. Patients understand it; they get it that insurance companies dictate care, slash fees and are not focusing on meeting the needs of the individual, unique patient.
These are all correctable traps and, with this being the start of 2011, you can start fresh.
Dr. Richard E. Busch III is a nationally recognized Doctor of Chiropractic, author, and speaker. He has successfully treated thousands of patients for chronic and severe disc conditions that traditionally would have required surgery. Dr. Busch developed the DRS Protocol™, utilizing spinal decompression technology. He has served as a national consultant for the continuing development of this technology and the DRS Protocol™. Dr. Busch has published a recent eye-opening book *Surgery not Included: Freedom from Chronic Neck and Back Pain. You can visit his website at www.allcashacademy.com or www.buschchiropractic.com or call 1-866-662-2225.