How to Do More with Less
Practice Operations
Written by Dr. Michael Failla, D.C.   
Monday, 21 February 2011 17:15 Read : 2216 times


s Doctors  of Chiropractic, as well as business professionals managing a practice, we are bombarded with solicitations to better our practice, improve our equipment, update our technology, and incorporate the “next best thing.” The economic realities of today, however, demand that we not add more and more “stuff,” but rather that we find a way to do more with less.  The road to efficiency is paved with streamlined operations, discarding what's unnecessary, automating processes, and simplifying what remains.

Doing more with less sounds wonderful, but at times it can seem like an impossible goal. At first, it may seem difficult to imagine how you can actually better your practice by cutting things out, and it often feels counterintuitive, especially in a "more is better" culture. However, the best practices are the ones without all the bells and whistles—they are the practices that have gone through the process of simplification, and found that they can actually accomplish so much more by using less.

Achieving efficiency while increasing effectiveness consists of three steps: get rid of what you can, automate what you can't get rid of, and simplify what you can't automate. Again, though it sounds counterintuitive and, in some cases, downright impossible, your practice will be better for it, and you will be able to use less overhead to accomplish more.

Get Rid of What You Can

This represents a problem for many doctors, since the idea of getting rid of something seems both hard and unnecessary. However, ruthlessly going through your practice and getting rid of the "dead weight" is the first and most important step in getting your practice to the point where it is running at a higher capacity with a lower level of effort.  Placing too many people in a boat will ride it too low, slowing it down and making it difficult to operate. In great economic times this is passable, but these are stormy days. If we can’t get a bigger boat, we must make better use of the space we have. This principle applies to both equipment and staff. Consider what items in your practice are truly necessary, from procedural equipment to the office supplies on your receptionist's desk.

If something is redundant, gets in the way, contributes to clutter, or simply does not provide an irreplaceable, evident and genuine use to your practice, it needs to go. You may be surprised by how much you can actually cut out this way, and how uncluttered and streamlined your practice will look afterwards.

Unfortunately, this principle also applies to staff. It is hard to follow through with cutting excess when it comes to real people but, if someone is not contributing to your staff, then it's time to consider letting them go. Staff is one of the primary costs of any practice, and even small reductions in unnecessary time in this area can save you a lot of money.

Automate What You Can't Get Rid Of

The issue of chiropractic documentation is a prime example of something that must be automated for an office to function properly.

The wonderful thing about technology is that it allows you to automate necessary processes, and also generally performs them better than a person could. This is especially true in areas like patient reminders and chiropractic documentation. Granted, there are some things that require a personal touch, but the best offices are increasingly making use of the innovative chiropractic EHR systems and software to streamline their processes.

The issue of chiropractic documentation is a prime example of something that must be automated for an office to function properly. Besides all the physical space taken up by stacks and file cabinets full of chiropractic SOAP notes and other documentation, consider all the lost time and inefficiency that a paper-based system produces. If you choose only one aspect about your practice to automate, it should be the notation and storage of chiropractic documentation. Investing in a good chiropractic EHR system will save you tons of money and time almost immediately.

The same applies for things like patient reminder calls. There really is no reason to have a person making those calls, since the majority of them go unanswered anyway. By automating the process, you save literally hours of time, lower your phone bill, and free up your staff to do other things. Just as investing in chiropractic software will save you time and money when it comes to patient records, investing in automated reminders and online intake forms will keep your staff from wasting time on busywork, and allow your practice to accomplish the same purpose with a fraction of the cost.

Simplify What You Can't Automate

Now that you've cleaned out the clutter, gotten rid of ineffective staff members, and automated your office as much as you can, it's time to simplify those things that can't be automated. This applies to everything from patient intake to the way you perform your procedures. Though technology does play a large role in this, a lot of it comes down to common sense. The key here is to keep a system that accomplishes the most with the least number of steps. Make use of the PEEP principle to keep your office simplified in the long run—a Place for Everything, Everything in its Place. Nothing is more frustrating than going through all the time and effort to simplify and automate your office, and then have you and your staff’s old habits slide back to the way they were within a month.

The Takeaway

The most important thing to remember about doing more with less is that it is a process. This is not a one-time change, but rather a long-term process of change in your procedures, habits, and service mentality. And, as anyone who has been through this process can tell you, it's not easy, especially at the beginning. However, the way your practice runs after you go through the process of getting rid of what you can, automating what you can't get rid of, and simplifying what you can't automate is truly astounding. You can accomplish more than you ever dreamed with less effort, equipment, and overhead costs than you would have thought possible, and from then on…it's smooth sailing.

Dr. Michael Failla, D.C. -

Dr. Michael Failla is the CEO 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. He 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. Go to for more information.

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