It's tough enough to run a successful practice, so don't set yourself up for failure by doing one of these practice catastrophes. Chiropractors graduate from professional schools, not business schools. Unfortunately, running a successful chiropractic practice requires extensive knowledge of staff training, patient relations, insurance procedures, business, taxes, legal issues and finances. Therefore, a "cram" course on these subjects is a must. Here are ten examples of practice catastrophes and how you can effectively avoid them.
#1 High Pressure Sales Tactics
Unfortunately, there are consultants that specialize in teaching scare tactics (i.e. telling patients they will die without their adjustments). These tactics will backfire on the DCs that use them. There are other consultants that recommend extremely long treatment plans, high case fees, years of care, etc. These tactics will backfire on the doctors, too. Both of these types of practices lose half of their new patients because the public doesn't want expensive long-term treatment plans. The patients who reject the doctor's recommendations will go out into their community and bad-mouth the doctor who made these recommendations. Remember, every satisfied patient will tell one to two people, while every patient that is dissatisfied will tell 11 people.
The doctors that use these scare tactics and long-term treatment plans are developing a horrible reputation in their communities. This requires them to advertise more, which means they will have a higher overhead to overcome the bad reputation they are creating for themselves, until finally they can't spend any more money to advertise. Then, they'll move to a different town.
Too long or too expensive treatment recommendations place too many people in the "dissatisfied category." And when the doctor's satisfied patients try to refer to their doctor, the doctor's recommendations will backfire on them. For example, imagine you need to see a medical doctor and someone tells you, "I know a medical doctor and he is absolutely great, but you have to go to him two to three times a week for a year so he can do his job. What would your reaction be? Would you go to him or her? Heck no! Or, the same person, says, "I have a great medical doctor and he is absolutely terrific and he only charges $4,000." Are you going to go there? A trip to the emergency room is less expensive. A trip to a walk-in clinic is less expensive. Why in the world would you want to go to a doctor who charges $4,000? Sometimes, an idea that seems good is actually bad and will doom a practice.
#2 Touching Patients Inappropriately
One of the greatest ways of totally ruining a practice is for a doctor to inappropriately touch patients. State boards, the patient's family and the police department "frown" on such practices. When your soiled reputation gets out into your community (and it will), what will happen to your referrals?
#3 An Inappropriate Relationship with Your CA
Too often, DCs have inappropriate relationships with their CAs. The words "sexual harassment lawsuit" comes to mind. What's more, the dynamics of the office are forever changed. Doctors find they no longer have a "working relationship" with the CA. Very little work gets done and their practices fail. Should you have cause to discipline or fire this CA, she may feel scorned, turn against you, attempt to blackmail you and/or ruin you financially. She'll report you to the authorities and you'll be out of practice.
#4 Doing Anything Illegal
Quite often a doctor will do something illegal – either inadvertently or on purpose. Shave a legal corner here or there and it will catch up with you. Whether you meant it or not, you can still lose your license.
For example: Forgiving co-pays. All doctors know they are not to forgive co-pays unless the patient has a dire financial hardship (which is only about 1% of the people). Then when an insurance company audits the doctor, which they will, they will find out he is forgiving co-pays. Guess who has to pay back all that money? That's right, the doctor! Quite often it is hundreds of thousands of dollars.
What about insurance fraud? Some doctors try to get away with insurance fraud. The doctor may say that he didn't know that insurance fraud was being committed. He simply and unknowingly "signed off" on work filed by his insurance CA. The DC still goes to jail. Maybe the DC shares the blame with the insurance CA. They both knew it was illegal. The DC still goes to jail.
[pb]#5 Hiring a Bad CA
A bad CA can also turn good patients into patients that stop coming to your practice, dry up your referrals, schedule the DC incorrectly and, in more cases than one might think, destroy a practice through embezzlement. In short, a bad CA can kill the practice and the DC may never know why it happened until it's too late.
#6 Practicing Without a CA
This is suicide and may result in the DC losing his license or putting himself in physical jeopardy. If the doctor is male and the patient is female, and the patient claims that something inappropriate happened in the DCs office when they were alone in the office, that's a disaster. What about female DCs? If the DC is female and a male patient is physically or sexually abusive to the DC because they were alone in the office, that's a disaster as well. Never practice without a CA. Protect yourself!
#7 Not Paying Your Taxes
This is another way to commit suicide. Some doctors see themselves as "tax protesters." They rationalize why they should not pay taxes. They'll have plenty of time to think about their rationalizations while they are serve time in prison for not paying these taxes. One of the worse things you can do is to not pay the withholding taxes on your employees. The government views this as stealing money from your employees. The IRS is 10 times tougher on DCs who don't pay their withholding taxes than on doctors who don't pay their income taxes.
#8 Not Purchasing Disability and Health Insurance
Most doctors try to save money any way they can, including making the foolish decision to not buy health insurance or disability insurance. This usually saves them about $500 to $1,000 a month. One out of 20 doctors will become disabled during their years of practice. Are you one of the one of these 20? Without disability insurance, you probably won't be able to pay your bills so you will have to declare bankruptcy. Trying to save on insurance is not a way to save. It will cost you too much money.
#9 Radically Changing Techniques
To illustrate this point, let me tell you a story of a friend of mine. This man was a charismatic, handsome, personable doctor who attracted new patients like a magnet. He started off practicing the "Palmer Package" which is HIO and Merrick adjusting and built a 100 patient-a-day practice. Then, he switched to Activator, which is a very low force type of practice. All the patients that came in for the Palmer HIO and full spine adjusting didn't like the low force technique so they quit care. All of a sudden, this very charismatic doctor was alone in his office. Then he built his practice back to the 100 patient-a-day level because he was a great practice builder. Then he changed his technique to NIMMO which is a deep fascia, painful adjusting procedure. The patients that liked the low force (no pain) procedure hated the high pressure, painful procedure and quit care. The doctor again was left in an office alone. Don't change your technique radically from one type of adjustment to another. It's a recipe for failure.
#10 Hiring the Wrong Consultant
There are good consultants and bad consultants. There are ultra-straight philosophical consultants and business-like consultants. There are consultants that specialize in building an established doctor's practice and consultants that specialize in starting a practice. Choose the type of consultant that is naturally right for you. Research the consultants and find out what they specialize in. Then, hire the one that matches your need.
And keep in mind that it is usually the consultant who teaches what you don't want to hear that you need to hire.
I found the same phenomenon with some of the doctors who join me as a consultant. They attended the classes they wanted to hear and avoided the ones they didn't want to hear. And where did they need help in their practices? They needed the help that is taught in the classes they avoided. They only wanted to hear what they already agreed with and disregarded the rest. So, their practices never grew until I motivated them to take the classes they avoided.
Everyone has a tendency to "take the easy route." The correct route to increased success is usually the harder route where you have to change something that you are doing. Change usually results in growth. And same old usually results in the same thing.
After you read the ten catastrophes that can ruin a practice, have your consulting firm fix those problems for you. Talk to your consultant or attend one of his seminars. Then follow his advice. He'll be happy to be of service.
When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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