The chiropractic profession has some of the most unique personalities, to say the least, and as a result there are literally thousands of practice strategies and methodologies. But oftentimes, what worked yesterday no longer succeeds today. The time has come for many of us to take a hard, deep look at how health care is changing based on federal pressure, ever-changing insurance guidelines and consumer demands.
Let's review what I feel are three of the most successful practice models and why they are thriving in today's health care marketplace.
1. The "Boutique" Model
The "boutique"-style practice is usually low volume with high fees per visit. This practice usually offers a special technique, a high level of service, and expertise on specific conditions or difficult cases. The positive points: low stress, low overhead, low number of employees and high patient satisfaction.
However, this model of practice requires that the doctor ask for, and receive, a high dollar per visit ($100 per visit or more), and that patients complete their treatment plans. In order for this model to succeed, the doctor must continually generate a high number of referrals and rely on word-of-mouth advertising.
Other negative aspects include that the practice income is capped by the number of hours the doctor works at the practice; business suffers radically if the doctor wants to take a vacation or gets sick or injured. A chiropractor can succeed with this model, it's just that eventually they may feel run down and tired; as if they are on a treadmill and can't take a break from "running" to keep the practice flowing.
That said, this practice is essential and saves lives; if you had a family member that needed special attention, this is the type of practice you would seek. It is essentially a cash practice and does not usually suffer from the whims of insurance companies, which is critical to some doctors' happiness.
2. The High-Volume Model
The second type of practice is the high-volume, lower-fee-per-visit model. This can be run by a single practitioner or with associates. It requires higher numbers of staff, higher overhead, lots of internal referrals, as well as an extensive outside marketing plan. This is a higher stressed practice, but with hard work, the owner / doctor can move up into management and focus on new-patient generation.
This practice requires a detailed explanation of the benefits of chiropractic and how it is a lifestyle; not just a corrective process, but also maintenance care. This practice is usually a mix of insurance and cash, but needs to be modernized with regards to documentation to remain compliant. If not, the doctor risks having to give back insurance reimbursements as a result of audits.
3. The Integrated Practice
The third model - the fastest growing of the three - affords the most flexibility to the owner. It involves diversifying into multiple services and meets the demand of today's public. It includes adding all the desired services under one roof. It is a one-stop shop and includes adding medical personnel and extending the care provided from traditional chiropractic, rehab and nutrition to include such services as weight loss, allergy, DME, diagnostic labs, decompression and up to 20 other additional services.
This practice markets itself as the wave of the future by offering complementary protocols at one location. It generates not only a plethora of internal referrals, but also has multiple advertising campaigns for its many services, bringing in vast amounts of new patients who are ultimately exposed to the myriad of other services and offers.
As a result, it has medium to high volume with the highest income possible, relying on approximately 70 percent insurance and 30 percent cash. It affords the owner a level of freedom and income second to none.
However, this type of practice model does require certain considerations. You need to reach certain benchmarks to even consider going with an integrated practice: at least 150 patients a week and/or five-plus new patients a week. You most likely need to be at $40,000 in collections per month, employ at least three staff members and occupy a practice with at least 1,200 sq. ft.
Make Your Practice Count
While several practice models can thrive, these three are the most likely to flourish today. Practitioners should strive to adopt one of these models because others may no longer succeed in today's health care environment. The key for each chiropractor is to find the model that best fits their particular strengths and then apply the necessary fulcrums to ensure success.
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