Cross-training involves a team effort with each position supporting the other by communicating and sharing responsibilities

The business of chiropractic may range from a single-doctor office to a complex multiprofessional facility. Although the numbers and complexity may vary, each practice strives for efficiency and profitability. The trick is how to manage practice maintenance, growth, and sustenance, yet be cost effective and profitable.

Chart Your Course

A small practice has the challenge of juggling multiple roles, whereas a larger practice must ensure that staff positions do not overlap. All practices, whether small or large, must exceed the collective goal of the practice by increasing the potential of its parts. To achieve this, chiropractors need to reconsider every position and cross-train staff to assured that interaction enhances procedures for practice growth.

First, review each room and its purpose as though you are a hired consultant. Are they being used correctly and efficiently? Is the traffic flow from room to room easy, or do you have to direct patients from area to area? Are routine procedures redundant, time consuming, or unnecessary? What patient management steps are being left out? How many opportunities to increase patient education or referrals are lost?

Next, create an organizational chart by breaking down the divisions within your office. Place headings for all the areas mentioned above, and include what is unique about your office. Write the staff person responsible for each position with their support staff beneath the headings.

Dream Team

While creating this chart, you may realize that one person may be responsible for too many tasks, therefore overextending skill level and decreasing quality of work. You can either hire a part- or full-time staff member or spread out job responsibilities by cross-training other staff members. So, how can you increase staff productivity with cross training?

Front desk CA or assistant. I believe that this vital staff member can make or break your practice. Often overwhelmed and overworked, this position is responsible for answering phones, scheduling appointments, collecting money, recalling missed appointments, maintaining office flow, managing irrate patients and unruly kids, updating patient files, filing insurance claims, and sending the bills—just to name a few.

Imagine what would happen if this staff person decided to quit or had to take a leave of absence. How much would get done, how much would be lost? Never be held hostage by your staff. Cross-taining begins with you—learn how to use the front desk and insurance programs, be cognizant of every office procedure, and importantly, develop a training manual. Creating a manual will force you to review every nuance of the position, write usual scripts, and remove unncessary procedures. This is a useful tool for temporary hires, new hires, and even reinforcing procedures to current staff members.

Insurance assistant and business manager. If you hired an insurance assistant to send and receive claims and checks, verify coverage, and review insurance explanation of benefits, also provide the assistant with some basic knowledge of the front desk responsibilities. Although you hired the insurance assistant to focus on claims and payments, he or she can assist in a business manager capacity to reiterate the value of chiropractic care to patients. With some training and a script, they can also increase patient compliance and visit averages, and offer financial options. This will cut down on missed appointments and office billing, and ultimately increase office statistics.

Therapy assistant. During adjunctive therapy, quality time and interaction between these staff members and patients often occurs. Therapy assistants should always be aware of promotional events and use appropriate moments to request patient cooperation. Once patients feel improvement and are therefore more apt to listen and assist, they can be motivated to learn more about chiropractic. Although therapy assistants are not hired as public relations staff, they can play a major role in increasing patient awareness.

Examination assistant. It is not unusual to find support staff assisting doctors during routine evaluation procedures, such as blood pressure, height, weight, and case history review. The primary doctor should never neglect the initial welcome prior to the consultation, as the first impression is permanent. After the introduction, the new patient can be evaluated by an assistant. Exam assistants must understand your chiropractic focus to educate patients while evaluating. Their time may be spent reviewing patient concerns and directing them to the chiropractic point of view. Doctors then solidify the foundation provided and render an opinion for both diagnosis and treatment. The initial examination and proper treatment protocols forge a lasting relationship with patients and taps potential referrals.

Massage therapist. Many chiropractors either offer massage therapy within their offices or refer out. Since massage therapy and chiropractic are hands-on, we can refer to each other and encourage clients and patients to continue with necessary care. Therefore, do not lose the opportunity to educate massage therapists about chiropractic and the mutual role. Offer their clients a complimentary chiropractic evaluation and your patients a complimentary massage.

Case Management. This position ensures that each patient is serviced correctly. In a large office it may be the office manager, and in a small clinic, it may be you, the doctor. The case manager must 1) Has the patient been given a schedule?, 2) Have all the financial responsibilities been discussed?, 3) Have support products been introduced?, and 4) Have all options available to get the patient well been explored?

Public relations. Whether you have a small or multiple-doctor office, public relations keeps the practice alive. Every employee is part and parcel of the new patient game—which is the lifeblood of an office. Maintaining your patient base through internal marketing is extremely important. Staff members should be reponsible in generating interest by encouraging referrals via the benefits of chiropractic care. For example, the front desk CA may overhear patients discussing health issues. The CA should then offer them patient education pamphlets and advise the doctor to take time to discuss chiropractic options.

Therapy assistants should encourage patients to continue their care while encouraging referrals. The examination CA, while determining family history, should offer complimentary evaluations for family and friends. The office manager can energize staff meetings with open discussions and role-playing planting referral seeds. This staff member can also be responsible for assuring that monthly themes spark interest and awareness of health and the chiropractic role.

Without an office procedure to handle new patients, your practice will slowly cease to exist. Who is responsible for new patients in your office? If all duties fall on the front desk CA, do not hope for massive success, as this is but one person. If it falls upon the insurance person, then your claims will not go out on time, nor will reimbursements be regularly checked. New patients have many divisions from acquisition to maintance.

Review the roles established for all employees and increase their skill and communications levels. Each employee should have an individual business card with name and title, which is instrumental for referrals and patient retention. As your employees’ responsibilities and roles grow, so will your practice.

Joel E. Margolies, DC, has been in practice for 24 years in Atlanta, and is the author of four chiropractic books—Smart Start, Workshop Workbook, Chiropractic Marketing, and Public Relations, and Personal Injury Workbook. Margolies sends a free weekly email newsletter concerning practice management, public relations, and philosophy to 8,600 DCs in 32 countries. He can be reached via email: joel3639@aol.com , or website: www.chirosmart.net.