Determine the shortcomings of your practice to implement changes for a positive effect on patients and the bottom line

Cause and effect is a concept readily understood by chiropractors. As biomechanical specialists, we can often pinpoint the effect of a structural problem by locating the mechanical cause. Change or manage the cause and the effect is reduced or disappears. Patient management often includes lifestyle adjustments and recommendations to alter their cycles of cause and effect. Be assured that the same emphasis placed on managing your patients rests also with managing your business—practice cause and effect.

Consider yourself a business consultant or an efficiency expert with the ability to quickly pinpoint areas of practice stress. Once areas of cause and effect are known, adjustments can be made. The secret of practice success rests with your ability to tweak or macro-manage cause and effect. Take a step backward to objectively look at your practice to determine the causes and effects of either your action or inaction.

Looking Inward
First, ask yourself these questions: Are you satisfied being a chiropractor? Did you make the right choice? Is it the perfect fit for you? Do you await each patient with anticipation, ready to reach his or her goals of increased physical performance?

Now, ask yourself management-centered questions: Does the daily grind of managing your patients and staff, dealing with insurance hassles and keeping a positive cash flow get you down? Do you accept the reality of business and market your expertise in an ethical and responsible manner?

If your answers are unacceptable, then reading further may be futile, since you probably are the cause of a negative effect, and only by reducing your personal interference will change be made.

Prior to stimulating practice change you must stimulate personal change. Energizing enthusiasm within chiropractic is easy since we have a direct effect on our patients. By tapping into this positive reality, it should transfer to you. Every day allows you to make a difference. Our profession also has many technical and esoteric seminars that offer renewed purpose and spirit. Amongst your colleagues are fellow doctors willing to share their experiences and professional wins. Practice cause and effect will always rest with you and your ability to adapt to every business nuance. Seek change if needed or increase your level of commitment to keep you technically and spiritually uplifted.

Team Players
Determine the productivity of your business. Are you service-oriented? Is your practice under- or overstaffed? Are they being used effectively? Interviews with your staff, as well as reviewing a profit-and-cost analysis will determine areas that need tweaking or an overhaul.

Your staff plays a vital role in practice cause and effect. Training them correctly and providing them the material and knowledge to be an extension of you is the goal.

Too often, the front desk and insurance staff, therapy assistants, and office manager may neglect following proper scripts and protocol, which leaves gaps of service and patient management. The effect is lost revenue, practice turmoil, and early burnout. The cause can be adjusted with additional training, protocol scripting, and staff meetings.

Financial Spreadsheet
To determine why statistical numbers are decreasing and financial waste is prevalent, look for the cause. Staff and doctor downtime with reduced productivity, and lack of assistance that causes vital services and patient appreciation to be overlooked may be a culprit.

Review all areas of your practice and eliminate redundancy and ineffectiveness. Are supportive, rehabilitative, and nutritional products being regularly sold or do they just take up shelf space? Are diagnostic tests used correctly or are they too time consuming with little reimbursement and do they often render scant data? To streamline procedures, call the company and ask for scripts and data to render quick and competent reports.

Are patients scheduled incorrectly? Open time gaps force a strained appointment book. Are your fees and insurance codes up to date, used correctly, and based according to your area? Keeping statistics will keep your practice afloat and on a steady climb.

Patient Management
The mantra heard at every practice-building seminar is: How do I get new patients? Practice-building has two components each with cause and effect. The success of your practice depends on your ability to sustain and continue its growth. Advertising money will be ill spent if you are unable to maintain the practice and capture the trust and confidence of new and established patients.

How many new patients slip through the cracks and disappear prior to your recommended schedule? How many patients refer their family and friends?

The effect of patients dropping out of care prior to completion of their schedule is lack of their perceived value of chiropractic. The cause is limited patient education and awareness of their problem. Educate patients with specific anatomical and physical illustrations. Discuss their daily living requirements and how they need to adjust ergonomically or socially. Review specific muscles that need rehabilitation or stretching and focus attention on the neurological complications resulting from physical wear and tear.

Lack of referrals is the effect of the same cause. If patients sense chiropractic as an unduplicated healing art, they will be more apt to refer their family, friends, neighbors, and coworkers.

Public Relations
Every business has marketing and public relations programs—chiropractic is no exception. Whether directly or not, every recommendation, patient workshop, and request for referrals is part and parcel with selling an idea—that chiropractic can increase performance potential, reduce physical instability and pain, and add life to years and years to life.

If you want your practice numbers to swell, you must do both. Review your community and determine areas that would benefit from your chiropractic expertise. Provide ergonomic workshops to local corporations and assist the police, fire and allied municipal workers.

They would benefit greatly from workshops on stress management and health and wellness. Many doctors provide community postural and stress screenings, pre-employment evaluations, participate in team sports, and work with civic and church groups.

If you write well, provide health and wellness articles to local newspapers. Be persistent with email newsletters to professionals such as attorneys and allied health care providers. If you wish to be the cause of your success, be effective with the programs mentioned above. Be creative and introduce other programs that will enhance your stature in the community.

If you were to hand over your practice for a month to professional consultants, how would they turn the numbers and excitement around? With the same budget, staff, and office equipment and without any further resources for advertising, what would they do? What effect would follow if they were the catalysts for change.

The challenge would be to turn things around and use every available resource for this change. The level of commitment and self-assurance would transfer to every patient and staff member. The confidence in creating and implementing excitement and urgency would make your practice soar. It is all a matter of cause and effect. CP

Joel E. Margolies, DC, has been in practice for 25 years in Atlanta and is the author of four books: Smart Start, Workshop Workbook, Chiropractic Marketing and Public Relations, and Personal Injury Workbook. He sends a free weekly chiropractic email newsletter concerning practice management, public relations, and philosophy to more than 10,000 DCs in 31 countries. Margolies can be reached via email: joel3639@aol.com,  or website: www.chirosmart.net