As sole proprietors, we have the direct opportunity and ability to increase our income in a grand way

Early in my career, I was given some sound financial advice: Be sure to put money away for taxes and retirement. I did not realize the importance of this advice until I had to pay my first estimated tax payment and found little left in my bank account. It seemed foolish to save for retirement as a new, young doctor, since retirement years seemed far away—but squirreling away money over time has really paid off. Everyone should heed this sage advice, realizing it is never too late to accumulate funds over time.

Although accumulating and profiting from our professional life is important, the purpose of this article is not how to invest in stocks and bonds but rather how to invest in your practice. More important, investing your time and money back into your practice and professional skills will actually generate more income, allowing you to benefit more from Mr Dow and Mr Jones.

As sole proprietors, we have the direct opportunity and ability to increase our income in a grand way. Depending on your creative energy, marketing skills, patient-visit average, and services, your income will fluctuate either up or down. If you lack the skill to utilize your staff correctly, and/or if your spending habits overextend your overhead, your income may also fluctuate, providing either more or less take-home and savings pay. Therefore, we are literally in control of our financial wealth. I intend to outline some ideas that may stimulate your creative energy, as well as help you overcome the intimidation of spending. But, if every dime spent is scrutinized and accounted for, it may inhibit you from taking the plunge with new products, procedures, or programs; and prevent your steady progress and growth. Contrast this with the doctor not spending frugally, finding their weekly bank deposits large but their monthly take-home pay paltry. Therefore, your best investment is how successfully you manage your practice habits, professional goals, patients, and staff. Investing in the mechanics of your business is the best investment of all.

Some doctors feel that adjustments are a sacred mission and that placing a fee for our services is inappropriate. They provide their services for a small “affordable” fee, and thoughts of chiropractic as a business is considered offensive. Others, on the other hand, see the challenge of creative insurance coding with multiple services as a means to a financial windfall. Either way, I do not apologize for considering chiropractic a noble business that therefore should be managed with efficiency with either patient load and/or money used as an incentive and a barometer of success. How you practice, and how much you save and give away, is your personal business.

Overhead Expenses
Let’s start with overhead. Is your practice rich with too many or underutilized staff; a huge advertising expense; overextended lease or loan payments for equipment and procedures rarely used; and poor patient management with new patients in noncompliance leaving before their scheduled appointments, forcing you to overspend to market for more? Or is it hamstrung with physical restraints? Throwing good money away to continue bad habits will only stifle the growth and goals of any business. The best investment would be time to review your expenses and either budget your practice or loosen the purse strings to allow growth. Staff development and practice-enhancement programs may be a short-term expense, but they have long-term benefits.

Seminars and Associations
How many technical or practice-enhancement seminars have you attended this year or throughout all the years since graduation? If money has been a factor, has it stopped you from the travel and seminar expense? But, have you ever considered that your investment of both time and money in quality programs may bear huge dividends? If the esoteric and philosophical ideals and technical prowess gained in a weekend was applied and followed through with confidence, there is no telling how many new patients you would have attracted and maintained, and how many of them would have referred their friends and neighbors to you. The technique and technical classes helped you with great adjustments, enthusiastic patient reports, community-outreach programs, and rehabilitative and diagnostic procedures. Investing in knowledge does not just cost, it pays handily. I recommend that you look to national and state associations for sponsored license-renewal, continuing-educational programs. Plan to attend one or two additional programs beyond these continuing-education programs required to keep your state license current.

Association Affiliation
Are you even a member of state and national associations? Time and money invested in the health of our profession is money well spent. Political action committees (PACs) are necessary evils, and they are sorely needed to keep up with the nuances of lobbying efforts to maintain a voice in the crowded health care industry. Protecting the scope and stifling the efforts of those with opposing views takes teamwork and funds. The statistical number of chiropractors in relationship to the number of members of either state or national associations is shamefully low—and worse for their involvement in PACs. Furthermore, too many sit on the sidelines moaning their concerns rather than take part within the process for either changing or maintaining the status quo. Get involved, and put your money where your dollars need to be.

Billing and Advertising
An area that is part of your money train is insurance coding and claims processing. If time and money were invested to learn the nuances of ethical and responsible insurance coding, as well as submitting the proper fees, how much more would you be taking to the bank? Have you been bogged down and not sending out or e-billing insurance claims? Are explanations of benefit forms piling up without being challenged? Are you reluctant to utilize insurance because of the anticipated headaches? These concerns are real. Therefore, if necessary, I recommend that you hire a professional billing service that will minimize the hassles while you still participate. Conversely, if you decided to refrain from insurance but offered patients payment programs or cash plans, the time and money invested to increase patient communication and report-of-findings skills will pay off handsomely, since knowledge bears confidence and confidence bears compliance.

Purchasing Equipment and Supplies
Have you ever read through our professional journals, reviewed the advertisements, and thought about purchasing the advertised equipment or supplies but were reluctant because of cost? You are not the only one. But consider if you did purchase that adjusting table, rehabilitative device, or diagnostic tool, or began to introduce nutritional products. How might it generate increased income or improve your ability to serve your patients better? It would if you followed proper procedures and protocol, and utilized them correctly.

Greg Stanley of Whitehall Management tells his seminar doctors that there are three ways to make a living in chiropractic: You increase either your fees, your services, or the number of patients you see. Providing diagnostic workups, adjustments, and adjunctive therapy, and offering orthopedic or nutritional supports, are services that generate income. Too many doctors have a poverty or philosophical consciousness that may hinder them from increasing their fees even a few dollars or their ability to recommend products such as pillows, cushions, pelvic stabilizers, posture supports, home rehabilitative and nutritional programs, and longer-term care plans.

Marketing and Public Relations
A doctor who gathers enough borrowed funds to create their first clinic usually fills it with the jewels of a new practice—some tables, staff, supplies, diagnostic and rehabilitative equipment, forms of all types, computers, beautiful pictures, and chairs—creating the ambience of a successful professional look deemed necessary to welcome the community and new patients. If the doctor leaves little funds for initial and perpetual marketing, this office may also stand as a tribute to the Taj Mahal—another beautiful edifice oozing completeness and warmth. But the Taj Mahal, which stands regally in India, was built as a tomb. A beautiful and well-equipped office is only as efficient as those participating inside. Well-spent money is often necessary and often overlooked to attract and increase business. Once patient flow is established and maintained, patient results will stimulate referrals; and internal and community public relations (PR), along with staff enthusiasm and efficiency, will help expand patient numbers. But the successful doctor leaves little room to wiggle, creating wins by reaching for them and often by hiring a marketing team or training staff with the skills necessary to introduce the office to their community. Money spent to hire a dedicated PR professional will be well-spent if the PR professional is trained properly and has the support of the doctor. Consider their annual salary, and multiply this by the deposits placed within your bank account after you pay for this added overhead expense. The reluctance of hiring a PR professional is widespread; but once the numbers are crunched, the foolishness of this will be apparent. Marketing and PR are not bad words. Instead, they are a means to capture the people who need your services for their myriad of health and wellness benefits.

Personal Time
When was your last vacation? Personal downtime is possibly the best investment of all. Recharging your batteries is crucial, as burnout can leech all your earnings and demoralize a career of success. Family and friends should be loved. They offer a base of contentment. You cannot pay enough for this, and it is free to those that cultivate it well.

Money reinvested in your practice will generate more than playing the stock market and buying material toys to soothe your savage beast. Consider the words above; once the cost of fear disappears and the gains from it appear, you will have enough money to invest in Mr Dow and Mr Jones as well as purchase the trinkets you desire and deserve. 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 e-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 Web site: www.chirosmart.net.