Educate yourself and market your product

One year ago, nutrition testing and counseling weren’t on the radar for Robert Baritz, DC, Brockton, Mass. For many years, his chiropractic practice focused mostly on rehabilitation. “It was a traditional, progressive rehab-type practice,” he says. “We do adjustments, exercise, physical therapy for more seriously injured people, and spinal molding.” Indeed, he adds, “We did that for many years. We’ve been extremely happy with it, and we’ve been very successful with it, too.”

At the beginning of this year, Baritz sat down to do some long-term strategic planning for his practice. The result of that planning: His practice is now called Holistic Health and Nutrition. He started seeing nutrition patients in mid-May and started selling nutrition bars in late June. “When I started doing some planning, I could see right away that insurance reimbursement over the last ten years had became less and less. At the same time, the cost of collecting from insurance companies was going up in terms of things like additional documentation and the staff time required to collect outstanding amounts due. I came to the conclusion that in the next five to ten years, the situation would get worse instead of better.”

Finding a Cash-Based Business
The trick was finding a line of business compatible with chiropractic that operates on a cash basis. Baritz visited a colleague who had been involved with nutritional products for many years. The colleague has a system that allows for dealing directly with patients, which is what Baritz had in mind. Baritz acquired a heart-rate-variability and body-composition-measurement instrument, for example, and started bringing in patients to test “to see how things work.” He stresses that early on he wasn’t trying to sell anybody anything. “I was just testing,” he explains. “If you want to buy a box of nutrition bars off the counter, that’s one thing. But if you move into a nutrition practice, you need to know what you’re doing.”

He knew that well from a previous encounter with a nutrition bar company. The business model didn’t work for him. “When I’d sell supplement products—including nutrition bars—I’d send 60% of the price to the company and keep 40% for my practice,” he says. “The company I work with now uses a 50-50 split. Under the other arrangement, I could have raised my retail price, but then everybody else would have been selling at a lower price than I was, so market dynamics would prevent me from taking that kind of action.”

Patient perception plays a role in that as well, he says, adding that one of the good things about chiropractic and rehab is that every dollar that comes in pays the practice expenses. “In a nutrition practice, if a dollar comes in for a meal-replacement bar, 50 cents goes out to the supplement company. But patients don’t see that,” he says. “When consumers spend a dollar in your office, they figure they spent a dollar in your office. The same thing goes if you send them out for a test. Even though they pay for it somewhere else, they think of it as an expense of visiting your office. And people are looking for lower expenses, not higher.”

The other problem with the first nutrition bar contract Baritz considered was that the company also offered a nonprofessional product line, he says, meaning the same bars would be sold at health food stores and maybe even drugstores and convenience stores. “And some of the people selling the nonprofessional line will make a point to tell customers that it’s the same product, only mine costs more. If I go with a product that Joe Blow down the street can also be a rep for, all of a sudden I’m in competition with everybody who wants to be a rep for a nutrition company. In other words, I’ve just trashed my chiropractic degree to compete with vitamin distributors on the street.”

Instead, he says, “If I’m going to compete, I want it to be with as small a number of people as possible. I’d prefer to deal with nutrition professionals only, rather than everybody who started an Internet company to sell vitamins.” It’s important to select a company that distributes only to professionals, he says.

Educate Yourself
Baritz says his current supplier sells whole-food supplements, which he prefers for his patients. He says that any reputable company that sells nutrition bars will have reps that come to the DC’s office, explain their products, and show how to introduce patients to a nutrition practice and promote it to them. The better vendors provide training seminars for DCs who sell their products and services. “They offer advice on the technical aspects of running a nutrition practice, as well as the business aspects,” he says.

Baritz took what he learned under those programs and started seeing nutrition patients a couple of months ago. Adding a retail outlet for nutrition bars was a natural outgrowth of that. He does a dietary analysis for each patient every week until his or her diet is right. Patients fill out forms disclosing everything they eat, and they bring them to Baritz’s office at each visit. Baritz will use those to see the amount of protein and carbohydrates the patients are getting. He will also employ a type of hands-on muscle testing to determine their individual sensitivities. “People don’t get enough protein, and they get too many carbs,” he says. “Part of the problem is modern life. We can’t go out and roast some deer meat if we’re hungry. For convenience, people need a health food bar that’s not loaded down with sugar and the wrong kind of unbalanced vitamins. High-protein bars are an important part of the overall picture.”

They also can be an expensive part. One of the fundamentals of offering nutrition bars is you have to have them available so patients can get them when they want them, Baritz says. “If I say I’m endorsing a product that I think is important for you, but we don’t have it in stock, the contradiction is obvious. Consumers want to be satisfied now.” Of course, you don’t want too much stock on hand, either. Baritz’s solution: “The first thing I did was search for computer programs that would help me manage my stock. I looked at some very excellent programs, but ended up with an off-the-shelf program called QuickBook. It’s less expensive and far more durable than many of the others I examined.” He says he invested about 2 months into the software search.

He decided to estimate 1 month’s worth of product. If he thinks he will need 10 boxes per month, he stocks up. Then, at the end of each week, he reviews his stock and computer program to order back up to the 1-month’s-supply level. He maintains an inventory of about $1,500 in nutrition products at any given time.

Marketing the Product
To draw patients’ attention to the nutrition bars, Baritz invested $500 or so in a small cabinet that’s placed prominently in a hallway that all his patients—nutrition and chiropractic—must pass through. “It’s a great advertising idea,” he says. “A lot of patients will say, ‘I didn’t realize you do nutrition.’” He also dedicated a 12- x 15-foot room in his suite of offices for nutrition-related documents and all his testing and nutritional product inventory. He also added nutrition-practice information to his Web site and installed a sign on his wife’s car that advertises the company and his Web site. “Lots of people say they saw it and logged on,” he says. “It’s a very inexpensive form of advertising.”

Another expense he’s had was a small learning center, which included a new television set and a DVD player. It cost a little under $1,000 for the whole set-up. The training for his staff cost a little more. He wrote training manuals for every aspect of the nutrition practice; he developed a nutrition seminar for patients and nonpatients; and he created advertising fliers, which he placed in grocery stores and other high-traffic commercial venues.

Thinking of following in his footsteps? Pay attention—and move slowly. “I went into nutrition very carefully to keep from having to pull the plug,” Baritz stresses. “Take it a step at a time. Don’t invest a lot of cash. Go low-tech as much as possible. This type of practice builds, so a gradient approach works very well.” Of course, you know what they say about the best-laid plans. “If you decide to jump out,” Baritz advises, “do it before you’re in over your head.”

Russell A. Jackson is a contributing writer for Chiropractic Products.

Kim D. Christensen, DC, DACRB, CCSP, CSCS, directs the Chiropractic Rehab & Wellness program at PeaceHealth Hospital in Longview, Wash. He has participated as team chiropractor for high school and university athletic programs, as a postgraduate faculty member at numerous chiropractic colleges, and as past-president of the ACA Rehab Council. He can be reached via email: kchristensen@peacehealth.org.