Sales of ancillary products can help your bottom line

Hands down, without much question, the most sensitive subject when dealing with health care is money. There are always questions about the value of what we do and how to properly get reimbursed for chiropractic services. But the most important question is, how much should we charge for our service? We all have experienced patients that have complete relief from adjustments when all other treatments failed. Is their care worth more than those who are in just for maintenance?

As professionals who care about the patient’s overall health, most DCs have a tendency to undercharge for their services. Add to this the pittance that insurance reimburses for chiropractic care, and you can see that it is often necessary to supplement your office income with more than just chiropractic adjustments to make sure that you pay all the bills and make a respectable income for your efforts. Many methods are available to supplement your chiropractic income, but some may not fit your chiropractic office profile. When choosing different ways to supplement your income, make sure that they fit with your “style” and that you are comfortable with recommending ancillary items to your patients.

Products You Would Use
The most common method of increasing profit margin is to sell nutritional supplements. As physicians, we have access to the best quality of vitamins, minerals, and herbal compounds that are available. Many of the products we recommend cannot be purchased by the general public, so your patients will rely on you to steer them toward the most effective product for their condition. Natural supplementation to increase immunity or to lower cholesterol can be a boon to many of your patients who might be considering a move away from prescription medications. Knowing that we can provide better-quality products—some that are unavailable over the counter—patients might come to your office just for this ancillary care.

As a natural part of our treatment to patients, selling back and neck supports, pillows, and other home-care products can not only help our adjustments to hold better, but can also help with the office’s bottom line. Sales of these items can be an integral part of your extra income, often producing as much as an office visit or two. Our patients expect us to be experts in pillows, mattresses, and back supports, and having these items available will help save your patients the effort of searching elsewhere for your recommended products. Remember to recommend only the products that you or your family would use, because this substantiates the need for a specific recommended item you have for sale.

Going outside of the average chiropractic office thought pattern often leads to new ideas for patient service that can provide you with additional income. With podiatrists now only rarely doing nonsurgical footwork, chiropractic is already there to provide foot adjustment (chiropody), treatment for fallen arches and pronation (orthotics), correction of short-leg syndrome (heel lifts), and support for mechanical injuries to the foot (taping and strapping). Acupuncture (needled and nonneedled) is accepted as an adjunctive treatment in many states, and it can be combined with chiropractic care or kept completely separate from your chiropractic practice.

Treating Nonchiropractic Problems
Treatment of nonchiropractic-related problems is becoming more common as a method of providing additional patient services. Laser hair removal, as well as cold laser treatment for carpal tunnel syndrome, are therapies that many chiropractors are using for their patients. Aqua massage (dry massage) beds are being placed in malls and other private locations to help people relax, and many are owned by local chiropractors.

Testing is becoming a common service of the DC. Within our scope of practice, we can test for body fat; test for drugs and alcohol; provide Department of Transportation (DOT) physicals; and in some states, test bone density and cholesterol. All of these are added services to our patients, because the patients do not have to travel to other locations to get these tests.

Many DCs are getting into rehabilitation services. With rehabilitation being a large part of so-called “evidence-based care,” DCs are installing exercise equipment and gym-style workout areas in their offices. Providing exercise rehabilitation can help your patients get well faster and enable them to have a better outlook on their care after you have completed your portion. Providing exercise regimens can help your patients maintain their health and change their lifestyle.

Deciding on Quantity
I have found that adding additional patient services has been at some times a boon and sometimes a bust to the business end of my practice, but always I have always found that it gives the patient extra care and additional choices for their health. There are many supplements you can choose for your practice, but for them to be there for your patients, you must stock them. The question is always, “how much, and how many?” when ordering specific supplements. I choose to keep a few specific items that a majority of my patients need, (such as calcium, CoQ 10, B vitamins, and multivitamins) and to order whatever else I need on an “as needed” basis. This is not good for the profit margin—shipping costs on one bottle can be the same as on 12 bottles—but it allows me to keep on hand what I need and not have a large stock of items that I don’t need.

I keep certain items, such as support pillows, on hand because the demand is there for them. I will order three, and then order another three when two are sold. The same goes for backpacks. Children today want specific colors—not just generic ones—so I keep a couple on hand during the summer and fall. If children want a different color, I order them as needed. This is a simple way to keep your storage down and your output of cash for supplies at a minimum.

Many of these methods can bring additional income into your office. Some will be right for your office, while other methods may not, but all of them will provide additional service to your patients and keep them from seeking the service elsewhere. Each of us is entitled to make a good financial living providing chiropractic services, and these ancillary methods of income are just an extension of what we do to help our patients. CP

Kenneth Martin, DC, is in private practice in Temple City, Calif. He can be reached at bacdoc@juno.com.