Building strong relationships with associates has resulted in two profitable clinics for Michael Budincich, DC, QME

Pictured in the back row, from left, are Brian Venerable, DC; Michael Budincich, DC, QME; and Michael Donia, DC. In the front row are CAs Maria Smith, Sancha Newman, Betty Servin, and Maria Matias.

It’s often said that people are judged by the company they keep—an adage that couldn’t be more true when running a business. Foar chiropractors, that company includes the professionals with which they surround themselves, because more often than not, the task of treating patients well—and thus ensuring their loyalty—often falls to the front-desk staff, a chiropractic assistant (CA), or associate DCs.

“The whole basis of my practice is this: We consider ourselves the Nordstrom of chiropractic—we spoil the patient, so if they go somewhere else, they immediately notice the difference,” says Michael Budincich, DC, QME, who has been in practice for 25 years.

At the Budincich Chiropractic Clinic in Pasadena, Calif, there is just one rule when it comes to working with the public.

“Everybody’s got a boss, and ours is the patient,” he says, noting that in today’s world of managed care and overworked medical professionals, doctors tend to overlook that fact. “And you have to make the boss happy, because if they are unhappy, they fire us.”

This attitude is apparent in the most basic business element: office hours. Structured to “keep the boss happy,” Budincich and his team open their doors at 8 to 8:30 am every day except Sunday and book patients until 7 pm at least 2 days per week. Doctors work on a staggered schedule, so each gets at least one day off during the week. The practice now has more than 19,000 case files spanning 3 decades, and a substantial portion of the patients are repeat patients.

Branching out
After working out of one location for 15 years, Budincich decided the time was right for expansion. The second location, a self-standing corner location also operating under a Budincich Chiropractic Clinic awning and street sign, is in Monrovia, Calif, just 8 miles east of the Pasadena office.

When Budincich purchased the building as a real estate investment in 1998, the space was already occupied by a DC who moved out shortly after the deal closed. Instead of converting the offices into a residential rental, he renovated the facility and opened it under his own name.

Michael Budincich, DC, reviews a patient’s x-rays at the Pasadena office.

At the satellite office, all of the patient care, along with much of the responsibility of building the patient base, falls to one of Budincich’s associates. But Budincich works closely with his associate DC in a mentoring capacity. The two meet one-on-one several times per month to discuss proven techniques for conducting a successful consultation and examination, reporting findings, and explaining packages of care to patients.

“People tend to be more pain motivated, meaning they stop treatments as soon as they get rid of their pain,” says Budincich, who believes that while most DCs want to treat patients on a deeper corrective level, they lose the opportunity to do so because they failed to properly educate and motivate the patient.

He seeks to find each person’s motivational factors for getting well—such as being able to play with grandchildren again or to minimize discomfort and stiffness—and uses each patient’s unique goals to inspire patients to commit to the entire course of treatment. Of course, that plan for success can only be offered if it’s a realistic option.

“If you don’t think you can deliver, you can’t make that promise, because you have to be ethical in your explanation of what you can and can’t do,” Budincich says. He cautions that DCs must present techniques along with an objective way of demonstrating there has been correction, such as putting a heel lift in a shoe where spinal correction is identifiable with before-and-after x-rays. “Always remember they’re the boss; tell them the truth, and then let them do what they want to do.”

Even for patients who refuse service for whatever reason—often due to a lack of funding or available time—the trust that is built through honest communication is vital to creating lifelong relationships with patients, as is Budincich’s confidence in making a point to underpromise and overdeliver.

“If you think the patient will improve by 50% in 30 days, be conservative and tell them you think they’ll feel 30% better in that time,” he says. “Giving them more than they expect makes them feel good about the choice they made, and that’s what makes them excited—and excited patients refer others to you.”

What Goes Around
A fundamental element of Budincich’s business philosophy is treating others in his inner circle with respect—not only by sharing his knowledge and experience, but by promoting his associates or partners to patients.

“One of the worst things a doctor in my position can do is to belittle the power and reputation of his associates in front of staff or patients,” he says. “They’re just as capable, just as educated, so they deserve the same respect, and that’s what builds long-term associate relationships.”

Budincich admits he learned this lesson the hard way.

“When I first started in practice, I didn’t know these rules, but after you lose people, you realize your attitude has to change,” he says. “It’s not about you, even if you’re the owner. It’s about building a team concept and becoming a team player.”

The ability to build and maintain strong relationships with his associates has resulted in two profitable chiropractic clinics. Without the reliability and talent of other DCs, Budincich doesn’t think it would have been possible.

“Without associates, a large clinic like mine would lose volume because you can’t service everybody,” he explains. “You have to create a mutual admiration society between the head doctor and all associates.”

Investing in his partnerships pays off in more ways than one. Budincich’s associates tend to stay on board well beyond their initial training. One DC practiced at Budincich Chiropractic for more than 10 years, several others for 5 or more. While successful busy practices are part of the equation, Budincich believes they stayed on for more than just monetary gain.

“People don’t stay with you because of the money; they stay because they like being there,” he says. “If one of your doctors isn’t happy, bend things, listen, and change, and make it work. You can stay rigid and you will have it your way, but you will be alone.”

Maintaining Focus
Unfortunately, as business grows, guaranteeing that the team provides patients with above-standard service becomes more challenging. The key for Budincich has always been to fill open positions with highly qualified staff; investing in finding the right person for every job. While this level of diligence can be time-consuming and tedious, the result is well worth it.

To that end, he employs several impartial rating systems when screening for new chiropractic assistants and other office staff, including a standardized IQ test and a personality-assessment battery. In addition to the written profiles, applicants must also present themselves professionally.

“It’s about intelligence, intent, communication,” Budincich explains, emphasizing how important it is for patients to feel like they’re talking with a knowledgeable person when they visit or phone the office. “If they don’t respect the front-desk CA, that’s going to carry all the way down to the doctor.”

Budincich also recommends being realistic when it comes to salary.

“You’ve got to have smart people working for you, and you’re going to have to pay for that intelligence,” he says. “Don’t cut corners when you’re trying to grow, because ignorance can really turn off patients.”

Meet and Greet
Even the best staff needs attention to keep the office running smoothly. Because of his firm belief that communication is the key to running a successful organization, Budincich helms a weekly staff meeting, gathering together teams from both locations.

During busy weeks, this meeting is the only chance everyone has to discuss items of business. Though the staff at smaller clinics will interact regularly throughout the day, Budincich’s main location is spread over 3,500 square feet, and is arranged in such a manner that it’s not uncommon for Budincich to work an entire day without having more than a brief chat with his CAs.

Meeting regularly gives them all a chance to catch up on events of the past week and to discuss upcoming plans. Gathering his team regularly also allows Budincich to identify trends or problems and handle them early. That doesn’t mean the atmosphere isn’t friendly.

“I bring in a meal to let the staff know I respect their time,” he says. “Also, when people eat together, they’re just closer, it’s like a family,” he says.

And as is often the case in families, disagreements sometimes arise. This serves to tighten the bond between the team members, however, because the discourse serves to clear the air, freeing faculty to get back on track, says Budincich.

“It gives everyone a chance to speak about what’s going right, what’s going wrong, what’s broken—to vent frustrations,” he says. “It also is where we discuss business, such as scheduling, practice growth, and upcoming marketing activities.”

A significant amount of time is spent reviewing patient activity, which gives staff members an opportunity to become familiar with new patients as individuals. This makes it easier to provide personalized service. All patient information is held in the strictest confidence by clinic staff, completely compliant with existing Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations.

Another regular topic is patient feedback. Around their third or fourth appointment, patients complete a “quality control report,” which is essentially a report card grading their experiences at Budincich Chiropractic. During the meeting, each report is reviewed.

“If a patient is dissatisfied about something, we fix it right away, and if they’re happy, we read those and we celebrate that,” Budincich says.

Service is a Cornerstone
A host of standard topics appear on every agenda, such as constantly stressing the importance of customer service and some specifics on how to ensure a consistent, friendly approach. Particular attention is paid to first impressions.

“The first telephone call is very important, so you want a bright, cheerful person on the phone, someone who is energetic and will smile before they answer the phone, because it comes across to the patient,” Budincich explains.

Patients entering the lobby are greeted with the same enthusiasm. Chiropractic assistants don’t thrust a clipboard at patients and move on. Instead, office protocol has staff shake hands with patients, sit down with them, and inform them about what information is required from them and what they can expect during their first visit.

“It’s about taking the extra time and knowing how to work with different personality types,” Budincich says. “It’s that extra touch that makes the difference.”

Another key aspect of his patient-focused approach is simply listening to patients—and not just about their physical ailments. From birthdays to promotions and everything in between, staff members regularly set aside time in their weekly meetings to sign greeting cards for patients, or sympathy cards if a patient loses a loved one.

“In the course of caring for people, we learn a lot about what’s happening in their lives, and I believe personal cards are very important and very impactful,” Budincich says. “We try to bring a human element to our practice, to let people know we really care about them and that we listen to them.” CP

Dana Hinesly is a contributing writer for Chiropractic Products.