Practice-management companies exist in various health care disciplines. Like in other disciplines, practice-management companies exist to serve as expert consultants to chiropractic practices. The areas of expertise must include the products that help increase a practice’s profits and improve the patients’ health.

Chiropractic Products interviewed four chiropractic practice-management experts to find out the latest product trends in chiropractic. Dennis Perman, DC, is cofounder of The Masters Circle (TMC) in Jericho, NY. Len Schwartz is president/CEO of ChiroPractice Marketing Solutions in Ivyland, Pa. Peter G. Fernandez is founder of DrFernandez.com in Seminole, Fla. Mark Sanna, DC, is CEO of Breakthrough Coaching in Vernon, NJ.

Which products do you recommend chiropractors sell to improve patients’ health while also achieving high profit margins for the practice?

Perman: Perhaps the easiest to implement, Foot Levelers Spinal Pelvic Stabilizers have high patient compliance and provide a significant profit for the doctor. Patients love them; they help them hold adjustments better. Patients often buy several pairs and return for new ones after a time. Nutritional supplements, such as those made by Biotics Research, have high patient approval and a solid profit margin. Analgesics like Biofreeze are small-ticket items, but have a very high repurchase ratio. And bigger tickets like the Insight Millennium, DMX Digital Motion X-Ray, SpineMed spinal decompression from Cert Health Sciences, and the PowerPlate all have a high return on investment.

Schwartz: Vitamins and supplements, pillows, air- and water-purification systems, and orthotics. These products are easy to buy and store; and with a little education, your patients will see the incredible value in using them. Plus, you continue to nurture a bond that extends further than the traditional adjustment-only relationship. This enables you to connect with your patients on a deeper level, and that can only mean more new referrals, new patients, and word-of-mouth advertising.

Fernandez: The two primary approaches to patient care that insurance companies are interested in are active care and passive care. They would prefer DCs to prescribe more active care products. My most recently published book is called Neck Pain, Neck Pain, You Don’t Want It, You Don’t Need It. This is an active care book for your patients that teaches activities of daily living—and doctors are paid to give patients their own copy of the book and the advice within it. Additional active care products would include orthopedic appliances, cervical collars, lumbosacral supports, vitamins, minerals, etc.

Sanna: With declining insurance reimbursement, the diversification of revenue streams is essential to success in practice today. Chiropractors should choose products that are consistent with their practice focus and philosophy, while focusing on providing patients with excellent products at a fair price. Ancillary product lines that frequently appear in successful practices include orthotics, pillows, supports, and nutritional supplements. When properly implemented, product sales can be staff-driven, allowing the doctor to maintain his or her focus on patient care.

What will the patient-education products of the future look like?

Perman: Patient education will follow the high-tech, high-touch trends of the last 20 years. Elaborate presentation systems like Brican and Chirovision will continue to gain popularity because they are sexy and effective. Daily tools like the print materials produced by Patient Media, Koren Publications, and Back Talk Systems, and the DVDs made by Health Visions, will maintain their firm position in the marketplace. The more transparent and user-friendly the approach, the more likely chiropractors implement them. The consistent presentation from Brican or Health Visions in the reception area, with the focused intention of Chirovision or the patient literature mentioned above, will be synthesized into cohesive programs of patient management that will enhance compliance.

Schwartz: I know that good old-fashioned research-based materials will continue to resonate with people and patients at the highest level. Simple, easy-to-understand posters and charts that explain how the nervous system is connected to everything will also reign supreme as long as the doctor takes an active role in explaining the how and why of it all.

Fernandez: In the future, patients will need to take a more active role in their own health care. My book Neck Pain, Neck Pain, You Don’t Want It, You Don’t Need It is visually informative and contains active care advice on the importance of correct posture, the proper use of cervical pillows and mattresses, ergonomics at home and work, and exercise. Patients will need more "visual education" from products like the Neuropatholator by Visual Odyssey. Also, large video screens in the reception area and consultation room, like those provided by Brican Corp.

Sanna: The future of patient-education products is Web-based, interactive, personalized, and content-driven. Internet technology permits a level of interactivity impossible to achieve with printed materials. People will seek out information that stimulates their interest and provides them with information that is relevant to their lives. The Internet enables exiting and potential patients to access the information they want when they want it. Doctors of chiropractic would do well to invest in a Web site that provides a learning e-resource for their patients.

Which passive modality will see the most growth in chiropractic over the next year, and why?

Fernandez: Interferrential (to relieve pain and swelling), trigger-point therapy, and decompression traction modality. Why? Interferrential is very effective in relieving pain, and that’s why the majority of patients go to a chiropractor. Trigger-point therapy, because patients can feel the change in their trigger points from visit to visit. Decompression traction works effectively and helps attract patients that would never normally go to a DC.

Sanna: Spinal decompression therapy is the hottest passive modality in chiropractic today and will continue to be so in the year ahead. This being said, it is essential that chiropractors carefully consider how they choose to implement this modality in their practices. Effective marketing is one of the keys to the success of spinal-decompression therapy, and chiropractors must be cautious about any claims they make concerning the modality. A careful review of CPT® coding compliance is also prudent when billing insurance carriers for this previously all-cash service.

Patients will continue to seek easy-to-understand materials that explain how the nervous system affects the entire body.

What capabilities should chiropractors look for when purchasing practice-management software? Which are the most popular?

Perman: Ease of operation, durability, flexibility, and quality of tech support are the keys I look for. We’ve had good results with ECLIPSE, but the Rolls-Royce is Pro-Soft, made by Dr Moe Pisciottano of Pro-Solutions and Pro-Adjuster fame. It’s based on the algorithms carriers use to decide the validity of your claim, so it’s designed to bulletproof your insurance reporting and streamline the collections process.

When buying software, get input from several current users about the qualities mentioned above, especially tech support—it’s a place where many companies fall short, so check it through to make sure you have the backup you need.

Schwartz: Complete billing solutions with a comprehensive database of essential paperwork.

Fernandez: The software needs to be expandable. As your practice grows, your software needs to keep pace. The larger your practice success, the larger your "software practice network" needs to be. The software provider needs to be established. Don’t buy from someone "here today, gone tomorrow." You’ll need software from a provider who has a reputation for excellence in servicing. They need to be service responsive—ASAP—to troubleshoot any problems. They need to provide continuing training. The software needs to be user-friendly. My recommendation is TGI Solutions software, Panama City, Fla.

Sanna: Effective and efficient practice-management software should include billing, scheduling, electronic health record, and daily notes capabilities. It must be certified Health Insurance Portability and Accountability Act (HIPAA) compliant and provide for electronic claims generation and remittance. Chiropractors should choose a software program that provides security features that include patient data access tracking. Finally, look for a system that will enable your practice to go paperless. While your practice may not be paperless today, it will certainly be the norm in the future!

What are some top products that practice-management companies can offer to best educate and inspire chiropractors?

Perman: The Masters Circle offers the Portable Mind Library, an iPod-based anthology of inspiring and educational programs. The basic package contains 87 hours of historic and contemporary programming, with dozens of industry leaders and traditional figures presenting their finest work, and quarterly updates available by subscription. TMC also has many CD albums on leadership, office procedures, CA training, new-patient acquisition, and much more. Go to www.themasterscircle.com or call (800) 451-4514.

Also, CLA produces an audiomagazine, On Purpose, which offers great information on science, politics, and philosophy each month. They also make the Insight Millennium, a patient-examination device that focuses doctors and patients alike on the importance of correcting subluxations.

Schwartz: Predictably successful practice-building marketing solutions, patient management and education solutions, and staff training and management solutions.

Fernandez: My own practice-management company, DrFernandez.com, provides information to educate and inspire DCs through one-on-one consulting, 140 online class videos, weekend seminars, books, the Internet, and audiotapes. I realized years ago that our client doctors wanted practice-management advice, education, and inspiration through multiple sources. One size seldom fits all. We pride ourselves on fitting our clients’ needs. When our client doctors know better, they do better. They experience less practice stress, are happier and more productive, and have larger incomes.

Sanna: One-on-one personal coaching is the top product a practice-management company can offer to educate and inspire chiropractors. Working with a personal coach who has the real-world experience of successfully managing chiropractic practices in today’s health care marketplace will accelerate your progress and hold you accountable to your goals and vision. There is nothing more inspiring than to learn from someone who has been there and done what you wish to accomplish. You’ll think to yourself, "If he or she can do it, so can I!"

What are the primary reasons a chiropractor needs a practice-management company? What do such companies have to offer?

Perman: Companies like The Masters Circle provide information, coaching, leadership, motivation, connections, products for practice building and management, and more.

Most companies are strategy-based, meaning that they concentrate primarily on actions for practice building. At The Masters Circle, we believe that personal growth is required to get the most out of yourself professionally, so our approach is identity-based. While we provide cutting-edge strategies for success, we help you at a deeper level to build a foundation of excellence, so the actions you take have that much more power and impact. Success comes from you, not to you, so if your want to grow your practice, grow yourself!

Schwartz: Chiropractors need to work with a company that knows how to market the doctor in a strategic (not tactical) way. This enables the doctors to build their name, brand, and fame in their community so that they dominate their market and become the most recognized, utilized, and respected doctor in their town.

Fernandez: To "buy knowledge." That’s the primary reason a DC wants a practice-management firm. We all "buy knowledge" from our CPA, tax consultant, doctor, lawyer, financial planner, insurance agent, realtor, etc. Why? Because they are the experts at what they do. And what a practice-management company gives you is its expert knowledge to save you money and make your income grow. DrFernandez.com offers our clients expert advice, encouragement, and training in all areas of practice management, including insurance coding, personal injury, successful office procedures, marketing, public relations, community relations, advertising, increasing patient referrals, attracting new patients, patient retention, etc.

Sanna: The rules of the game of chiropractic practice have changed and will continue to change at a pace that outstrips the ability of any individual practitioner to keep up. Coding and compliance rules and regulations are changing at lightning speed. It’s been said that, "None of us are as smart as all of us." The insular practice of the past is obsolete. There is safety in numbers. A practice-management company should provide your practice with the advantage of a national perspective, delivered with relevance to your local marketplace. A national perspective enables you to spot and respond to health care trends before they impact your bottom line. A practice-management company should simplify the business of running your practice so that you can do what you love to do most: care for patients.