Having visited well over 500 offices in the last few years, I can tell you that 80% of the chiropractors have a definite “blind spot” that is preventing them from achieving a higher level of chiropractic success, satisfaction or safety.
The other 15% are acutely aware of their problems but unwilling to fix them. And the top 5% of chiropractors seem to have everything dialed in.
Of that large majority of chiropractors whose “blind spot” is literally obstructing their path to bigger and better things, almost all of these DC’s land in one of the following three categories:
1. The Perfectionist Practitioner These chiropractors are constantly busy developing their technical (i.e. clinical) skills. They subscribe to (and read) multiple chiropractic and scientific journals and are easily apt to double their required CE credits in one calendar year with all the technique workshops they attend. Some are “seminar junkies” who have more initials behind their last name than some people have teeth. And though they may not admit it, they live in hopes that they can increase their clinical skills enough to ignore the “business side” of chiropractic. Worse, the number of practitioner-perfectionists who are both extremely accomplished clinicians and near broke is frighteningly high. Despite their incredible intellect, basic logic is a bit of an Achille’s heel because if academic success or clinical prowess were directly correlated to business success, all the straight “A’ students would be wealthy and those who can adjust the talus ten different ways would have no financial worries either. Unfortunately, those stereotypes are far from the truth.
Instead, what we see inside the business of a practitioner-perfectionist is a chiropractic practice that has woefully inadequate or obsolete systems in place. Their treatment notes may be 10 pages long (as a result of their tendency towards clinical perfectionism) but they still aren’t paid what they are really worth. At least, that’s what they would admit (if they were truly honest) but in reality, they probably don’t know much about their stats. They don’t keep them and if they do, they definitely don’t manage by the numbers. As a result, these docs (and their staff) spend most of the time haphazardly putting out fires only long enough for the next one to erupt.
The one positive aspect of these offices is most are painfully aware of the fact that they are not businesspersons at all and are in fact, technicians or practitioners who have created a less than satisfying job for themselves. These docs hope to do something about it someday. They know they are under-producing and feel like they can see more patients, do more services and make better income. However, the next fire which is just around the corner always seems to prevent them from actually getting around to doing so. In the meantime, the stress level keeps building and the chiropractor remains in the perennial state of “never living up to his or her potential.”
2. The Patch Practitioner. The good doctors of this category have developed adequate skills to serve their patients but have never really developed the “business side” to the same degree. It’s not that they haven’t tried…at least for a short while. But they never see things through or develop a cohesive strategic plan that will enable their business to get to the next level and increase. In their defense, these offices have some systems in place and as a result, they generally have a bit bigger or better business than the Perfectionists. But they are rarely consistent in their application because the next shiny object appears as the “silver bullet” on the horizon and they are off and running in pursuit of that…for a time. If they do have systems in place, they are typically patched together from all the various seminars, free tips and advice from Uncle Larry they’ve pieced together over the years.
Instead of solid systems and strategies, they usually have slightly murky “might-do’s” (Ex: 1st visit = NP Exam, maybe adjust, maybe not. 2nd Visit = more treatment, maybe ROF. Visit 3-396 = Random Mush ). As a result, these offices leave even more money on the plate and miss out on even more potential to maximize revenues and efficiently utilize doctor and staff time. There is still too much doctor dependence and, at times, too much on the doctor’s plate.
Consequently, several things emerge: the doctor is still forced to put lots of time and energy in to keep the appearance of the practice running smoothly. In the long run, this doctor is destined for burnout because they look a bit more professional than the average doc and thus, they are deceived into thinking they have systems in place. Life in these practices is like a rollercoaster of endless ups and downs; some months are good and fun, some teeter on not so fun. This is the most dangerous category because they don’t really have effective systems and because the doctor has so much to lose (and gain) in the way of potential. And if they don’t develop solid systems that transform the doctor into a business owner, they will remain a practitioner who is chained to their practice.
And the worse news of all is that this category of chiropractors is also the most common.
3. Excellent But Exposed. These larger chiropractic offices are sometimes hard to define other than they have achieved a great level of success and are in the top 10% of chiropractic income earners. Some docs in this category are incredibly skilled chiropractors and have found and filled a niche to keep them busy or booming. Others are booming business people but adequately skilled craftsmen. What binds the offices in this category together is that they all DO have some solid systems implemented. The basics are in place and the practice is generally profitable and smooth running.
Although this type of practice has obviously achieved a respectable amount of success, landmines that threaten to destroy the practice lurk beneath the surface. For example, the doctor has good protocols to generate revenue, but he’s not quite sure if his billing or coding is correct or legitimate. In other areas, he’s found some good ways to streamline processes and utilize staff, but he’s not sure if those methods are exactly compliant. And his notes? Well, he knows that his documentation could use some improvement but he’s hoping that it’s good enough.
The other threats to these big practices exist in the almost ubiquitous potential of things falling through the cracks. Even with the best systems, tightening up little areas can result in huge gains — and these doctors know it. But they are often blinded to their own problems because there’s so much good stuff going on.
If this type of doctor were to tell the truth, they lose more sleep than they are willing to admit and spend a little too much time looking over their shoulder and worrying that some day, their castle may come crashing down. They have an excellent practice, but they feel exposed and don’t like the thought of being a hair away from an audit, a complaint or a compliance violation creating major damage to their expensive estate.
Which Doctor are You?
Doc, no matter which category you identify with, it’s time to face reality.
The chiropractic landscape amidst audits, increasing insurance hoops, declining reimbursements and an ever changing set of rules to play-by will bring one thing to your practice: magnification
What I mean is that the chiropractic marketplace will either magnify your current problems and in turn multiply your messes OR it will illuminate your obstacles giving you the opportunity to fix them and take your practice to the next level.
Getting rid of your “blind spots” that are causing you to miss opportunities and obstructing your view of real threats isn’t always easy, but it is a matter of perspective or, in some cases, simply adjusting your mirrors to a different angle than you’ve been accustomed to. With that, here are my recommendations for you, depending on which category you feel closest to:
The Next Steps
If you are in the Perfectionist-Practitioner category, you already know you need help boosting the business side. What you need to realize and recognize is that you already know enough on the clinical side. Don’t get me wrong: I’m not advocating chiropractic ignorance or clinical sloppiness. But from having observed many docs just like you, I can tell you that your skills are already superior and it’s time to skip the technique seminars, face your fears and build your business. You are excellent at getting people well and you deserve to make an excellent living from that fact.
- If you are a die-hard do-it-yourself-er, then begin taking some chiropractic business seminars (yes, ones that focus on what we do to get paid, like chiropractic billing, coding and business strategies) and then apply what you’ve learned. I’m biased but I highly recommend my chiropractic seminars which focus on these strategies and they will be well-worth your time and trip (if you need to travel).
- If you are teachable and need guidance in an area that you haven’t paid much attention to (the business side), consider chiropractic coaching. But be sure to get a coach who isn’t going to jam you into a cookie-cutter clone of themselves. You won’t listen to them anyway. And you will regret the experience. But a coach who can help you elevate your practice, regardless of your technique or practice style, will suit you just fine.
If you are in the Patch Professional category, you probably need to put yourself on a spending moratorium for all new toys and techniques. Your business is doing well and you don’t need a shiny new object. You need strategies that will work with what you’ve already built and help make it better.
- Attending a chiropractic seminar that focuses on the business side and strategies you can use on Monday will help…unless you attend 10 of them and continue to patch together advice from all angles. Find someone you resonate with, see their seminar, and start implementing.
- In my experience, many docs who are in the Patch Professional category would like to be DIY-ers and many try. But your tendency to jump from one idea to the next or to simply focus on the wrong things actually makes you an ideal candidate for coaching. Some of my best clients are “reformed” Patch Professionals whose practices have significantly changes thanks to putting together a mutual plan, through guided instruction, accountability and perspective that coaching lends. If you have ridden the DIY roller-coaster too long and seen consistently inconsistent results, perhaps it’s time to reach out and get help. Complete a coaching application.
Finally, if you are in the Excellent But Exposed category, you need to give serious thought to protecting your awesome asset. Chances are, your practice is the single largest revenue producing entity you’ve got in your life, and you’ve got the equivalent of a $2.50 Master Lock on the door. Your level of protection should be proportionate to the level of success you’ve achieved in practice. And if you’re not sleeping well, if you’re not 110% confident that you can flawlessly fend off an audit, or if you absolutely admit (to yourself, of course) that you know that there a few areas in your practice that aren’t completely dialed in, you owe it to yourself and your loved ones to get help.
- The average seminar may not deliver the specific solutions you need for your practice challenges, but customized coaching would definitely fit the bill. You may already have a coach, but if you’ve got the challenges listed above, you don’t have one whose dedicated to keeping you compliant (enough) or to making sure your business is bullet-proof. Complete a coaching application today and I’d be happy to discuss how I can help you.