How to pay yourself more ‑‑ and work less

by Dr. Geoff Ricchio

I'm always amused at those of my fellow chiropractors who seem to be concerned only with the number of patients they see each week or how big their practice is.

I've consulted with dentists, medical doctors, and hospitals over the last five years and know for certain that those physicians don't concern themselves with the number of patient visits each week. They're more business‑oriented and strive to increase income each month, not necessarily patient visits.

Why do "consultants" in the chiropractic profession only seem to concern themselves with the number of patient visits each week or month?

Let me offer the following observations from what I've seen across the country in physicians' offices (all specialties).

*** High patient visits do not equal high income. I have consulted with a good number of DCs over the last year who have more than two million dollars in past accounts receivables. These doctors are some of the busiest in their cities, yet they can barely pay their rent or employees. It's plain and simple "lame business" if you think that seeing many patients will be the answer to your practice prayers. It doesn't matter how many patients you see. It ONLY matters how much you collect and pay yourself!

*** Private pay insurance is slowly changing or going away altogether. If you've been in practice for at least three years, you've probably seen more and more insurance denials for payment or requests for records because it's claimed your treatment was "over reasonable and customary." This will happen more and more in the future. Your monthly income will be severely affected from these cuts. You will work much harder for less pay.

*** High practice stress will affect your personal relationships. I've talked to more doctors in the last year who've gone through a divorce or who are going through one. They usually tell me that the extreme financial stresses, coupled with long office hours destroys any and all energy to work on their personal lives. Is a large practice worth this heartache?

*** Work Comp and PI laws in your state will change for the worst. Workmans compensation laws are a political issue and Personal Injury issues are controlled largely by the insurance companies. This means that if you're making good money in either Work Comp or PI, the industry will change to make it harder for you to get paid. I've seen it occur in every state (recently California) and it WILL happen to you. It's unwise to specialize in just one area of practice. You must diversify!

*** Most chiropractors are lousy collectors. The most important component of any practice is the collections for services. High billing each month doesn't matter, only high collections. If your collections are down, concentrate over the next 90 days on correcting this problem.

*** Develop multiple streams of income. The real key to a successful and happy practice is developing multiple streams of income. For example, I specialize in helping doctors develop a massage program in their office. Massage is very popular with the public, so ‑‑ whether or not you like it or "believe" in it ‑‑ it's important to have a service like this available to increase your income and new patients.

*** Work less in your office. Stop hiding there. When patients aren't coming in, get out in the community and do speaking engagements, or network with local businesses. Your office and collections will grow bigger than you ever dreamed if you work in your office only when patients are scheduled. Shoot for a goal of 20‑25 hours a week of active office time.

*** Develop a wellness program. The majority of chiropractors don't have a clue as to the proper payment structure and programs to offer their patients when active care ceases. You're losing a huge portion of your income if you don't have a wellness program that pays you monthly.

(Geoff Ricchio, DC, creator of the Get Paid Autodebit, Get Paid Small Claims, Rub Club Massage, MRI Income, and 40‑60 New Patient Systems, is consultant to more than 700 doctors and hospitals nationwide. For information on all programs, products and services, call 831‑GET PAID. Or contact him by e‑mail at drgeoffricchio@aol.com)