September 2008

The perfect practice

by Dr. Dennis Nikitow

If someone were to ask you what your perfect practice would be, what would you say? Is there such a thing? Would it be the same for everyone or different? The dictionary defines perfect as "complete," "precise," "ideal," "accurate" or "excellent." After training and teaching more than 30,000 chiropractors in 20 years, I can confidently say that most DCs embrace the principles and philosophy of chiropractic and would like to see a chiropractor on everyone's health care team.

What is imperfect about their practice is that they don't know how to convey chiropractic in a modern, practical way that will convey to people how much they need chiropractic for their entire family as part of their health care wellness. They communicate chiropractic as a musculoskeletal treatment.

The perfect practice would start by having a complete, precise system of communicating chiropractic philosophy so everyone would see it as practical and understand why they need chiropractic for overall health and wellness.

The perfect practice would also be high in conversions and retention. People would reach for care rather than need to be pulled into it. They would see maintenance of spinal alignment as a necessity, not an option. The perfect practice would embrace a technique for spinal restoration not just symptom correction. There would be scientific research to support spinal correction and maintenance for wellness and people would see that posture has a profound affect on health.

The perfect practice wouldn't be a cash practice or an insurance dependant practice, but would have the best cash plans available so people would be able to accept care regardless of their financial situation. Yet, it would also utilize insurance to lower out-of-pocket expense for patients and increase profitability for the clinic. It would include updated, precise documentation that would be effortless for the doctor. Most importantly, when insurance stopped paying, patients would continue care because of the high value they had for chiropractic care.

Lastly, the perfect practice would have unlimited new patients where 80% would commit to long term care. Every new patient strategy would be simple, effective and consistent. New patients would bring their entire family in by the second visit and 80% would start care.

In addition, there would be less anxiety, less stress and less worry. There would be more fun, balance and ease. Spinal results would be predictable, procedures systematic and results remarkable. Income would be stable and work hours minimal, allowing optimum family and personal time. The big question is, does this reflect your practice? It is attainable if it's something you want.

Here are some simple steps to start down the road to the perfect practice.

First, adopt a system for every procedure in your clinic and break them up into steps. During the first visit history, touch the areas of complaint and relate it to visceral function. Next, explain chiropractic philosophy and the subluxation concept, with visuals the patient can understand. Key point: Subluxations do not cause symptoms. Next, show posters with medical research to give credibility to the philosophy.

During the exam, point out postural distortions and relate them to subluxations and aberrations to the spinal model. Use touch and tell when palpating the spine so patients understand where the nerve goes. Last, tell them these problems run in the family and they should have their children checked. FHP is the best link because most people have it.

Do x-rays and schedule the ROF for the next day. (I use the Certainty pre-ROF DVD because it ties all the education together in a simple, understandable way.) Compare their x-rays to the normal. Point out deviations in curves, DJD phases, and estimate how long the problem was there. Prognosticate the possibilities to their health potential if it isn't fixed and lay out a plan for correction. Explain the dynamics of nerve muscle memory so the adjustment frequency without degrading treatment schedule and rehab makes sense.

If patients have insurance they will usually pay more for rehab than chiropractic, so bill it. Do in-clinic rehab in addition to home rehab. If they don't have insurance, just use home rehab and offer a cash plan if doing in-clinic rehab.

Explain that maintenance is the key, and not to fix the spine unless they're going to maintain it. Go through appropriate patient guidelines for starting, finishing, maintenance, missed appointments, orientation class and family exams, etc. Have them make appointments for their family because of the spinal condition they have.

Next, have them see the financial CA and get cash plans to pay for multiple visits at a discount. Bill insurance for "X" number of rehab visits if appropriate. Make sure to have affordable family plans available also.

Remember, if you do a good job of communicating the chiropractic principles and philosophy, and back it up with medical research, patients will understand why they need to have chiropractic on their health care team, and they will comply to recommendations given.

Finally, the acquisition of new patients will follow your purpose. If your communication and education system creates value by repositioning patients off of a back pain mentality to wellness, your internal referrals will be consistent and families will be coming in by the end of the first or second visit. When promoting referrals, always mention your purpose and mission, then ask for the referral to add impact.

For external promotions, you should become proficient at screenings and lectures so they are natural and don't sound like sales pitches. Do them anywhere there are people -- especially companies, and corporations. Also, get a website to direct people to (I love "Now You Know" by Bob Braile). There is so much more, but I can't cover it all in one column.

If you want specific instruction on any of the above strategies so you can perfect your practice, attend the new Perfect Practice Seminar for three full days of intense practice rejuvenation. You can register at the Certainty website -- www.certaintypracticeproducts.com -- or by calling 800-544-3884.

(To learn more about the Certainty System, Certainty Practice Products and Dr. Dennis Nikitow's upcoming seminar schedule, call 800-544-3884. Outside the US, 303-721-6202.)