I had a patient the other day make this statement when she came in for an appointment.  Perhaps this is my own fault as she is an established patient and I should have educated her better. 

Regardless, I have had this experience more than once. 

So why is the procedure that we call an adjustment and go to school for years to perfect so simple that it is done by a significant other in the convenience of their home? 

I believe that the answer lies in the fact that certain marketing techniques and outside of the office chiropractic care has de-professionalized the art of chiropractic and belittled the adjustment itself.

 Here are a few reasons how this may happen:

• There are some in my area that give chiropractic care at the local fair...not evaluations but actual adjustments! I see no place for diagnosing at these venues either.
• How many of our colleagues may be guilty of giving a friend an adjustment at a party or other random gathering?  The fact that some people will ask me to give them an adjustment at the ski area or social outing is evidence that they do not respect what I do....they may appreciate it but not all respect it.  By succumbing to the request and not having them call the office for an appointment is only condoning such undermining attitudes.  Ask them if they would get a root canal, pelvic or rectal exam under similar surroundings!
• Something that is so often given away through promotions and marketing really can not be that difficult to do or have a whole lot of value. 

No matter how tempting it is or how much they beg me or how much I may want to give them relief, I will not perform any chiropractic care on anyone outside of the office....and definitely not in a public setting.  

I refuse to even lay my hands on them in any "evaluating" manner. I give them a card or my office number if I do not have a card on me. I will even offer to meet them at the office after the event we are attending if they are in alot of pain.

As for the self and ordained "adjuster", I emphasize the harm they could be doing to themselves or each other and make note of it in my records if a non-licensed DC tried to give them an "adjustment." 

There are times when I wonder if I should even treat these patients - because if and when something happens, who are they going to blame and sue? 

I am sure this will hit a nerve with many out there so tell me the positive aspects of treating someone outside of the office and why my philosophy on this matter is wrong.

One of the more interesting stories I've heard recently was from a new doctor who had just purchased a software system. She was thrilled with all of the components and how easily the software would "grow" with her practice.

She could enter patient information just once and the software would tag her client's record for appointment scheduling, billing, marketing, follow-up, etc. It was HIPPA compliant, user friendly, not too expensive and all around a great product.

What she had failed to do when she purchased the new software was to make sure it was compatible with her "old" computer system, a throwback from her college days.

After installing the new software, which was no problem, then entering about 45 patient's names and information as well as  insurance providers, two days later -- you guessed it -- the system crashed, sending the information into a black hole!

Although the seller of the software had been very diligent about explaining the immediate need for back-up systems to the doctor, she felt that it would be a long time before she ever needed to worry about that. Besides, she was sure everything could be recovered -- somehow.

Missed appointments, a new computer, a back-up system, hours of re-keying information and lots of wasted time and money later, the D.C. is back in business.

The moral of the story is this: think ahead of possible equipment failures. How would you retrieve and save your patients' records in case of some sort of diaster like fire, rain, flood, earthquake, or equipment failures.

For more information on protecting your technology for small business check out SCORE, "The Counselors of America’s Small Business Owners" at http://www.score.org/guides.html

And don't forget to talk to your insurance agent and find out what your policy covers.

For now BACK UP!!

Might anyone have some experiences similar to the example above? Any innovative plans to both save and protect your patient records during disasters?

With the start of the new year we have the chance to leave behind any unreached goals or bad habits from 2009 and start fresh with more focused and attainable goals.

One of the most important things you can do to jumpstart a new year is to take time and assess the highs and lows of the last year and plan for the new one. 

Consider putting adequate time on things you perceive as weaknesses.  How can you improve on those things and make them strengths this year? 

Take some time to evaluate your strengths.  Decide how to continue those so they become a pattern of excellence.  This can all be planned at a start of the year office meeting.  

I have heard many successful practitioners in our profession talk about the importance of the office meeting.  Your office staff might just include you and one other person, but the meetings are still important.  Our office meeting was not large by any means - just the other doctor in the office (who happens to be my wife) and me. 

We both had goals and ideas of where 2010 could bring our office.  The main goal for both of us was continued growth for the practice and to some degree inspiration.  

How can we grow or better express or promote our value?  Being relatively new practitioners still, we don't have a huge budget for improvement. 

That said, we purchased a rather outdated office and there is definitely room to improve!  To improve the perception of value in our office within our budget, we decided on fresh paint in treatment rooms and improved filing in the office area to streamline the space.  These are small changes, but they are changes we hope will make our patients feel more comfortable in the office and keep us excited about coming to the office!

This is very exciting to me because it is a new start. 

Buying an existing practice, there can be a fear of changing from what the previous doc had.  Slowly, this year we hope to start incorporating some ideas that we have to improve on the good start we've had so far. 

In future blogs, I will address other changes we're hoping to make this year - new equipment, new methods of marketing, and any exciting things that pop up in 2010.

Wishing you a prosperous and successful new year!

It's that time of year again ...tax time! 

I used to dread this time of year.  I have always used a CPA, but until recently, that was often frustrating and difficult.  Even though I had hired a professional to prepare and file my taxes, it was still time consuming and I was never confident my taxes were done correctly.

I was using the wrong professional.  We were not a good fit.  He did mostly personal taxes and very few entities with multiple properties, depreciation schedules, multiple partners, etc.

So I did a little shopping and made the switch to a more suitable firm.

Now, tax season is much easier on me.  My new CPA has experience with my type of business and makes the process much quicker and easier for me.

When looking for a tax preparer, CPA, attorney, etc., finding a good match is important.  The IRS has a few more recommendations you may find helpful as well.

The holiday season sure brought many greeting cards. It's certainly enjoyable to hear from those who we've not had contact with in some time. I always particularly look forward to the photo cards to see how children and family members change over the years.

While we all receive these personal greetings, it's also interesting to see how retailers inundate the public with coupons and messages. With the advent and expansion of the internet, Iike most, I receive email cards 24 hours a day.

Whether it's Neiman Marcus, Walmart, Wendy's, Dell or Amazon, these e-cards (which often include special offers) come in droves. While a bit less personal than the Hallmark product delivered with a 44 cent stamp, they still can be quite effective and a great tool to communicate with your patients and community in an efficient and cost effective fashion. 

Our office updates our email list on an ongoing basis. Contacts are kept and we periodically mail patients, friends and community members information as well as general greetings. These cards provide an opportunity to stay in contact with those who we've  treated in the past and those we hope to see in the future as their health requires.

How many individuals do you have on your email list? How many will you add this month and this year and when was the last time they heard from you?

Remember the old saying... "Out of sight, out of mind." Happy days!  

What should happen after a patient referral and what actually does happen are many times not the same.

It drives me crazy when a doctor sends a patient out for a referral and then has no follow-up in place or lacks the documentation to remind him or her of the referral. 

So you want to ask yourself the following questions: 

1. Did I document the referral?
2. Did I follow up with the patient?
3. Did I get a report back from the referred source?
4. Did I discuss the outcome appropriately with my patient?

It's too easy to make a referral and then just forget about it. But that's what many doctors and their staffs do.  This is certainly not the best outcome for the patient.

When making a referral for a patient, always remind them to list you as the referring doctor to enable you to receive reports effortlessly.  This is also a wonderful way to build relationships with other providers and centers. 

The office policy manual is something that's easy to push to the back burner.  When working on getting your practice up and running, it's just not something that is a priority.

But it should be and here's why.

Without written policies, those working for you lack the guidance that will determine their behavior.  With a policy manual, which has been read by all and available for reference, people know the expectations.

An example is winter weather. 

As I write this, there is a blizzard warning for my state.  What is the expectation for me to report for work tomorrow when there's 12 inches of snow blowing around in 50 mph winds?  Without a policy, I would need to guess. 

With a policy in place, though, I know exactly what to do.  I know how an office closure would be communicated.  I know my options to stay home, if I choose.  The expectations have been communicated and everyone knows what to do.

The time to write your policies is before you need them.  After situations occur, you will undoubtedly need to revise policies for the reality of your experience.  But it is better to have something in place to ensure your office runs as it should and your patients are well-cared for.

You have heard so much about marketing and all of its aspects.  I would like you to consider, for a moment, that the least expensive way of making your community aware of your presence is by immersion. 

It does not matter whether you are practicing in the largest of cities or the smallest of communities.  One of the best ways of creating awareness is by involvement as a volunteer. 

But first you must have clarity around your vision and your mission as a chiropractor and to be able to communicate it as though it was a reflex action.  Once that is indelibly clear, you can move forward with community involvement. 

If you are in the early stages of practice, your own luxury, in all likelihood, is time.  Make rich use of it by community service.  Such entities as town/city government, school systems, charitable organization, chambers of commerce and many more organizations are searching for individuals who can assist in serving their needs. 

Yes, involvement may take a good deal of your personal time, but the rewards will be gratifying.  By that I mean that the rewards of service are fulfilling, while at the same time the involvement exposes you to a multitude of people, who, after meeting you, become more than a casual census of potential patients. 

Community immersion is an opportunity to meet hundreds and hundreds of individuals that you might not meet otherwise.  The important thing to note is that immersion should not be for the exclusive purpose of meeting people who might become patients but rather for a genuine desire to be involved. 

Once that happens, and it is genuine, people will recognize you for who you are and the marvelous of magic will be returned to you in ways that will grow your practice.

Finding a mentor is difficult only because you want to find the right one, with the right values and ethics. 

After you ask your mentor for help, what is your responsibility?

Your mentor will give you the most priceless possession he/she has … their time.  And you should regard that as if it were gold. 

Respecting that possession demands that you demonstrate some follow-through on the suggestions made by your mentor.  You can disagree and have discussion - which creates learning experiences. But when the meeting or discussion is over, your follow through is the payment your mentor expects.

Anything less will dampen the enthusiasm and desire to continue to participate and you may have lost a precious gem for a lifetime of learning. 

Respect time and follow through!

At NCMIC, our motto is "We Take Care Of Our Own."  It is not just something we say and use in our advertising.  It is a philosophy that colors every aspect of our business.

We do a lot of work with students at every chiropractic college in the U.S.  And we see first hand the commitment and sacrifice it takes to become a Doctor of Chiropractic.  And we want to help make it a bit easier.

So, we have developed a new scholarship program to help students meet the financial obligations of completing their chiropractic education. 

Each spring, beginning this year, NCMIC will award one $1,000 scholarship to one student at each of the 18 chiropractic colleges in the U.S.  The scholarship is for students within the last 18 months of their program.  Applicants will be asked to submit a 500 word essay explaining their leadership style and how they see themselves contributing to the chiropractic profession in the future along with two faculty recommendations.

Application deadline is March 1st.  See your financial aid office for more details. 

Good luck!