Technology is driving our society so that we rarely step back and ask, “Is this really the way I want to communicate?”

Think about Maslow’s hierarchy of needs which identifies the most basic of needs at the bottom of the pyramid and the more complex at the top of the pyramid. In communication, there is a similar “needs triangle” in which there is the inverse value of time and money.

The more money you spend on communication vehicles such as direct mail and television ads, the greater the distance between you and your audience.  When more personal time is spent, the less dollars are required and the more individually effective the communication becomes.

Nothing replaces a look in the eye and a handshake to begin a relationship and convey a sense of confidence in the individual.

As simple as this may be, a handshake is still the most effective manner of communicating today despite the Blackberry, i-Phone, computer, telephone solicitation or annoying and ineffective blast fax. 

In this world of high-tech depersonalization, a young practitioner’s best communication tool might be the low-tech handshake:

• Use the powerful handshake with every new patient upon introduction.
• Use it with visits within the community.
• Use it every opportunity you have - this powerful force that has been used since the beginning of time to establish rapport.

Sometimes we simply need to look at our hands as therapeutic systems and communication tools combined into one very versatile and economical ally. They are always with you and never need charging.

A couple months back, I wrote about an unfortunate office water leak.  The cloud did have a silver lining as I was reminded that reactions are more important than actions. The carpet was in need of replacing anyway, and it inspired us to update the entire office with new paint and decor.

Oh, and I got a new patient out of the whole mess.

Have you ever heard the saying that bad things run in three's? Well, I hope someone can enjoy the following comedy/tragedy. I hope you laugh so hard you cry ... I'm still waiting to laugh.

On a beautiful Sunday morning, I arrived early at the office - coffee in hand, ready to paint the lobby/reception area It had been sleeting for three days and we finally had a sunny day. It was too nasty outside, so I was settling for a productive, indoor project.

I walked down the hallway and something appeared in my peripheral vision.  At first startled...I gasped in horror as I saw two square tiles and insulation dangling from the ceiling.  Another water problem?

Any other year, this would have been an unpleasant problem to a business owner.  But to me, after all this...it was nauseating.  From the words of a popular TV show Grey's Anatomy (my guilty TV pleasure)...  

"Seriously?  I mean, seriously?"

First things first ... bucket under the leak. There didn't appear to be any dripping water but everything was soggy.  Up on the ladder next to climb up into ceiling with a flashlight ... ahhh, there's the problem. 

Attach a smaller bucket to a rafter with bailing wire (hey, I'm learning as I go here!) 

Call insurance adjuster (again) who thinks I've GOT to be joking!  

Call someone who knows how to fix these kinds of things.

Mercifully, this was in a room I could close off for a couple days.  Oh, and that "third bad thing" concept?  Due to the ice that weighed down the roof and caused the leak, we lost electricity and had to close the office on Monday.  AHHHHHH!!!

"That which does not kill you makes you stronger"

But what about that which merely drives you insane?

Very rarely is my office closed besides holidays as my partner and I try to make sure that our committments or vacation time are not in conflict. However, there are three times over the course of the year that we are both gone and the office is closed. 

So how do we deal with getting coverage?

We do not have another doctor come to our office but instead make sure that there are two other D.C.s in the community that our patients can contact for emergencies.  After making arrangements with the docs, we put their names and number on our answering machine with the date we will return.  Of course there is the standard message recommending they go to the ER for any emergency and contact the family doctor, etc.

The DC's we make arrangments with know that our office will accomodate them as well when they need our help for their offices.

When we return, if any of our patients were seen by another D.C., the progress notes for that visit are on the fax machine with a note on the cover letter stating the patient was instructed to contact "THEIR" chiropractor for follow-up.

This is the type of professional courtesy that needs to be shown to other D.C.s in your area and not seen as an opportunity to steal a patient. 

One time, I asked a new D.C. in the area if I could use his contact info for my patients while we were gone.  He saw one of my patients but never sent reports and continued to re-schedule the patient. 

After the patient recovered from that injury, she again returned to my office for regular treatment and informed me that the D.C. who was suppose to be covering for me told her that she needed to see him as long as it was for "this condition" or the insurance would not pay. 

Needless to say, there is no longer a professional relationship between our offices.

There are plenty of people out there who would benefit from chiropractic care so there is no need to try to take existing patients from other practices.

I have just returned from one of many conventions and homecomings we attend. I am always amazed at how many opportunities are passed up by D.C's who fail to carry business cards.

For instance, just on my journey to the convention, I passed out three cards. One was given to a man sitting in the terminal at Chicago O'Hare. We gabbed about his limp, which in turn was related to his back. I happen to have a friend who is a chiropractor in the man's city and voila! a new customer.

Another card was given to a man on the plane who happened to know an old friend of mine and would pass on the information. The third card went to a woman who needed a product we sold! That was just on the way there!

At a convention, you'd expect vendors to have business cards, because we don't want to miss any sales opportunities. But what about doctors of chiropractic? If D.C.s serve less than 10% of the population, wouldn' t you think having business cards might be an inexpensive marketing tool and give them an edge in acquiring new business or business opportunities?

Even in school, cards with general contact information can be used to:

• Foster new relationships
• Provide information on chiropratic
• Make buiness contacts
• Show professionalism

It goes back to the old addage. "You only get one chance to make a first impression!"

Make it a special one. Hand out a card!

I've been involved in the Starting into Practice seminars for going on four years now.  Every time we do the program, there is a slide that discusses the reasons that businesses fail.  What is interesting about this slide is that what actually causes business to fail, and what we perceive to cause business to fail are not the same.

Most students, myself included, strongly believe that the key to keeping a practice running is marketing and bringing in new patients.  However, the facts show that the number one reason that we go out of business is due to money management issues.

I learned harshly how true this is the past few months.  The story itself is long and involved, so I will give you the cliff notes. 

We were required to change our electronic claims filer here last year.  Why we were required is an issue unto itself, but that is for another time.  When we switched over in October, my revenue dropped by 80% overnight!

At first, I wasn't too worried.  My staff is awesome; they know what they are doing, and I was sure the company knew their product as well.  It was just a bug.  It would be sorted out. 

Then a month went by, then another, and another.  I keep a three month overhead buffer in my account just in case.  By January, I had burned through that.  As I approached my 6 year anniversary, I had to take out a line of credit to cover my overhead expenses!! 

Scared doesn't even begin to describe how I felt.  The worst part was that I continued to be busy in the office, yet it just didn't matter.

To make matters even worse, no one knew what was happening.  The company was blaming my staff, my staff was blaming the company, and I was just sitting there asking people to please tell me what the hell was going on! 

Things finally did get sorted through, 4 months later.  We are not quite back where we were, but we are recovering.  The bottom line is this.  Know your business and the inner workings of it.  Seeing my dream almost evaporate because of computer problems was very scary, but fortunately, I do have a good team around me that figured out what was happening and got it fixed.

I went to a new shop to get my hair cut the other day. 

I won't be back.

I got a decent enough haircut.  I liked the person who cut my hair.  The environment was friendly, cheerful, and clean. It was even close to my home.

One big problem.  They take cash or check for payment only.

Really???  I rarely carry much cash and I don't even know where my checkbook is.  Last time I wrote a check was August 2009.  I do everything through online bill payment or....

Plastic.

If a business won't take credit and debit cards, it is extremely inconvenient for today's consumer.  Furthermore, as a healthcare provider, if you don't take cards, I have to do a bunch of paperwork to access my Flex Spending Account or my Health Savings Account.  I don't want to do that.

I've heard the argument from chiropractors who don't take cards.  It is a hassle and the processing services cost money.  I would argue that it will cost you more in the patients you lose.

Your practice is patient-centric in all other respects.  How your patient pays should be as well.

Last week, I was invited to attend the first board meeting of the year for a large community organization which has existed for almost 100 years. The board includes 35 senior executives, businessowners and community activists. Generally, members serve staggered terms of three years, and as a result, there were approximately 12 "new players" in the room.

As with many meetings of this type, several familiar faces and friends were present. Those new to the organization, were asked to stand and share a bit about their business or group.

I was introduced previously as an observer/adviser by the chairman, who was most generous in his reflecting that he was "able to stand up straight" as a result of my services.

As people arose to give their self introductions, it was interesting to listen to their mini-presentations. Quite candidly, they were all over the board...some being short and sweet, others rambled and were somewhat scattered, with some being perfect and directly out of "central casting." 

Following the meeting, I personally introduced myself to all those I did not know. I spent considerable time with a person who had described a service which may be beneficial to my practice and we've scheduled a followup lunch.

Every day, each of us in our personal and professional lives, has numerous opportunities to make a first and hopefully positive impression and it's important to put your "best foot forward."

Do you have a short "elevator speech" which succinctly describes what you do and how you might be of service to others...and if not, how about formulating one for the future as no doubt, it will be useful along the way.

How would you introduce yourself?

Happy days!  

Dr. Braxton Pulley, one of our stalwart bloggers here at StartingIntoPractice.com, has been named one of Des Moines, Iowa's "40 Under 40." 

This is kind of a big deal!  This honor is awarded by the Business Record newspaper and is not easily earned.  The Record looks for young leaders who are not only successful business people, but leaders in the community and are making a tangible impact on Des Moines.

I'm honored to work with Dr. Pulley through NCMIC and currently serve on a non-profit board which he chairs.  I get to see firsthand the impact he is having on this community.

Congratulations, Dr. Pulley!

I remember years ago during the boom of computers when every company told you that their computer would "eliminate paper" and keep you clutter free...NOT!

After just moving my office, I found that my drawers and cabinets were full of useless "stuff".

Here are some steps to help you decultter.

1. Feed the wastebasket.  Get rid of what you don't need.  If you can honestly ask yourself the question "if I throw this out, do I know where/how to find it again" then you are ready to toss that paper.
2. Skim material as soon as it arrives.  Do not skim junk mail...toss it.  Skimming can at least help you qualify what/where to save that item for another review.
3. Pass on to the appropriate person to handle. 
4. Find a place for everything worth keeping and put the papers where they belong...NOW...not a week from now!
5. Ask yourself: Do I really want to be caretaker of this paper?  Do I really want to devote precious space to this?  Probably not.
6. Handle each piece of paper only once...which means you can now eliminate #2! 

Bottom line: free yourself - get rid of it!

P.S.  Take a good look at your computer files. They probably are an electronic version of your paper saving habits.  Once a year I now back up "everything I might need someday" on a thumb drive and purge it from my computer.  Funny, I just found the 2007 and 2008 thumb drives. I haven't opened either since I created the archive. Hmmmmmm.

Why did you choose to become a chiropractor?  Why did you choose to practice where you are?  If you can answer those questions with authenticity then you have a story to tell. 

In my instance, I became a chiropractor because my father had a health problem that was resolved through chiropractic care.  It was not unusual for me to go to the chiropractor's office with my dad and I was impressed with the office environment and the friendliness to the staff and how my father responded to care. 

As the years moved forward and the time came to make a decision as to my future, the idea of becoming a chiropractor fit quite well.  I chose to return to my hometown to practice...a marvelous community on the ocean, proximal to Boston and all the pluses the community had to offer. 

I do not know how many times I shared that story with people that I would meet; but somehow this story resonated with them and, in time, many became patients of mine.  The story was true and the words I chose to use were congruent with my inner being...warm and believable.

What is your story?  Is it real or contrived? 

People who you have not met before and who you come in contact with you on a daily basis are truly interested in "your story."  If it is fabricated and not one of congruency, it then becomes a fable and people know it.