I ask the question. 

The answer varies. 

I ask "Why?" 

The blank look I receive back is always the same.

This is how it goes when I ask chiropractic students seeking associateships what they are expecting for compensation from an employer. 

I always get a number back as the answer. 

When I ask why....what is that number based on...I get a blank look of confusion.

The point is how can you begin to negotiate a compensation package if you don't know where you need to be on a monthly basis?  And how do you know where you need be on a monthly basis?

Your personal budget.

Budgets are not just for those of you starting your own practice.  Budgets are for everyone.  Not only does it give you the understanding of your finances to help you negotiate, your budget gives you the foundation of facts you need to live responsibly and serves as a tool for discipline to reach your financial goals.

Take the time.  Make the effort.  Write your budget.  It's the best foundation to get you where you are going.

I just came back from a risk management program and had a student on his very last day of chiropractic college lament about how he was never going to be able to pay back his enormous debt.

Although I shared some encouraging words about making sure he kept his credit rating up by making timely payments and starting his practice the "lean and mean" way, I couldn't help but wonder if things would have been different if he had thought about his loans in the beginning of his educational process.

When visiting the college campuses, I see new cars in the parking lot, new i-pods and the latest in phone and computer technology in most students backpacks.

I hear students talking about their last vacation spot and overhear them planning their next big trip or big purchase "when the check is deposited."

The money that is made available to students via Federal loans, grants and scholarships are meant to assist students in reducing the debt of college, not fund the "extras" that seem so prevalent on the campuses of today. Every dollar you save by being a "Scrooge" will make a huge difference when you start planning your business budget!

Try these few tips:

• Borrow only what you need to pay tuition and books.
• Check into available work on campus.
• Tutor someone in an area of your expertise.
• Be a campus entrepreneur. My own son used to give haircuts for $5.00 a cut.
• Ask friends and family to "gift" you with money toward your loans or provide gift cards that can be used for your living expenses.
• Make your interest payments during deferrals to keep your loan balance at the original amount .

Be a "miser" when it comes to your school loans.  In the long run it will help you reach your break even point sooner than expected.

The holiday season is here which brings the thought of giving back to your community and those who are in need.  Everyone has exhausted the idea of food drives, giving away turkeys...you name it.

Here is one that I thought was clever and served multiple needs.

A doctor went to the local Wal-Mart and purchased lots of yarn.  He went to the local senior center and assisted living centers and passed out the yarn to all those lovely ladies with time on their hands. 

Most "grandmothers" have knit their share of mittens and know the pattern by heart.  And knit they did!  All sizes, and designs. 

The doctor's staff got involved in knitting too...and in fact, this grew into such a community event over the years that the skeins of yarn were in a big basket in the reception room for anyone to take.  For those who don't know much about knitting, it doesn't take long to knit a pair of mittens. 

So, then the doctor put up a tree in the office, tied the set of mittens on the tree and just before the holiday, donated it all to the local family shelter.  The local paper did a special photo article on this novel idea. 

Over the years it grew and grew...mittens for kids, adults, men, women..you name it! 

The local junior and high school got involved...patients got involved...senior centers started calling in July to order their yarn.  Mittens grew to scarfs. Scarfs grew to afgans and blankets and on and on it went. 

Local stores donated yarn, too.  What a way to give back to those most in need, get lots of press and become known in your community. 

Oh, for those of you in Florida, I guess this may not work? 

But the lesson here is to THINK OUTSIDE THE BOX.  So share your outside the box ideas.  I'm looking forward to hearing them. 

Not a day goes by that I don't receive a solicitation to "invest in the future." I'm sure you get the same requests from HILLARY, MITT, BARACK, and RUDY... just to name a few.

While you may not want, or be in a position to contribute... local, state, and national campaigns are a great way to meet not only residents, but influencial people and opinion makers.

Volunteering your "time, talent, and treasures" can be a terrific opportunity to network and build your practice. Walking precincts with a candidate is a wonderful way to meet present and future leaders as well as your neighbors.

And your efforts won't be forgotten by the candidate, when a critical issue affecting chiropractic comes up. And who better to serve in the legislatively appointed position than Dr. X who knocked on doors to "get out the vote."

Whether you walk districts, man a telephone bank, work a candidate event, host a reception, or contribute to a campaign, political activism can and should be a part of your community committment and endeavors.

While some individuals believe that religion and politics should not be discussed, getting involved in campaigns can be an effective tool in building your practice and enhancing your reputation.

And who knows... maybe one day you'll be like my friend Dr. David Brown... both chiropractor and mayor of your town!!!

GET INVOLVED.

We talk alot on this site about community involvement and how being involved can promote your practice.  But there is another community you need to think about being involved with beyond your city's business, healthcare, service and social communities.

The chiropractic community.

I attended the Congress of Chiropractic State Associations (COCSA) convention last weekend in Nashville.  I was impressed with the dedication of the doctors of chiropractic who are serving the profession in their respective states.  The conference was attended by the rank and file state association volunteers and the heavy hitters of the profession.

The sessions were informative, but what really struck me was the issues these dedicated folks are dealing with which will shape the future of this profession.  Everything from healthcare reform to chiropractic education.  These leaders are making a difference and ensuring the future of the chiropractic profession.

So when you think about your community involvement, think about the chiropractic community too.  There are many ways and organizations to work with.  COCSA is just one of many organizations working hard for your future.  Find one that matches your goals and values and dive in. 

We are all in this together and your leadership is welcome and needed.

I've talked before about the importance of complete information on your business card, but what do you do with them anyway?  Many doctors use the reverse side as appointment cards.  Others print their mission statement or personal philosophy on the back.  Ok, so now what? 

Some ideas on what to do with those little cards...

1) Set a goal of how many cards you'll pass out a day/week/month and do your best to stick to it.   

2) Ask permission to post on bulletin boards everywhere you eat lunch, workout, etc. 

3) Offer a community bulletin board in your clinic lobby where your patients can post their own business card.  They just might return the favor at their office. 

4) When you pay for a meal at a restaurant, leave a card with your check.

5) Find a couple of other health professionals in the area and agree to do a 'card swap'.  This is a great way to promote each other's businesses via personal referral.  For example, my massage therapist has a stack of my cards on her front desk, as I do some of hers. 

6) Make sure you (and your family/spouse if they are willing) are always equipped with a few of your cards to hand out. 

If you are really feeling ambitious, hand a person two cards!  One to keep, one to give away.

What have you done with your business cards? 

I see it all the time.

A new doctor sets up practice in a new community and avoids the established chiropractors in town like they might have an infectious disease.

Why?  It's not that the new doctor views the other docs as competition.  The avoidance is because the new doctor is afraid the other docs will view them as competition.

Highly unlikely.  Most doctors who are established and successful will welcome a new doctor to the community.  They will view you as a collegue and an addition to the community of healthcare providers.  Most new doctors who take a leap of faith and network with their chiropractic neighbors find:

• They open doors
• They offer access to their network and invitations to community events
• They mentor
• Sometimes they offer used equipment and furniture....anything to help

But most importantly, they are welcoming.  Don't miss this opportunity to get a jump start on establishing yourself in your new home.  Get busy networking and start with your colleagues.

I have a full-time practice.  I am also a teacher. 

As an instructor for NCMIC, state associations and Logan College of Chiropractic, I have the opportunity to travel around the United States and talk to doctors, students and staff.  It is exciting to see “The Wellness Revolution” taking shape around the United States.  Baby boomers are striving to hold on to their youth. 

Chiropractic has long been touting wellness care, however I wonder if chiropractic is missing the boat. 

In the past, we chiropractors were unhappy with the “health insurance game.”  We felt that we were misunderstood, but people came to us anyway.  They came largely through patient education and success.

In recent years, I have seen an increasing trend to give away services for free or for far less than fair market value, and for doctors to waive co-payments and deductibles. 

I feel it cheapens your services, but more importantly, it is illegal to waive deductibles and co-payments.  As far as I know, it is illegal in every state of the United States to participate in No Out Of Pocket Expense (N.O.O.P.E).

The Office of Inspector (OIG) releases a goal sheet for the next fiscal year called their Work Plan. 

This is a heads up as to what are the major issues for fraud at this time.  Other insurances typically read this and also set out to investigate these issues.

On the OIG Website, for the first time in my recollection, chiropractic has been specifically named as being targeted for high frequency of treatments and health care in general, for waivers of co-payments and deductibles.

No matter what you perceive the status of the economy to be, most everyone has some degree of expendable income.  This is money that they spend on frivolous things. 

A recent trip by my wife and me to the movies cost $15 for the movie and another $16 for popcorn and soda.  Is $31 for a movie, popcorn and a soda perceived as more important than chiropractic treatment? 

Is this a trend in our profession to “lure” the patient in for care?  If so, then we all need to do a better job at educating the public and marketing chiropractic.

Is there hope?

OK...let me expain.

While at the Congress of Chiropractic State Associations (COCSA) meeting in Nashville last week I learned an easy way to support chiropractic research and education.  And it doesn't cost me a thing.  It just requires and extra click of the mouse.

The Foundation for Chiropractic Education and Research (FCER) has teamed with Amazon.com.  If I go to FCER.org first and click through to Amazon, FCER gets dollars for every purchase I make.  Doesn't matter what it is.

So when I went out to Amazon this week and bought Kanye West's CD, Madonna's concert DVD and Hemingway's Old Man and the Sea, I went to FCER.org first.  I would have made the purchases anyway.  May as well support chiropractic while I'm buying.

The wildfires in California are an unfortunate reminder of how fragile our environment is and how we can suddenly be faced with a disaster of catastrophic proportion.

Is your practice ready?

Most are not.  Most practices operate under the assumption that the bad stuff will happen to someone else, somewhere else. 

This ostrich-like thought process is a recipe for potential devastation for your practice and your patients.

I urge you to be prepared for the unthinkable.  The Disaster Recover Journal offers some guidelines and insights to help you prepare as does the Disaster Recovery World website.

Many chiropractic state associations have addressed the issue for their members as well and I encourage you to check the resources your state offers.

When you are setting up your practice's policies and procedures, don't overlook your disaster recovery processes.  It could mean the difference between successfully surviving a catastrophe or being one of its victims.