An open house is an opportunity to open your doors to people from the community and future patients.  I decided to do this because I wanted to give back to my current patients, get my name out in the community, and to show the community what I had to offer. 

This could be a daunting task, but I wanted to keep it simple.  I know many will say not to do this in the winter but my brainstorm of ideas hit me at the end of October, so my fiance (who is now my wife) decided it was a good time to try something different.

OK, I knew it would be cold, but prayed that it didn't snow because snow in any amount would deter visitors.  

We knew we had to let people know when and what we were doing.  So with a little legwork we gave brochures out to local businesses and active patients.  We sent out 300 postcards to inactive patients and did a small newspaper ad. 

Not only that, I sent out invites to everyone in my email inbox.  In the brochure and newspaper ad we described what was to be expected, times, and free food and beverage.  Next we cleaned the office inside and out, although the office is always clean we did some housekeeping.  We had muffins, trail mix, and light snacks, coffee, punch, and water for beverages.  

The weather held up and we had about 25 people show up, which wasn't bad considering the time of year.  I showed new people around the office and talked with my current patients about a bi-monthly mini lecture series I was doing in office starting the new year.  Altogether it was a nice night. 

The hard part for me about the open house was not knowing if 10 people or 100 people would show up.  My goal was to have 10% of the people who received postcards attend. So we were pretty close! 

I was pleased with the open house, I know you could go over the top with something like this but I opted to stay simple. 

Don't fear about the unknown and don't be afraid to try different things ... current and future patients appreciate the effort

The headlines are everywhere.  The economy is struggling.  Many companies have faced layoffs, cutback the services they offered, seen their profits disappear.  Some have even totally collapsed.

Now more than ever, you need to assess the companies you do business with.  This is another area where price is not the only thing to consider when buying a malpractice insurance policy.

One of the biggest concerns when buying an insurance policy is whether the company will be around for the long haul and be there for you in the event of a claim.

With the current issues in the financial sector, you need to do your homework.  Here are some things you can do to assess the condition of the insurance company you are researching:

• Find out the company's AM Best rating and the trend of that rating over the past several years. A downward trend means the company is dealing with some financial stability issues. 
• Ask how long the company has been in the chiropractic malpractice business.  A company with few years in the business is less likely to remain serving chiropractors for the long haul.  One step companies may take to make it through rough times is to cut back services and pull out of markets they have not served very long.
• Find out who owns the company.  Is it a mutual company (owned by policyholders) or publicly traded? 
• Read up about the company.  Try to determine their involvement in the chiropractic community, reputation with other chiropractors, how well they serve their policyholders.  A well respected and involved company is more likely to be in this market long term.

Bottom line:  You want a company that will be there when you need them. 

Not too long ago, I changed office locations. After 15 years I moved about one mile to a spot I'd had my eyes on for a long time which became available. It's in the downtown corridor and centrally accessible for the region.

The one story building has one other tenant, that being a national real estate affiliate office. My suite had previously been occupied by a printing company which they'd outgrown after 25 years. The interior needed to be totally gutted, reconfigured and brought up to current code requirements. While having an idea about my needs and what the space would include, I also knew that I needed professional assistance.

I met individually with both an architect and interior designer who each asked several questions. They wanted to know about my staff, equipment, patient volume, x-ray, the "type" of patients that I had... and those that I hoped to attract.

I recall the architect and I standing outside of the office, reviewing the surrounding structures and discussing possible alterations to enhance the exterior of the building.

The interior designer and I visited a job which she was completing, that of a plastic surgeon. His specialty was cosmetic procedures and his instructions to the designer were  "make it feel as if you're in a 5 star hotel." Needless to say, there was lots of marble, leather, dark wood and trim, where  "the rich and famous" might feel right at home. 

Over the years I have had the good fortune of treating people from all socio-economic sectors. This has  included senators and politicians, dishwashers and constructions workers, generations of families and the homeless. While visiting a 5 star hotel is nice, my goal was to have a clean, professional facility where anyone from any group would feel welcome and comfortable in the surroundings.

As you plan and make modifications to your office, ask yourself if the image presented by your facility is one that serves your current patients and those you desire to see.  Naturally, patients want to receive quality professional care, and be comfortable in the an office's location and environment.   

Happy Days!  

The "New Year" is always a good time to review your office policies and procedures.  If you have not done so, establish a verification procedure for your practice that will serve to give clarity to the patient and the office.  Here are some steps to follow:

Group Insurance:

1. Make a copy of the patient's insurance card for your file. 
2. Call the verification number on the card to confirm benefits and co-payments.  Remember, co-pays and deductibles can and sometimes do change the first of the year.
3. Confirm the address to mail claims or the process for electronic submission.
4. Complete your insurance verification form and review these notes with the patient.

Managed Care:

1. Make a copy of the patient's insurance card for your file.
2. Call the verification number on the card to confirm benefits and any referral/precertification requirements.
3. Confirm the address to mail claims or the process for electronic submission.
4. Same as #4 above

Auto/Personal Injury:

1. When the patient makes an appointment, request a copy of the accident/policy report for their file.
2. Request the patient bring a copy of their insurance policy declaration page.
3. If represented by an attorney, have the patient sign a lien protecting your payment. Send lien to attorney using email (fast, efficient and you can request a receipt of email).
4. Have complete information regarding the attorney, law firm, address, phone/fax numbers and email address.
5. Same as #4 under Group Insurance,
6. NOTE:  Personal Injury Protection benefits vary by state.  Check the State Dept. of Insurance website for coverage guidelines.

Workers' Compensation:

1. Request the patient bring a copy of the notice of injury filed with their employer.
2. Call the employer to verify accident was reported.
3. Request name, address and phone # of employer's Workers Compensation carrier.  Call the carrier for address, phone, email address to use for submitting bills.
4. Same as #4 under Group Insurance.
5. NOTE:  Workers' Compensation benefits vary by state.  Check the State Dept. of Insurance website for coverage guidelines.

Medicare:

1. Make a copy of the patient's Medicare card for the file.
2. Call the verification number on the card to confirm benefits under Part B of Medicare coverage.
3. Confirm address to mail claims or electronic submission procedures.
4. Same as #4 under Group Insurance.

Taking the time now to establish clear procedures saves time and energy cleaning up unpaid billings.  And don't forget to clearly define your cash policies.  If you do not take MC/Visa in your practice, now is the time to apply to become a merchant.  Contact NCMIC for options available.

One of the by-products of our high-tech society is the often-asked question "What technology have you found to be of the greatest value?" 

I must say that it is my Global Positioning System (GPS).  It has guided me to my destination in virtually every sector of the United States from the mountains of Colorado, the multitude of California freeways and the maize of Boston's streets and avenues.  My trusty Garmin always gets me to my destination with a most accurate time of arrival and constant consideration for speed and unexpected detours.  It would be difficult to return to the emptiness of pre-Garmin days.

Trying to figure out where you are and where you are going is probably one of man's oldest past-times.  It finally took the Department of Defense and an expenditure of $12 billion to build something that has changed navigation forever.  With the push of a button and the input of a location you will know exactly where you are, the route to your destination (within 25 feet) and the time of your arrival.  What a marvelous boon for those of us who are "direction deficient."

How many of you who read these blogs are direction deficient as it relates to "Where am I in practice?"  "Will I start my own practice?"  "Will I seek employment in an established practice?"  "What are my career goals for the next year, the next 5 years and onward?"

Might I suggest that there is a Practice Positional System (PPS) available to you?  It was not funded by the federal government.  It was built by the collective experience of those of us who write these blogs ... the cumulative experience of well over 200 years in and around the profession.

• Be clear as to where you are in your profession and business life. 

• Be sure that your goals and objectives are committed to writing and are specific. 

• Set goals that push you to the discomfort zone and above all be willing to pay the price of time, focus, hard work and sacrifice in order to achieve the objective. 

• Set time limits in the planning process.  Do not procrastinate ... procrastination is the loving friend of failure. 

• Remember your goals and objectives on a daily basis. 

• Have a magnificent obsession with the achievement of your objectives...do not allow detours on your path to achievement. 

Surround yourself by those individuals who embrace your dream.  Your PPS will take you to your destination as long as it is energized by your discipline, focus and clarity just as my GPS will get me to my destination as long as the power source is viable.

In a perfect world, we'd all have wellness practices full of patients who come in for chiropractic check-ups with few symptoms because they follow your recommendations to the letter.

They'd complete their full treatment plans, pay their bill, and refer others. 

Hopefully these things are happening in your office, but undoubtedly a shift has occurred in today's economy.  Let's face it, we're all trying to cut back these days, but you have a practice to keep afloat, so how do you deal? 

Now is the perfect time to re-think your expectations. 

I am often an optimist, but always a realist.  Will all employers continue to provide abundant chiropractic coverage in the face of company layoffs? 

Doubtful. 

Will a cash patient complete the entire treatment plan if they are struggling to pay the utility bill?  

Nope. 

Will you continue to lecture from the pulpit on the importance of wellness care?  

Ahhhh...but it is important you say?  Yep. I know it. You know it. Your patients quite likely know it too.  

However, times are tough, so relax and be there for what you patients need you for.  For some patients that might be symptom care.  Nothing more.  They'll leave when the pain is gone and come back when it returns.  You can reject them for 'non-compliance' or you can educate them on the importance of preventative health care. 

They are listening, they just may not be able to act right now. 

Don't beat your head against the wall because some patients aren't following your well-devised treatment plan.  If you've done your best, they probably are, too. 

What does this translate to?  Much needed sanity for you and a practice full of appreciative patients ready to refer a neighbor in pain!  

If you haven't noticed, Medicare (CMS) has posted the new reimbursement rates for 2009. 

For the first time in several years, the rates have actually gone up!  The deductible has also stayed the same as for 2008 at $135.  Deductible amounts are only for covered services.  Non-covered services are not applied to the deductible.

You can look up the rates for your local area by going to the local carrier for your state. Once in the web site, you will want to look under the New Fee Schedule for your local area.  If you do not know your region, you can look it up by zip code.  These fees went into effect on January 1, 2009

The fees listed under spinal manipulation will be broken down into fees for

• Participating Physicians
• Non-Participating Physicians
• Limiting Fee

Depending on your classification with Medicare, you can note your fee.  There will be two sets of fees.  One will have a pound sign (#).  The pound sign is for a facility setting, such as if you do manipulation in a hospital, nursing home or a home-visit. 

Don't forget to use the appropriate "Place of Service" code for your service.  The place of service code for your office is 11.

Once in a while there is actually something good on TV.  Besides the recent return of American Idol, that is.

A&E has a show where a business guru, a tech wizard and a designer go into business that are struggling and do a makeover.  It's called "We Mean Business".  The leader of the trio is Bill Rancic who won the first season of "The Apprentice."

Well, guess what? 

The team tackled a chiropractic practice in a recent episode and I was enthralled.  The issues this doctor faced were not unusual.  He's a talented chiropractor, but just did not have his act together to get the practice off the ground. 

After three years, he was still struggling to make ends meet.

Here's the link to "We Mean Business".   Look for the episode called "Spinal Fit".  Enjoy!

Happy New Year everyone!  Nothing like a horrible economic outlook, world security issues, and change in our government to make things all sorts of fun. 

Yup, people are about as insecure as they possibly can be when it comes to their spending habits, as well as their very futures.  Unemployment is expected to rise over the next year, wages are going to stagnate, it is one great big roller coaster straight to hell... WHEEEEE!!!

Phew, now that the pessimism is out of the way, let's talk about opportunity.  Now is a great time to be a chiropractor. There are several reasons people need us more than ever. 

• Number one: people are stressed to the max!  Their shoulders are tight, they are having headaches, they are not exercising as much, THEY NEED HELP! 
• Number two:  Aside from mortgage issues, the reason for most bankruptcies is medical bills.  The medical profession and insurance companies are actively pricing themselves out of the market.  The public is looking for cost effective solutions to maintaining their health and dealing with issues that arise. 
• Number three:  We have excellent bedside manner/ doctor patient relationships.  People want someone to hear them, to talk with them, to work with them.  They are not looking to be dictated too, especially now. 

There are many more reasons, but those are a few that I have been noticing frequently lately.

The question is though, how do you engage the public in your services.  Again, with the poor market people are acting a bit more skittish.  This doesn't mean that they are unwilling to spend, it is simply that they want to have extra assurances that they won't be wasting their money.

The public needs to know you.  I feel that an effective marketing strategy for the beginning of this year especially (and generally good overall) is to get back to beating the pavement. 

• Meeting and greeting.
• Taking people out to lunch. 
• Personal one-on-one relationship building. 
• Developing your network. 
• Getting out and talking to people.

My marketing has gotten a bit lax in the last few months. I have been relying fairly heavily on radio and TV ads for my office.  These ads have been effective, but I was noticing my numbers dipping near the end of the year. 

I pulled out my old idea book and I started doing talks around my area on topics like exercise, and ergonomics.  Again, back to the basics.  I have seen my numbers returning to the higher levels that I experienced over the summer with a few weeks of starting that.

There is a reason we do these things more when we first start:  they work.  There is also a reason we tend to stop doing them as we get into practice:  they take a lot of work. 

It is a bit of a Catch 22, but work on altering your strategy a bit.  Pace yourself.  When I first opened up, I was to the point where I was doing 4 to 5 talks a week.  This wore on me after a while.  Now, we are focusing on 2 or 3 a month.  Consistent, but not overwhelming.

The opportunities are there.

P.S.  I have truly put my money where my mouth is this time.  Not only am I saying this is a good time to practice, I am opening a second office.  I'll keep you all posted on how it does.

Over  the month of December, my partner and I were very busy delivering holiday gifts to the hospital departments and health care practices in our community.  We have been doing this for several years and always give the same wonderful box of roasted peanuts.  

When the holidays are coming closer, people who receive these gifts make sure that they are on the list as they love the peanuts!

The important aspect of this tradition is not the actual gift which we are fortunate that they enjoy, but the actual face-to-face when we deliver the peanuts. 

It gives us an opportunity to PERSONALLY thank them for the referrals and wonderful care that they provide for mutual patients. Sometimes they need a little reminder of you and your practice and this is a non-aggressive way of networking. 

Be sure to include the diagnostic departments that you use as they are usually overlooked when it comes to holiday gifts and the least appreciated over the course of the year.  I find these people appreciate the gifts the most.  When I get an x-ray or MRI report from the hospital, the women sending the report always sign the cover sheet and add a smiley face!