The hiring process was not what I had expected. 

We (my wife, Melissa, and I) started with an advertisement on Craigslist seeking a motivated and trustworthy applicant for a receptionist position.  This was free advertising and other offices that I talked to said it would be a good starting point. 

The first week we had 25-30 applicants who emailed us, expressing interest in the position.  Just by email alone we figured we had potentially 10 strong applicants. 

We invited those 10 applicants to stop in to introduce themselves, fill out an application, and drop off their resume.  Just by doing this, we narrowed the field to five.  We called the remaining five for a personal interview. At this point, it started to get more difficult to determine the best fit for our office. 

After the interviews, Melissa and I talked about who we thought was a good fit and most qualified to join our practice.  

It definitely was an interesting process - one that you do not want to take lightly. We tried going by the book - the only thing we neglected was the background check.  I know that a background check is important, but we relied on references and past employment to fill in that blank.  

The first day consisted of paperwork (W-4, social security, and drivers license) that was faxed to my accountant. From my understanding, much of this is to make sure of legal citizenship. And then we focused on the introduction to office procedures, and patient filing and charting. 

Billing and coding will not be introduced until regular/daily operations are mastered.  

I'm figuring on a month's transition to get the new employee acquainted with the office and everthing that comes with front desk operations.  It was understood that during the transition, wages would be lower and then after the first month wages would increase to a competitive rate.  

A yearly review will be implemented and any questions and/or concerns prior to would be handled accordingly.

Overall, the hiring process was not as bad as I had initially anticipated. We'll see what the next few months will bring.

If any bloggers have suggestions on when and how to introduce new staff to billing procedures, please leave a comment.  

While attending both undergraduate and chiropractic school, I worked as a waiter at two very nice steakhouses. Not only did I do well financially, but I learned several lessons which have served me over the years. Both restaurants shared a similar philosophy: "THE CUSTOMER IS ALWAYS RIGHT!"

I'm sure that most would agree that while we're in the business of healthcare, it's also a service-related industry.

Regardless of how hard we work at providing excellent care, unfortunately from time to time a patient may be dissatisfied with something about our offices. It might be a staff member, the time spent waiting to receive treatment, your office decor, fees, or your particular practice methods.

Whatever the case, "handling an upset" in a timely fashion is important to you and your success.

A few things to consider as you address a particular "patient issue:"

• LISTEN: Allow the patient to describe [vent] the problem without interruption.

• ACKNOWLEDGE: Demonstrate that you understand their feelings and apologize or address.

• INVESTIGATE: Research the problem and plan how you will attempt to correct/rectify the issue.

• COMMUNICATE: Follow up with the patient and discuss how their concern has been resolved.

Complaints can be unsettling and disruptive to any practice or business. Often they can be solved easily and involve a simple misunderstanding. The key is communicating that you understand the concern and will do your best to resolve it.

As a very successful business friend of mine once shared, "A satisfied customer will tell one person, but a dissatisfied customer will tell ten!"    Happy Days.

Life is beginning to return to our nation.  Green will soon replace the dreary grays and whites of winter.  Outside is becoming an option for activity.  People, animals, plants are ready to spring forth as we transition into warmer weather.

As part of this ritual, we engage in a process of cleansing, a process of renewal, a process called spring cleaning. 

We dig through our mountain of crud that has accumulated over the past several months to a year.  Clothes, magazines, sundry items, ideas, etc.  We purge through these items and open ourselves up to new potential and new stuff to fill up our lives, our homes, and our offices.

While you are going through this process I have a suggestion. 

We all have that file.  You know the one I'm talking about. 

It is our seminar notes / marketing ideas / patient education processes, etc.  This is the file that holds ideas that we either did use and got away from, were going to use but never did, and so on. 

Dust them off, clean them up, try them out for size.  There are so many things that work in marketing and chances are you have been exposed to these ideas. But they be stashed away in the file waiting to be rediscovered.

Open up that file and clean it off. 

Get back to the basics. 

What were you doing when you first opened that seemed to work so well.  Re-invigorate your practice and have some fun while you are at it!

For example, a simple idea that I had forgotten about but brought back into play was a dialog I had been using to help explain the relationship between ligaments, bones and muscles. 

I tell my patients to look at the walls and the doors around them as the bones, you opening and closing the door are the muscles, and the hinges are the ligaments.  It is a simple way to give them an idea how things work and what it means to have an injury to one of these areas.  People connect with the idea, and it makes it easier for them to relate their injuries to their friends and family.

Try to take one older idea that is in your file and air it out and see what happens.

Have a wonderful spring!

Unless you have been living under a rock, you are undoubtedly aware of the push by President Obama and Congress for universal health care. 

In a speech at the University of Iowa, President Obama said, “…my health care proposal will ask hospitals and providers to collect, track, and publicly report measures of health care quality. We'll provide the public with information about preventable medical errors, nurse-to-patient ratios, and hospital-acquired infections. We'll also start measuring what's effective and what's not when it comes to different drugs and procedures, so that patients can finally start making informed choices about the care that's best for them. And instead of rewarding providers and physicians only by the sheer quantity of services and procedures they prescribe, we'll start rewarding them for the quality of the outcomes for their patients.” 

One mechanism for the measurement of quality care has actually already been established under the Bush administration when Congress passed the 2006 Tax Relief and Health Care Act (TRHCA).  

It is time for the chiropractic profession to take the initiative and participate in these programs, before the time has passed and we are on the outside looking in.  For the future of our career, our profession and our patients, I am urging you to participate in the Physician Quality Reporting Initiative(PQRI).

The PQRI was first established in 2006.  This voluntary program is open to all providers possessing an NPI number. 

The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) made the PQRI program permanent, but only authorized incentive payments through 2010. 

Providers who are eligible and who meet the criteria for submission of the quality measures data for the services they furnished during the reporting period, January 1, 2009 - December 31, 2009, will earn an additional payment of 2.0 percent of their total allowed charges for covered services (spinal manipulation) furnished during the 2009 calendar year. 

Claims with the required participation codes must reach the National Health Claims History (NCH) files no later than February 28, 2010.

The Categories of Codes included in the PQRI are as follows:

Pain Assessment Prior to Initiation of Patient Therapy and Follow-Up                   
Percentage of patients aged 18 years and older with documentation of a pain assessment (if pain is present, including location, intensity and description) through discussion with the patient including the use of a standardized tool on each initial evaluation prior to initiation of therapy AND documentation of a follow-up plan                 

Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)            
Documents whether provider has adopted and is using health information technology. To qualify, the provider must have adopted and be using a certified/qualified EHR

Functional Outcomes Assessment in Chiropractic Care   
Percentage of patients 18 and older with documentation of a current functional outcome assessment using a standardized tool AND documentation of a care plan based on identified functional outcomes deficiencies.

Check with your state association or the ACA for instructions on how to file the claims.

There's a lot of buzz these days about integrative healthcare and for a few it's akin to crossing enemy lines.  

However, I am one of the many new generation D.C.'s. 

We learned of the Wilk v. AMA lawsuit in school, but didn't live through that degree of opposition.  We respect the struggles of our chiropractic ancestors but honestly can't wrap our head around that level of scrutiny. 

I myself, look forward to conversations with 'traditional' medical providers and recently had an opportunity fall in front of me.      

So, I'm asking you, fellow bloggers and readers alike for a little guidance...

I've been invited by a local M.D. to join his satellite clinic as part of his specialty team of physicians.  He'll offer primary care full time and have a rotation of specialists throughout the week. 

It's an attractive idea to me because the location is in an area I already draw patients from - but compliance is an issue because of the distance.  I'm hoping to see those established patients more as well as direct referrals that may not otherwise consider chiropractic care.

Aside from the obvious "overhead vs. profit margin investigation" - what are the pros and cons?  Has anyone had an experience working with another provider outside of our profession?  Are there any resources available? 

Please comment below - I'd love to hear your thoughts. 

Last November I had the privilege to be among thousands of people participating in the Susan B. Komen Breast Cancer walk in Phoenix, Arizona.

The cause of finding a cure for cancer is dear to me because, like  many participants, I have lost friends and family to the dreaded disease. It delighted me to know that one of the sponsors was the Arizona Association of Chiropractic.

As a gesture of partnership, I had their logo printed on the shirts that my friend and I wore throughout the race. That logo along with the 62 names of friends, family and strangers I had met at airports were proudly displayed on our backs throughout the walk. Many passers-by remarked about the logo and I was able to promote chiropractic through an event so dear to my heart.

On day two of the three day, 20 mile a day walk, a sweaty young man in combat boots stepped up beside me. His steps were slow and halting, his face beet red from the sun.

I recognized the "blistered" walk immediately as I, too, felt like I was walking on painful water pillows. He pointed to the logo on my shirt which catapulted us into a conversation on alternative health care. 

He talked about his reservations of chiropractic care, citing bad press and poor reports from unnamed acquaintances. I was able to share my experience, not as a DC, which I am not, but as a patient. We laughed and joked about our sunburns, our aches and pains and the fact that we had only 16 more miles to go for the day.

As is the custom of these walks, I then asked who he was walking for.

He looked at me, tears welling in his eyes and said nothing. We walked together for well over another hour, both in tears, me reaching out to offer a comforting touch on his arm, he responding with a bob of his head.

When we arrived at the next water stop, he stopped, faced me and shared that his wife had been the one to volunteer for the walk. He had not. A couple of days before the walk, his wife had been diagnosed with stage four breast cancer.

He was walking because she could not.

Surgery was immediate and she was lying in a hospital 200 hundred miles away insisting that he take her place.  He thanked me for stepping in beside him, walking in the silence he needed, sharing the pain he was feeling. At the end of the day, as we hugged goodbye, both wiping the wet from our eyes, he smiled wide and promised to see a chiropractor upon his return home.

I didn't have an agenda that day. I didn't want anything more than to offer a shoulder to someone whose need I recognized and whose name I don't even know.  A simple chiropractic logo gave me an opportunity to help someone and in doing so maybe change a mind about a wonderful health care alternative.

Twenty miles never seemed so short.

Do you have an experience that might have changed someone's mind about chiropractic you'd like to share with us? Just comment below and let us all know!

If you watched the presidential address on Tuesday night, you heard that healthcare reform will be one of the three major areas of focus of this administration.  And I know that this has been mentioned by every president over the past four terms, but for some reason, maybe it was the tone he used ... I think there will be a change.

But what will that change be and how will it affect the chiropractic profession? 

I may not be a politician or political analyst but I believe the influence that our association has on Capitol Hill will be the most important factor.  If you do not have the time or personality to get politically involved, support the profession financially by being a dues paying member of your national and state organization.........and you might want to do it today!

Many say they can not afford it and I can appreciate financial constraints.  But with everything going on right now ... can you really afford not to?

If our political associations are weak, we stand little chance to be heard over those stronger than us in terms of finances and support/unity.  And like it or not, other groups in healthcare are all vying for a similiar position of influence.  Looking at the positive points we have to offer:

We can help lower the cost of health care.

We can help produce a healthier society and the president wants a focus on wellness and prevention.

We are low-tech-high touch, and that is a powerful combination in health care today, not to mention a huge patient satisfaction score.

We need to unite for this to happen!

And although we may not be directly involved with the new technology the president discussed in order to create new jobs, we do understand the importance of investing in RESEARCH which the president emphasized.    

NCMIC has done a commendable job of supporting our profession's research projects, and as policyholders, we can be proud to know that by our collective actions, we help to keep NCMIC strong. This research will be important when our leaders are sitting at the political table.

Don't forget about education as it is an important component about how we are judged. If we are seen as an integral part of the healthcare reform, our chiropractic colleges by default will prosper with increased admissions.

On a final note, if I was able to proof read the address, I would have added one thing.  When the president mentioned that premiums are increasing he should have followed it up with the fact that re-imbursements to the provider continue to decrease. 

So if providers make less and premiums cost more, what part of our healthcare needs to be reformed?