These four tips can make a difference in your patient relations:

1. Instead of waiting room use reception area.  No one likes to wait.
2. Instead of suggest, use recommend.  It's more forceful.
3. Instead of old patients use established patients.  It's more prestigious.
4. Instead of reminding someone about an appointment, confirm the appointment.  There is no negative connotation. 

Small changes...better results!

John Jones (not his real name) called me a few weeks ago. I've seen him and his family periodically over the last several years and they've always responded well to short periods of chiropractic care.

John's son, Jimmy, recently started school at an out-of-state university, straining his back while lifting some luggage and moving into his dormitory. Jimmy contacted a local chiropractor and after undergoing an examination and x-rays, the doctor recommended care on a three times per week basis for eight weeks with reevaluation thereafter.

His dad called me somewhat concerned as Jimmy had always responded with a few visits to my office. He indicated that the chiropractor, during his report of findings, used terms and words that Jimmy was unfamiliar with and suggested that without treatment the condition might be irreversible.

As Mr. Jones and his family had had favorable results in my office he called to inquire of my opinion.

My first thoughts included that some miscommunication or misunderstanding might have occurred. Over the years while discussing findings and recommendations with patients, on occasion some will have a "glazed" look in their eyes.

I believe it's important to talk with patients using terms and concepts which they'll understand. Sometimes, using technical language can create problems as well as barriers. Patients certainly want their doctors to be knowledgeable and bright, but they also want them to speak plainly and in terms which they can understand. They also want and deserve the facts about their conditions and  "fear based" recommendations are inappropriate. 

I'm happy to report that a few days ago I ran into Mr. Jones at a local event. He related that Jimmy was well and had had four visits with the chiropractor and thereafter was pain free.

As we each see patients, it's important to put ourselves in their position and consider how we would like a loved one of ours treated in a somewhat "foreign setting."  Happy Days!

How do you become the ONE that people in your community will TRUST when then need your services?

Recently I received a letter from a former patient who moved away 10 years earlier - and out of desperation she sent me an e-mail about her condition. 

I could almost feel the tears of pain and despair in her words.  By the way she is a journalist...ugh...(having won state and national honors for her human interest stories). And she often told tales of chiropractors who wanted to sell her case fees, and told about how she visited their office four times and only saw the doctor on the first visit with no adjustment and only received therapy applied by staff.

I thought about the fact that you simply never know WHO is coming into your office, WHAT they do for a living, HOW they are connected and to whom, and WHAT could be the far reaching ramifications of an action that is less than stellar on your part.

There was a concept at one time that was referred to as the WALL STREET JOURNAL syndrome, which simply encouraged people to think about how any action taken would appear to the public if it reported on the front page of the WSJ.

Think about your patients and imagine they are reporters for the largest newspaper in your area. They could write a positive or negative story about you depending on their experience.  

This view is not to frighten you, but rather to encourage you to treat every patient as if they had access to a column in your newspaper or a segment on your television...because they do.  Maybe not formally but informally by the manner in which they speak about you to everyone they know or for that matter who will listen. 

A statisfied patient will tell 4-7 people but a dissatisfied will tell many more!

Make yourself the doctor they tell others...."you can really trust this doctor." That is a community image worth a fortune.

In my last blog, I provided a link and phone number to sign up for PECOS – which is the very first step you must take to participate in Medicare’s Electronic Health Record Incentive Program (aka Meaningful Use Rule). The Meaningful Use Rule establishes incentives for health care provides to obtain and use certified electronic health records (EHR) technology.

Once you’ve signed up for PECOS, your next step is registering for the incentive program with Medicare. To do this, go to the EHR incentives website by clicking here.

You’ll need your:

• National Provider Identifier (NPI)
• National Plan and Provider Enumeration System (NPPES) web user account
• PECOS login information

If you have questions about the process, contact your Regional Extension Center at www.regionalextensioncenters.com. There are 62 RECs throughout the U.S. to help answer questions from registering for Meaningful Use to receiving funds.

The Centers for Medicare and Medicaid Services policy preamble states that a provider is responsible to know the rules and regulations that apply to all services he/she bills to the Medicare program.  According to the Medicare Carriers Manual, Section 7103.1.e.1, “In general, the physician should have known a policy or rule if the policy or rule is in the Federal regulations...” 

In January 2010, Medicare regulated that all notes must be signed by the doctor.  Each encounter must be signed by the provider.  A recent CERT review revealed a 97% error rate, due to a lack of signature, resulting of denials of all claims.  While poor or non-existent documentation is still of primary importance, it makes their job easier if you don't sign the SOAP note.

Below is the synopsis of the clarification.

For medical review purposes, Medicare requires that the author authenticate services that are provided/ordered. Medicare denies many claims due to the lack of an appropriate signature. Here are some things to keep in mind on signature requirements:

1. The signature must be that of the provider of service. This means the person providing the service whether that is the physician or a non-physician practitioner (NPP). No one else can sign for the physician; this includes another physician in a group, the office manager or the CA.
2. The signature must be hand-written or electronic. Medicare does not accept stamped signatures.
3. The Centers for Medicare & Medicaid Services (CMS) 1995 and 1997 Documentation Guidelines (DG) for Evaluation and Management (E/M) services require that the provider's signature be legible. If your signature is not legible, please provide a signature log or authentication statement verifying the information.
4. The signature of the transcriptionist is not the same as the physician signature. While your office may need or require this information, Medicare does not. (You can no longer put dictated by XXX/transcribed by XXX) 
5. If you are using electronic medical records, please verify your system and software products protect against modification. (This includes password protection and backups)
6. If you are splitting or sharing services between yourself and a NPP, then both parties must sign their portion of the service. The NPP cannot sign for the physician. (In a chiropractor's office for instance, this may include the massage therapist.)
7. Physician offices should have a protocol in place to have physicians sign their records within a reasonable time, generally 48 to 72 hours after the encounter, but certainly prior to submitting the claim to Medicare.  You cannot add a signature to a record later (this does not include the brief time to transcribe the record), instead use an attestation statement.

It is recommended that each office consider the guidelines and establish policies pertaining to the signing of the note, rather than initialing.

As discussed in my last post, disasters close to home remind us to be grateful.  

Lately, going to work has been a daily reminder of all I have to be thankful for.  We've had friends and patients suffering the loss of property, treasured possessions, family memories, and even a few losses of human life.  

Imagine for a moment, your life...and all your possessions, thrown into a blender. The puree button is pressed, but someone forgot to put the lid on.  Total destruction.   A drive through affected areas will reveal the raw power of Mother Nature.  Asphalt peeled right off the pavement, grass sod ripped from the ground.  Homes split in half - and the 'other half' is nowhere to be found.  In the midst of chaos a few miracles exist. A single rose remains in a vase on a windowsill, where there is no longer a window.   The family pet appears from nowhere just as a devastated home owner needs a reason to stand back up again. 

I've spent as much time listening as I have adjusting lately, and that's just fine with me. 

I've spent time making phone calls to refer for mental health and grief counseling. 

We've donated when we could. In the midst of practice building it feels good to slow down and just Be Present for whatever, wherever, and whoever needs it. 

Sometimes compassion is the best treatment of all. 

In the midst of a struggling economy and poor insurance reimbursement, it seems reasonable that many D.C.s need to refine their advertising approach to attract more patients.  

I've notice an alarming trend of coupons and vouchers for free care lately and I wonder - is anyone else bothered by this?  Is this cheapening the profession or simply the "new" way to do things?  A few examples I've seen lately. 

1. "All the care you can stand for $99 p/month
2. Internet discount websites with free or significantly reduced care (e.g., Groupon, Living Social)
3. Grocery store coupons on the reverse side of receipts  

Now, I personally subscribe to Groupon and Living Social in my area for restaurant discounts and other retail services.  Recently however, I've seen several chiropractic "Deal of the Day" ads and wonder...what have we become?  

As I ponder this disturbing trend, in walks a salesman today asking me to advertise on the back of the local grocery store receipt.  He promised I'd be the only "chiro" and it would generate 300+ coupons into the community per day.  

Now, if I was willing to give away a free fountain drink with the purchase of a large combo I'd be ready to sign up...but this is a doctor's office!!!  

This disturbs me for multiple reasons, but specifically this presents a problem ethically. 

• Under contract with insurance carriers, physicians are not allowed to give discounts.  This also applies to Medicare. 
• It attracts the wrong patients.   Quite likely, someone who calls your office with a coupon in hand will quickly move on the next "chiro" giving something away.  

Now, for the purpose of conversation and blog traffic, I'd love to hear any positive or negative experiences anyone has had.  

STILL EDITING...DO NOT POST YET!!! 

So this spring has been one softball and/or baseball game or track meet after another!  My kids are 9 and 11 and I am amazed at the amount of running around that needs to be done. But those of you who have kids can appreciate my anxiety. It is fun ... but a planning nightmare.

Since I have morning, afternoon and evening hours, I try to get to as many of the games as I can.  Most late games and Saturday afternoons, I am usually going straight from work to the field in my tie and sometimes a sport coat depending on the weather. 

My wife wants to know why I don't take a change of clothing?

• People see me in a tie and they recognize me as Dr. DeMatte the Chiropractor.
• They see me coming from work rushing to the game after a busy shift worrying about patients and watching my children rather than changing into comfortable clothes.
• Some are amazed and did not realize that I had office hours until 8 p.m. ... a better way of getting the word out than an ad in the paper! If i was coming from work but in casual clothes, I would have to tell them where I was coming from and that is less subtle.
• On the days that I have off, I go to games in jeans and a cap. I say "hi" to people and they do not know who I am until I introduce myself....this goes the same for food shopping as they do not recognize me unless I am dressed in work attire.
• When I work the refreshment stand, they all comment on how the place is really getting fancy as I serve them with a tie!

These games are a great way to get to socialize with other docs and people in the community, so take advantage of them.  I do not discuss chiropractic or work but my attire lets them know who I am and where I just came from. 

Also, remember I said how I used ice and hot packs with my name and number on them for marketing?  I make sure that the freezers at these games are loaded with them!

Is anyone else taking advantage of such social gatherings without being pushy...I would love some advice!

New doctors may think of the employees of NCMIC as being one-dimensional. Yes, it's true our main focus IS our customers! But just like you, the employees of NCMIC have varied interests that range from volunteering to novel writing, scrapbooking to motorcycle riding. With such a variety of skills and hobbies, how is it we let those around us know about our latest achievements, our dreams, goals, or skills that may assist others?

We talk about it! We text our friends, Facebook and Twitter, send press releases to publications and newspapers and tell groups we speak in front of!

Just like you should be doing as you begin or expand your practice!

It's never too early to start spreading the news that you will be or have just become a doctor of chiropractic! Free press releases are a great way to start. Here's a link that gives you an idea on how to get started.

http://www.ehow.com/how_8793_write-proper-press-release.html

Just remember...

• Be professional in what you highlight about your new practice.
• Be cautious about social networks as anything in the public realm can and will be used against you in a court of law.
• Be proud, but humble. No one really likes a braggart.
• Highlight what makes you different.
• Don't forget to use news outside of chiropractic, such as, something you volunteered for, CE credentialing, seminar or educational achievements, attendance at unusual events, etc.

Start spreading the news!

Has anyone out there enjoyed success with a press release or some other unusual form of garnishing attention for your new bsuiness you'd like to share?