It has been just over one-year since my wife, Melissa, and I started practicing.  In that time, Melissa has been associating in a well-established office in the community with two other doctors and I have been in private practice.

While we’ve had some ups and downs like any new practitioner, overall I would consider this year a success. If you would ask us, in the first year, what was the single most important thing we did to help us succeed in practice it would be this: find a mentor.

Melissa and I have been extremely fortunate in this regard as we have been surrounded by experienced and willing mentors. When I purchased my office, the retiring doctor stayed at the office for two months, acquainting me with patients and particular adjustments that he had learned in his many (many, many) years in practice.  He was quick to share the clinical pearls that often only come with experience.

When Melissa started practicing in her office, the advice of the other two doctors and their office staff was invaluable to her, but also for me as I worked to establish my office in a nearby community.

Melissa was able to ask her colleagues about particular issues of patient management. And they offered me a wealth of knowledge from experienced practitioners and staff whenever I had questions about insurance companies, billing issues, and a variety of other things you cannot prepare for until you are in practice.

If you don’t have a mentor in your area, do not be afraid to look elsewhere. 

Recently, Melissa developed an interest in pediatric chiropractic.  However, there are few chiropractors in the area that specialize in this particular population.  Through one of the many professional organizations she was able to contact a female practitioner in Michigan.

Like Melissa, she is married to another chiropractor and just out of school she became an associate while her husband opened an office.  Through email they learned that our situations had much in common and she was able to share the ups and downs of their experiences with us. 

She freely offered suggestions and advice which will be invaluable for us as we continue in practice. As you go into practice, whether as an associate, an independent contractor, or private practitioner, there are many practicing doctors who shared similar experiences as they were starting out. 

It is worthwhile to develop a relationship with a chiropractor either in your area or your particular area of interest as their experience and advice can be invaluable. 

And when you become an experienced practitioner, don’t forget to pay it forward.

If you are having trouble finding a mentor, consider starting here.  Feel free to post a comment or question for any of the bloggers on Starting Into Practice.

Everyone is up to their eyeballs in work.

Time constraints are everywhere. So much to do and so little time to do it.  

This refrain is a constant in every community in America and it goes to the heart of how to build relationships …especially with local MD’s. 

For new D.C.s, visiting your colleagues is a must - not only because it is the right thing to do, but also because they can help you if you simply ask.  Don’t try to avoid your colleagues when you move into a community - this is simply not the best way to approach relationships. 

Start with the local D.C.s who have been in practice for some time to get some advice and introductions to the M.D.s in your community.  Chances are most have had some relationships with the local orthopod, neurosurgeon, cardiologist, etc and can easily let you know if they are cooperative, friendly, etc. 

Everyone needs referrals, the orthopods et.al. and your colleague might just be the best people to make an introduction.

Depending on how good the relationship is, they can arrange a luncheon where all three of you can meet. They can write a letter on your behalf letting the physician know you will be calling. Or they can simply pick up the phone and call the doctor to announce your arrival in the area. 

Why would this be good?

Because it enhances everyone’s position. The ortho has a new referral source, you have made a new referral contact, and the established doctor has made the connection happen. 

Some of the business books have fancy names for these kinds of individuals.

• in politics they are lobbyists

• in society they are the social butterflies

• in business they are the matchmakers

Regardless of what you call them, do not overlook your colleagues as the first approach to introductions not only in the medical community but also in the advisors they feel comfortable with and trust.

Sometimes the acres of diamonds are in your backyard.

All start-up doctors know the standard ways to meet people -- Rotary, Kiwanis, church groups, social networking -- and all these are valuable places to make yourself known.  I happen to believe there is huge value in meeting everyday people as well.  People who may have a more immediate need for your services.

This thought came to mind the other day when I was at Staples. 

Over several years I have made a good number of friends there ... all of them work in the store.  One in particular is a guy named Marty.  In fact, he is my "main go-to" person when I have a problem, a question or a return!  He knows what I do for a living (sort of) and is always willing to help (more about Marty in another blog).  In fact, most times I go to the store when I know Marty is working. 

So what does Marty have to do with building your practice? 

How many "everyday people" do you come in contact with who don't know who you are or what you do? 

 What about the guy at the gas station (ok, you pump your own, but if you need a windshield wiper, your oil checked etc. there is someone there you know).  What about the lady at the window at Starbucks?  Are you just a casual "hello thank you for choosing Starbucks" or does she know you are a new chiropractor in town? 

How difficult is it to say that ... and your name ... and hand her your business card (the one with your website on the back)?  How do you know she may not hand it to someone else who is looking for a doctor?

I think we have become so mechanized as a society (bank machines, drive ups, ordering on line) that we forget or don't even see the humans we come in contact with!  I have watched chiropractors who are committed and interested in meeting people hand out cards with ease ... and don't forget to ask for a card in return (mailing list fodder!). 

How about every time you had your credit card to someone you hand a card too? 

I assure you this isn't a 1-2-3 deal ... unless of course your "weekly to do list" includes handing out THREE cards a day!

It's everyday people who build practices...people who know you, like you and remember you when they have a need. 

Don't think so?  I challenge you to reply to this blog and ask the SIP experts about this fact....and start with Dr. Sportelli ... there isn't anyone in Palmerton, PA who doesn't know him! 

In the 1990s, comedian Flip Wilson would put on a wig and a mini dressand transform into Geraldine ... a truly outrageous character.  Geraldine's screeching byline was "Honey, what you see is what you get!" 

Using that as a reference, I would suggest that what the public sees in all matters that relate to you, is the perception of you ... and remember, perception is the viewer's reality. 

• What does your personal demeanor say about you?  
• Do you demonstrate the qualities of a professional in terms of grooming, choice of clothing, communication skills (both verbal and non-verbal)?
• How have you branded yourself in all things representative of you:  letterhead, business cards, website and collateral?
• How strong are your interpersonal and intrapersonal communication skills? 
• How confident are you in intraprofessional dialog essential to the new health care paradigm?

Does your reflection in that mirror need a little "buffing up"?  Take a good look in that mirror and if there are blemishes, get to work on them ... NOW!

Remember, "what your community sees is what it gets!"

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?

I had lunch yesterday with a very influential business person in our community. It's part of my New Year's resolutions to meet at least one new contact for lunch each week this year.

Our conversation focused on many topics including the new Obama administration, football and recruiting, kids and schools, and our businesses.

I have been in the community longer than he, but over the past three or four years we've crossed paths but had not gotten to know each other well. During our discussion, we shared information about our educational backgrounds, and he told me of his experiences and student life, while at the U.S. Naval Academy.

He commented on both the mental and physical hazing (which has since been reduced) associated with being a cadet. Limited conversation and communication, marching drills, shining shoes and multiple menial tasks were all part of the training to prepare future leaders and soldiers.

He strongly believed that these exercises assisted him and his classmates with their organizational abilities, critical in battleground settings and future occupations. Important to the cadets were the "Seven P's of Preparation."

We've all been in meetings or settings where things are "out of sorts." Whether it's an office which is unprepared for a new patient, a meeting where an agenda has not been established, or participants of a group who are ill prepared.

Most successful businesses have clear-cut and well-defined systems and procedures as a part of their organization, Each of us, as professionals should be well-prepared, whether treating patients, serving as an expert witness or on a civic committee.

Your reputation depends on your knowledge and preparation. And  much can be gleaned from the cadets and their "Seven P's" of......

Proper Prior Planning Prevents Piss Poor Performance.  Happy Days!

There are dozens of articles within Starting Into Practice about networking with other professionals and outlets to filter patients through our doors.

But what about networking with our peers?

The popularity of chiropractic is expanding exponentially, and our graduation rates send many (some may argue too many) DCs out into the world. 

As Dr. Braxton Pulley pointed out in a recent blog, this creates a tendency to "eat our young."  I see another trend: forget the veterans; new grads are feasting on each other! 

You can read through any chiropractic publication or attend any seminar and find undertones of the unfortunate trend of DCs circling their wagons and firing inward.  We argue over technique, philosophy, whose alma mater is 'better,' scope of practice, and the list goes on.  Enough already!

I decided to break this trend, even if for just one day, and accepted a recent invitation. 

I joined forces with another chiropractor and set up a joint booth at a local health fair.  Yes...my competition and I worked together for a whole day!  

We made the agreement that until every person in the county was seeing one of us, we were not competitors. 

• We split the cost of a banner promoting chiropractic, not his practice or mine.  
• We did posture screenings, blood pressure checks, etc. 
• We passed out spine charts and literature with neither of our names on it. 
• We each left a stack of business cards on the table, but it wasn't about that. It was about educating the public of what CHIROPRACT-I-C has to offer!  There are plenty of patients to go around, many just don't know what we have to offer!  

Take it one step further! 

Another friend of mine in a larger city formed a Community Chiropractic Collaborative.  They meet monthly to create chiropractic awareness events all over town.  As a group, they sponsor 5K's, blood drives, little league, and more. 

Consider the possibility of 20 like-minded individuals working together and sharing expenses to promote the profession in a concentrated area!  He reports to me that they are all seeing increased office flow along with welcomed camaraderie!

Ok, so maybe this is too far out there for you, but it starts with small steps. Start with a good ole' fashioned Attitude Adjustment. Pun Intended. 

Do you sneer at another DC's ad in the newspaper or do you smile because maybe just one person read that ad today and finally got the Big Idea?

Your brainstorming ideas are always welcome.  Any other ideas on joining forces?

I just returned from Parker Las Vegas where I had the opportunity to observe the mood of both new and established DC's. Truthfully, I was expecting to hear how everyone's business was down and how the poor economy was affecting business.

What I heard was quite the opposite!

DC's from across the nation were saying that business was good! I heard speakers telling the crowd that NOW was a wonderful time for chiropractic, especially because of the economy.

DC's were excited that for the first time in a long time, people were seeking chiropractic care which offered them HOPE. No longer willing to pay high prices or settle for medication that often masked physical issues, patients are looking toward more natural alternatives where doctors care about them.

You can take advantage of this situation as a new DC. YOU have a chance to spread the word throughout the area where you live. Here's how:

• Offer your speaking services to your community
• Write news articles on health care
• Local radio stations love interviewing doctors who have a passion for what they do. Find a patient who has benefited from chiropractic care and invite them along to share their story!
• Contact local companies and offer 30-minute lunch programs. Tout your education and statistics that prove your expertise and knowledge.

Remember, chiropractic is offering patients HOPE without surgery or high costs. So in this new year, with a new president, take up the gauntlet and realize the opportunities you have in this economic downturn!

Get out there and make a difference in chiropractic!

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!