Category: Interviews

Each article in the MILLION DOLLAR CHIROPRACTIC series (M$C) focuses on the top surveyed issues facing chiropractors today.  Recruiting new patients, retention, profitability, marketing and staffing are each a determining factor in the growth, potential and success of the practice.

The subject of this issue’s profile is Dr. Rick Markson, an extremely successful chiropractor who has practiced in Florida for the past 9 years.

Originally from Long Island, New York, Rick Markson began his chiropractic journey in early childhood.  The son of Dr. Larry Markson, a 23-year veteran of success coaching and one of the founders of The Masters Circle, he literally grew up with a love of chiropractic and is “thrilled” to be able to offer his wife, Robyn, and eight month old son, Pryce, the same experience of living a healthy, drug free life.

One of only twelve chiropractors in the country certified to teach the Thompson Adjusting Technique, Dr. Markson also lectures at chiropractic associations and colleges throughout the country on practice building, office procedure and personal growth.  He  received the 2003 International Chiropractor of the Year award given by The Masters Circle, and has acted as President of the Broward County Chiropractic Society for the past two years.

In an interview with The American Chiropractor, Dr. Rick Markson answers our Million Dollar Chiropractic (M$C) questions about what he describes as his “good old fashioned family practice” where the focus is always on chiropractic care.

M$C: What influenced you to become a chiropractor?
Markson:  I recall knowing that I was going to be a chiropractor since the age of six.  Having a father who was so successful and well respected in the profession fueled my desire to follow in his footsteps.  I have been adjusted my entire life and chiropractic care has always been the mode of health care for our family.  So, it wasn’t a far stretch to imagine myself sharing what I have learned over a lifetime.  I majored in sociology at Syracuse University.  I chose that field, because I knew that the more I understood what makes people make the decisions that they make, the better able I’d be to assist them in making the proper health care decisions.   

M$C: What type of practice do you have?
Markson:  Our practice is a good, old-fashioned family practice.  Before I started, nine years ago, my vision was to see fifty percent general practice, twenty-five percent personal injury and twenty-five percent pediatrics.  That felt like a perfect balance to me, and that is almost exactly what we see in the practice.  As I stated earlier, I grew up as a chiropractic kid. Therefore, we make sure we educate every patient on the benefits of lifetime chiropractic care for every member of their family.  I am very strong with my patients on understanding the subluxation concept and I believe that has a huge impact on our success.
I have one associate doctor and another one in the works.  They are instrumental in being able to provide the quality of care that we pride ourselves on.  We have two massage therapists on staff at all times and I see a huge benefit in having the massage therapy on premises.  

M$C: Give us a physical description of your office facility.
Markson:  We started in a 1600-square-foot office with four adjusting rooms and one massage therapy room.  We began to see some capacity limitations, so I purchased the massage therapy company that occupied a 750-square-foot space in the same strip center.  We moved the massage over to the new space to give us another adjusting room and were able to have two massage rooms as well as rent-ing space for acupuncture and Chinese medicine.
Two-and-a-half years ago, we moved down the road to a magnificent freestanding building in a professional plaza.  It is a 2700 square foot space and houses everything under one roof.  I believe it to be the dream office.  We have decorated it in a very warm, welcoming way and it suits all our needs.  We now have the capacity to see a virtually unlimited volume.  Not a day goes by that a patient doesn’t comment about how beautiful our office is.  Needless to say, I’m very proud of it.

M$C: What’s the income service level that you provide annually?
Markson:  Our goal has always been to grow financially by twenty percent each year.  I have been fortunate enough to be surrounded by a team that understands that goal and helps me to fulfill it year after year.  As the practice has grown, our income has followed as well, and we continue to see the twenty percent increase every year.  Also, this past year, I purchased another practice with a partner and that has created another income stream for me.  

M$C: Do you have a set profit-standard or margin formula for the business? 
Markson: I believe that setting very specific goals is of the utmost importance in running the practice effectively.  Second in importance is to make sure that your team knows each goal and that continuous training is done to ensure the achievement of each one.  Due to the nature of our practice, our overhead tends to be a little high at approximately 55-57%.  This is due to the multiple associates and the multiple massage therapists.  Employing professionals may have a higher price tag, but I believe that their value makes it worthwhile.  Additionally, thanks to our insurance and collections team, our accounts receivable is actually lower now than it was three years ago.  Our goal is to collect 90% of services rendered, and we get closer to that goal every year.   

M$C: Is there anyone in particular to whom you attribute your professional success?
Markson:  On a personal note, my mother taught me to always do the right thing, regardless of what the cost.  I strive to accomplish that task in every facet of my life. 
On the business side, I was fortunate enough to have a father who revolutionized much of how chiropractic is now practiced around the country and the world.  I learned early on that the practice of chiropractic follows a triad of personality, procedural efficiency, and clinical competence.  I have been listening to my dad’s Markson Management Services cassette albums since I was a kid and I follow his procedures to the letter.  The chiropractors that I know who try to “reinvent the wheel” end up struggling needlessly. 
Now, as I have become involved with the The Masters Circle, the success philosophy has taken center stage.  I follow their manual and CD albums lesson by lesson.  With Bob Hoffman and Dennis Perman helping me work on my own weaker areas, I have become a better boss, a more confident leader, and the kind of person who can create the life and practice of my dreams.
     
M$C: What marketing strategies do you use to attract new patients, and to keep current patients?  
Markson:  I have always loved public speaking, so I have built the practice predominantly on doing outside lectures in our community.  I have spoken at various companies, schools, support groups, and municipalities on the topics of stress management, back safety, raising a healthy, drug-free family and, of course, the benefits of chiropractic care.  I have used Michelle Geller Vino of MGV Marketing since the day I opened my practice.  She has been responsible for opening countless doors for us to educate our community and I would never practice without her in my corner.
For patient retention, we do a mandatory new patient orientation in our office that all new patients are required to attend.  This has translated into a very high patient visit average and decreased our reliance on new patient volume.  All patients receive a detailed report of findings, which further educates them on the three phases of chiropractic care.  This eliminates the patients’ desire for the “quick fix”. 

M$C: How do you handle problems with patient retention? 
Markson:  We work very hard on understanding the personality type of each patient.  Depending on who they are, we will cater our communication skills and our procedures to the fulfillment of their needs.  This translates into each and every patient feeling as though we understand them.  I believe very strongly in relationship building and we work diligently, as a team, on our rapport building skills.  Confrontational tolerance is something that every successful person in every field has mastered.  We are able to confront patients about u  ukeeping up with their appointment schedules and financial responsibilities so that they understand that it is in their best interest to do so.

M$C: We all know that an efficient staff is a crucial component of a successful practice.  Tell us what you look for in a staff member.
Markson:  I used to hire people out of desperation.  I sounded like everyone else.  “Good help is impossible to find.”  Through the teachings of The Masters Circle, I have learned that attracting the right team members is no different than attracting new patients, or the perfect mate.  You must work on goals, affirmations, and visualizations to manifest whatever it is you want.  In this instance, I am very specific on hiring my teammates by their personality type.  I believe that almost any task can be taught, but you can’t train someone to be the type of person you need for each position. 

 Our associate doctors are fully empowered to take the patient through consultation, examination, Report of Findings, and all aspects of care. 

M$C: Do you enjoy your work? 
Markson: How many people do you know who knew what they were going to do with their life since the age of six and then actually made it happen?  When someone asks me what my purpose in life is, I believe it is primarily to become the best husband and father   I can possibly be.  Then, it is to help get chiropractic to the mountaintop…where it belongs.  I really am living a dream.

M$C: Any final words for our readers? 
Markson: I am flattered by the fact that I have other chiropractors visiting my office on a weekly basis.  They ask many of the same questions that I have answered here.  The advice I have for them and for the readers is simple.  First and foremost, start having more fun.  Chiropractic is an amazing healing art…enjoy it.  Our patients love us.  If you fuel your passion for chiropractic, patients will flock to you.  Second, you must have a coach.  If Tiger Woods, Michael Jackson, and every other superstar in any field have  coaches, you should to…if you want to be a superstar!  I am also flattered that you asked for my inclusion in your publication.  I love chiropractic and I am honored to share what I have learned with each and every one of you.

You may contact Dr.Markson at (954) 472-7975.

Our sincere thanks to Dr.Markson and his staff at Markson Chiropractic, Plantation, Florida.

Each article in the MILLION DOLLAR CHIROPRACTIC series () focuses on the top surveyed issues facing chiropractors today.  Recruiting new patients, retention, profitability, marketing and staffing are each a determining factor in the growth, potential and success of the practice.

The subject of this issue’s profile is Dr. George Michalopoulos an extremely successful chiropractor who has practiced in Illinois, for the past fourteen years.

Originally from Toronto, Ontario, Canada, George Michalopoulos began working for his parents in their family owned fast food business in Napanee, Ontario.  He played competitive hockey and was a member of the Ontario Provincial Softball Championship Team, representing Ontario in the Canadian National Softball Championships.  He is a “huge” Toronto Maple Leafs hockey fan. 

Dr. Michalopoulos still plays hockey and is a Member of the Chicago Blackhawks Alumni Association.  He treats a number of the ex-Chicago Blackhawks and participates in their fundraising auctions and golf tournaments.  An avid golfer, he treats a professional caddy of one of the top 10 golfers in the world, as well as top ranked high school and NCAA athletes.

In an interview with The American Chiropractor, Dr. George Michalopoulos answers our Million Dollar Chiropractic (M$C) questions about his successful multidisciplinary and physical therapy center.

M$C: Dr. Michalopoulos, what influenced you to become a chiropractor?
Michalopoulos:  Ever since I was 8 years old, I wanted to be a doctor.  I remember walking down the halls of Toronto General Hospital going to visit an aunt in the hospital and thinking how much these doctors and nurses had helped her.  From that day, I knew I wanted to help people but I did not know what type of doctor I wanted to be until 1981.
In 1981, I hurt myself playing high school football.  Prior to this injury, I had always had some mid back pain and I used to have my little sisters “walk on my back”.  Finally, a friend of mine told me to go the local chiropractor in Napanee, Ontario, Dr. Larry Shaw.  From the first time he adjusted me, I had instant relief.  He proceeded to explain what chiropractic was  and also the benefits of supplements, all—amazingly—without drugs.  I thought, what a great way to help people and do it without medication.  
After high school, I went to Queen’s University in Kingston, Ontario, and then, in 1986, started at the National College of Chiropractic.  I completed the 5 academic years in less than 3-and-a-half, and was on my way.

M$C: What type of practice do you have?
Michalopoulos:  Our practice is a “multidisciplinary” practice.  We have integrated medical doctors, chiropractors, physical therapists and massage therapists into our clinic.  We quickly realized that, to be successful, to be able to grow your practice and to cater to a large number of patients, you need a great network of doctors to work together.  We had a number of patients that needed chiropractic care, but needed some type of medical care at the same time.  There have been many times when patients have come in that were in excruciating pain who truly need medication to at least “take the edge off”.  Initially, we would refer the patients out and not hear back from them.  At this point, we decided that we needed go get our own medical team assembled.  This is where the expertise of Practice Perfect and Dr. Daniel Dahan came in.  They made this new marriage of medicine, chiropractic, physical therapy and massage work together legally, ethically and honestly to accomplish the patient goals we wanted as an outcome. 

M$C: Give us a physical description of your office facility.
Michalopoulos:  Our clinic is on the second busiest street in Addison, Illinois.  We initially started out with about 600 sq. ft. of treating area down the road and quickly graduated to a new 2,000 sq. ft. facility that I thought I would never grow out of.  We are still at this 2000 sq. ft. facility, but have knocked down walls to incorporate our growing physical therapy department. 
We have a beautiful office with a therapy suite that has our interferential electrical stimulation, ultrasound and micro stimulation units.  A front office and insurance department combined; and 3 treatment rooms as well as a physical therapy room for active aggressive physical therapy and strengthening.  Beyond the physical therapy room is our X-Ray and dark room facility. 
We have great visibility on a busy street in a town of 37,000 next to a locally famous pizzeria.  When new patients ask for directions, we tell them, next to Nardi’s pizzeria.  They know exactly where to go. 
 
M$C: What’s the income service level that you provide annually?
Michalopoulos:  Our income service level has consistently risen every single year in practice; however we seemed to plateau just prior to our office becoming multidiscipline.  We were seeing more patients, working harder and longer hours, but  had become limited in income growth because we were running out of room.
Dr. Dahan of Practice Perfect taught us how to cut overhead, increase the practice and even cut my hours all at the same time.  Within one year, I was astonished at how receptive my patients were to our new medical doctor and the extraordinary service and knowledge our office was providing.  Our patients’ response was, “It’s about time MD’s and Chiro’s started working together.”

M$C: Do you have a set profit-standard or margin formula for the business? 
Michalopoulos:  Our practice runs on goal setting.  We set our goals at the u u beginning of the year and revisit them every quarter.  Our objective is always to do better than the year before, and we have a bonus system for all of our staff and doctors.  We all strive to give the best quality care, from the front desk and insurance department to the doctors and therapists in the back.  We have weekly staff meetings and get all questions answered at that time.  If patients have questions, comments, complaints or compliments, we want to hear them.  The personal profit margin formula for the business is to decrease unnecessary expenses and to have a blow out Christmas party with bonuses at the end of the year. 
 
M$C: Is there anyone in particular to whom you attribute your professional success?
Michalopoulos:  My parents with their strict work ethic and honesty have undoubtedly contributed to my professional success.  When I was going to school in the US, the Canadian government didn’t offer student loans to go to a US school, so my parents and younger sisters worked many hours and weekends to pay for my tuition, which was almost  7 times more than it would have cost had I gone to a Canadian school.  For this I am very grateful.  
My wife, Kathy, not only believed in me but also trusted that I would do the right thing for us and our family.  She is the love of my life and we are cut from the same cloth. 
There are several other people that have changed my life personally and professionally.  First of all, Anthony Robbins has helped me set my goals by having an ultimate vision for my life.
Secondly is my consultant, and dear friend Dr. Daniel Dahan.  He has outlined for us a program that is honest and ethical with continual updates to stay on top of the rules and regulations that are constantly changing in our profession.  He discusses ethics and honesty in detail at every one of his mastermind seminars, and I consider him a true friend and great person.
Thirdly, my priest, Fr. Chris Kerhulas, was very instrumental in changing the direction of my life.  His determination and foresight are second to none.
Lastly, and most importantly, my partner, Dr. Ralph DeStephano.  In the almost 10 years that we have been partners and 15 years I have known him, we have laughed—no exaggeration—every single day and we could count the number of disagreements we have had on one hand.  He is a partner’s dream and a true friend.

M$C: What marketing strategies do you use to attract new patients, and to keep current patients? 
Michalopoulos:  We outline our marketing strategies at the beginning of every New Year.  We use a wonderful newsletter from L. K. Graphics that we send direct mail to 50,000 homes several times per year. We also have internal marketing, of course.  This is the most effective, I believe, because when a patient comes in that was referred from another patient, this tells you, your staff, and the new patient what an effective job you have done.  We have had several food drives for Thanksgiving and toy drives for Christmas.  We have even done spinal screening in malls and seminars at local and big businesses in the area. 
The most fun of the year comes when our wonderful staff has a Patient Appreciation Day.  On this day, we get local businesses to donate bagels, donuts, coffee and numerous other things to give away.  The patients come in, get their adjustments and massages at no charge, and all new patients come in and get consultations and examinations at no charge.  There is so much energy in the office that day, how couldn’t you have fun.

M$C: How do you handle problems with patient retention? 
Michalopoulos:  Our patient retention is monitored carefully by the doctors and, even more so, the front desk.  The importance of the patient keeping up with their scheduled appointments is stated to them right from the get go.  We explain to the patients how important their care is and that every treatment and physical therapy session builds on the next.  When they come in, they are taking 3 steps forward; however, every time they miss, they are taking steps back.  We explain that we want to continually make progress and not “tread water”.  It is also explained that there is a high probability that their problem did not occur yesterday when they took the trash out, but over years of some type of abuse to their body.  With this in mind and explained in an easy to understand manner, the new patient realizes that several years of problems will not go away in 3 or 4 visits.  We are very strict with our appointments.  Our front desk, who I call our quarterback, knows the importance of keeping the patient schedules and does a spectacular job doing that.  Missed appointments jeopardize care and potentially our practice.
We have a staff meeting every Wednesday to discuss the status of our patients and what needs to be addressed, and with which patients, before the next staff meeting.
Our patients can feel the energy in our office.  The patients love to come and to send others to get better.

  We all know that an efficient staff is a crucial component of a successful practice.  Tell us what you look for in a staff member.
Michalopoulos:  Organization is the key to any staff member.  Every single one of our staff members is extremely organized and knows what to do.  I have been in Addison for 12 years and I still have one of my original staff members, who is the organizer for all supplies and in charge of getting us the best deals.  She also does physiotherapy and is in charge of filing our note documentation, which, in any practice—especially a multidisciplinary practice—is crucial.  As I mentioned before, the front desk is our quarterback.  My belief is, “As the front desk goes, so goes the practice.”  The insurance u udepartment needs somebody with great knowledge and expertise of the insurance business, and we have a 20-plus year veteran that keeps up with all the changes.  Our physical therapist’s, massage therapist’s, therapy assistant’s and associate doctor’s work ethics are unmatched.
The whole office is closely involved with getting the patient better.  I look for not only organized people but also friendly and empathetic people when hiring.
We have an outstanding team, and most of the staff participates in hiring new staff members.  Once we get the approval from the staff, the new staffer is put on a probationary period.  If they fit within our mold, they are a keeper.  The majority of our staff has been with us for at least 7 years so, as you can see, there is little turnover.

 Do you enjoy your work?  How do you feel about going to work in the morning? 
Michalopoulos:  Enjoying my work is an understatement.  Our office is a very dynamic place.  It is filled with love and energy. This, along with outstanding doctors and staff are key ingredients to this wonderful healing profession.

M$C: Having a multidisciplinary practice, what advice can you offer our readers about setting up and maintaining such a practice in today’s healthcare system? 
Michalopoulos:  First of all, multi-discipline practices are not for everyone.  It takes a tremendous amount of work and constant preparation to achieve your ultimate outcome.  Second, you cannot do it alone.  You need someone with a tremendous amount of knowledge and a person that has access to knowledge of this type of practice.  Our consultants, lawyers, and other professionals help us, almost on a daily basis.  If you want to go this route, you must find a consultant and healthcare attorney who can answer all of your questions.  The more knowledge people have about this business, the easier it is for you to succeed. 

  Other than traditional chiropractic care, do you include any other type of services or products in your clinic which further help your patients, as well as bring in additional revenue to your practice?
Michalopoulos:  One of our associate doctors provides nutritional counseling, and counseling for fibromyalgia.  Our MD occasionally gives trigger point injections.  We do offer our time for outside industrial lectures for carpal tunnel syndrome, low back pain and headaches, and are also preparing to do manipulation under anaesthesia.
 
M$C: Any final words for our readers? 
Michalopoulos:  I will say that my office is a ball of revitalizing energy.  It didn’t just happen overnight.  There have been many long days and questions that have come up while building this practice.  There are many transformations that have taken place.  You need to be a leader, to lead yourself and your team; innovative, to not be afraid to take a chance and experiment with new products and new technology; enthusiastic, because enthusiasm is the battery for healing; and, especially, be honest, open and ethical with your patients.  If you apply these simple techniques, not only to your professional life but also your home and personal life, with everything you do, you will have the recipe for success.  Get an ultimate vision for yourself, and never lose sight of that vision.  Have a purpose and mission statement, not only for your business but your family life also.  Balance, balance and more balance is essential to true success.

You may contact Dr.Michalopoulos at 630-833-1552.

Our sincere thanks to Dr. Michalopoulos and his staff at Addison Physical Medicine and Rehabilitation, LTD., Addison, Illinois.

Editor’s Note:  Do you have a million dollar practice that you’d like TAC to highlight in our Million Dollar Chiropractic column?  Contact TAC’s editor Jaclyn Busch Touzard by phone/fax: 1-305-716-9212, or email: [email protected].  We want your inspiring story.  Contact us today.

Each article in the MILLION DOLLAR CHIROPRACTIC series (M$C) focuses on the top surveyed issues facing chiropractors today.  Recruiting new patients, retention, profitability, marketing and staffing are each a determining factor in the growth, potential and success of the practice.

The subject of this issue’s profile is Dr. Mitch Mally, a 1981 graduate of Palmer College of Chiropractic who has practiced for the last twenty-two years in chiropractic’s fountainhead city, Davenport, Iowa.
Originally from Detroit, Michigan, Dr. Mally began his Pre-Medical Training (1974) at Wayne State University in the heart of Detroit. Not only did he carry a heavy class load, but also played football for the Great Lakes Intercollegiate Athletic Conference (GLIAC) Division III Champion, assisted in biochemistry research, electron microscopy, surgical pathology, cytology and observed many autopsies at William Beaumont Hospital Pathology Department. Additionally, an avid martial artist, sprinter and weight lifter, Mally found his niche in sports chiropractic subsequent to nonsurgical (chiropractic) treatment of his traumatically injured left knee.

In an interview with The American Chiropractor, Dr. Mitch Mally answers our Million Dollar Chiropractic (M$C) questions about his incredibly successful sports and occupational injury rehab center.

M$C: Dr. Mally, what influenced you to become a chiropractor?
Mally:  In retrospect, my path has always been directed. Just three courses prior to entering medical school or embarking on a career in pro football, an injury to my left knee sidelined me, resulting in a personal quandry…surgery or non-surgery?
Chiropractor, Alan Kash, and his young associate, Rick Dybowski, whose conservative treatments and rehabilitation resulted in my dramatic recovery, opened my eyes to an alternative form of health care, although my family and friends referred to it as quackery, a cult, etc.  Much to the dismay of all who learned of my career plans change and against the odds, the head spinning, rapid matriculation and immediate acceptance to Palmer College in 1978 resulted in an exciting opportunity for me to experience a tremendous practice, become an author, inventor, academician and world-wide lecturer in the field of Sports and Occupational Injuries.

M$C: What type of practice do you have?
Mally:  My practice is mulifaceted and highly specialized in sports and occupational injuries, workers compensation and personal injury, with an emphasis on extremity injuries, syndromes and conditions.  A high volume of referrals come from chiropractors, MD’s, DO’s, dentists, attorneys and factory safety personnel for treatment of extremities including, most commonly, shoulder, elbow, TMJ, carpal tunnel syndrome and cumulative trauma disorders.  Also, frequent and numerous depositions as an expert witness for the above noted specialty add to an exciting and lucrative practice.

M$C: Describe your workplace for us.
Mally: The Mally Chiropractic Clinic and Rehabilitation Center, currently undergoing a multidisciplinary practice transformation, is operating under the auspices of the newly named clinic, TRI-MED Health and Wellness Center, P.C., in Davenport, Iowa.
The spacious, contemporary, open format 4500-square-foot state-of-the-art facility is equipped with an efficient floor plan and a design that comfortably incorporates various departments, including: examination, diagnostics, radiology and videofluoroscopy, treatment rooms, physical therapy, low tech and high tech rehabilitation, massage therapy, and patient orientation and education viewing area with two large flat screen TV/DVD players, administrative area and a seventy-doctor lecture hall.

M$C: What’s the income service level that you provide annually?
Mally:  Our office production volume for a Davenport, Iowa, high end, expensive practice surprises many, due to what others term “competition”.  My attitude is the only competition is between me, my patient and sickness/disease.  I also feel that competition is healthy, in that it prevents mediocrity and practice complacency, spawning interest in continued education and practice enhancement.  I have often said, if I can have one of the largest practices in a two state region (Iowa and Illinois), namely Davenport, Iowa, with the largest number of DC’s per populous, then others can be successful anywhere else on the planet.

M$C: Do you have a set profit-standard or margin formula for the business?
Mally: I believe in setting goals to achieve goals.  Based on a 22-year practice and the results of quality care, I expect certain conditions to respond within an approximate timeframe.  I utilize an initial twelve-visit Intensive Care Treatment Plan, followed by a re-evaluation and a prescribed Condition Specific 4-week Prehab/Rehab Program, with a subsequent re-exam and additional treatment recommendations to follow.  Therefore, mandatory management by daily, weekly, monthly and yearly statistics is simplified.  Interdepartmental and total office goals are plotted and appropriate stats reviewed at regular weekly staff meetings. 
Practice analysis is as critical to a successful business as early detection of cancer or subluxation is to the patient’s ability to recover.  Early detect…early correct!!!  Day-to-day in-office motivation among doctor, staff and patients is contagious;  and what a great way for each to profit, with a smile and the care that is so worthwhile!

M$C: Is there someone in particular to whom you attribute your success? 
Mally:  My greatest inspiration was, and still is, my father, who passed away at 49-years-young, from a medical malpractice issue following a “routine” gall  bladder surgery, when I was only eighteen.  Dad had an incredible and enviable work ethic others would jealously term “workaholic”.  He had a genuine passion, a love for whatever he attempted—no task too difficult or menial, always giving 100% effort, even if it meant personal sacrifices.  He always said, “Son, treat others the way you want to be treated, and work with that same conviction.”
My energy and leadership skills definitely stem from my mother, Nora, who, when under pressure and despair after my father’s death, raised three successful boys by herself. I will always value her dedication and belief that through any circumstances, success  can be accomplished! Thank-you Mom, for making me the man I am today!
My two older brothers, supposed to be the brains (and I, the brawn) also inspired me, although with a different twist (no pun intended).  Being the youngest of three boys, always one of the last picked for sports among their friends, motivated me to try harder, eventually running faster, throwing harder and lifting more; later, being the one choosing the teams for pick-up games.
There’s motivation in telling someone like me NO, or YOU CAN’T, DON’T, or YOU’LL NEVER; those are words that do not register in my gray matter.  In fact, they are, rather, interpreted as entirely the opposite, motivating me as YES, I CAN, I WILL, and I’LL ALWAYS.
These people and experiences I credit with paving the way for my success as a positive, benevolent person, a chiropractor with a great practice, and they motivated me, subliminally, to be a pioneer, inventor, author, and national/international lecturer.
Incidentally, my family eventually accepted me as a Doctor of Chiropractic, upon graduation, but, in the next breath, said I could never make it (a good practice) in Davenport, Iowa, with all the practicing chiropractors there.  The rest is history.

M$C: Tell us about your family?
Mally: My family is my inspiration and fuels my passion for life!  I am a divorced father with three beautiful daughters, Alissa (19), Genna (16) and Shailyn (7), plus, my adorable new granddaughter, Aaliyah.  But, with change comes reward, and I currently also share my life with my partner and fiancée, Jules Johanson, and her children Jacob (9), Breanna (8) and Ashleigh (7).

M$C: What marketing strategies do you use to attract new patients and to keep current patients?
Mally: We use the strategies of my twenty-two years of trial and error experiences coupled with the genius marketing campaign of marketing director, Jules Johanson, whose experience and skills in marketing are unparalleled.  However, the best marketing comes from three words that I preach:  RESULTS, RESULTS, RESULTS.
In-office marketing begins with the smile and positive energy from you and your staff.  Telephone rule #1:  Let the person on the phone hear your smile.  Happiness is contagious. Remember, if disease and negativity spread quickly, why can’t health and positive attitude.
We offer patients bottled water while they’re waiting in the lobby or treatment rooms, staff assist new patients with form completion, doctors call patients the evening of the first treatment, or for any special reasons or concerns.  Paperwork is often sent out and completed prior to the patient’s first visit, with an accompanying reminder-call the evening prior to the first appointment.  The chiropractic patient miracle book of testimonials circulates in the lobby and staff encourage patients to interact about their positive treatment experiences.  Of course, greeting, reminder, condolence and congratulation cards are sent accordingly, with doctor and staff personal signatures.  The finer touches in life always impress, and keeping the patients happy is our motivating methodology.
All new patients attend Monday night one-hour health classes within the first month of care.  We encourage patients and the community to attend, as we have various topics, speakers and/or vendors present.  Our lobby has seating for sixteen, arranged conversationally and directed toward two flat screen TV’s recessed into the wall, providing current, flashy, eye-catching, outstanding patient educational DVD’s.
External Marketing is via newspaper, radio and cable TV.  Regular newsworthy press releases and media hype are leaked strategically in an artistic fashion, utilizing Jules’ skills and experience.  Banquets, screenings, event sponsors, cocktail parties, meet-the-pro, lunch-and-learn and many other secret tools of the trade have proven incredibly effective at generating outside referrals. 

M$C: Obviously, every doctor, at some time or other in his practice, experiences problems with patient retention.  How do you recommend handling such problems?
Mally: Ongoing in-office motivational events, gift certificates, and other marketing tools work well for patient retention, as does a good report of findings, explanation for care and, most importantly, achieving the best results in the fewest number of treatments.  Confucius says, “Do, not efficiently, that which need not be done.”  This implies brevity is brilliance, verbosity is ignorance.  Recall my earlier philosophy, to treat others the way you want to be treated.  It has worked well for me and my practice.  That and the old u  u  cliché, If you love something, set it free and, if it was meant to be, it will return to thee.  Use your verbiage wisely and timely (once the patient is responding) in promoting within your practice to those patients who are most compliant, and give them five business cards each and other referral items, requesting that they distribute them to family, friends and co-workers and not be selfish about their care or their doctor.

M$C: What are your ideas on selecting and maintaining an efficient staff?
Mally: We all know that staff are very powerful, in that they can make or break a practice.  Therefore, I always look for multi-taskers, waitresses and sales personnel.  The Five Love Languages, by Gary Chapman, should be required reading for staff.  In short, the book summarizes that people (apply theory to spouse, family, children, co-workers, and patients) are different, interact differently, have different desires and needs.  Failure to recognize these differences will lead to certainty of failure to fulfill the needs of others.  For example, if a little old man or woman presents to your office for treatment and you are a high volume, fast-talking, in-and-out doctor that doesn’t recognize that the patient needs time with you, the patient will likely discontinue care.
I also recommend that—weekly, monthly and quarterly—doctors motivate their staffs with various perks, be it picnics, boat outings, staff lunches, gift certificates, etc.  A happy and healthy staff promotes a happy and healthy practice.  It starts from within:  Are you happy?

M$C: Do you enjoy your work?
Mally: Two words that best exemplify my work ethic, twenty-four/seven.  I work well in the mornings, so I begin my day at 5:00 AM at Gold’s Gym, and I train until 6:30 AM.  I see patients Mondays, Wednesdays and Fridays, 8:00 AM-6:00 PM;  Tuesdays and Thursdays, patient hours are 8:00 AM-12:00 PM, because I also teach private one-on-one extremity adjusting seminars for doctors from 1:00 PM-5:00 PM, and student seminars from 6:00 PM-9:00 PM.  No weekend patient hours for me, as I travel to teach seminars worldwide, approximately forty weekends of the year. 
I love what I do and it is my passion. 

M$C: With your practice being multi-disciplinary, can you give our readers some advice about setting up and maintaining such a practice in today’s health-care system?
Mally: Practice makes perfect is not a good cliché for a multidisciplinary practice.  Not to know is to guess and, in the eyes of the public, the high profile offices are under scrutiny.  Therefore, they must have all the “I’s” dotted and the “T’s” crossed.  This is why I chose Dr. Mark Sanna and Breakthrough Coaching to mentor my practice transformation.
The admirable, unique, private coaching from Dr. Sanna and his Breakthrough Coaching staff, namely Dr. Charlie Schuster, is preparing me and, my staff for the exciting changes forthcoming in our quest to becoming a legitimate, true multidisciplinary practice.  Medico-legal issues, Stark Laws, contracts, compliance, structure, billing, treatment and interdisciplinary protocols, as well as standards of practice, etc., are among the 300-400 on-line power point and audio training modules that are required to be completed, tested and implemented by the doctors, PT’s and all staff.  Individualized weekly coaching, constant analysis of practice statistics, teleconferences, chat rooms for the doctors and staff, regular national meetings and special seminars enhance the growth of the practice.

M$C: Any final words for our readers?
Mally: We’ve discussed communication and business management skills, practice styles, beliefs, attitudes, opinions, marketing strategies and various success ingredients; however, the skill level and expertise of the clinician is key to the success of the practice.  Consistency and Continuity of Care are the 3-C’s I promote in my 5-Star Extremity Adjusting Seminars on Sports and Occupational Injuries, a must for the practitioner that wants documented, scientifically validated techniques supported by the medical journals, as well.  Also, attend extensive hands-on technique seminars offered weekdays, weekends, one-on-one, or group, and inquire with your state board for state sponsored license renewal courses and/or conventions in your area.
Enjoy the fruits of your hard work and put your money where your mouth is and hands are…invest in yourself.  Remember the 4H’s:  Use your HEAD; have a compassionate HEART; sharpen the skills of your HANDS; and with balance of the HEAD, HEART and HANDS, touch the patient and watch them HEAL.
Good luck and God bless!!!

You may contact Dr. Mally  at 1-800-779-4263. Visit him at www.docmally.com or  e-mail [email protected]

Our sincere thanks to Dr. Mally and his staff at TRI-MED Health and Wellness Center, P.C., in Davenport, Iowa.

Each article in the MILLION DOLLAR CHIROPRACTIC series (M$C) focuses on the top surveyed issues facing chiropractors today.  Recruiting new patients, retention, profitability, marketing and staffing are each a determining factor in the growth, potential and success of the practice.
The subject of this issue’s profile is Dr. Timothy Weir an extremely successful chiropractor who has practiced in North Carolina, for the past twenty-two years.
Originally from Eau Claire, Wisconsin, Tim Weir began working at a very early age in a freight salvage store owned by his parents.  “That,” he says, “bred into me a good work ethic.”
As a child, he also loved music and started playing the piano at age four.  When he was sixteen-years-old, he traveled the United States and Canada in a gospel singing group, subsequently cutting a solo gospel album in Nashville, Tennessee, and, touring the US giving concerts. 
And this was all BEFORE he got into chiropractic!
Then, newly married at the age of eighteen, Tim and his bride, Rose, were off to Davenport, Iowa, where he proceeded to attend Palmer College of Chiropractic, graduating in 1981.

In an interview with The American Chiropractor, Dr. Tim Weir answers our Million Dollar Chiropractic (M$C) questions about his successful multidisciplinary practice where their motto is, “Get Well, Have Fun.”

M$C:  What influenced you to become a chiropractor?
Weir:  In 1956, my father was in a wheelchair suffering from Multiple Sclerosis.  The Mayo clinic had given up on him, and sent him home with six months to live.  Instead of taking him home to die, though, my mother took him to the Toftness Chiropractic Clinic in Cumberland, Wisconsin.  Within weeks, he was walking; within six months he was back at work; and he lived another thirty-two years. 
I had two brothers.  My older brother, Mike, who now practices in Monterey, California, was the first of us to become a chiropractor.  Mike has been a great mentor and friend;  but it was my other brother, Kevin, who just passed away after a short battle with liver cancer, and myself who went to Palmer at the same time.

M$C:   What type of practice do you have?
Weir:  Our practice is a true “multi-disciplinary” practice.  We are basically a medical practice, with chiropractic and physical therapy incorporated into the practice.  I realized that patients needed chiropractic care, but I also realized that they needed some type of medical care at the same time.  I am quick to admit that I am a big baby when it comes to pain, and that, when I had a severe back problem, I took some type of pain relief.  My feeling was, if I need this, the patients in my town deserve to have the same thing:  the marriage of the healing arts…medicine, chiropractic, physical therapy and massage.

M$C:  Give us a physical description of your office facility.
Weir:  First Choice Family Healthcare is right on one of the busiest streets in North Raleigh.  We have approximately 5,700 sq. ft.  We have a beautiful office and a great therapy suite, and are set up to do urgent care as well as physical medicine.  You have heard that the three success points of any business are location, location, location.  Well, our clinic is on the corner of two busy streets, right between Wendy’s and Burger King (great locators for people.)  It is also possible to be on a street that is too busy…as is the building two doors down from ours.  Our saving grace is a back entrance from a less busy street. 
Raleigh is the capital city of North Carolina, and is a wonderful city to live and practice in.

M$C:  What’s the income service   level that you provide annually?
Weir:  I guess that I tend to look at our practice “pre-multidisciplinary.”  We actually started the multidisciplinary practice under the direction of a consultant.  But, it seemed like everything that he told us to do required some type of equipment to purchase from him.  We did well, but there were a lot of chiropractic practices in town that were doing just as well. 
Then we found Dr. Daniel Dahan of Practice Perfect.  He was able to help us get rid of some equipment, cut overhead and increase the practice all at the same time.  What I always considered a “pipedream” a couple of years ago—a million-dollar-per-year practice—is now a dream come true.

M$C:  Do you have a margin formula or set profit standard for the business?
Weir:  I run our practice on goals.  We have an objective, and that is to be better this year than we were last year.  Our goal is to provide quality service to a greater amount of people.  I get our staff involved with this.  Every staff member knows what our goals are, where we stand every day of the week, and how far we have left to go.  Bob Proctor taught me that the important thing was to write my goal down, put it in my pocket and read it as often as I can.  My staff all have these goal cards, and the front desk person will walkie-talkie everyone to read their goal cards several times per day.

M$C:  Is there anyone in particular to whom you attribute your professional success?
Weir:  I was raised with Judeo-Christian ethics.  I practiced WWJD (What Would Jesus Do?) long before bracelets. 
My wife is not only the love of my life and my best friend, but also my business partner.  She has believed in me, and our vision, more than anyone. 
But there are two people who have helped change my life.  First, in my professional career, there is my  consultant, Dr. Daniel Dahan.  I have never met a more caring, loving and ethical u        u man than this guy.  There is never a time that I have called on him that he has not helped me walk through a problem.  There are so many issues involved in a multidisciplinary clinic, and he has been there every step of the way—never a question of whether something should or should not be done but, rather, is it right or wrong—end of discussion.  He is filled with wisdom beyond his earthly years. 
Second of all, Bob Proctor has helped me in my success education.  He has helped me grasp the concepts that I needed to help me become wealthy.  Gaining wealth is easy; believing that you deserve it is the hard part.  He helped me realize that life is too short to waste it doing things I hate to do.  One of my favorite quotes from Bob is, “Most people are tiptoeing through life, hoping they safely make it to death.”  Just make the decision that you are going to have the best practice in your city, goal for that, and go for it.   Don’t just look to chiropractors for mentoring.  Success has nothing to do with how many patients you see, but it has to do with what thoughts go on between your ears!  Most of us need mental enemas!

M$C:  Tell us about your family.
Weir:  My wife, Rose, and I have been married for twenty-seven years.  We have three beautiful children—Wendi, Nikki and Tyler—and they all work in our office.  Our daughter, Wendi, graduated from Oral Roberts University with a degree in marketing, and now has become a certified coder.  Nikki has taken over our front desk area, and is doing a tremendous job.  Tyler is six, and he has placed himself in as office manager.  We have been blessed with a wonderful family and marriage.
 
M$C:  What marketing strategies do you use to attract new patients and to keep current patients?
Weir:  Of course, when you first start a practice, you have nothing to do but external marketing.  When we first started our chiropractic practice, I went door-to-door doing surveys, mall screenings and newspaper ads.  Now, most of our marketing is done internally. 
As you know, our office motto is “Get Well, Have Fun.”  When you realize that people give up over an hour, three-to-four times per week, it makes you appreciate them.  So, we try to make their visits enjoyable.  We are always looking at ways to have a party in our office. 
For example, our July program was “It’s Christmas in July at First Choice.”  We had our office decorated with Christmas decorations and we had our “12 Days of Christmas” Contest.  Everyday, for twelve days, we gave away a present.  Patients would get a ticket for keeping appointments, referring patients, etc., then, everyday, we drew a name for a prize.  All month we were aiming for July 31st, our Christmas party. 
We adopted the Wake County Foster Care Program.  We decided these kids needed to have a little Christmas, so our patients helped us collect book bags for these kids to go back to school with.  We collected over 150 book bags u  u filled with supplies.  On the 31st, we had games, prizes, snow cones, moonwalks and lots of food at our Christmas party.  These kids had a blast, and we did, too!  You would be amazed at how many people will help you reach your goal if you but ask.
Another key is to keep your name in front of your patients.  A couple of years ago, a patient came in with this tremendous story of how this surgeon had literally saved his life.  When I asked the surgeon’s name, the patient could not tell me.  That made me realize that, if I don’t keep my name in front of them…they won’t remember my name either. 
Everyday, our patients receive a positive thought e-mail from me and our clinic…it’s called the “Insight of the Day.”  It is done by a service called the 3% Club and, once our patient’s name is given to them, I don’t have to do a thing!  Everyday they get an uplifting positive message in a very short sentence.  Then it gives my name, and the clinic name.  It is an incredible marketing tool that is so inexpensive it is ludicrous! 
The key is good customer service.  We choose where we go to eat by their customer service.  One of my favorite restaurants in Raleigh is Winston’s Grille.  These people treat you like kings.  So, when we shop, or go out to eat, and if the customer service is great, we emulate that. 
We are known around the city as the clinic with fresh baked chocolate chip cookies.  We bought   a little convection oven, and we go to Sam’s Club and buy bulk dough.  It takes so little time and effort, but it makes a tremendous impact on patients.  I got this cookie idea from Dr. Bob Lupo in Tampa.  Use other people’s ideas!
We started to study the “Fish Philosphy” based on the books written about Seattle’s Pike Place Fish market. Again, it boils down to giving good customer service. It starts on day one, and ends with their release from care. At their release, it is announced over the walkie-talkies, “There’s a fish swimming away”. At this point, we give them a First Choice tee shirt, and take their picture with the staff. Within a week, they have a copy of this picture with a nice thank you card. If Nordstroms can send you a thank you card for a little $15.00 purchase, we figure that we can too!

M$C:  Obviously, every doctor, at some time or other in his practice, experiences problems with patient retention.  How do you handle such problems? 
Weir:  Our patient retention is a staff endeavor!  From Day One, when they walk in the door, we are letting them know the importance of keeping up with their care.  I learned from Dr. Peter Fernandez several years ago to keep missed appointments under 10%.  We are very strict with our appointments.  Our patients know that it is a major infraction to miss an appointment in our office; it jeopardizes their care.
We instituted something from the game of baseball, “Three strikes and you’re OUT.”  On the first missed appointment, they get a big red sticker on their chart:  “Missed Appointment.”  Every person that they see that day, comments on the missed appointment.  Honestly, if a person misses their appointment, and no one notices it or says anything, they don’t believe that you think that it is all that important for them to keep either.  But, if everyone hits them with some type of remark, you can bet they are going to think twice about another miss.  The second miss is not as graciously acknowledged, and number u      u three is downright stern.  After that, they have become more of a liability than an asset. 
You must genuinely care.  People can tell.  If you have a fun, positive place to come to for care, it’s not hard to get people to come.  Again, question yourself!  Would you come to your office three times per week for twelve weeks?   Make the climate in your office fun and enjoyable, and they will come.
 
M$C:  We all know that an efficient staff is a crucial com-ponent of a successful practice.  Tell us about your staff  (how  you find them, train them, what qualities you look for).
Weir:  In a multidisciplinary team, the key has to be this:  Nobody is the big cheese!  We are all important to the patient’s getting well.  I look for people who are friendly, people loving people.  I also understand that, although I am an extrovert, not everyone is, and there are a lot of things that I don’t like to do; and so, to get those things done, I best not hire an extrovert like me!  I try to surround myself with people who will balance me out. 
I was once taught that I need to find my weaknesses and get stronger in those areas.  What a mistake.  The key is to find your strengths, get stronger in those areas, and hire other people to do your “weak areas”.  Regardless of whether you are an introvert, or an extrovert, you still need to love and care for people.
We have a great team, and when I hire new people, I let them know that my main goal is to protect my team and that the rest of the team has to approve.

M$C:  Do you enjoy your work?  How do you feel about going to work in the morning?  
Weir:  I am not a morning person!  I have had to learn to be a morning person.  Chiropractors are special birds!  They really are.  It takes someone special to do what we do.  We are healers, business people, entrepreneurs and in sales, all in one package.  It is really amazing how much more you love going to work when you are earning a great income, seeing great patients and have a loving staff.  All of those things are things you have control over!  If you don’t love going to work, you need to take inventory of your life, find out what is out of sync and fix it.  As Bob Proctor says, I think that the only people who are working are those people who are doing what they don’t love to do!  If you go to a place and do what you love to do, that is not work!  It is fulfilling your destiny and purpose.  What you do should give you life…not sap life from you!

M$C: With your practice being multidisciplinary, can you give our readers your advice about setting up and maintaining such a practice in today’s healthcare system? 
Weir:  If you decide that you want to build a multidisciplinary practice, you must realize that you cannot do it alone.  This is not the kind of practice that your great-grandfather had!  You must partner with a management consultant who knows the multidisciplinary practice from A to Z.  You must also have a good healthcare attorney and a good accountant.  I am amazed by people who will go to stockbrokers who drive thirty-year-old cars and live in apartments over hardware stores!  I also do not understand how doctors can go to other doctors who are failures in practice and ask for their advice.  If you want advice on how to put in a Jacuzzi, don’t ask your mailman! 
Solomon once said that there is wisdom in the council of many.  Surround yourself with people who believe in you and your vision.  Immerse yourself in the knowledge you need to succeed.
 
M$C:  Other than traditional chiropractic care, do you include any other type of services or products in your clinic which further help your patients as well as bring in additional revenue to your practice? 
Weir:  We provide urgent care in our practice.  Our MD is in the office from the early morning huddle until the door is locked at night.  She loves to do sutures and injections.  We are getting ready to expand into trigger point injections and possibly prolotherapy. 
I wrote a book a couple of years ago on fibromyalgia, You’re Not Crazy, an Overcomers Guide to Fibromyalgia.  We do a couple of things for fibromyalgia.  One is nutritional counseling.   We also use the Synaptic Electronic Nerve Block.  Ninety-five percent of the time, if a patient comes in with a migraine, they leave without it.  If you are going to treat fibromyalgia, get a “toolkit” for these patients to use.  One product that you want to make sure that you include is stopain® Professional Strenght Cryotherapy  Spray.  This is a pain relieving spray that contains MSM.  It is a part of the puzzle.  We also use it for any type of muscle pain.

M$C:  Any final words for our readers? 
Weir:  Yes.  Never, never, never give up.  It seems like there are so many people who are on the brink of success, and they give in to temporary defeat.  Success is not based on how many times you fall, but on how many times you get up!  You are a part of a great profession.  People who believe that there is a power that animates the living world, and you help people come in contact with that power every day!  Forget about going to an office to practice chiropractic!  Turn your office into a healing center, a filling station for the power of life!  Have the mind that you are going to have a blast doing the very thing that you love to do:  getting sick people well—spirit, soul and body.
You may contact Dr. Weir at 919-954-0050 or visit him at www.DrTimWeir.com.

Our sincere thanks to Dr. Weir and his staff at First Choice Family Healthcare, P.C., of North Raleigh, North Carolina.

Editor’s Note:  Do you have a million dollar practice that you’d like TAC to highlight in our Million Dollar Chiropractic column?  Contact TAC’s editor Jaclyn Busch Touzard by phone/fax: 1-305-716-9212 or email: [email protected].  We want your inspiring story!  Contact us today!

Dr. Steve Querio’s M$C Profile

PERSONAL:
Married to wife, Lisa for 5 years and has 3 children; Nikki, age 10; Luke, age 3; and Emily, age 1 1/2.
Recreation and Leisure:  I enjoy spending time with my kids.  I also enjoy traveling and watching Green Bay Packer football. 
Professional Affiliations: Wisconsin Chiropractic Assn., American Chiropractic Assn., Green Bay Chamber of Commerce
Seminar Attendance:  Wisconsin Chiropractic Assn. license renewal seminars; Breakthrough Coaching seminars & various other seminars
Vacations:  I have been trying to take more time off in the form of extended weekends and love to travel to warmer climates in the winter.

PRACTICE PARTICULARS
Clinic:  We are located across the street from a hospital.  We utilize 9000 sq. ft., which is an entire floor of a 5-story medical office building.  We are quickly running out of room.
Office Hours:   Our chiropractic division is open  8 A.M. to 6 P.M., Monday, Wednesday &  Friday; Tuesday and Thursday, 8 A.M. to 5 P.M.  Our medical division is open 7 A.M. to 7 P.M., Monday through Friday and 8 A.M. to 1 P.M., Sat. & Sun.
Techniques:  Gonstead & Diversified
Staff:  Dr. Querio’s office employs approximately 30 employees.  The professional staff includes 2 D.C.’s, 2 M.D.’s & 1 P.A. in the urgent care, 1 occupational M.D., 1 P.T., 1 P.T.A., 1 massage therapist, a nursing staff, and a lab and X-ray staff.  The office also has administrative staff in management, reception and billing.

M$C: What influenced you to become a chiropractor?
Querio:  As with a lot of chiropractors, I have a story to tell.  I was about thirteen years old and I injured my low back.  I had always been interested in the sciences as long as I could remember.  So, I knew that I would eventually be in some type of health care field.  Following my injury, I visited a local chiropractor, Dr. Gerry Abbeglen, who did a fantastic job and later got me interested in chiropractic.  The rest is history!

M$C: What type of practice do you have?
Querio:  My practice life has been an interesting and exciting experience.  I began my chiropractic career without the incorporation of any physical therapy procedures.  Over time, as I slowly used some various rehab, I experienced the great benefit that the combination of adjusting and rehabilitation has had with my patients.  So, I continued to advance my practice. 
I started by adding massage and physical therapy.  After some time, I decided to bring a medical physician into the practice.  Two friends, Dean Lois, M.D., and Dave Andrews, P.A.-C, and I recently had an opportunity to create a new company by taking over a medical facility and adding chiropractic and physical therapy to it.  This combined facility began March 1, 2003, and we are having a great time.  My partners direct the medical division and I direct the chiropractic and physical therapy divisions.  I can’t say that every step in this conversion has been an easy task.  We’ve had to handle a number of difficult starting issues such as the overall merger of our staffs, combining two different software systems, and changing a large number of procedures.  We use a professional coach who has helped us a great deal in making this a smooth process. 
It was an eye opening experience for me with the different types of issues that a medical facility faces as compared to a chiropractic office.  In one aspect, our facilities are quite different in that medical clinics treat a variety of conditions that don’t typically walk into a chiropractic clinic.  But, on the other hand, we’re similar in that we all try to provide great care and all have the same business concerns.
As far as our practice mix, we are presently trying to develop our chiropractic, occupational and physical medicine, and physical therapy areas.  I partnered with a company that specializes in u u working with multidisciplinary practices to bolster our occupational medicine area.  We also have a mix of reimbursements that range from general insurance, managed care, company contracts, and cash.

M$C: Please describe the size, lo-cation and physical appearance of your practice facility. 
Querio:  Our clinic is located on a fairly busy street in Green Bay.  We are in a medical office building, across the street from a local hospital, and are in a small medical area in the city.  We presently utilize 9000 sq. ft., but would really like to grow into approximately 12-15,000 sq. ft. by next year.  Green Bay is a city of approximately 100,000 people.  Brown County has a population of about 250,000.

M$C: What’s the income service   level that you provide annually?
Querio:  When we took over the medical facility and added the chiropractic and physical therapy, we had to rethink the numbers because we made so many changes.  We cut over $700,000/year in expenses!  We’ve been running the new facility for approximately four months now, and we have been fairly consistent with what we thought we would produce in service.  We certainly have qualified for this article series and hope to have tremendous growth in the future.
M$C: Do you have a margin formula or set profit standard for the business?
Querio:  I think one of the most important things you can do in a practice is to track the office statistics.  We try to monitor various stats so we always know what direction the practice is going.  Some of these statistics include number of new patients, patient visits, performance of staff, financial stats, etc. 
Some of the standard formulas that we set as goals include collections, where we feel that our practice should be at approximately 80% of services; our Accounts Receivable should not be greater than 2.5 times our monthly services; and we want to keep our cancellation/reschedules below approximately 13%.  Due to the fact that we now have urgent medical care in our clinic where patients may come in for one visit, this significantly alters our previous patient visit average for the overall clinic, so we are coming up with some new numbers.

M$C: Do you have someone to whom you attribute your success?
Querio:  Without question, I attribute my work ethic and determination to my parents.  I grew up in a middle class family and they always taught me the value of hard work.  They always encouraged me to never give up.  Over time, now, I’ve learned that working smart is just as important as working hard. 
I learned a great part of my technique from Larry Troxell, DC.  I certainly consider my present mentor to be Mark Sanna, DC.  He has incredible vision and is taking Breakthrough Coaching to the forefront of the chiropractic profession.  I must also acknowledge my coach, Charlie Schuster, DC, who has helped me through this massive transition of practice.  I am surprised he has an ear left after all of the phone calls I’ve made!

M$C: Tell us about your family.
Querio:  I have been married to my wife, Lisa, for five years.  I have three great kids; Nikki, Luke and Emily.  Nikki is the social butterfly and I’m sure she’ll be on Star Search someday.  Luke is my “shadow” and goes wherever I go.  He’s very strong willed.  Emily is my little princess. 

M$C: What marketing strategies do you use to attract new patients and to keep current patients?
Querio:  I have always felt that a combination of internal and external marketing was necessary.  However, I feel that you must always start with internal marketing and plan your external marketing off that.  With that said, our clinic has mainly used patient and professional referrals as a source of our new patients.  We have added a fulltime director of sales and marketing, which has helped greatly.  She mainly works with the occupational area, but we have been having very good success with this.  Marketing is really a relationship game.
As far as keeping the patients we have…I think that if you give patients service that exceeds their expectations, they’ll be patients for life.

M$C: Obviously, every doctor, at some time or other in his practice, experiences problems with patient retention.  How do you handle such problems? 
Querio:  I think that patient retention starts on Day One.  The patient has to feel comfortable with you and your staff.  I also feel a good report of findings is essential.  I tell it like it is, good or bad.  I’ve never been the type to pressure the patient into care.  I’ve just given good reports of findings and the patients usually understand the need for the care.  When the patient makes the decision to complete a plan of treatment, they will usually follow through.  If they start to fall from care, it’s important that you talk to them about it immediately.
 
M$C: We all know that an efficient staff is a crucial com-ponent of a successful practice.  Tell us about your staff  (How  u you find them, train them, what qualities you look for).
Querio:  As everyone reading this knows, a staff can make or break a practice.  I’ve found that I would much rather hire someone who has a positive personality and passion over knowledge.  I can teach anyone anything; but I can’t teach someone how to have passion or how to be friendly to people.  You either have it or you don’t. 
Unfortunately, in this practice transition, my partners and I have had to make some tough decisions and release a lot of employees.  It never is a fun thing to do, but, if you want a successful practice, you must have the right team in place.  I’ve also learned that keeping a staff member on the payroll when you know they should be released is a huge mistake.  Poor staff members are a slow cancer in a practice.  Get rid of them.  Take it from me, I’ve made (and learned from) every mistake in the book.
I feel that the staff we have now is the “right team”.  We are all working well together and we can see the positive effects of it.  They are working really hard and no practice runs well without a good staff.

M$C: Do you en-joy your work?  How do you feel about going to work in the morning?  
Querio:  I am very fortunate to have two great partners.  We all have our different strengths and work great together.  They were chiropractic patients prior to our partnership, too.  It’s been very exciting to start this new venture and, although it has been challenging at times, I go to work every day with a big smile on my face.  The challenges drive me.  I would be bored without them.  I think, if you start going to work with a frown on your face, it’s time to take a hard look at yourself.

M$C: With your practice being multidisciplinary, can you give our readers your advice about setting up and maintaining such a practice in today’s healthcare system? 
Querio:  The business of healthcare today is becoming more and more complex.  Certainly, with multidisciplinary practices, there are a great deal of legal requirements.  My advice for anyone who wants to move into this type of practice is to get sound legal, accounting and management advice.  Don’t try to do this on your own!  You should find an ethical and knowledgeable management group.  Research this, as I did, and you’ll be happy you did. 
Also, find an accountant and attorney who are well versed in health care issues.  Don’t just go out and hire your attorney friend who practices PI and divorce law to try to set up your multidisciplinary healthcare practice. 

M$C: Other than traditional chiropractic care, do you include any other type of services or products in your clinic which further help your patients as well as bring in additional revenue to your practice? 
Querio:  This is another area that our clinic is expanding.  We have used orthotics from Footlevelers and have had good success.  Due to the fact that we treat a variety of conditions in our medical and chiropractic departments, we use a multitude of orthopedic devices from Hessco.  These include everything from pillows and knee supports to casts.  We also utilize some nutritional products from Phytopharmica, which is based out of Green Bay.

M$C: Any final words for our readers? 
Querio:  I truly believe that this is a new era for our profession.  I’ve found that every health discipline has its own problems but, if we can put our differences aside and try to become a collective chiropractic voice, there are significant opportunities out there.  Patients are looking for what we have to offer.  If you can keep the positive picture in front of you, you will go far.  Don’t listen to the negative people around you.  Remember, no one ever built a statue for a critic.
You may contact Dr. Querio at 920-497-5711 or [email protected].

Our sincere thanks to Dr. Querio and his Staff at Fox River Healthcare, S.C., of Green Bay, Winsconsin. TAC

Editor’s Note:  Do you have a million dollar practice that you’d like TAC to highlight in our Million Dollar Chiropractic column?  Contact TAC’s editor Jaclyn Busch Touzard by phone/fax: 1-305-716-9212 or email: [email protected].  We want your inspiring story!  Contact us today!

Dr. Deane Mink’s M$C Profile

PERSONAL
Married to wife, Sue, for 15 years; 7 children:  Mark, 43; Debbie, 41; Mike, 39; Matt, 36; Mitch, 29; Cheri, 32; and Christie, 25; 10 grandchildren.
Recreation and Leisure:  Fishing and/or netting shrimp almost every week; boating; weekends at Florida waterfront properties; season ticket holder for Univ. of Florida football team. “GO GATORS!”
Professional Affiliations: Georgia Chiropractic Assn., Florida Chiropractic Assn., International Chiropractic Assn., Palmer College Alumni Assn., Valdosta Chamber of Commerce, Better Business Bureau.
Seminar Attendance:  Georgia Chiropractic Assn. license renewal seminars; various other technique and nutritional seminars.
Vacations:  Many extended weekends, mostly to Gulf Coast and Atlantic Coast of Florida; weeklong family vacation the week of July 4th (25+ folks).

PRACTICE PARTICULARS
Clinic:  9000 sq. ft., freestanding building, includes 13 treatment Rooms, 2 massage Rooms, Rehab Room and Vitamin Shop.
Office Hours:   7 A.M. to 6 P.M., Monday through Friday; Saturday, 8 A.M. to noon.
Techniques:  Palmer, Full Spine, Diversified, Activator, Flexion Distraction.
Staff:  Dr. Mink’s office employs 2 DC’s, 1 Rehab Director, 6 Licensed Massage Therapists, 2 receptionists, 4 chiropractic assistants, an office manager (wife, Sue Mink), and 4 staff in business office.

M$C:   Dr. Mink, what influenced you to become a chiropractor?
Mink:  I was a minor league baseball player, from 1952-1958, with the Dodger organization.  My first chiropractic experience was for treatment of an injured shoulder that threatened my baseball career.  As a result of that experience, I made the decision, with the encouragement of my chiropractor, to pursue chiropractic.

M$C:   What type of practice  do you have?
Mink:  Mink Chiropractic Center is a subluxation-based practice.  We currently have over 4300 active patient records.  The breakdown is as follows:  54% health insurance, 25% cash, 12% Medicare, 8% personal injury, 1% workers comp.  We have all our new patients attend a health care class offered each Tuesday night, and have them bring their immediate family members to get the whole family educated about a drug-free lifestyle.  We treat patients for pain management, but strive to build a wellness-oriented practice.

M$C:  How many hours a week do you work?
Mink:  Our office is open from 7 A.M. to 6 P.M., Monday through Friday, and on Saturday, 8 A.M. to noon.  I presently treat patients on a three-day work week (Monday, Wednesday, Friday), working about thirty-two hours per week doing patient treatments and the related patient paperwork and records.  My associate, Dr. Ken Register, works about thirty-eight hours per week, Tuesday through Saturday.

M$C:  What’s the income service level that you provide annually?
Mink:  I treat an average of 230 patients per week and my associate, Dr. Ken Register, treats an average of 280 patients per week.  The practice averages one hundred new patients per month.  In 2002, the gross collections for the clinic were 1.6 million.

M$C: Is there someone in particular to whom you attribute your success?  Any mentors, perhaps? 
Mink:  In the early 1960’s, I approached Dr. William Harris for guidance in growing my practice.  Dr. Harris is a retired Georgia chiropractor that still contributes his time and his wealth to the advancement of chiropractic on a state and national level. 
My patients are responsible for my success, as I am now treating the 3rd, 4th  and even 5th generations.  My success is due not only to my own efforts but, also, to the hard working and dedicated staff in our clinic that believes in what we do and in the health of our community.

M$C:   What marketing strategies do you use to attract new patients and to keep current patients?  
Mink:  I have mailed an in-house newsletter quarterly consistently for over forty years.  My patient mail list is updated and maintained in my office.  This listing is of great value.  Patients may drop out of care, but they will come back; and not only the patient that previously received care, but the family, friends and acquaintances of that patient. 
I am, also, involved in the community and contribute to the success of our community.  The local Chamber of Commerce named our office the “Small Business of the Year” for 1999.  The local paper sponsors the “Best of South Georgia”, where the readers’ vote on various categories.  Our office has won the “Best Chiropractor in South Georgia” for the three years since this feature began.  Being a very active positive aspect of our community draws patients to our office. 
Dr. Register has a booth at many of our community shows and health fairs and offers in-business lectures and training. 
We offer lots of TLC to our patients.  We have a state-of-the-art new office, and equipment that projects to the patients that we are here to serve their health care needs for now and the future.  We encourage a family-type everybody-needs-adjustments attitude.

M$C:  Do you enjoy your work?  How do you feel about going to work in the morning?
Mink:  I LOVE IT.  I am committed to the healing power of chiropractic, and serving my patients is so much a part of my life that I cannot imagine full retirement.  I work because I love it.  We have such a wonderful fully equipped, well-maintained, and professionally staffed office that going to work everyday is like going to Disney World.  My wife and I work together, and when we work—we work hard.  But when we’re off –we play hard.   This makes life well balanced and very satisfying and rewarding.

M$C:  Having such a successful practice which has served the same community for your long professional career, what is your advice about setting up and maintaining such a practice in today’s healthcare system? 
Mink:  Determine your demographics and make a plan that works in your area.  Start and maintain a mailing list of your patients.  Newsletters are a wonderful way to communicate to large numbers of previous and potential patients and to keep your services in their minds on a regular basis.  Potential patients must feel confident and comfortable with your office, and your staff, as well as yourself.  Your office must be patient friendly. 
Be sure everything you do is ultra ethical—your reputation and your future depend on it.  You must genuinely care about chiropractic and the lifestyle it offers; and you must care about your patients and their families’ health.

M$C:   Other than traditional chiropractic care, do you include any other type of services or products in your clinic which further help your patients, as well as bring in additional revenue to your practice?
Mink:   We have a nutritional shop in our office with everything that works; and we keep it well stocked.  We have a free nutritional class each month for our patients, staff and any family members or guests they wish to bring.  We have all necessary support belts, collars, traction devices and pillows.  We offer custom fitted orthotics.  Our facility has a completely equipped rehab room and we do computerized range of motion and muscle testing. 
We also have two massage rooms available each day for full body massage therapy.  Every day we have licensed massage therapists as part of our staff to do eight minutes of specific trigger point therapy as part of the patient’s chiropractic visit.

M$C:  Any final words for our readers?
Mink:  Chiropractic practices are the reflections of the concept the chiropractor has about his profession.  There are lots of one-man-show type practices around.  This is the concept of the chiropractor and, is perfectly all right.  I know many of these chiropractors, and they are happy in what they do.
My concept has always been “bigger can be better” and we’ve “biggie sized” chiropractic in South Georgia by building the new building and offering so many health related services and products.  We keep it simple for our patients.  Almost 100% of our patients—whether active or occasional—have a good taste in their mouths about chiropractic and are happy to send their family and friends to us.
After forty-two years in my profession, all this sounds like so much hard work for me; but I’ll be the first to admit that having a wife “who runs the whole place,” a young associate who is a wellness disciple and very dedicated, and lots of great employees (total of eighteen) makes my job much easier.
You may contact Dr. Deane Mink by telephone at 229-242-3042, or by e-mail at [email protected].  Visit his web site at www.minkchiro.com.

Our sincere thanks to Dr. Mink and his Staff at Mink Chiropractic Center, LLC, of Valdosta, Georgia. TAC