OHIO:  A recent series of cases, all based on the same set of facts, got a pair of Ohio chiropractors as well as other health care providers in deep trouble. The facts were the same in all situations. In exchange for referring patients to a diagnostic company, the providers received “lease” payments for office space. The amount of payment under these sham leases was directly related to the number of referrals made, and had no relation to the actual fair market value for rental of the leased space. The tests were found to be medically unnecessary.

The chiropractors pleaded guilty. One DC was required to pay $50,000 to defrauded insurers, and she was lucky; the other DC had to pay in excess of $67,000, spent four months in prison and another four months in home detention.

The government is not happy with doctors who receive money for the referral of patients. If you do enter into a business arrangement with a referral source or with someone, to whom you refer patients, make certain that your business arrangement fits into a bona fide safe harbor.

Keep in mind that the federal anti-kickback statute prohibits knowingly and willfully soliciting, receiving, offering, or paying anything of value to induce referrals of items or services payable by a federal health care program. The government considers kickbacks to be harmful because they distort decision-making; cause over utilization; increase costs to the federal health care programs; and result in unfair competition by freezing out competitors unwilling to pay kickbacks.

Both parties to an impermissible kickback transaction may be liable. Violation of the statute constitutes a felony punishable by a maximum fine of $25,000, imprisonment for up to 5 years, or both. The government may also initiate administrative proceedings to exclude persons from the federal health care programs or to impose civil money penalties for kickback violations.  Many states have similar laws in effect so, even if you do not treat Medicare/Medicaid patients, you may still be liable under your state’s laws.

What Does This Mean to You?  In order to avoid problems, consider the following issues when analyzing a proposed transaction—they signify potential problems.

1. Will the new source of income generated be provided by your existing patients?

2. Will the company that you’re working with pre-dominantly, or exclusively, service your existing patient base (or patients under your control or influence)?

3. Is your primary contribution to the venture referrals?

4. Are you required to make little or no financial or other investment in the business, delegating almost the entire operation to the other party, while retaining profits generated from your captive referral base?

5. Is the practical effect of the arrangement, viewed in its entirety, to provide you with the opportunity to bill insurers and patients for business otherwise provided by an outside party?

6. Does the remuneration from the venture to you (i.e., the profits of the venture) take into account the value and volume of business that you generate?

7. Is someone making you promises that sound to good to be true?

8. Is the other party telling you that you can rely on his lawyer and that you do not need to go to the expense of hiring your own?

If your answer is, “Yes,” to any of the foregoing questions, make sure that your health care lawyer carefully reviews this “terrific deal” before you, too, are discussing a “deal” of a different nature with your local district attorney.

 

If you have any questions with regard to the above or with respect to any other legal health care issues, FAX your questions to Deborah A. Green, Esq., at 954-971-3787 or call 954-971-7778 or e-mail [email protected]. In future columns, she will be answering those questions which are of interest to the broadest audience.

Ms. Green has been a practicing attorney since 1977. She is admitted to the practice of law in the State of New York and Florida and is a member of the American Health Lawyers Association, the New York State Bar Association Health Care System Design Committee, the New York State Bar Association Health Care Providers Committee, the American Bar Association Health Law Section and the Florida Bar Health Law Section. She has formed numerous multi-discipline practices throughout the country.

DISCLAIMER

Because this column is being presented to you by an attorney, it would not be complete without a disclaimer. This column is provided subject to and governed expressly by the terms of this disclaimer. This column is provided for educational purposes only. The accuracy or timeliness of the information presented herein is not warranted. The information presented herein is not intended to be advice as to a specific fact pattern with which you may be presented.  Accordingly, please note that the information contained herein is not being presented as legal advice with respect to any matter and that no attorney-client relationship is hereby established.

The children have gone back to school and summer is over—the season, if not the heat.   Many offices see an ebb and flow to their practice volume during certain times of the year and summer can be one of the more relaxed times.  The pace of activity usually accelerates going into fall.  Along with your regular schedule, there is an abundance of conventions, seminars and trade shows you can attend.  You have your choice of courses for continuing education or additional training and certifications.

Many people are accustomed to making resolutions as they celebrate the New Year.  Where business is concerned, the end of summer almost seems a more appropriate time for this process.  Evaluating the different facets of your practice at this time of year can provide the time and resources to adequately research and plan any changes or additions you might wish to implement in your practice.

Several basic questions should be considered when assessing diagnostics in your practice. Honesty is the best policy when answering.  There is no pass or fail, just the opportunity to gain insight to improve your practice and the health of your patients.  It may be helpful for your associates and staff to also provide responses.

1. What diagnostic equipment do you have in your office?

2. What diagnostic procedures and tests do you regularly use?

3. Are you taking the full and best advantage of your current diagnostics?

4. For each of the tests or procedures, can you answer the following:

 a. What information will be gained?
 b. How will that knowledge help the patient?
 c. Do you know how to document the necessity for the procedure?
 d. Do you document and use the results from the test or procedure?

5.  Are you being reimbursed appropriately for the diagnostic procedures you bill?

6.  Are there “new or improved” procedures or equipment available?

Compare your answers to the first two questions—do you have diagnostic equipment in your office that you do not use regularly?  If you have equipment not being utilized, consider why you no longer use it.  Was the equipment difficult to use? Did it take too much time, or not provide useful information? Were there problems when billing for the test?  Was the equipment ever used on a regular basis?  Are there diagnostics you previously used regularly but, now, do not?  Why not?  If you were able to resolve or correct the problems that led to your rejection of the test or procedure, would you reconsider its use?  Is there a habit in your practice of acquisition and abandonment?  (Shiny toy syndrome!)

Questions three, four and five should be correlated to each other as well.  If you and your associates are not able to provide appropriate answers to all aspects of question four, it is doubtful you are realizing the full potential of diagnostics.  Lacking sufficient necessity and documentation, it is also likely reimbursement is being denied or requires additional time and effort to collect.  Billing and collections staff should have the same information about diagnostics readily available to them, especially for tests or procedures you bill.  There is a general consensus in diagnostic collections; more expensive procedures require submission of more documentation of necessity and efficacy in order to obtain payment.

You now have an idea of the equipment, tests and procedures that have proven most beneficial to you and your patients.  In your evaluation, did any patterns develop?  The results allow you to recognize strengths as well as weaknesses in your diagnostic protocols.  What resources are available to correct or improve the deficiencies in your existing systems?  Would training or certifications help?  Many seminars and courses are available for fall and winter.  Do any of your vendors make in-service presentations available to you and your staff that could provide additional training or documentation?  These are just a few suggestions.

And lastly, of course, new and improved equipment is available.  Your review may show the benefits of new or upgraded equipment or implementation of advanced diagnostic procedures in your practice.  Your analysis can help prevent repeating the same types of mistakes and will enable you to take the full and best advantage of diagnostics for your practice and the health of your patients.

Ms. Plank has an extensive background in medical and facilities management.  During the past 15 years, Ms. Plank has provided technical and management services to healthcare providers, specializing in radiology and neurology.  She is currently the Vice President of Corporate Services for Practice Perfect.  Contact her at [email protected], or visit www.dahan.com.

Diagnostic procedures used by many chiropractors fall into two basic business classifications:  those that represent billable services for the doctor or clinic and those that are referred to another practitioner or facility with no financial component to the referring chiropractor.
 
Do It Yourself

In many cases of the tests or proceures that can generate billing, the chiropractor has a choice of “doing it yourself” (DIY) and providing the service in-house.  This usually represents full ownership/long-term equipment lease of equipment and the doctor or staff trained and qualified to perform the procedure.  Interpretation of the testing may also be required.  X-ray exams are a billable diagnostic procedure commonly offered in-house by chiropractors.     

Referral

The diagnostic procedures you refer out should be reviewed on a regular basis from a business management perspective.  What is your average monthly referral volume for each specific procedure?  What would your costs be in the delivery of the service?  Is the referral number high enough for you to consider providing and billing the service?  Is the procedure in the scope of practice for your licensed professionals?  Does it represent additional liability to your practice?  Is the procedure reimbursable to your practice structure by insurance plans? Would it make sense… professionally and financially?

The answers to these questions may identify revenue potential for your clinic.  Although your monthly referral average for procedures such as MRI tests may not justify the expense of operating an imaging center, the number might be sufficient to justify purchasing or leasing time at a local facility, particularly if your referral average has a steady and sufficient base.

There are usually costs involved if you plan to bill for something.  Insurance companies wonder where the value is if the test or service did not represent costs to you, in the form of time, the training and expertise necessary to provide the service or the hard costs of overhead and equipment.  The logic is, if you did not have to do anything and it did not cost you anything, then it probably isn’t worth anything in reimbursable terms to you.

Outsourcing

Outsourcing, the term and practice, has been in use by hospitals and large health care providers for years.  Outsourcing is really just hiring someone, a company, a physician, group or other entity, to provide specific services for or within your facility.  The outsource provider is hired to supply services, sometimes which may be billable by the hospital/clinic or it may represent a separate entity within the medical complex which charges for its own services, just like another store in the mall.  Radiology and laboratory services are departments that are often outsourced.   

Neurodiagnostic procedures, musculo-skeletal ultrasound, functional capacity evaluations, videofluoroscopy and nutritional testing are just a few diagnostic services many chiropractors regularly employ in their analysis and diagnosis of their patients.  These services are available as referrals, DIY and outsource.  Many of these diagnostic tests are reimbursable when billed by chiropractors.

It may be within your financial capability to purchase or lease equipment to offer these services, but who is going to operate it?  Interpretation of the data, training, certification and regular and consistent use of the equipment are significant factors that should be contemplated.

Outsourcing can be a cost effective method enabling doctors to provide more advanced diagnostic procedures without requiring large capital expenditures for equipment, staffing or training.  Contracting with an outsource provider can minimize or fix your delivery costs for these services.  There are various contract and agreement structures when using outsourced services.  However, if the service does not cost you anything in money or time, it may not represent a service that is reimbursable to you.  Additionally, an outsource provider can bring experience and knowledge to you and your staff in the necessity, application and use of the diagnostics as well as billing and collections assistance.  This support aspect supplies you a resource that can jumpstart your ability to successfully implement a revenue producing diagnostic service in your clinic.

Diagnostics are an important resource in your care of patients.  Consider the appropriate diagnostic options available, whether referral, outsource or DIY and diagnostics may represent an untapped resource for you as well. TAC

Ms. Plank has an extensive background in medical and facilities management.  During the past 15 years, Ms. Plank has provided technical and management services to healthcare providers, specializing in radiology and neurology.  She is currently the Vice President of Corporate Services for Practice Perfect.  Contact her at [email protected].

There are many treatment options available to chiropractors today.  Regrettably, many of them carry more hyperbole than technology.  Wildly expensive “cutting edge” technology can have its advantages, but can also really hurt your practice (and your credit scores!).  However, there are treatments which have proven their value and relevance over the last few years of successful clinical use.  If a treatment method is put to the test in hundreds of clinics and earns unreserved praise, with over 40% buying a second unit within the first year, it is probably not only an excellent investment but perhaps a necessary one as well. Such is the case with axial decompression/decompressive traction therapy.  My clinical experience with decompression has been a ten year clinical “grand slam”; a journey with few regrets—even in the face of having spent over $100,000 each on our first units.  Both clinically and as a practice builder, I have yet to see any other treatment as impressive.

In a very rudimentary sense, there are really only 2 passive mechanical treatments you can administer to the spine:  Thrust and stretch.  To limit your patients to just one option because of your own limited paradigm may be bad for them and bad for business.  Think about it.  Compressed discs are in need of “decompression” and avascular tissues are in need of renewed blood contact.  These effects are logically much more likely via stretch than thrust. (By stretch, I mean a prone or supine, restrained, +10 minute cyclical protocol).

Additionally, of course, mechanoreceptor types I, II & III are activated during “traction”.  Decompression is very likely to foster both pre-synaptic inhibition as well as phasic healing through enhanced blood and fluid exchange, a double shot, so to speak.  This basic fact seems somehow lost on many chiropractors, but it is incredibly well accepted and intuitive to the general public.  Of course, science is one thing; business is another.  We are in the unique position of being able to introduce our patients (and community) to scientific advancements and treatment methods and, in the process, get more business for ourselves.  This win-win situation is the essence of success.

The success of “Activator” practices and various pulsed adjustment devices is not hard to understand, if you place your “ear close to the rails”, i.e., listen to the general public.  Many people are afraid of or apprehensive about manipulation.  Many practices have found adding gentler adjusting methods and decompression therapy garners far and away more new patients than it ever discourages.  Adding additional methodologies deflects much of the criticism related to being limited and “dangerous”.  We have had hundreds of patients say, “My doctor said it was OK.  I come here because you’re gentle and use that ‘stretch treatment’.”  Additionally, proven and cost effective methods simply give a greater opportunity to appeal to a wider range of patients.  It establishes your practice as more eclectic and, as a result, fewer patients will “jump ship” looking for a different or more “thorough” approach (because that’s what you offer!).

I believe I have created that eclectic practice with the addition of decompression, stabilization exercises and various gentler adjustment methods.  This combination is so powerful as to virtually eliminate patient attrition due to treatment “failure”, per se.  That’s not to imply some patients do fail to respond, but we are able to be much better at prognostication and when to refer to other specialists.  An eclectic treatment practice allows a much easier determination of when “done is done”, something some practices may find difficult to identify.  If the patient didn’t improve, was it because they needed “supine decompression” and not flexion/distraction (they couldn’t lie prone) vs. rotary manipulation?  Though it is based on my own empiricism, I have seen very few patients with referral pain gain dramatic relief with adjustments if they had first “failed” decompression therapy.

Separating yourself and your practice from “the other guy” is no easy task.  However, offering a variety of reasonable, effective and safe treatment options makes it much more likely.  Most practices now offer manipulation (89%), flexion/distraction (65%) and modalities (75%).  As Napolean Hill said, “Being a little better that mediocre can get you great things in life.”  My initial $200,000 investment 10 years ago has paid off nicely, but not without some financial stress over those years!  At that time, more cost effective units were unavailable.  Now that decompression therapy is available for about the price of a quality adjusting table, there’s simply no good reason to miss out on it’s numerous clinical and business advantages.  My grandfather used to say, “A man who sees his life as small and limited makes his life small and limited.” I don’t want that as my legacy.  Stretching the limits of my practice has helped me build a reputation and practice I’m proud of. TAC

Dr. Jay Kennedy has been practicing Chiropractic Biophysics (CBP) in Western Pennsylvania since graduating Palmer College in 1987.  In the last nine years, he has owned and operated several decompression systems, treating over 2000 patients on them in his multidisciplinary clinics.  He lectures extensively and has authored various articles on axial decompression.

Florida Chiropractor, Dr. Alan M. Creed, one of the leading authorities on instrument adjusting in the chiropractic profession, gave a seminar, in March 2004, to the chiropractors of the Chiropractic Services Unit (CSU) of the 244th Medical Clinic of the New York Guard (NYG).  Dr. Creed, himself a US Army veteran and a Past-Commander of a veterans post, donated his lecture to the NYG as an act of appreciation for the service the Guard rendered to the participants of the post-9-11 operations.  Having read that the CSU had rendered over 200 chiropractic treatments each day during the crisis, he felt compelled to contribute his share to the overall effort.

Dr. Creed was welcomed to Camp Smith by LTC Patrick Delamere, DC, the NYG Chief of Chiropractic Services and MAJ Floyd Miller, DC, the Deputy Chief.  In their welcoming remarks, LTC Delamere and MAJ Miller told Dr. Creed, “It is a proud day in the history of the CSU to host his seminar.  The chiropractors of the NYG were the first fully-commissioned chiropractors in any military organization, and the fact that we could host such a prestigious seminar is a further sign that chiropractic and the military are to be partners in the 21st Century.”

Dr. Creed’s seminar stressed the various techniques of specific spinal correction with emphasis on the established protocols for evaluation, treatment, and assessment of the soldiers’ health issues. 

The seminar was sponsored free of charge by Foot Levelers, Inc., of Roanoke, VA, and Impac Instruments of Salem, OR.  Foot Levelers and Impac provided Dr. Creed’s transportation and lodging and further provided the instruments and visual aids that made the seminar possible. Continuing Education Credits, as mandated by New York State law, were provided by Texas Chiropractic College.

Dr. Alan Creed presents a nation-wide seminar series, Boost Your Practice: Bridging Techniques, Styles & Technology, which is approved for Continuing Education Credits by the Texas Chiropractic College.  He has a chiropractic practice on Key Biscayne, FL, and can be contacted at 305-365-7988 or [email protected].  You may also visit his website: www.dralancreed.com. TAC

Seminar dates – May & June

 

Anabolic Laboratories:

 

May 22–23, Levittown, NY; June 24–25, Allentown, PA. For more information, call 1-800-445-6849 or visit www.anaboliclabs.com.     

 

Breakthrough Coaching

 

May 20–22, Crowne Plaza Times Square, New York, NY; July 10, Sheraton Newark Airport, Newark, NJ. For more information, call 1-800-723-8423 or visit www.mybreakthrough.com.

 

Chiropractic Leadership Alliance

 

May 21–23, Puerto Rico; June 17–20, Minneapolis, MN. For more information, call 1-800-285-2001 or visit www.subluxation.com.

 

David Singer Enterprises

 

May 1–2, San Francisco, CA; June 19, Atlanta, GA. For more information, call 1–800-326-1797 or visit  www.davidsingerenterprises.com.

 

DMX Works

 

May 28–29, Cayman Islands. For more information, call 1-800-839-6757 or visit www.dmxworks.com.

   

Footlevelers

 

May 15-16, Des Moines, IA; June 5, Virginia Beach, VA. For more information, call 1-800-553-4860 or visit www.footlevelers.com.

 

Fred Van Liew’s  Water & Air Essentials

 

April 24, Dallas, TX. For more information, call 1-800-964-4303 9-6 CST or email [email protected].

 

ICPA

 

April 29–May 2, Long Branch, NJ. For more information, call 1-610 565-2360 or visit www.icpa4kids.com/chiropractic_pediatric_seminars.htm.

Integrated Expo  

 

May 13-16, Chicago, IL. DC/MD/PT Seminar. For more information, call 1-888-67-DAHAN or visit www.dahan.com.

 

Loomis Institute of Enzyme Nutrition

 

June 12-13, Dallas, TX. For more information, call 1-800-662-2630 or visit www.loomisenzymes.com.

 

The Masters Circle

 

May 14-15, Los Angeles, CA; June 4-5, East Rutherford, NJ. For more information, call 1-800-451-4514 or visit www.themasterscircle.com.

 

Nutri-West

 

May 1–2, Denver, CO; June 26–27, Reno, NV. For more information, call 1-800-443-3333 or visit www.nutriwest.com.

   

Parker Seminars

June 17-20, Minneapolis, MN. For more information, call 1-888-727-5338 or visit www.parkerseminars.com.

American Chiropractic Association

 

 

Speaker Of The House, HHS Secretary Applaud Chiropractic at ACA’s National Chiropractic Legislative Conference

 

House Speaker Dennis Hastert and Health & Human Services Secretary Tommy Thompson each paid visits to ACA’s National Chiropractic Legislative Conference (NCLC) to acknowledge the contributions of DC’s to our nation’s health care system and to encourage ACA members to continue their grassroots lobbying efforts.  ACA also welcomed more than a dozen members of Congress to the conference.

 

 

From March 3-6, over 450 doctors of chiropractic and chiropractic students converged on our nation’s capital to urge elected leaders to support chiropractic legislation. 

 

 

According to Thompson, who made his third visit to NCLC, “As the national voice for the chiropractic profession, ACA has contributed significantly to improving the lives of countless Americans.”

 

 

Meanwhile, House Speaker Dennis Hastert, a former football and wrestling coach, thanked chiropractors for helping get kids back on their feet.  According to Hastert, “A chiropractor is someone who can get people well without giving them a pill.”  Hastert also recognized the work of Dr. William Morgan, the DC who practices at the Bethesda Naval Medical Center and in the Office of the Attending Physician at the U.S. Capitol.  “As word gets around, his office is getting busier and busier,” explained Hastert.  The House Speaker also discussed his critical role in getting the ACA-backed Medicare chiropractic demonstration project passed.

 

 

“I’m blown away, not only by the sheer number of ACA members who participated in this NCLC, but by the enthusiasm of everyone involved,” said ACA President Donald Krippendorf, DC.

 

 

 

International Chiropractic Association

 

 

Governor Arnold Schwarzenegger Delivers Inspiring Address to ICA Fitness Symposium:

 

Focuses on Service, Health And Responsibility 

 

 

 

For the 12^th consecutive year, global superstar and chiropractic supporter, and now Governor of California, Arnold Schwarzenegger was the featured speaker at ICA’s Symposium on Natural Fitness held March 5-6, in Columbus, Ohio.  Speaking to over 400 participants, Governor Schwarzenegger told the crowd, “I am honored to be back with you and to celebrate this great weekend once again.  We share a common mission, and that is health and fitness for everyone.” 

 

Governor Schwarzenegger also thanked the ICA for its longstanding partnership and support, and acknowledged ICA’s leaders as “key contacts” for the work he is engaged in as Governor.  ICA honored Governor Schwarzenegger this year with the presentation of a San Francisco 49-ers official helmet, inscribed, “To Governor Arnold, The Captain of Our Team,” and embossed with an engraved gold disc from the ICA Council on Fitness, autographed by all-time great running back Roger Craig, who was one of the main speakers at this year’s program. 

 

Governor Schwarzenegger also met privately with a delegation of ICA leaders on the very difficult and much discussed workers compensation situation in California.  Dr. John Maltby, ICA’s Western Regional Director, ICA’s Assembly Representatives for California, Dr. James Musick, and Dr. Brian Porteous, as well as ICA Executive Director Ronald Hendrickson participated in what can only be characterized as positive, direct and productive talks.  Such discussions are part of ICA’s on-going dialogue with the Governor and his senior representatives on a wide range of issues important to the chiropractic profession. 

 

For more information, contact the ICA at [email protected] or visit www.chiropractic.org.

 

 

 

World Chiropractic Alliance

 

Chiropractic Research Generates Widespread Television Coverage

 

 

 

A press release about research into chiropractic and fertility, distributed by the World Chiropractic Alliance (WCA), has generated widespread coverage on television stations around the nation.

 

 

Madeline Behrendt, DC, lead researcher for the series of articles in the Journal of Vertebral Subluxation Research (JVSR), was spotlighted on a special syndicated television news feature. Dr. Behrendt is a member of the WCA International Board of Governors and chair of the WCA Council on Women’s Health.

 

 

The taped segment was distributed to news outlets around the country and aired on major television news programs in New York, Philadelphia, Seattle, Boise and other cities. Many of the stories were also placed on the Internet, either in print or video format. A link to the story was also included on the website of The American Society for Reproductive Medicine.  For links to online TV news videos and stories, visit the WCA website at www.worldchiropracticalliance.org.

 

 

In the interview, Dr. Behrendt made certain the audience understood what chiropractic was really for. “The chiropractor identifies spinal distortions, which are called subluxations, and once they were detected and corrected, the fertility function improved,” she explained.

 

According to the Centers for Disease Control, more than six million women in the United States are infertile and over nine million use some kind of infertility service.

 

“I think this proves that we can generate positive publicity for the profession without shying away from the word subluxation or spending millions on paid programming or advertising,” says Terry A. Rondberg, DC, WCA President.

Fifteen years ago, a DC told me, “In a perfect world the best patient education would be self extinguishing.”  Why?   “Because everyone would always understand where health comes from and would demand chiropractic care.”

The world is still far from perfect.  Just last week I heard of a “healthy” 45-year-old who woke up with heartburn and a headache.  He treated it the way his TV and pharmaceutical companies told him.  He took pills for the heartburn, but it didn’t go away.  He treated the symptoms rather than seeking professional help.  The next morning he didn’t wake up, because he had had a massive heart attack.

As you know, the “symptom vs. cause” canyon is deep and wide, but it is being successfully traversed by many enterprising and persistent chiropractors.  How?  They use materials that communicate instantly, are in perfect harmony with their philosophy, and their message is repeatedly reinforced.

To cross this great divide, you must somehow get the first rope across.  Whether you throw it, or climb into the canyon pulling it behind you, without that first line, you cannot build a bridge.  On the other side stand your patients solidly rooted in symptom relief dogma.  You stand on your side resolutely poised to teach them your “truth”.  Sometimes it seems that you’re both so very far away. 

So, go ahead.  Start by throwing them a “life line”.  Acknowledge their initial complaints with visuals and discussion about how successful chiropractic can be at helping with complaints just like theirs.  Show them that you recognize that their pain was motivating them to find you in the first place.  Once they’ve arrived on your side, you can make the bridge strong and sturdy with posters, models, electronic nerve charts, and videos, plus passive and interactive computer software.  Remember to take advantage of their ability to explore pamphlets, videos and, especially, computer programs and games at home, on their own.  These lay a great foundation for family involvement.

In your office, a strong ROF(Report Of Findings) is the basis for their understanding and acceptance.  It is here that you shift their primary focus from pain relief to a, “Let’s keep this from getting worse,” mentality.  And, finally, “Now, let’s keep your improvement.”  Either electronic wall charts or computer programs will show them, not only the type of symptom that they are currently experiencing, but, also, on a performance level, what muscles might be impacted by those same subluxations.  The most useful visual aids will simultaneously show them how the organs rely upon a clear and functioning nerve system for proper expression of health.

Your group orientation helps smoothly pave the bridge’s surface while saving time in getting your message out more effectively.  A great way to do this is with some dramatic visuals.  Traditionally, flip charts have been very useful for this; but, with the advent of inexpensive computer monitors and projectors, it is much more exciting and memorable to use graphics and animations that “come to life”.  It’s easy, too.  Good interactive and customizable software takes you “by the hand”, making talks lively, fun and virtually effortless.

For ultimate success in getting the public across to your side, you must have an office environment that is inviting, modern and congruent with your philosophy.  This provides the comfortable vehicle for their journey with you.  Daily or, at least, weekly topic discussions that are team delivered will keep your bridge full of traffic and constantly moving along.

You must earn the right to teach your patients that there is something better than just symptom relief.  The only way that you can do that is by starting where they are now.  Make sure that you have patient education tools that demonstrate the health potential reduction and life stealing effects of subluxations left uncorrected.  Build rapport and then present the chiropractic solution.  This is how you shift their paradigm and help them cross the canyon and stay there.

Bruce Goldsmith is President of Visual Odyssey.  He invented the Neuropatholator® wall chart systems in 1976, and has been making chiropractic patient education tools, including the very popular SHO® flip chart, ever since.  You can reach Bruce at 800-541-4449 or 770-646-8031.  For more information, visit www.chirocharts.com.