The Practice You’ve Always Wanted

We’ve headed into a new year and, with that, we’re offering some great advice from the experts! We’ve asked ten of them to answer what they feel are the most important questions to help you advance your practice. From focusing in on who you are as a doctor to over-all advice to the entire profession, these experts have the answers to help guide you through 2005 and beyond.

Tip #1Dr. Larry Markson / The Masters Circle

Q: What should I DO to get more new patients and what should I DO to get them to comply and stay longer?

A:  I have been answering that question in person, on the phone and from the stage for 25 years or more, and every other “authority” on practice building has been “doing” the same thing.  Yet, in my opinion at least, the same question will be asked until the end of time.

Why?  Because there is no good answer to a bad question—it is never about what to DO that makes a person successful and happy, it is always about WHO to BE!

You see, all of the “do’s” often are not effective until you take a look at the “who”—who you are as a person and who you are as a doctor.  Simply stated, “Who you are determines how well what you DO works.” It is the WHO, not the DO!

Success is a result of who you BE—your securities and insecurities, your belief systems, your ability to communicate, to influence, to be decisive, to change, to motivate, to organize, to make people like themselves better.

Success is, in fact, very personal.  It is about your clarity, your congruency, your determination, your guts and audacity to be different and to stand for principles that separate you from tasks and procedures (the doing part).

To grasp this concept, I offer the following in evidence.  Three DC’s participate in a Health Fair. Are their results the same?  When one doctor purchases another’s practice (same staff, hours, fees, procedures), doesn’t the volume shift up or down?  Why does one doctor collect 100% of their fees and another 50?  Why do partners in the same practice have different volumes and results?

Because it is not what you do, it is who you be that is responsible for attracting the people, places, circumstances and events that contribute to your success.

For more information on Dr. Larry Markson, The Masters Circle, visit, or phone 800-451-4514.

Tip #2Dr. Pete Fernandez / Fernandez Consulting

Q: My practice is on the brink of bankruptcy. What can I do to avoid it?

A: That’s the most common practice problem I’ve been asked about in the past 12 months. All of the doctors had a large patient volume (250 to 400 per week), few new patients per month (10 or less), and small monthly incomes ($1,000 to $12,000).

They also:

• only accepted patients who agreed to one year treatment plans. 
• discounted their fees by approximately 50%.
• were adamant about not treating patients for pain.
• were positive that they would finally make money if they increased their patient visits by another 100 to 200 per week.
• were determined not to change what they were doing.

Their “my way or the highway” attitudes eliminated those patients who chose not to pay for a year’s care, and drove off the type of patients who are a practice’s biggest referral centers (called retro-flectors, in psychology).  The only patients left were easily compliant—patients who don’t refer much—thus, very few new patients.

These doctors didn’t understand that a 50% discount of fees made it impossible to meet their overhead expenses.  And, they failed to recognize that a practice’s overhead increases proportionately with increase in patient volume (extra CA’s, etc.).

Their answer was to drop their hard-headed “I’m right and I’ll prove it” attitudes, and be open minded to different, common sense practice procedures.  In other words, be willing to change.  Those DC’s who refused to change, failed.

To use the words of my good friend, Mark Victor Hansen, “If you keep believing what you’ve been believing, then you’ll keep achieving what you’ve been achieving.”   If your practice isn’t what you want it to be, it’s time to make some changes.

For more information, email [email protected].

Tip # 3Dr. Daniel H. Dahan / Practice Perfect

Q: What would you say is the most important accomplishment for a chiropractor?

A:  There is nothing more gratifying then having patients refer friends and family members to your practice.  Indeed, the highest compliment anyone can pay your center is to promote your services to the point of actually producing new patients.  Doctors, by nature, are passionate about their work and love to give.  Hence, what can be more fulfilling than to build a practice largely on internal referrals?  However, aside from the doctor’s ability to diagnose properly and treat with fervor, following is a list of “ attributes” necessary to achieve that goal.  To make it easy to remember, use the following mnemonic: “ DEAL WITH ME”.

D= Devoted to the patient’s health care needs
E= Enthusiastic each day to spread goodness
A= Appreciation for the privilege to heal
L= Love each individual genuinely

W= Warmth to be infused in each treatment
I= Intense: The trademark of your personality
T= Tenaciously resolve to heal everyone
H= Humane and caring, the only way to act

M= Motivate, inspire and persuade more people to come to you.
E= Enjoy the benefits and the right to be successful

I must admit that I have not found anything to be more true, in my last 16 years of guiding over 4,700 doctors, than these focused and factual directives.

For more information, call 888-67-DAHAN, 888-673-2426 (toll free), or visit

Tip #4Dr. Maurice A. Pisciottano / Pro-Adjuster

Q: How effective is your documentation?

A:  All practitioners seem to have their own ideas as to what constitutes effective documentation. It is paramount, in today’s healthcare and insurance arena, that medical necessity be established for each treatment procedure rendered, in order to have those completed procedures become reimbursable. For documentation to be complete, treatment needs to be recorded.  However, the rationale for the treatment must also be present in order that a clear picture exists that the treatment was not only done, but that it needed to be done in order to achieve a specific, pre-planned functional outcome.  It is important to understand that medical necessity is not something that the doctor decides about his treatment validity. It is an already-established standard for healthcare.  Medical necessity precedes all treatment.  It is the process of determining what will happen from the examination of the patient through their release.  It is a pre-determined “roadmap” of the rationale for your treatment, how it correlates to the patient’s diagnosed condition, and the expected outcome as a result of doing that treatment.

For more information, call 724-942-4284 or visit

Tip #5Dr. Dallas Humble / Dallas Humble, Inc.

Q:  What is anti-aging and how does it fit into the chiropractic model?

A:  Anti-Aging is a new specialty in the health field. The public is demanding more methods that are focused on looking better and feeling better than ever before. You do not stop the aging process, but you can slow it down. Age related diseases are in the focus of the fight against aging. The chiropractic profession is in a great position to take advantage of this trend.

Q:  How can anti-aging benefit a practice?

A:  Simple. The answer is new patients. Patients pay for what they want as opposed to what they need. With the baby boom generation aging, this trend is becoming more the rule rather than the exception. If the chiropractic profession wants to thrive in the upcoming years, this is the way to do it.

Q:  Give us one way to attract new patients?

A:  Target obesity. People are more overweight now than ever before. Every DC should have a weight loss plan within his/her office that can assist the patient in reaching their optimum weight. I advocate the Internet to do this. With technology the way it is, you can educate the public in a way that has never before been possible. I train doctors to market and offer an Internet-based weight management business for their patients. The attraction is nothing less than phenomenal and the benefits to the practice bottom-line will make you smile.

Dr. Dallas Humble is the President of Dallas Humble, Inc,. and a co-author of The YoungSlim Lifestyle. For more information, visit or call 1-800-282-1947.

Tip #6Greg Stanley / Whitehall Management

Q: What do you feel indicates a healthy growing practice the most?

A: If I’ve learned one lesson about practice management in 25 years on the consulting front lines, it’s that there is no more important indicator of your practice’s prospects than your monthly direct patient referrals. It tells you how well you’re u meeting your patients’ expectations. There are really only two kinds of chiropractors, those that understand this and those that don’t. The ones that don’t will spend a frustrated 41 years in practice, constantly in pursuit of enough new patients to survive.

The doctors who suffer from low monthly referrals actually believe that they are cursed with the gift of only being able to attract patients that just don’t get it. Patients that are only interested in pain relief.

If you’re getting less than 15 direct patient referrals each month, your offering of service, price and convenience only qualifies you to appeal to less than half your potential market place.

If your monthly direct patient referral number exceeds 25 and you’re not growing, you can bet that your problems are delivery-related as opposed to demand-related. Monthly patient referrals are the “North Star” of practice management: Unchanging and worth setting your course by.

For more information, contact Greg Stanley, Whitehall Management; phone, 623-934-2108; or email [email protected].

Tip #7Dr. Timothy Gay / Ultimate Practice Systems

Q:  How we can utilize staff and chiropractic assistants for new patient referrals?

A: Every day in your office, your staff may be missing many new patient opportunities. The single most important thing that your staff has to think about is education of the current patients and listening to their needs. The patient that understands the reason “why” they continue to come in for chiropractic care is the patient that will be referring their family and friends. Chiropractic assistants need to be educated by the doctor as to the importance of patients staying on schedule and minimizing idle chit chat. Patients and staff build the relationship based upon the patient’s results and the services that they receive. A well educated and caring staff can help you build an internal referring machine, simply by giving out appropriate information and staying focused on the patient and what they truly need. The simplest technique is to educate and ask!

Dr. Timothy Gay can be reached at 866-797-8366, or [email protected].  For more information on Ultimate Practice Systems, visit

Tip #8Dr. Eric Plasker / The Family Practice

Q:  To be successful and financially independent, does a chiropractor need insurance?

A: Managed care, personal injury, and workers comp are slashing fees across the board.  Rather than be insurance-based or cash-based, we think it is important that a chiropractor be care-based.  Set up all of your systems, procedures, communication, financial policies, and education to build value for people receiving chiropractic care and they will pay for that care regardless of insurance.  Bundle the expected insurance payment into the cost of the total care you recommend for a person or family and the patient will then commit to the care and pay their portion.  Chiropractors worldwide, who have made this transition, have doubled their collections by adding this lifetime care base to their practice. 

Q:  Is wellness care profitable?

A:  Wellness care is high profit chiropractic.  You can provide wellness care without giving the care away.  People pay full price for wellness books, bottled water, fitness equipment, nutritional supplements, massages, and numerous other products and services by the billions, and they will do this for chiropractic as well.  One thing is clear, however, if you don’t teach wellness and have a solid financial system to support wellness, then you can’t expect people to respond.  Teaching wellness and mastering lifetime care wellness-based systems is the single best investment a chiropractor can make in their practice.  You just have to be committed to the path.

For more information, call 866-532-3327, Ext. 118, or visit

Tip #9Dr. Mark Sanna / Breakthrough Coaching

Q: What is your best advice to the profession?

A: The following quote appeared in the Millbank Quarterly of the Medical College of Wisconsin, in a report by Richard A. Cooper and Heather J. McKee, Chiropractic in the United States: Trends and Issues. “Having crossed the chasm into the reimbursed world of health care, chiropractors must now prove their quality, effectiveness, and value.  The profession is buttressed by satisfied patients and sympathetic politicians and by the general longing for someone who will listen and be supportive.  But, as our aging nation struggles to define the health care system it can afford, it is uncertain whether this will be enough.”  The practicing chiropractor is ill-equipped to meet the challenges this report describes.  We must accomplish the following if we desire to meet the opportunities this report presents:

1. Practice with a standard of care based upon an empirical evidence objective, and document the functional improvements chiropractic care delivers, and how this impacts the quality of life.
2. Master the arts of coding and compliance to effectively communicate the value of chiropractic to interested third parties.

3. Finally, we must accept that only through combining our philanthropic efforts can we reach the level of financial commitment necessary to impact legislative regulation, reimbursement, and widespread public acceptance. Contribute wholeheartedly to your local and national organizations and to the only unified marketing campaign endorsed by every chiropractic leader in the nation, “The Campaign for Chiropractic.”

For more information, contact Breakthrough Coaching at 800-7-ADVICE.

Tip #10Dr. David Singer / David Singer Enterprises

Q:  How do I get more new patients?

A:  New patients, for almost all practices, come from referrals. Referrals, as a basis of practice growth, is certainly a point of stability. Therefore, to grow, no matter the changing insurance climate in your community, you need to market your practice to build your referral base.  The easiest procedure to do this is to add in-office workshops.

In-office workshops are the easiest of all new patient procedures to introduce into a practice.  This can be in the form of a twice-a-month class for all new patients, or a once-per-month special workshop on weight loss, women’s hormone problems, natural solutions to arthritis, fibromyalgia, fatigue or allergies, etc.

A class for all new patients results in more new patients, if they bring guests. The logical and successful system to get guests there is to teach a method, such as trigger point massage, shiatsu, stretching, etc., that would require them to bring a partner.

A special workshop on weight loss gets new patients, if patients bring guests.  Charge a nominal fee for the workshop, but make it free for those who bring guests, and you will get guests there.

At the end of the workshop, simply give the new patients a free consultation and schedule them for it that night.

For more information on David Singer Enterprises, call 800-326-1797, or go to

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