Hitting the restart button

Kats, David J

Practicing chiropractic, like everything in life, has its ups and downs. It is not possible to start a practice and experience continuous positive growth straight through to retirement. Every practice will have periods of slow growth, plateaus, or declines-regardless of the doctor’s experience and talents. The key is to make these into temporary inconveniences. Don’t allow them to develop into major trends. Here are some suggestions if you are experiencing a negative trend.

Sharpen your mental focus. The practice must become everyone’s top priority–especially the doctor’s. Success in practice often leads to opportunities for other ventures. New businesses funded by practice profits can require a great deal of the doctor’s time and attention, as can hobbies and recreational interests. Financial management and time management priorities must be established to maintain a healthy practice.

Personal problems experienced by the doctor or staff will also divert attention from the practice. Marital problems, divorces, health problems, child-rearing issues, and caring for elderly parents are not uncommon. Alcohol and drug addiction can devastate a practice. In some cases, the problem can simply be left at home and not brought to the office. Do not be afraid to seek professional help in working toward control or resolution of a serious personal problem. Professional help may save the marriage, the practice, or your life.

Stop outside distractions, good or bad, from diverting focus away from the practice. As Keith Maule, co-owner of Kats Management, says, “The main thing is to remember to keep the main thing the main thing.”

Have a strategic planning session. Set a date for a day-long staff meeting. Select an off-site meeting place to get away from phones and other distractions. Everyone should participate in identifying the problems of the practice, solutions to the problems, the strengths of the practice, and the practice goals for the next six to 12 months. Plans for reaching the goals during the meeting should also be developed.

During the two weeks leading up to the meeting, the doctor and the office manager should develop an agenda and gather all necessary materials. They should also speak with each staff member for input on planning session discussion topics.

Strategic planning sessions should be held every six to 12 months. The gaps between strategic planning sessions should be bridged by weekly staff meetings to help maintain focus and carry plans forward.

Develop a new patient activity plan. This may coincide with the goal setting during the planning session or be performed as a separate procedure. Develop a list of major new patient activities for each of the next six to 12 months. Procedures like patient appreciation days, spinal screenings, and newspaper inserts are good examples.

A second list of other activities to be performed each month should also be developed. These are simpler procedures, which require less planning, and provide a more modest number of new patients per activity. Their total effect on new patient numbers, however, can be significant. Professional lunches, speaking engagements and press releases are good examples. Perform one major activity and several minor activities each month to maintain a steady flow of new patients. Plan for new patients and carry out the plan.

Go back to the well. During periods of growth, office and patient procedures are used that result in practice increases. As the practice becomes busier, many of these procedures are altered or discontinued. Some say, “As we got busy, we dropped some procedures due to lack of time.” Actually, they were discontinued due to a lack of management skills. Truly great office teams manage to continue these vital procedures and handle the growth they create. Review all procedures used in the office to determine if they should be continued, revised, or restarted. Return to the procedures that worked before. This time, plan for their continuation.

Make the most of resources currently available to the practice. Does the current office floor plan make the best use of the square footage available? Is the x-ray unit used as frequently as it should be? Are therapy machines idle and gathering dust? Has the rehabilitation equipment been fully implemented? Is the new patient education video being shown? Are all services rendered being billed? Are all patients receiving a written report of findings? Too many times we shortchange our patients simply by under-utilizing our current resources.

Develop new revenue centers. Review the following list of ancillary services. Identify those that are not currently offered in your facility and add those procedures that fit the philosophy of the practice.

– Physical modalities

– Rehabilitation

– Nutritional counseling

– Medical integration

– Acupuncture

– Body aesthetics

– Massage therapy

Do something different ANYTHING DIFFERENT! Change the office hours, team a new technique, try new advertising, alternate doctor or staff hours, remodel or rearrange the office. Try the new procedure for at least three months. If the new procedures do not work out after three months, change back. For example, new office hours can be advertised as new summer hours (or whatever the current season). If the hours work well, make them permanent. If they do not work well, change them back when the season ends.

Clean house. Get rid of old, unused equipment. Replace it with something that will be used. If a room is not being used, use the space to expand into new revenue centers. Work to eliminate negative attitudes and thought patterns, help non-productive employees find a new career, stop using outdated, unproductive patient and office procedures, and discontinue unproductive advertising. Remember the old saying, “Insanity is defined as doing the same thing over and over again and expecting to get a different result.” If something or someone has stopped working, move on!

Keep track of vital statistics. Every office should track statistics for new patients, patient visits, services, collections, collection percentage, and patient visit average, but that’s just the start- It’s not unusual to see successful offices track dozens of stats. Each employee should be involved. Each employee needs to understand the statistics and the impact they have on the practice. Covering practice statistics should be a part of every staff meeting.

A review of practice stats helps keep everyone’s focus on the practice. When stats are not tracked routinely, a decline or plateau is inevitable.

Find a mentor or develop a brain trust. Mentors are usually found in the practice management field. A management consultant can assist in motivation, goal setting, staff training, financial planning, plans for expansion, insurance problems, and many other aspects of practice. A brain trust is two or more individuals interested in self-improvement and practice growth. The group meets regularly to discuss goals, challenges, business plans, new products, motivational topics, new business opportunities, new management ideas, and problem solving. The group can also take turns providing programs, share reading and listening lists, and other activities. Mentors and brain trust partners improve focus and provide a fresh point of view.

Go back to step one and start. In other words, you need to take action now. If you do, you have a great opportunity to restart your practice!

Dr Kats is owner/manager of Kats Management, a chiropractic consulting organization based in Lincoln, Nebraska.

Copyright American Chiropractic Association Mar 2000

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