October 2001

Quality vs. Quantity in Practice

by C.J. Mertz, DC

            Dr. Mertz received a Bachelors Degree from the University of Montana in 1980. He received his DC degree from Palmer-West Chiropractic College in December 1984.He had a large volume practice in California before starting Waiting List Practice seminars in 1986. He has received numerous awards from the chiropractic profession including Chiropractor of the Year, Entrepreneur of the Year, and a Humanitarian Award. He has taught over 500 seminars and personal development camps to more than 5000 chiropractors and their staffs.

            Over the past twelve years, I have had the privilege of coaching five thousand chiropractors and providing more than one thousand on site evaluations.  I have seen every conceivable practice volume, technique, layout design, team size, color scheme, paper work system, piece of equipment, software program, and doctor headspace that exists on the planet.  What you are about to learn is the absolute truth in your practice.

            If you took one hundred chiropractors and wanted to see who showed the greatest degree of patient satisfaction and over all practice performance, how would you do it?  And, what correlation would there be between the quality service to patients and the volume of practice?  After my first four hundred on site evaluations, a few very important patterns began to emerge.  “The chiropractors who started out with the intensity of high quality service had it, and the ones who didn’t, didn’t.”  The practices that are most clean, most orderly, most pleasantly designed and most patient care oriented, are only because the doctors had those values before they ever got into practice!

            The most amazing find of all, however, none of those things determined the level of success of that doctor’s practice.  I evaluated many practices seeing less than one hundred fifty adjustments per week and witnessed every level of quality service imaginable.  Some doctors have preferred to personally spend more time with their patients, while others had six to ten C.A.’s on their team to provide personalized service to the patients.  Some had incredibly expensive equipment and instrumentation, others had impressive artwork, and some had every magazine subscription in circulation.  Some focused on diplomat courses, some focused on technique courses, and others focused on management courses. 

            I also evaluated scores of practices consistently serving between three hundred and six hundred patients per week. (Per doctor, not per practice)  Once again, there was every conceivable variation of quality service in practice.  I must admit, for the first few years I was quite confused doing these evaluations.  You see, there were doctors seeing about 100 patients per week who saw their patients for ten minutes each, and those patients swore by their chiropractors.  Other doctors saw their patients for less than three minutes (who adjust over three hundred patients per week) and their patients would stand in front of a bus for them.  I saw excellent retention among patients and wonderful written testimonials inside the lower volume and the higher volume practices.  I saw referral only practices as well as practices that attracted seriously sick people to see them.  I saw amazing pre and post x-ray changes in both the lower volume and higher volume practices.  

            There was not a single quality component that I found in a lower volume practice that I could not find in a higher volume practice.  The doctors, who value quality, maintain those values no matter how many patients per week they serve.  Unfortunately, relatively poor quality service was observed at every level of volume as well.

            So you see, serving more patients and providing high quality care are both choices.  There are more practices growing over five hundred adjustments per week than at any other time in our history.  This is because more vision is emerging and a deeper understanding of the urgency to educate families suffering from the effects of subluxation.  This in no way determines the quality of the care, but we now know it does not prohibit the highest quality of patient care from being delivered.

            Being on purpose in our profession has become a cliché, but it really speaks of the choices each chiropractor has to determine the quality and the quantity of the contribution for their community.  There is no quick fix for becoming philosophically sound or technically certain.  There are no short cuts for building patient centered procedures and a championship team of C.A.’s.  There is no substitute for the work involved in creating tremendous patient results, lifetime retention, and multiple referrals per patient or a world-class patient education program. 

            Team WLP is a chiropractic leadership and training organization designed to re-engineer a chiropractor’s practice so the greatest number of patients can experience the greatest expression of philosophy and excellence.  As a profession, we are in desperate need of shaping our identity so the public can receive a powerful message of united strength and principle.  We must rid ourselves of the myths that hold us back personally and professionally in chiropractic, and direct our focus on the task of getting out of our own way. 

            Chiropractic is a melting pot of personalities and beliefs, but it is our core principles that bring us together like a clan of rebel warriors.  The quality of our individual efforts should not be seen as a reason to reduce the number of people we can help, rather seen as the standard by which we can serve masses.  It has been said, “It often takes twenty years to become an overnight success”.  I have watched too many chiropractors “stuck” under two hundred adjustments per week for ten to twenty years, suddenly “awaken”.  Perhaps it is right timing for you to take a deep look at what you want to ultimately contribute through your work and find the best way possible to turn those dreams into reality.

            (Dr. C.J. Mertz is founder and head coach of the prestigious Waiting List Practice chiropractic training organization.  For more information on WLP services and products, visit the WLP website at www.TeamWlP.com or call 877/TEAM-WLP.)