April 2005, Vol. 15, Iss. 2

Table of Contents

Altered Cervical Lordosis and DJD • Chiropractor Invents Car Seat Headpiece • DACBRs Cause Professional Embarrassment at RAC • Eight Major Aberrant Forms of the Lumbo-Pelvic Spine • European Spine Journal to Publish 6th CBP® Clinical Control Trial • Evidence Based or Not • Glutamate/Aspartame - Pain and Your Brain • Greg Buchanan Donates $30,000 to CBP® Nonprofit • Inappropriate Characterization of CBP® Technique • Missed Appointments and Patient Education • Money, Taxes, Life and Practice • Palmer College Takes Alumni Group to Court • PosturePrint™ Research with ICA • Presenting Defendable Care Options to Patients • Published Papers Near 81 • Resign or be Terminated • Thermography: Renewed Interest • Using Silence to Communicate • Whiplash Injuries: Pathophysiology, Diagnosis, Medical Management and Prognosis

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Money, Taxes, Life and Practice

by Mark Radermacher, D.C., President
Total Practice Management Int’l, LLC

Dr. Radermacher has been a chiropractor for the last 25 years and has been coaching some of the largest, most balanced and profitable practices nationally and internationally for the last 17 years. He is the author of: The 5 Minute Report Of Findings©, The 5 Minute Pre Consultation© (including the invaluable Life Impact Points©), The Dynamic Micro Report© (communication with patients during adjustments), The Fade and Fade Response©, The Minimization and Minimization Response©, Cluster

               I originally drafted this article for the April 1994 AJCC. Many doctors are very concerned about taxes and their financial status, therefore, I decided to re-run the same article 11 years later. The subject matter is still quite apropos for younger doctors, (those who weren’t in practice in 1994) read and learn. For doctors who read this article in 1994, ask yourselves if you are in better financial shape than 11 years ago. If not, why in the world haven’t you changed? And when, if ever, will you change?

              It certainly is nice to know that you are current on all your taxes, including, of course, this year’s taxes. And, it’s nice to know that you have money and are enjoying both life and practice. Just for a moment, however, imagine what it would feel like to be behind on taxes, to have no money, to see life and practice as two evil necessities on the way to death. Impossible? Silly to assume, you say? Not at all. This is the sad routine reality for many in the profession.

              This story is about a fictitious chiropractor named Dr. Behind. The story takes place in “Any Town” USA

and admittedly, in your eyes, with some very unbelievable circumstances. You see, Dr. Behind is middle

aged and has a typical family. He has no money, is $140,000.00 behind in taxes, $480,000.00 in debt, has not had a vacation in 10 years, feels life is miserable, and despises practice with a passion. Here is a day in what is left of the life of Dr. Behind.

Monday Morning, 8:00am:

              Ring-a-ding-ding

              Receptionist: “Sharp As-A-Tack Accounting Services, may I help you?”

              Behind: “Yes, this is Dr. Behind, could I please speak to Mr. Sharpen Your Pencil?”

              Receptionist: “Yes, please hold.”

              Pencil: “Hello, Dr. Behind, Pencil here, can I help you?”

              Behind: “Yes, how bad is it?”

              Pencil: “Well, are you sitting?”

              Behind: “Yes.”

              Pencil: “It is pretty bad, it is worse than we thought.”

              Behind: “Real bad?”

              Pencil: “Yes, Dr. Behind, real bad.”

              Behind: “Am I going to make it?”

              Pencil: “Well, that depends on how hard you push. Your production has been down lately.”

              Behind: “Yeah, but, I was pretty sick, and I am awfully tired.”

              Pencil: “That may be, Dr. Behind, but you know what they say about taxes and death.”

              Behind: “Yes, I know, I am beginning to wonder whether or not the latter is less painful. So how much do I owe?”

              Pencil: “On last year’s taxes or this year’s taxes?”

              Behind: “Both.”

              Pencil: “Well, you owe $120,000.00 for last year and $20,000.00 so far this year.” (Long pause...) “Hello, Dr. Behind, are you there?”

              Behind: “Yes, I am here. What did you do wrong? You told me all along it would only be about $50,000.00.”

              Pencil: “Well, Dr. Behind, you never know until you get the final numbers in. How much have you saved?”

              Behind: “Well, I had $40,000.00.”

              Pencil: “What do you mean, ‘had’?”

              Behind: “Well, I sort of spent it on an investment.”

              Pencil: “What investment, Dr. Behind?”

              Behind: “Well, I thought I could float the taxes a little bit by buying a boat through the SUPER SPECIAL, CONFUSE ALL PARTIES INVOLVED CORPORATION, you set up for me. You said I could play a few tax games, and the money was there, and I need to spend more time with the family, and my wife and I have not been getting along real well at all lately, and I thought we could regain some solid footing on a boat, and you know I don’t take vacations, and well, I deserve it, I am a Doctor you know.”

              Pencil: “So, Dr. Behind, you have no money saved for taxes at all?”

              Behind: “Well, not really. At least it is good news that I am only $20,000.00 behind for this year, huh?”

              Pencil: “Not exactly, Dr. Behind, you are only $20,000.00 behind this year because your collections have dropped so significantly.”

              Behind: “Oh, that’s not so good then, huh?”

              Pencil: “Actually, Dr. Behind, you have dug a very deep hole for yourself.”

              Behind: “What should I do? I can’t take anymore out of the home equity, and all credit cards are maxed out. What should I do?”

              Pencil: “I would put nose to the grindstone and push, push, push.”

              Behind: “Okay, thank you.”

              Pencil: “One more thing, Dr. Behind, my bill for preparation for your taxes is $4,200.00, send that

right away.”

              Behind: “Okay.”

              Pencil: “Oh, and one more thing Dr. Behind, what did you name your boat?”

              Behind: “SINKER, Mr. Pencil, SINKER.”

8:15am

              Front Desk: “Behind, you have had two patients waiting for five minutes and they are not very happy with you at all!!”

              Behind: “Okay, Ms. Front Desk, I will be right there.”

              Front Desk: “And just so you know, Behind, you still have three weeks of reports to do, and I am leaving an hour early tonight because I have something important to do.”

              A few stomach pains and some slow steps take our Dr. Behind to the bathroom to splash cold water on his face to get ready for the push. This morning is fairly busy with seven visits and a report of findings to do. He looks in the mirror and notices his eyes are a little red and swollen from the fight he and his wife had last night. She wants more money and so does he, she used to want him home more, now she tells him to be at work more. She sort of does the books and he wonders and worries about how he is going to break the tax news to her. As he wipes his face, he notices the note taped to his mirror, it says, “Clap you hands ten times, jump up and down three times, and repeat your top ten goals four times, and all will be yours.”

              Dr. Behind paid for this information from an energetic u-rah-rah seminar he has attended twenty one times

now. He added one special genie rub step to the list on the mirror and that is to rub the mirror real hard forty times after he read the list.

              Finally, the first gimmick ritual of the day is over and Dr. Behind heads to the first patient waiting in curing closet number two.

8:20am

              Behind: “Good morning Tom, how goes it?”

              Tom: “Fine, and you?”

              Behind: “Oh, just great. I just got off the phone with my idiot accountant, the jerk said I am behind on taxes.”

              Tom: “Yeah, but you Doctors have all the money in the world anyway, so what’s the dif?”

              Behind: “Hey Tom, did you see the basketball game last night?”

              Tom: “Sure did, blew them out of the water, didn’t they?”

              Behind: “Yep, sure did Tom. Hey Tom, what was it you told me you used to take when your stomach used to bother you?”

              Tom: “Crackers, peanut butter, and vodka. It works every time, why, is your tummy sore?”

              Behind: “Yeah, sure is, I got a lot of stress right now, I have to try something. Say Tom, I think you better see me a little more often for a while.”

              Tom: “How come? I feel fine.”

              Behind: “You do? Must be nice, but you really should see me about another, let’s say, two times each week.”

              Tom: “Gee, this is pretty expensive, Behind, tell you what, if you could float my bill for awhile, I will step up the visits for one week.”

              Behind: “Okay, Tom, it’s a deal. See you soon.”

8:50am

              Behind: “Hi Sandy, what’s up? Sure is a nice day and everything, the sun’s up, it’s warm, just wonderful, wonderful, wonderful.”

              Sandy: “This is my last visit, Behind.”

              Behind: “What?”

              Sandy: “You heard me you little wimp, last time you cracked me you hurt me, so I am quitting!”

              Behind: “Gee, did it hurt a lot? I didn’t mean it, maybe I can make it better, we can do three or four more therapies than normal, that might work, or, what about a refund?”

              Sandy: “No way, I just came in today to get your malpractice insurance company’s name, good riddance.”

9:15am

              Behind: “So John, how is your day so far?”

              John: “My day is fine, Behind, It’s your billing I’m not happy with.”

              Behind: “What do you mean, John?”

              John: “I found out you charge my insurance company for an adjustment, an office visit, an exam, and five therapies every time I come in here, that is $140.00 a visit, but you only charge Tom Smith $15.00 a time, what’s the deal?”

              Behind: “Well John, Tom is one of our few cash patients so he gets a special deal. And, anyway, I have overhead, taxes, a house payment, car payments, a boat payment, and cards, cards, cards... who cares about the stupid insurance companies anyway?”

              John: “Look, Behind, it’s not fair I tell you, that’s playing Robbing Hood, it’s hi-way robbery and I quit!”

10:25am

              Office Manager: “Behind, Behind, this is your office manager just letting you know the front desk, the two therapists and I decided to go to lunch early today, there is only one more left to come in and you can handle him, the rest cancelled because it is so nice outside.”

              Behind: “Yes Ma’am, have a nice staff lunch, see you later.”

10:30am

              With what is left of it, Dr. Behind’s mind begins to race. He realizes he has no money, he now actually knows how far behind he is in taxes and he is not feeling very well about any of it. He decides to call a close colleague friend to share his woes. Ring-a-ding-a-ling-a-ling...

              Behind: “Hello, Bob? Behind here, how ya doing?”

              Bob: “Practice is garbage. Remember when it used to be fun and easy, Behind? It will never be that way again, we have no say-so in the matter. The restrictions and the paperwork are a joke, can’t make a decent buck anymore.”

              Behind: “Yeah, Bob, I have noticed the same thing, I am really finding it hard to sell this stuff to the patients, they don’t care, they don’t even want it.”

              Bob: “Yep, Behind, like I’ve said all along though, when insurance was good and easy we should have made our hay; now — good luck.”

              Behind: “Yeah, Bob, if only we really believed in this stuff maybe it would be different.”

              Bob: “Come on, Behind, you don’t even adjust your family, heck, you don’t even get adjusted, don’t give me the ‘if only we believed stuff.’ A crack here, a crack there, tell ‘em they are

doing better and move on, that’s all this stuff is.”

              Behind: “But Bob, all I want to do is get this practice going again. I tried a new technique, I went to a seminar and walked on some hot coals, I bought a few new chiropractic toys for the office, I even hired an office manager to tell me what to do. Gee, what does it take to get a successful practice going and make a decent buck? Well, my last one must have missed his appointment also, I’m going to lunch.”

              We now find our Dr. Behind moving, at the speed of sludge, to the post office. He picks up the mail, frantically rips open the envelopes, no checks, only requests for additional information. He curses those who told him to develop this type of practice. His eye is then caught by a flashy ad, “Become Ultra Successful” it says, he reads on, “Come To Our Four Day Seminar And Expand Yourself, Use Our Techniques And Explode Your Abilities.” He had tried all sorts of follow the leader gimmick seminars in the past, dancing on a bed of nails, walking across hot banana peels, eating live worms, etc... but this one, the ad said, was different than all the rest. This was a ONE TIME ONLY, ultimate expander. You chant and moan and groan and share and get honest and cry and support and get supported by, and with, each other all weekend, then you get in a plane and at 10,000 feet you jump, together, no chutes. Dr. Behind is so confused by now that he fails to see why this seminar is absolutely, no matter what, a ONE TIME ONLY event. He calls the 1-900-IAM-DUMB number, charges his card, and goes home to pack and leave.

              When he arrives home, his wife greets him with...

              Mrs. Behind: “I don’t think this is working, Behind, I need to make a change, we are through! There is no money, no fun, no reason to stay with you.”

              He invites her to the ultimate seminar, she walks out, instead. He takes inventory of his life: No control, no money, true. Major taxes, true. Now he has no health and will lose his family. He also recalls this morning, not much left in practice, just like his good friend Bob said.

              “I am going to have to do something,” thinks our Dr. Behind. He pops a beer, sits down to T.V. and relaxes over an extended lunch break.