April 2006, Vol. 16, No. 2
Table of Contents
CCE Recognition by USDE Set to Expire • CCE Response Spurs Follow-up Complaint • Differentiating Neuromuscular from Musculoligamentous Subluxation • Chiropractic Pioneer Passes Away • Early Life Infections Improve the Function of the Immune System • European Spine Journal Publishes PosturePrint® Study • ICA Defending Chiropractic from PT's • Immunization • Letters to the Editor • Life University Teaches CBP® as an Elective • The Ineffectiveness of Over Accommodating • Parker College and Seminars Begin Celebration Preparations • PosturePrint® Used to Determine Stability of Upright Posture • CBP® Hits 91 Publications • Thanks for Helping Your Local HMO Grow! • The Perfect Chiropractic Storm • Three Keys to Practice Success • Building Wealth Securely: Maintenance, Not Pain Relief •
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Three Keys to Practice Success
by Scott J. Heun, DC
Dr. Heun practiced chiropractic very successfully for over twenty years. As a second generation chiropractor he has a unique perspective on the profession. At various times he has owned and operated single and multi-doctor offices, managed multiple office locations, as well as a physical therapy and rehabilitation center. Dr. Heun successfully implemented an intern program in the last 8 years of practice and was a preceptor for Palmer College of Chiropractic-West. Dr. Heun is a Certified Chiropractic Sports Physician (CCSP), taught the CBP® II elective at Life-West and is a CBP® Certified Fellow and CBP® Instructor. Dr. Heun retired from practice in 2004 and is now a full time practice consultant with Total Practice Management International, LLC.
Whether you are a rank beginner or an experienced veteran in chiropractic practice, there are three key elements to success in practice. Though these elements of success are similar for many human endeavors, the sub-categories associated with these primary elements are unique to our profession. The three primary elements to practice success as I see it are organization, skill and focus.
Organization
In order for a doctor to practice in a dynamic, responsive fashion, an organizational system must be in place that provides a framework for the doctor to operate from. I contend that the system employed, must fit the doctor’s personal style, practice technique, and physical ability. For example, all too often, goals are set for practice growth with the focus only on “new patients” with no attention paid to the logistics of the current practice or the doctor’s unique abilities. A superior way to practice is to analyze the current system, determine what is working and what is not, and to consider the current skill level of the doctor in this exercise. Then, and only then, a plan can be formulated to re-organize the practice and implement systems, which match the product the doctor wishes to produce, and which also provide structure to allow the doctor to function dynamically within the system. Without the framework office organization provides, the doctor is forever reacting to the office environment, rather than proactively moving the office forward. Some doctors can accomplish this analysis and implementation on their own; however, many need an objective outside consultant’s help. If you are not sure of your own abilities or proclivities, you may need assistance, for that matter if you are sure you are not naturally organized, you most definitely need help in this area.
The organized office must have a written office policy that all staff understand and abide by. The office must also have a written office manual. This document is dynamic and responsive to the changing needs of the practice; it must include all the procedures, systems forms and protocols that make up the office. As the office function becomes more complex, the document must adapt to reflect these changes and enhancements. To function without this level of organization is to live out reactive crisis management. In offices relying on energy, passion and charisma, there is often no system in place to manage the business. Volatility ensues, and burnout eventually rules the day.
The office must have a communication system in place. All team members must understand the hierarchy of the office, and how to communicate with one another. Email can be a wonderful way to communicate, and follow up and monitoring is much easier with written communication. A system for advancement must be established and monitored. The doctor as the chief executive must be constantly monitoring the staff to insure the practice is on track with the desire of the doctor.
The process of organizing the practice can help to define the office systems. I contend that if a doctor is not practicing within a structure purposely created and intentionally defined; that a default system has been created for them that mismatches their practice and personal goals.
Skill
Students in chiropractic college have a set of raw skills. Some have been athletes and may still consider themselves so. These gross physical skills are helpful in the art of chiropractic practice. Some doctors have had experience as massage therapists, or athletic trainers, or as physical therapy assistants. Regardless, students had a given skill set. Chiropractic practice demands a unique skill set that must be learned and then continually developed. For example, the ability to connect with patients through verbal and non-verbal communication is one of the most critical components of practice success. The ability to read posture efficiently, and the physical strength and coordination to deliver manipulations and adjustments are critical to success with patients. To physically examine, palpate and interpret the information you obtain, and the intellectual proficiency to evaluate, filter and interpret information, to formulate a logical treatment plan that matches the needs and tolerance of the patient, always considering the whole person. The effective doctor must have the wisdom to “know their own weight,” in other words, to know their ability at any given time, as well as their limitations.
Existing skills can be enhanced and new skills can be developed. It is unfortunate that our chiropractic educational system does not prepare the graduate to practice successfully. Fortunately, there are quality seminars such as those offered by CBP® Seminars that teach the fundamentals required to practice CBP® Technique. These seminars are also constantly updated to ensure the most defendable and practical clinical information is available. In addition, the latest research on the spine and related subjects is regularly disseminated. This practice is helpful in supporting the individual doctor’s confidence. To enhance your skills in the area of doctor patient communication and efficient clinical case management, contact the author directly. For better overall knowledge, consider the post-graduate orthopedic or sports injury programs, and the programs by Dr. Arthur Croft for mastery of the motor vehicle crash cases. In any event, constantly learning is critical to advancement in practice. To enhance your adjusting strength and coordination, consider a martial art such as Aikido, or a more passive form, Tai Chi. Yoga in many forms can also help to strengthen your core.
Focus
I contend that in order to practice effectively, the doctor must eliminate all negative outside influences and thoughts and orient their focus completely on the patient. Patients even in the largest, highest volume practices only present for care one at a time. Doctors must eliminate negative outside influences, including people and situations in order to concentrate and focus on practicing chiropractic.
The other side of the equation to enhance focus is to continually stimulate one’s mind. Reading and writing are two of the best ways to accomplish this. Reading on a variety of subjects promotes balance in your thought processes. Of course chiropractors must allocate time for clinical and research information to stay current with professional obligations. However, reading thought provocative literature, and writing about what is read, and when convenient, discussing the ideas explored in reading with others can help to exercise one’s brain in a unique way. In approaching intellectual growth this way, the possibility of burnout is reduced or eliminated. In other words, one is still exercising one’s mind, sharpening one’s wit and enhancing one’s memory, skills critical to practice success, yet not doing so by constantly reading chiropractic literature and scientific information. This intellectual sharpness, which results from intellectual stimulation, will produce a better communicator, by helping to keep the mind sharp.
Putting It All Together
The most successful practices of any size have a balance of these three primary elements firmly established. The doctor arrives in the morning prepared to face the day, and the patients in need, all the while knowing the appropriate systems to handle them are firmly in place. The patients are scheduled in a sequence that matches the doctor’s speed and skill level. The staff trained by the doctor, know and understand their duties, and in turn, they know the office systems well enough to adapt it to any change in circumstances which may occur. The system is in place so that the doctor can focus on meeting the patients, greeting them, rhetorically questioning them to illuminate for them why their care is so important and the impact it has on their condition and their life.
The doctor is prepared to use the level of skill presently enjoyed to apply these skills to the patients’ needs. In the successful office, the doctor is constantly improving physical, intellectual and communication skills. The balanced practice grows based upon the development of these three components. All of these components must be in harmony to have the practice advance with minimal stress to the doctor, staff and patients. Success is defined as moving the practice forward consistently with balance, constantly succeeding on all fronts. When a doctor sets a practice up in this model, creating the opportunity for patients’ needs to be met, and expectations to be exceeded, success is achieved. The patients get what they need, are taught well, and refer others in need. A fair exchange for services rendered is charged and tended and profit is enjoyed by all.
