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January 2006, Vol. 16, No. 1
Table of Contents
CBP® Non-Profit Matches Dr. Bill Harris' $25,000 Research Grant • Counter Point Round III • Dr Deed Harrison is the Most Published Chiropractor in the Index Medicus • Flawed Thinking • It's Don's Opinion • JCCA Publishes CBP® Structural Rehab Protocol • More Studies to Confirm the Validity and Reliability of PosturePrint™ • Thriving in the New Health Care Marketplace • Organic Chiropractic • Patient Education • Point Round III • The Purpose Driven Practice • Radiation Hormesis • Research Corner • Subluxation Update • System Failure • Ten New Year's Resolutions for Your Practice • Chiropractic: A Useful Component of Traumatic Brain Injury Rehabiitation • Triano is a Chiropractic Pariah •
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Ten New Year's Resolutions For Your Practice
by Christopher J. Colloca, DC
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A 1995 cum laude graduate of Life College School of Chiropractic (Marietta, GA), and a 1990 graduate of Ithaca College (Ithaca, NY), Dr. Colloca directs a full time private practice and clinical research facility in Phoenix, Arizona. Dr. Colloca holds postgraduate faculty appointments in five chiropractic colleges and is Master’s Candidate in the Department of Kinesiology at Arizona State University (Tempe, AZ) with an emphasis in biomechanics. His original research has been presented at numerous international scientific conferences and published in several biomedical and professional journals. To this extent, he has authored over 100 professional articles, over 40 journal publications, more than ten textbook chapters, and over 25 conference proceedings. He is a reviewer for the Journal of Biomechanics, Spine, and European Spine Journal. Dr. Colloca received the prestigious Scott Haldeman Award (1st Prize) for the best research paper at the 7th biennial congress of the World Federation of Chiropractic (2003) and is a recipient of the Sofamor-Danek Poster Presentation Award (2002 International Society for the Study of the Lumbar Spine). He has lectured extensively throughout the United States, and around the world, providing hundreds of post-graduate educational seminars for thousands of doctors of chiropractic.
Two-Thousand-Six is here. Have you kept your New Year’s Resolutions thus far? Eating less and exercising more will certainly help you personally (and may even speed you up in the practice, too), but adopting these ten New Year’s resolutions for your practice are sure to make a difference in your bottom line in 2006.
1. Create Written Job Descriptions and Cross Train. You’ll find that your employees would be happy to do their job if they only knew what it was. Create written job descriptions so that there is no doubt about who is supposed to be doing what. Cross train your team so they know each other’s jobs. This way you’ll be able to seamlessly transition when an employee is out on vacation or leaves the practice.
2. Thoroughly Train and Supervise. Many times we’re so busy when a new team member begins in the office that we short-change the training and leave the training to another team member instead of ourselves. Be sure that new staff members are thoroughly trained to ensure that the practice can grow. Don’t think your team members can read your mind. Train them and supervise. 3. Supervise and Comment. Remember, the staff respects what the boss inspects! Are you checking to ensure that recalls are being made? Are you looking at EOB’s from time to time to see what’s being paid and what’s being written off? Is your staff spending work hours on their own personal interests on the internet or on the phone? Be sure to supervise your team and comment on their greatness as well as their weaknesses. You must have the confrontational tolerance (ala Greg Stanley) to actually comment to staff about the quality of their work.
4. Hold Weekly Staff Meetings and Monthly One-on-Ones. Trying to get everyone in the practice on the same page is a challenge for any office. A weekly staff-meeting solves this dilemma by everyone coming together for the betterment of the practice at a set time. Hold the staff meeting during the lunch hour and do not answer the phones. Throughout the week, make notes of what is going well in the practice and what is not. Discuss these issues at the meeting and invite all team members to participate in the dialog of practice improvement. Individual personnel issues must be discussed one-on-one. Do not let problems fester in your office. Nip them off at the bud for the good of the whole. 5. Set Policy and Stick To It. All businesses must have policies that staff can operate under. Policies are the rules of the office. What policies do you have in place regarding employment, patient flow, recalls, marketing, and collections? Setting your policy for every procedure in your office and ensuring your staff knows and follows the policy will eliminate uncertainty in the office and portray a professional and organized image to your patients.
6. Hire the Right Employees. Do you have the right employees in the right positions? Front desk personnel need to be high-energy, bubbly, warm, friendly and able to multi-task, while always making the patient feel like they are the most important person in the office. Do you have a grumpy front desk person? Is your insurance department personnel detail oriented, neat, and organized? If not, you may not have the right person in the right job. Reassess your employee’s performance and meet with them regarding change that needs to take place. Set a reasonable time period to observe the change (30 days) and follow-up to be sure it’s been done. The right employees are the key to helping your practice grow.
7. Document and Bill Properly. There is no excuse for poor records. Whether it’s an insurance audit, personal injury case that will go to arbitration or trial, or a cash patient with a malpractice or board complaint against you, good records are always helpful. Remember, if it isn’t written down, it didn’t happen. Take the time to put into place the proper documentation procedures in your office. Good records will help you get paid and help you avoid any potential professional claims the future may bring.
8. Re-implement The Basics. Are you making each and every patient feel special and not rushed? Are you making patients wait too long? Do you listen attentively and speak with authority? Are you giving a good report of findings? Are you and your team asking for referrals? Do you call your patients after the first adjustment to see how they’re doing? Are you doing re-exams and clearly communicating patient progress? There are no home runs in practice success, just base hits. Do the little things right and watch your practice grow.
9. Practice By the Numbers. You can diagnose a practice’s problem quite easily when looking at the numbers. What are the monthly gross billings, overhead, collections, patient visits, number of new patients, number of re-exams, numbers of each service being provided, and number of cancellations? Here are some calculations to help you manage your practice.
a. Average Billing/Visit = Monthly Gross Billings / # Monthly Patient Visits. You may find that you are billing a lot, but not collecting a lot.
b. Average Collection/Visit = Monthly Collections / # Monthly Patient Visits. This statistic will tell you how much you collect on average for each patient seen. If that number is $50.00/visit, increasing your practice by 100 visits per month will yield an additional $5,000.00 in your office per month.
c. Percentage Collection = Monthly Gross Collections / Monthly Gross Billings. If your percentage collection is low, this means that a lot of money is being written off. Check with your collections department to see what is happening.
d. Average Overhead/Visit = Monthly Overhead / # Monthly Patient Visits. This statistic will tell you how much it costs you to see a patient. If your average overhead per visit is $21.00 and you are on an HMO plan that reimburses $16.00 per visit, you are losing $5.00 every time you see that HMO patient.
e. Retention = # Monthly Patient Visits / # Monthly New Patients. A low retention is a diagnosis of a pain-relief type of a practice. If you desire to have a corrective-care or wellness type of a practice, this statistic should at least be over 20.
10. Lead By Example. You are the leader of your practice. Act like it. Motivate, congratulate, praise, hold accountable, and set goals for the team. Integrity is doing the right thing even when nobody is looking. Successful people do the things that unsuccessful people don’t want to do. Be a leader in everything you do. Don’t ask your team members to do things you wouldn’t do yourself. Leading by example will encourage others to lead all on their own.
Last year completed my first decade in practice. I began as a solo practitioner and added doctors along the way to the three-doctor group practice that I have today. I think it’s safe to say, “the more things change, the more they stay the same.” I truly believe that the secrets to our growth and success lie in the principles listed above. They’ve worked for me, and they’ll work for you, too. Have a great 2006 and Happy New Year!
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