It’s tough to build a business in this profession, or any other profession for that matter.

Most chiropractors fresh out of school fail within the first two years of opening their practice, those first two years in business can be scary, risky, draining, and frustrating.

Seriously, the first two years running your own business can be both horrible and the most exhilarating and fulfilling time in your life. Everyone wants to “make it big”, and they want to make it big “fast”, but more often than not, results almost always come more slowly than you anticipated.

I share this with you because it’s almost always within the first 2 years of practice that “newbie chiropractors” in our profession fail. They start out excited to share their message, but because the results can come slowly, they give up on their vision. They lose sight of the big picture, The Big Idea and their practice starts to crumble because they become so focused on their failures. They become “small minded” and can’t see past the mounting bills of the practice.

You see, it’s easy to stop, it’s easy to quit, it’s easy to give up when your vision is not immediately matched by your bank account. It’s easy to stop and play small in life when you are not earning the level of income you thought you would be earning when you opened your practice.

But I have a message for you: Never let your small practice make you small minded!

Don’t give up on your vision or play small just because things aren’t going the way you thought they would.

This is what separates the men from the boys, the master from the student.

You know there are a lot of doctors that need help. We’ve found that out in the Masterminds we conducted over the phone last week.

So here are some quotes you may want to write down and look at on a daily basis, regardless if you are seeing 1,000 patient visits per week or 10 patient visits per week!

Granted, looking at these quotes daily will not bring you more new patients “directly”, but they will give you the right mindset in moving forward and keeping your nose to the grind stone!

“Nothing can stop the man with the right mental attitude from achieving his goal; nothing on earth can help the man with the wrong mental attitude.” – Thomas Jefferson

Old Thomas J. knew what he was talking about, right?

“Crystallize your goals. Make a plan for achieving them and set yourself a deadline. Then, with supreme confidence, determination and disregard for obstacles and other people’s criticisms carry out your plan.” – Paul Meyer

“Goals are like a map. They help us determine where we want to end up, and give us personal direction on which to focus our energy.” – Catherine Pulsifer

Catherine was good but, check out Ralph.

“The world makes way for the man who knows where he is going.” –Ralph Waldo Emerson

So really doc, what are goals?

“Goals point to where you want to end up, not where you are today.” – Catherine Pulsifer

Remember this doc,

“There is one quality which one must possess to win, and that is definiteness of purpose, the knowledge of what one wants, and a burning desire to possess it.” – Napoleon Hill

Never Give Up! Remember, you were called to serve. True success will ONLY be obtained when that small still voice on the inside becomes louder and more profound than all the voices and opinions on the outside!

Successful clinics have strong brands. And strong brands don’t just happen – they are built over time with focus, consistency, and hard work. But what does it mean to be a strong brand and how does one build a strong brand? Strong brands are those brands that are distinct when compared to other competing brands. They stand out – not based on fluff and meaningless promotions, but real substance found in the patient experience. And strong brands are built through the process of positioning.

Positioning

An important element of branding your clinic is a concept called “positioning.” How your patients think, feel, and emote about your clinic as compared to all other health care providers is your brand position. In this article, I want to explain the positioning concept and its influence in the interpretation of your brand image so you can begin to think more strategically about how you are constructing your clinic’s brand image.

The first thing to note about positioning is that it occurs “in the minds of your patients.” In other words, your patients are the ones that create your brand position. It doesn’t matter what you think, what your staff thinks, or what your spouse thinks – all that matters is how your patients think. And it’s more multidimensional than just how they think about you. Positioning encompasses thoughts as well as feelings, emotions, experiences, etc. It is really everything that surfaces when your clinic comes into consideration by your patients.

The second thing to note about positioning is that it is “relative to your competition.” The thoughts, feelings, and emotions that your patients have about your clinic are referenced against what they think, feel, and emote about your competition – which includes all other health care providers. It’s this concept of positioning that allows patients, and prospective patients, to make judgments about your clinic – which helps them make decisions about visiting, or continuing to visit, your clinic. These judgments are made on both tangible and intangible factors.

The third thing to note about positioning is that you can influence your patient’s positioning process by carefully matching your clinic experience to the desires of your target population. The process still occurs “in the minds” of your patients, but you control many of the inputs that go into that process. And you control those inputs through your clinic experience, not through your clinic advertising. This is why I always remind you that marketing is more about creating an experience than it is about advertising. Experience influences position which influences brand which influences loyalty.

Examining your Positioning

To begin your examination of how your brand is positioned you may want to utilize the following process. Take the time to list out three groups of your competitors: direct competitors (probably other local chiropractic clinics), secondary competitors (probably other alternative or holistic health care providers), and tertiary competitors (probably MDs and other traditional providers). Take your time developing this list as it may have been some time since you last considered what other health care alternatives your patients are considering. As you know, the lines between your practice and other health care providers has blurred lately as more providers offer more “nontraditional” services. Keep that in mind as your identify and categorize your competition.

Now that you have this list, you should attempt to understand how your clinic is being evaluated as compared to these competitors. There are many ways to accomplish this – ranging from highly quantitative to a more subjective assessment. If you’ve never done this before, then a simple and subjective approach will be very beneficial. Start by spending time, just by yourself, wrestling with this process. Then give the same assignment to your staff to get their input. At this point, it would be good to get out the white board and have an office meeting to discuss everyone’s input and arrive at a consensus.

Next, bring together a cross-section of your patients ranging from new arrivals to multi-year loyalist. Be open with these patients that you are seeking to understand better how patients “really” think, feel, and emote about your practice – as compared to your competition groups. My guess is that you’ll be a bit surprised what your patients tell you.

Please note: Sometimes it’s wiser for you to have someone else facilitate the discussion among your staff and your patients. Outside “eyes” can sometimes see more clearly than inside “eyes.”

Next Step

At this point, you should have a better understanding of the distinctive factors that patients use to differentiate your clinic from the competition. From here, the next step in positioning your brand is to design these distinctives into every facet of your business. To build strong brands, it is important to establish these distinctives into the experience that patients engage in when they interact with your clinic.

Although the design phase is critical to building a foundation for your band and establishing it for a long-term perspective, it is beyond the scope of this article. We’ll come back to this design phase in a later article.

Positioning for success involves positioning your brand to be distinct among an increasing number of look-alike health care providers.

By Glenn Bryan, GrowthMatrix, Inc.| Branding and Marketing Consultants to Healthcare

Practice Management Tip #1:

The key to patient compliance is good communication. Follow the communication cycle:

• Tell them what you want
• Why you want it
• Ask for permission

Action Step:

• You are the authority: don’t ask questions, make statements!
• Tell patients what they need and ask if they want to do it.
• Be clear, be truthful, be convincing.

Practice Management Tip #2:

Understand where proper note taking fits into the overall case management model. SOAP notes are an account of the visit that demonstrates medical necessity in summarizing each case. Your exams and re-exams form the basis of medical necessity. Notes need not be long; what is important is that the content validates the visit.

Action Step:

Be direct and to-the-point, and don’t feel that you must say things in a specific manner. Be sure your notes are legible and complete but don’t waste time on them. They are important but they should not steal time from patient care.

Practice Management Tip #3:

Understand that after their health (or even on a par) your patients’ primary concerns are time and money. Address these issues over the phone. Your patients will then be more receptive to what you tell them in the office.

Action Step:

When a patient calls your office, get their basic information immediately and fill out part of the paperwork for them. Explain what you are doing and why. They will feel valued and you will be able to start your treatment process sooner, with better compliance leading to better outcomes.

Practice Management Tip #4:

Instead of spending thousands of dollars to attract a high volume of new patients that often don’t appreciate the concept of your care, strive to build a quality practice through relationships with other healthcare professionals. While some M.D.s do not understand and may undervalue chiropractic, those who do “get it” can be your best referral sources. Cultivate them.

Action Step:

Go through your charts and identify your patients’ primary care physicians. As appropriate, send them letters of professional courtesy. Let them know that you want to assure that their charts are current with respect to treatment their patient is receiving in your office. A brief, friendly, letter with a copy of the latest re-exam report will enhance your image as a professional. Don’t pitch; play for mind-share and future referrals. It works.

Practice Management Tip #5:

Verifying insurance can be confusing and often, the information derived is incorrect. Learn the rules for getting information from insurers and for determining if is correct and that it is what you need.

Action Step:

Control the speed and accuracy of the interview. Ask direct questions and make sure you understand the answers; if you do not, ask more questions. Furthermore, since there are four major categories of services that you provide — Evaluation and Management (992xx codes); Physical Therapy (97xxx codes); Diagnostics; and Chiropractic — make sure you get the limitations on each of them individually.

Practice Management Tip #6:

Understand that when you are billing CPT codes you are not just submitting a bill, you are telling a story. Make sure that your notes correspond to your billing. For example, if you are billing for EMS and you note that the patient is 2 out of 10 on the pain scale – that is not a match, since there is no medical necessity for pain-based treatment if there is no pain documented.

Action Step:

Look up the codes you use in CPT or ChiroCode and learn the actual definitions so you understand fully what you are saying in your documentation. When writing notes, use part of the definitions and be specific in telling the entire story. Don’t look at CPT codes as financial entities but as the language of the treatment story!

by Bharon Hoag
Executive Director of the Ohio State Chiropractic Association

The American Chiropractic Association

A critical mass of recent surveys and studies document the fact that the public, and conventional health care providers and payers, have come to recognize that traditional medicine can’t answer all of consumers’ health care needs. In particular, more people are turning to chiropractic services. A study published in the July 1, 1998 issue of the Annals of Internal Medicine shows that chiropractic treatment is appropriate for low-back pain in a considerable number of cases. This study by the Rand Corporation found that 46 percent of a sample of low-back pain patients received appropriate care from doctors of chiropractic – an appropriateness rating similar to that of common medical procedures.

Poll results released in January 1998 by Landmark Healthcare, Inc., showed that one in every five adults ages 55 to 64 has used chiropractic care.

A December 1997 report from the Federal Agency for Health Policy and Research (AHCPR) notes that the chiropractic profession is now the third largest group of doctoral-level providers in the United States (after medical doctors and dentists).

That same AHCPR report shows that fully 80 percent of American workers in conventional insurance plans, preferred providers organizations (PPOs), and point-of-service plans now have coverage that pays at least part of the cost of chiropractic care.

As the recent AHCPR report states, “In the areas of training, practice and research, chiropractic has emerged from the periphery of the health care system and is playing an increasingly important role in discussions of health care policy.” And, notes a March 1998 article in Business and Health magazine, “Many companies say chiropractic coverage has lowered their medical and workers’ comp costs, while raising overall health and productivity. ‘It’s one of the best benefits possible from a quality, quantity and pricing perspective,’ says George McGregor, president of [a firm that is a third-party administrator].” The article also cites an Oregon study, which found that median work time lost for employees with back injuries who used chiropractic care was only 9 days as compared with 34.5 days for workers who used medical care.

Quick relief of symptoms and sustained effectiveness have long attracted consumers to chiropractic care. In fact, in just one year — 1997 — more than 20 million adults used chiropractic services. The 1994 AHCPR guidelines for low-back pain concluded that spinal manipulation, chiropractic’s primary treatment technique, is one of only three treatments whose effectiveness is substantiated by rigorous research. According to a 1992 RAND Corp. study, patients see a chiropractor primarily for low back pain and neck pain, though many seek chiropractic care for mid-back pain, extremity problems, headaches and other symptoms as well.

Because back pain is so pervasive in our society, a recent study published in the British Medical Journal pointing out that back pain doesn’t go away that easily confirmed what chiropractors have always known. Only 25 percent of low back pain sufferers had fully recovered 12 months after their first visit to a general practitioner, the study said. This low number is in conflict with the commonly-held notion that low back pain episodes go away by themselves after a month. “This hardly comes as a surprise to low back pain sufferers who have been told by their medical doctors not to worry – the pain will go away on its own,” said Dr. Michael Pedigo, president of the American Chiropractic Association. “In many cases, further treatment is necessary.”

Doctors of chiropractic have long understood the cyclic nature of low back pain, and perhaps this is one of the reasons they consistently rate higher than MDs in patient satisfaction in this area. In a recent Gallup poll, 90 percent of all people who visited a chiropractor agreed that their care was effective.

Successful outcomes in both effectiveness and patient satisfaction, have paved the way for chiropractors to enter the mainstream of health care services. Some have even begun to collaborate with medical doctors in integrated health care practices. As reported in the May/June 1998 issue of Health magazine, the prestigious Texas Back Institute (TBI) at one time included only surgeons and other M.D.s. Then, about ten years ago, when TBI’s medical doctors discovered chiropractic’s success with lower back pain, they hired their first chiropractor. Now, according to one administrator quoted in the article, about 50 percent of the Institute’s patients see a chiropractor first when beginning their treatment. Also, the Washington Post recently reported on the success of the 5-year-old company, American WholeHealth, whose clinics incorporate a consumer-driven mix of traditional medical and alternative health care including chiropractic.

Due to years of criticism — and even an illegal boycott by the American Medical Association — chiropractic training was sometimes called into question. However, the fact remains, chiropractors must complete a minimum of 6 and, on average, 7 years of college and post-graduate study to earn their degrees. Their education includes at least 4,200 hours of classroom, laboratory and clinical experience, and as much — and sometimes more than — course work in anatomy and physiology as most medical doctors. After they receive their degrees from one of the nation’s 17 accredited chiropractic colleges, they have to pass rigorous exams and be licensed by the state before they can open a practice. The practice of chiropractic is licensed in all 50 states, and in 1994 there were approximately 50,000 chiropractors licensed in the United States. This number is expected to double by the year 2010, according to the 1997 AHCPR report.

“These recent surveys and reports finally vindicate the chiropractic profession after years of enduring doubt, questions and criticism about our training and practices,” said Dr. Pedigo. “What the health care and medical communities are just beginning to accept is what our patients have known all along — that our treatment is safe, effective and highly successful at improving their quality of life.”

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(The Corn Refiners Association (CRA) has been busy the past few years trying to salvage the reputation of high-fructose corn syrup (HFCS), a heavily-processed chemical sweetener derived from corn starch that a growing number of Americans are now seeking to avoid for health reasons. The industry’s latest marketing stunt involves renaming HFCS to “corn sugar” in order to make the additive sound healthier and more appealing to the public.

(ManyNaturalNewsreaders will recall CRA’s ridiculous television ad campaign alleging that HFCS is the same as “sugar,” and that consuming it is safe in moderation. Well, the group has now modified the campaign to refer to HFCS as “corn sugar,” and is petitioning the US Food and Drug Administration (FDA) to grant approval for this deceitful name change.

(The FDA has not yet made a decision on the matter, but that has not stopped CRA from already using the term “corn sugar” in various marketing materials. In fact, some companies have already begun using the term on ingredient labels, which is a violation of the FDA’s policies concerning false and misleading product labeling.

(To combat CRA’s assault against truth in labeling, Citizens for Health (CFH), a consumer advocacy group, has launched a campaign calledFood Identity Theftto rally its 100,000 subscribers and others to contact the FDA and urge a rejection of CRA’s “corn sugar” petition. CFH says the scheme is misleading and will trick many Americans into thinking that corn sugar is somehow different from HFCS.

(“Millions of Americans are choosing to avoid products that contain HFCS. But many don’t know the corporations that make it want to change the name high-fructose corn syrup to corn sugar,” said James Gormley, CFH’s vice president and senior policy advisor. “If the FDA were to allow this, we’d never know if it’s in the foods we’re feeding our families.”

(Senator Jon Tester (D-MT) also recently sent a letter to FDA Commissioner Margaret Hamburg asking her to deny CRA’s proposal on the basis that it will confuse and mislead customers. HFCS is not “sugar,” by definition, but rather a chemical concoction that has a sweet flavor. It is processed differently in the body than refined sugar derived from sugar beets or sugar cane. And numerous studies have linked HFCS to obesity, diabetes, liver damage, and various other health problems.

To learn more about the CFHFood Identity Theftinitiative, visit: http://foodidentitytheft.com/

Sources for this article include:
http://www.citizens.org/?p=2767
http://foodidentitytheft.com/