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June, 2013

Weathering the Storm: 10 Practice Disasters and How to Avoid Them

By Peter G. Fernandez, DC

It's tough enough to run a successful practice, so don't set yourself up for failure by doing one of these practice catastrophes. Chiropractors graduate from professional schools, not business schools. Unfortunately, running a successful chiropractic practice requires extensive knowledge of staff training, patient relations, insurance procedures, business, taxes, legal issues and finances. Therefore, a "cram" course on these subjects is a must. Here are ten examples of practice catastrophes and how you can effectively avoid them.

#1 High Pressure Sales Tactics

Unfortunately, there are consultants that specialize in teaching scare tactics (i.e. telling patients they will die without their adjustments). These tactics will backfire on the DCs that use them. There are other consultants that recommend extremely long treatment plans, high case fees, years of care, etc. These tactics will backfire on the doctors, too. Both of these types of practices lose half of their new patients because the public doesn't want expensive long-term treatment plans. The patients who reject the doctor's recommendations will go out into their community and bad-mouth the doctor who made these recommendations. Remember, every satisfied patient will tell one to two people, while every patient that is dissatisfied will tell 11 people.

storm - Copyright – Stock Photo / Register Mark The doctors that use these scare tactics and long-term treatment plans are developing a horrible reputation in their communities. This requires them to advertise more, which means they will have a higher overhead to overcome the bad reputation they are creating for themselves, until finally they can't spend any more money to advertise. Then, they'll move to a different town.

Too long or too expensive treatment recommendations place too many people in the "dissatisfied category." And when the doctor's satisfied patients try to refer to their doctor, the doctor's recommendations will backfire on them. For example, imagine you need to see a medical doctor and someone tells you, "I know a medical doctor and he is absolutely great, but you have to go to him two to three times a week for a year so he can do his job. What would your reaction be? Would you go to him or her? Heck no! Or, the same person, says, "I have a great medical doctor and he is absolutely terrific and he only charges $4,000." Are you going to go there? A trip to the emergency room is less expensive. A trip to a walk-in clinic is less expensive. Why in the world would you want to go to a doctor who charges $4,000? Sometimes, an idea that seems good is actually bad and will doom a practice.

#2 Touching Patients Inappropriately

One of the greatest ways of totally ruining a practice is for a doctor to inappropriately touch patients. State boards, the patient's family and the police department "frown" on such practices. When your soiled reputation gets out into your community (and it will), what will happen to your referrals?

#3 An Inappropriate Relationship with Your CA

Too often, DCs have inappropriate relationships with their CAs. The words "sexual harassment lawsuit" comes to mind. What's more, the dynamics of the office are forever changed. Doctors find they no longer have a "working relationship" with the CA. Very little work gets done and their practices fail. Should you have cause to discipline or fire this CA, she may feel scorned, turn against you, attempt to blackmail you and/or ruin you financially. She'll report you to the authorities and you'll be out of practice.

#4 Doing Anything Illegal

Quite often a doctor will do something illegal – either inadvertently or on purpose. Shave a legal corner here or there and it will catch up with you. Whether you meant it or not, you can still lose your license.

For example: Forgiving co-pays. All doctors know they are not to forgive co-pays unless the patient has a dire financial hardship (which is only about 1% of the people). Then when an insurance company audits the doctor, which they will, they will find out he is forgiving co-pays. Guess who has to pay back all that money? That's right, the doctor! Quite often it is hundreds of thousands of dollars.

What about insurance fraud? Some doctors try to get away with insurance fraud. The doctor may say that he didn't know that insurance fraud was being committed. He simply and unknowingly "signed off" on work filed by his insurance CA. The DC still goes to jail. Maybe the DC shares the blame with the insurance CA. They both knew it was illegal. The DC still goes to jail.

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