StudentDC Interactive

A readaer asked me about this one a few days ago.  Here is how I responded:

Setting up a website is definitely a good idea; having a site is becoming more and more the preferred way to attract potential patients to your site - even higher in importance than getting a Yellow Pages ad.  But the website business has gotten much more complicated in the past few years, with the addition of stuff like search engine optimization, flash special effects, and fancy widgets.  I did my own website a few years ago, but I would not attempt to tackle it now.

Here is another important reason why you should hire someone to set up your practice website:  Even if you have the expertise, do you really want to spend the time doing this when you could be doing other things - like talking to prospective patients or doing adjustments?  Setting up a website is a huge “time sucker-upper” and I would suggest you not get sucked into that task.

You can set up a fairly simple site for not much money, with all the information a prospective patient needs - who you are, where to find you, all about chiropractic, your services, the ability to contact you by email, even new patient forms.  If you want to do the “max” (and spend much more money) you can create an interactive “member” site where people can go to interact with you and have lots of information about chiropractic.  It’s up to you, your purpose for your site, and how much money you want to spend.

There are many web designers out there.  Here are some suggestions for getting your site done, depending on your budget and your preferences:

1.  I have been working for several years with a company called VirtualImpax.  The owner, Kathy Hendershot-Hurd, is a marketing guru, book author, and website setter-upper. She has helped many people set up great-looking sites with high ranking in search engines.   She has a service called easychiropracticwebsites.comto help chiropractors set up simple but effective websites.   You can see her main website at VirtualImpax.com and you can email her at kathy[at]virtualimpax.com.

2.  I ran a search on Chiropractic Economics online to see what came up for “website design.”  There were lots of vendors on the list.  (http://www.chiroeco.com/buyersguide/Search/MarketingResults.php  .

3. I also know that Bill Esteb over at Patient Media has a partner website service called PerfectPatients.  They have lots of chiropractic content, if you’re looking for a site with more services.

When you get your site set up, send the link to me at jean@dcpracticesuccess.com - I collect chiropractic websites and I would love to see yours.

I mentioned Google Sketchup a while back.  If you are not comfortable using their software, maybe you will find these tools from OfficeFinder.com more helpful. Here is what they have on their site:

• A planning checklist to use when you are looking for office space
• An office space calculator.  This one wasn’t quite as useful as I thought it would be.  It’s more for a typical office, not a chiropractic office.  Still, it’s free so you might want to give it a try.
• A lease-vs-buy discussion
• A good article on measuring office floor area, including the difference between usable space, rentable space, and common areas.  Note their chart on conversion factors.

I sat down a week or so ago with a new DC who was looking at an associate contract.  My question to him: “If you had to live on just the base, could you do it?”  Here is what we did:

Monthly Base                          $2500

Income Tax                              $  375

FICA                                           $192

Student Loan payments          $800

Available                                    $1133

So, can you live on $1133 a month?  What if you had a family?  And your spouse couldn’t work?  This doesn’t seem possible, does it?

But, you say, “I’m going to make lots on incentives/bonuses each month.”  But what if:

(a) The doctor made you work for him while he went on vacation and you couldn’t get your own patients in?

(b) The doctor did everything in her power to keep you from getting the incentive, even if you are seeing new patients and bringing in money (this happens more often than you can imagine)

(c) You have to take time off for a family emergency or you are just not able to bring in new patients one month.

Scary thought, isn’t it?  This young doctor was in the Seattle area, where the cost of living is even higher.  Unless his wife works, it doesn’t seem like this is a good deal for him.  What do you think?

If you have been to the bank and you were turned down, don’t despair.  There is another possibility for getting some of the “stuff” you need for startup.  The alternative is “trade credit.”  In a nutshell, trade credit is using vendors and suppliers to finance your purchase of their products.

For example, you will need office furniture for your startup, so you could head to Staples or Office Max and see if they will give you a credit card.  Or, better, go to your local office supply plaee.  You might be able to get credit from them without having to get a credit card.

Talk to chiropractic vendors, like table manufacturers and x-ray machine companies.  See what kind of credit they will give you for startup.

Yes, you may pay more in interest, but you will be establishing BUSINESS credit, which is separate from personal credit.  You could also open a credit card for your business, but be cautious about putting a lot of purchases on it until you are sure you can pay it back.

What I’m really saying is to consider other sources of credit before you go to a bank.  Once you have built up a reputation for paying your business bills, you can talk with a bank more confidently, and they feel more comfortable about giving you a loan when they see that you already have a business going and that you are a responsible business person.

I just saw a great article by a business funding expert, discussing the reasons why business plans fail.

Some of these failings I have been talking about with classes for many years.  In particular:

* Value Inflation - Many DC grads have an over-inflated idea of their value to society.  Just because you think chiropractic is wonderful, doesn’t mean others will too.  You must PROVE your value by providing care that relieves pan and through outstanding customer service.  Don’t toot your own horn until you have something to toot about.

* “We have no competition.”  Yes, you do; it’s every other chiropractor in your community, in addition to orthopedic doctors, physical therapists, and osteopaths.  This statement shows an ignorance about the basics of business that turns off banks and lenders.  Until you can prove to prospective patients that your practice is valuable to them (see item 1), you are just like any other chiropractor.  People who don’t know chiropractic don’t know the difference between NUCCA and Gonstead.

 *Trying to be all things to all people.  I know when you start out, you want to take everyone.  But you need to more specifically define your market.  What kind of patients are you really looking for?  What do they look like?  What kind of care do they want that you can provide?  Limiting your market actually brings you MORE people rather than fewer.  Trust me on this; I’ve seen it work many times.  If you don’t define your market very tightly, no one will know they are supposed to come to your office.

* Unrealistic financials.  I see lots of business plans with very high income projections and minimal expenses.  Back way off on the income projections.  Even if you think you can start out with an income of $10,000 plus a month, the bank won’t believe you.  And be sure to put all possible expenses in your cash flow listing.  Put a large amount in Miscellaneous (at least $500 to $1000 a month).  Remember Murray’s rule:  Over-estimate expenses and under-estimate income.  And you’ll be about half right.

* Forgetting Cash.  Speaking of cash, understand the difference between cash and profits.  Just because you bill it, doesn’t mean it wil be collected.  You must manage collections to bring in the money you need to pay your bills.  If you bill $10,000 a month and you only collect $5000, you may not have enough to pay expenses.  This is the place where I lecture on keeping down expenses (but I’ll save that for another blog post).

In conclusion, read the About.com article carefully and follw what he says.  If you follow the ideas in this article, it could mean the difference between getting your loan accepted or not. 

The term “pig in a poke” comes from the old days, when someone would buy from someone else, and not see what he or she was getting.  The item being bought was not shown to the buyer before the money was paid.  Would you buy a pig in a poke?

I wouldn’t.  I would want to see what I’m getting before I shell out my hard-earned money.  But too many young chiropractors do just that.  They buy a practice, or they sign up with a practice management company, or they become an associate before getting all the facts.  Due diligence is the process of getting all the facts.  It is a complete 360 degree analysis of a business opportunity, with disclosure of all material (important) facts.

For example, if you were doing due diligence on a practice purchase, you would want to know if there were any outstanding debts that the practice had not paid.  There are lots of other items to check in a practice purchase.  A comprehensive list is included in my e-book Buying a Practice (scroll down the page to find this booklet).

If you’re looking at a practice management company, check them out at the Better Business Bureau or Ripoff.com, or go to the office of the Attorney General in your state and see if the company has complaints against it.

In any case, doing your due diligence can mean the difference between a bad transaction and one that works out well.  Get what you’re paying for - do your due diligence.

As usual, there’s no “rule” about this.  I’ve seen it both ways.  At one extreme, I have seen contracts in which the hiring doctor required the employee (associate) to have X amount of coverage, with Y malpractice carrier before starting work.  That’s pretty restrictive.  It’s also a reduction in the base pay (assuming there is a base pay), so the take-home pay is less. 

On the other end of the scale, I have seen hiring doctors pay the malpractice insurance for the employee.  That’s great, but what happens when you leave?  If it were my (personal opinion here), I’d choose to pay my own malpractice, and with the company I choose, so I can take it with me when I leave.  The insurance is very cheap for the first couple of years anyway. 

What do you think?  Would you rather pay your own and take it with you or have your employer pay? 

One final comment:  Remember that EVERYTHING IS NEGOTIABLE.  If your hiring doctor demands that you get insurance with his/her malpractice carrier, politely say you’d rather get it from your own company and then be prepared to give up something else, if necessary, to get this concession.