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“We Mean Business” is a new TV show, sponsored by Dell Computers, on the A&E network.  The latest show features the “makeover” of a chiropractic office called Spinal Fit in Redondo Beach, California.   The makeover team came in with guns blazing to save the office from its primary problem: lack of patients.

Their solutions:

1. A new networked computer system (provided by Dell, of course) and QuickBooks.  And new appointment software (not sure what this was(.

2.  New front door and reception room decor, with a big computer screen (provided by Dell, of course)  to show off the services the office provides.

3.  New  seminar room with a computer and digital video projector (provided by you-know-who) so the doctor could show videos for patient lectures.

Of course, the team left, and now what?  Is this stuff supposed to fix all the doctor’s problems?

1.  Sure, they showed the staff how to use QuickBooks and the appointment scheduling software.  But did they teach them how to cluster book or to re-schedule patients or do recalls, to get lapsed patients back in?  I’m betting not.

2.  The  lovely new waiting room probably will make patients feel more comfortable while waiting.  But why did they have that many patients waiting?  The number one complaint by patients in all health care practices is … waiting time.  It would have been better if the rescue team spent more time teaching the doctor how to move patients through the office more efficiently.

3.  The new seminar room will give the doctor a space for lay lectures, new patient lectures.  But does he know how to give a presentation with  lots of good emotional and factual punches, and a “call to action”?  Did he really learn how to get people to sign up?  And stay?  Probably not.

My problem with extreme makeover shows and especially shows like this for businesses is that they over-simplify the problem.  The decor, the computer system, and the lack of a space to hold lectures in the office is NOT this doctor’s problem.  I would like to go back to this office in a year and see how he’s doing.  If he’s doing well, that’s great.  But if he hasn’t solved the more essential problem of getting and keeping patients, don’t be surprised.  What do you think?

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.

1.  Don’t get involved in patient billing or collections.  That is the job of the billing person (what?! You don’t have a billing person?  Get one, now!).  You don’t see medical doctors or dentists talking to their patients about “why didn’t you pay your bill last month?” or “Medicare won’t pay, so you have to.”  Discussing financial issues with patients damage the doctor-patient relationship, which should focus on health care.  If you talk about financial issues with a patient, it sends a mixed message:  “I want to provide you with excellent care, but I’m really more interested in making sure I get paid.”

2.  Don’t discuss appointments, missed appointments, late  appointments, walk-ins with patients.  Let your front desk person do it.  Figure out your policies, communicate them to the front desk person, then stay out of the way.  If you get involved in discussions about “I am too busy to see you now, but come back at the end of the day,” you destroy the credibility of the front desk person (no one will pay any attention to him/her because they know you’ll break the rules).  And don’t contradict the front desk person in front of a patient:  “It’s ok, Jennifer. I’ll see Mrs. Smith, just this once.”  Bad idea.

3.  Finally, don’t get involved in patient/employee, employee/employee disagreements.  In these cases, you will always lose.  Let people work things out on their own.  If the communication breaks down completely:

a.  In the case of a patient vs. an employee, you must support the employee.  If you don’t, you won’t have any employees left.  Set policies, stick to them (see #2 above), and support your employees as they deal with these policies.  If the policy is bad, change it, but don’t do it in front of a patient.

b.  In the case of employee/employee, you will never win trying to arbitrate.  If they feel you’re taking sides, both will resent you.  If they aren’t speaking to one another, tell them you’ll fire them both unless they agree to get along.  You’d be surprised how fast they can “make up.”

In all three of these situations, the presence of a policy/procedure before there is need for one (i.e., before the crisis happens) is vital.  Sit down before you start your practice and set out a policy manual, an employee benefits/office rules manual, and procedures for dealing with patient.  I have an ebook clled “The Practice Manual” on my website  that you can download, along with a template to fill in.

How would you handle these types of situations?

Fear of speaking is the #1 fear in the U.S.; more people are afraid of speaking in public than of dying. I figure it’s because you don’t want people to laugh at you, and you don’t care about that if you’re dead.  As a health care professional, you’ll need to be out in public talking about chiropractic.  It’s the best way to get new patients and get yourself respected and noticed in the community.

The best way to overcome your fear of speaking is to join TOASTMASTERS.  I have been a part of the Toastmasters Club at Palmer for several years, and I’ve seen dramatic improvements by students in ability to feel comfortable in front of an audience.  Form a club on your campus or find a local club right away.  Any city of any size will certainly have a Toastmasters Club. 

To overcome learn more about shyness and how to overcome it, here is a great article with tips from Think Simple Now.  The faster you overcome this fear, the sooner you’ll be able to relate to people and get them through Know-Like-Trust - absolutely essential for building a chiropractic practice.

This is an unusual website for a chiropractic practice.  It has been running for several years, and I used to use it as an example of what NOT to do in a website, because it took several clicks to get into the site and I didn’t like the sound (personal preference - I don’t like sounds/music on websites).

I recently saw on a group discussion that the chiropractors who saw this site loved it.

My question is this:  Pretend you are NOT a chiropractor.  Would you like this site?  Would you go through the trouble to click to get to the “real” home page?  I know it’s difficult to imagine yourself without a chiropractic background, but as a web user, I’m sure you can look at it like any other site.   Ask family and friends.

Here is the link:  Shephard Chiropractic

Post a comment and let me know what you think of this as a website.  Compare it to other websites you see and like, not just to other chiropractic websites.

Here are a couple of Chiropractic Economics articles on this subject:

Get caught in the Web! 4 Strategies…

Three Secrets to Profiting From Internet Marketing

You know what I’m going to say … “It depends.”  Here is what I told a young DC recently:

I don’t agree that yellow pages ads are a waste of time.  I know a couple of chiropractors who get a respectable number of new patients from YP advertising.  I don’t think $103 a month is very much, if you’re getting in the printed phone book and on yellowpages.com for that price.   

I would think your best advertising (particularly if you’re in a small or medium-sized town) would be community involvement, health fairs, other local events, just getting out where people are, especially women and families.  This doesn’t cost much (the price of a business card and a brochure).  I’m sure you’ve already done some of this. 

This DC also asked about whether to set up a website.  Again, it depends on the area.  In a small town, don’t bother.  In a medium-sized town with several competing chiropractors, it can give you an edge and help new people find you.  In a big city, it’s definitely a good idea. 

Of course, this is all my opinion.  I’d like to hear from you.  What do you think?

For more information, see what Dr. Mark Swerdlick says about essential steps for startup marketiing.

This is a sad story I saw about a new DC in Wichita, Kansas .  Reading between the lines, it sounds like he got in too far with a lease commitment, then he couldn’t get patients in the door fast enough (or he couldn’t get them to pay) to meet his commitments.  If he had borrowed a little more and spent a little les on startup, he might have had enough money to pay his bills while he was building his patient base.

This is a classic example of “lack of capital.”  It can happen any time, but is most common in the beginning.  How do you overcome it?  A wise chiropractor told me “DSATM - Don’t Spend All the Money.”  In other words, dole out your loan proceeds very carefully, not spending on all your “wants” but focusing on the minimal needs you have in startup and the requirments to pay back your loans and make required payments (like the lease, utilities, etc.).  Then you’ll (hopefully) have enough money to pay your bills while you work to build up a good patient base.

This young doctor sounds optimistic.  I would encourage him to try again.  What do you think?

Sure. I know of several people who started out of their homes or by going to people’s homes with a portable table. This is an excellent way to build a patient base before you commit to paying rent.

Here are some things to consider:
1. Working from Home. If you have a house you want to use as an office, you will need to check with the city where you live, to see what their zoning requirements are. They may have restrictions on how much of the home you can use, and parking restrictions. Many cities require you to poll the neighbors to see if someone objects, and then you must show up at a city council meeting to present your case. If no one objects, and you have met all the restrictions, you may be able to work from home. If you are in an apartment, you will also have to get permission from the landlord.
2. Traveling Office. If you want to work by going to people’s homes, all you need is a telephone and a portable table. This is a good way to get started in a small town, where you can build a patient base quickly. Be careful about going into homes of people you don’t know, especially in the city. You may want to schedule a brief first visit to talk to the family before you decide you want to continue going to this home. You may still need a license from the city, in addition to your chiropractic license, so check their requirements.

Building relationships with patients is a key to a great patient base.  Read this Lifehack article on building relationships , which contains the 11 rules for self-promotion.