ChiroMasterMind

Gold standard billing advice: Bill for what you do, but back it up in writing! Insurance companies will play an interesting game with you. They will usually pay for most of the procedures you bill for, if you use the proper codes of course) and they might put up a little fight for reimbursement, but they will generally pay out.  

Here’s the kicker. They come in months to years later and ask for all documentation supporting your rationale for the prior treatment rendered and reimbursed for. If you do not have sufficient S.O.A.P notes to back up your clinical decision making, they WILL ask that all the prior patient payments made to you be refunded to them within several days or immediately. Most chiropractors live hand to mouth and do not have sufficient funds to make payment, so the insurance companies have full legal right to wipe out the assets of the doctor, and he/she is forced to shut down the office. 

Morale of the story: Take the time to back up your clinical decision making. NO TRAVEL CARDS! They do not have adequate room for proper documentation. Do so at your own peril. Gone are the glory days of documenting subluxation listings, “same as previous visit” and “schedule next visit.” Make sure to document for ‘CASH ONLY’ patients. Why, the State can audit you and you want to back yourself up in case of litigation or malpractice suit. Be smart. Oh and don’t be dumb enough to adjust someone at any event outside your office without a proper evaluation. Otherwise, you may end up in court. DTA- Dont’s trust anybody when it comes to simple adjustments. Pessimistic, yes. Realistic oh YES!

Dr. Perry Nickelston is VP of Practice Devleopment for K-laserusa and Clinic Director of The Pain Laser Center in Ramsey, NJ.

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. #2

Tags: General, Practice Tips of the Day by Dr. Perry
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 “To be a great champion you must believe you are the best. If you’re not, pretend you are.”
––Muhammad Ali

Create a Unique Competitive Advantage (UCA)

 Your UCA is what makes your business stand out form the crowd of every other business. It’s what helps your patients understand how you’re different, and it shows how this difference is an advantage or benefit to them.  

The UCA can be many things. Here are some examples:

• IT can be your UMM (problem/solution statement itself.
• It can be the type of patient you treat (niche)
• It can be the way you provide your service (24-hour emergency care)
• It can be your style (gentle adjustments)
• It can be the speed of service or the quality time spent with a patient
• It can be a payment policy (group package rates) *check state laws
• It can be a solid guarantee (my personal favorite) Guaranteed best consultation you ever had. *More on this later

It has to be the right UCA for you, your business and your purpose. A great UCA does the following: 

• It speaks to the WIIFM (What’s in it for me?) first and foremost
• It makes it clear who the service is for
• It communicates something others are not communicating
• It offers a difference that is interesting
• It guarantees a level of performance

The mistake most doctors make is not looking at their practice/business from the point of view of the client. What can you see about your practice from their point of view that is fascinating, helpful, unique, or dynamic? Look for the WOW factor that sets you apart. 

Here is an example: “For the time sensitive patient on the go-we offer morning commute hours. From 7-9 A.M. we guarantee you will be in and out in just 15-minutes or the treatment is Free!”

This is a great guarantee because you attract the people who want fast service and it motivates you to do a better job so you can meet the 15-minute treatment window. Restrict this time to existing patients only. No new patients!

Dr. Perry Nickelston, Vice President of Practice Development for K-laserUSA and clinic director of the Pain Laser Center in Ramsy, NJ.

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext #2

Tags: General, Practice Tips of the Day by Dr. Perry
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“You miss 100% of the shots you never take.”

If you see overweight people in your office, and most of you probably do since they usually have back pain, it is important to evaluate the adrenal glands. They can be a primary cause of chronic pain due to elevated levels of the catabolic hormone Cortisol. Ignore them at your own peril. I have found Ionic Footbaths to be a great way to help detoxify the body and improve hormone function. Worth invbestigating!

Hormones and Weight Loss

Adrenal Fatigue and the Cortisol Connection

Adrenal Fatigue is a syndrome that results when the adrenal glands function below the necessary level, usually because of intense, prolonged or repeated stress. Its severity can range from a general sense of tiredness and the inability to lose weight, to difficulty getting out of bed for more than a few hours. Every organ and system in the body is more profoundly affected if left untreated.  Changes occur in carbohydrate, protein and fat metabolism (leading to weight gain); fluid and electrolyte balance; nervous system function and even libido. Although it affects millions of people in the U.S., conventional medicine does not yet recognize it as a distinct, treatable condition. Most doctors are not aware of adrenal fatigue. They only recognize Addison’s Disease, which is the most extreme end of low adrenal function. Astute doctors who are familiar with the degrees of adrenal fatigue usually test the adrenal hormone levels in the saliva.

What are the adrenal glands?

The adrenal glands are two small glands, each about the size of a large grape. They are situated on top of the kidneys. Their purpose is to help the body to cope with stress and help it to survive. Each adrenal gland has two compartments. The inner or medulla controls the sympathetic nervous system through secretion and regulation of two hormones called epinephrine and nor epinephrine that are responsible for the fight or flight response. The outer adrenal cortex comprises 80 percent of the adrenal gland and is responsible for producing over 50 different types of hormones.

 Is too much Cortisol bad for you?

Chronically elevated cortisol levels may have a variety of negative effects. Cortisol is catabolic, and elevated cortisol levels can cause the loss of muscle tissue by facilitating the process of converting lean tissue into glucose. An excess of cortisol can also lead to a decrease in insulin sensitivity, increased insulin resistance, reduced growth hormone levels, and reduced connective tissue strength. Chronically elevated levels of cortisol can also decrease strength and performance in athletes.

 Should I take Cortisol supplements?

In my opinion, no, absolutely not. Cortisol suppressing supplements are not a valid solution for losing weight. No pill can replace a healthy program of diet and exercise. Pills do not make you lose fat. Body fat is lost by creating a caloric deficit through exercise and nutrition.

 What can I do naturally?Avoid very low calorie diets, especially for prolonged periods of time. Low calorie dieting is a major stress to the body. Low calorie diets increase cortisol while decreasing testosterone. Avoid overtraining by keeping workouts intense, but brief (cortisol rises sharply after 45-60 min of strength training) Suppress cortisol and maximize recovery after workouts with proper nutrition: Consume a carb-protein meal or drink immediately after your workout. Get plenty of quality sleep (sleep deprivation, as a stressor, can raise cortisol). Avoid or minimize use of stimulants; caffeine, ephedrine, synephrine, etc.  

Dr. Perry Nickelston, Vice President of Practice Development for K-laserUSA and clinic director of the Pain Laser Center in Ramsy, NJ.

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext #2

Tags: General, Integrative Treatment Strategies by Dr. Perry
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Motivating your staff

Staff is the little-known secret to practice success. They are on the front lines in your office everyday. You can be the best doctor in town, but if your staff stinks, so does your practice. Make sure you take care of them. Having a proper reward system in place can be the deciding factor in motivating your staff to reaching your practice goals. In reality, if they have no vested interest in making the practice busier, they won’t! It makes no difference to them if you see 50 patients a week or 250 per week. Unless you make it worth their efforts. You can do that by good increasing incentives with good old fashioned MONEY!

There are many types of systems you could put into effect. Here is an outline of steps you need to take to implement a staff motivation program. Keep in mind that a good motivation program pays for itself through increased production form the staff members. Everybody wins!

 Ø  Set a goal of how many patient visits per week you can achieve in 6 months.

Ø  Set a secondary goal as a back-up to that number.

Ø  Set a third goal as a back-up to the secondary goal.

Ø  Tell your staff what the first, second and third place goals are.

Ø  Set dates by which the goals must be reached

Ø  Once you meet the primary goal. Set another one to meet and consult your staff about the new rewards they would like to receive.

Have fun with it. Let your staff come up with idea too.

Dr. Perry Nickelston

www.k-laserusa.com

1-866-595-7749 Ext. #2

www.painlasercenter.com

Tags: General, Practice Tips of the Day by Dr. Perry
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ATTITUDE IS EVERYTHING!

               -Jeffrey Gitomer

What is the secret to effective communication? Tell Stories. People tire quickly of concepts, but stories-well told and relevant-will always increase response. Instead of jamming facts and figures or new chiropractic technology terms down your patient’s throats, tell them stories of how chiropractic has improved the lives of people with similar conditions. When telling stories paint a vivid picture in their minds using as many senses as possible to involve their subconscious mind. If they can see it, hear it, feel it and taste it, they’ll remember it! This is called WORD PICTURES! Master this skill and it could be the single most effective practice tool you ever use. No kidding! 

More on WORD PICTURES later.

Telling stories is an awesome way to use the power of “Emotional Triggers” (see prior post) You will learn how to uncover these Emotional Triggers during the Initial Consultation.

 Here is a an example: Patient is seeing you for a shoulder injury they sustained while exercising. Now you know exercise is an emotional trigger that the client enjoys. It has value to them. Here is your “Emotional Hot Button”. Now all you have to do is push the button to get a desired response. 

Doctor “Brian, imagine yourself back in the gym again. You can hear the weights banging, the music blasting, you smell the leather on the equipment and you are braced up under the bench press ready to do your all time best benc. You take the weight off, slowly lower it and press it right back up with no help. It was easier than you ever thought possible. And the good news, your back did not hurt. You had zero pain and no mental distraction afraid of the back going out yet again. How does that sound? If you follow my recommendations and keep to your plan this can eventually become reality.”

 Now isn’t that a much better motivator than comparing range of motion numbers or telling them their spine is moving better. No offense, but they could care less. Think about what’s valuable to them, not to you. 

Dr. Perry Nickelston, DC

www.k-laserusa.com

1-866-595-7749 Ext. #2

Tags: General, Practice Tips of the Day by Dr. Perry
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BEGIN

“In advertising you will frequently find claims that a product is described as “optimal” or“ideal”. This is strange, because too often a previous product from the same manufacturer wasoptimal, too. So how could it then be improved? Advertising is filled with meaningless wordssuch as “technology”, “recent”, “proven”. This is all part of the advertising jargon and since itis not illegal, we will have to live with it. Now and then sheer lies are used. A classicalexample is the beauty products tested by “The Swiss Vitamin Institute”. There never was suchan institute… 

It is natural that a salesman wants to promote and ultimately sell his product and we cannot asa customer expect full objectivity. But pushing ones luck too hard will in the end be contraproductive. The laser therapy market is no different from the cosmetic market; there are allkinds of salesmen ranging from the earnest ones to the sheer liars.”

Click here to continue reading Laser Sales

Tags: Class 4 Laser Therapy, General by Dr. Perry
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“An investment in knowledge pays the best interest.”

Benjamin Franklin (1706-1790)
American statesman, writer & scientist

 Ever wonder why people hesitate to just to ‘yes’ to visiting you for care? Why don’t they see the value of chiropractic and how it can help them? Now you can learn the ‘emotional’ reasons why people hesitate to buy your services. Once you know them, then you can learn how to address them before they become an issue. Enjoy and learn!

Most people avoid decision-making because…

They are unsure of themselves
They are unsure of their ability to handle the problem
They are afraid it will get them in trouble
They are afraid it will make them look bad
They made a wrong decision before and were berated
They don’t want the hassle
They don’t like, or are afraid of conflict
They lack the motivation
They know they can’t fix it

People reject or don’t want to deal with complaints or problems for these very same reasons! Create a ROF that takes away all of these emotions and you will get them to commit.

Dr. Perry Nickelston

www.k-laserusa.com 1-866-595-7749 Ext. #2

Tags: General, Practice Tips of the Day by Dr. Perry
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I will be on vacation for a few days folks, so I wanted to leave you with some inspiration. The key to success is never stop learning. Read positive material every day from successful people in the past. Learn from them. Keep focused on improving your attitude. It is 85% of your total success in practice. I am not kidding! Enjoy.

Success Quotes: 

1. People have no limits except those which they choose to set for themselves.
2. The minute you start talking about what you’re going to do if you lose, you have lost.
3. Dreams are things you hope for; goals are things you make happen.
4. The only way to truly fail is to stop trying.
5. If you aim at nothing you will hit it every time.
6. The difficult we do immediately, the impossible just takes a little longer.
7. Some people dream of success; others wake up and work hard at it.
8. Half of getting what you want is realizing what you have to give up to get it.
9. Success is sweet, but it usually has the scent of sweat about it.
10. The difference between who you are and who you want to be is what you do.
11. Pride comes from what you do when nobody is watching.
12. If I can’t then I must. For if I must, then I can.
13. If you want to have what most people will never have, you’ve got to do what most people will never do.
14. The problem for most people is not that they aim too high and miss. It is that they aim too low and hit.
15. Every day you either get better, or you get worse, you never stay the same.
16. Winners will do what losers won’t.
17. In life you are either the steamroller, or the pavement.
18. It’s never too late to be what you might have been.
19. Champions never look at what they are going through, only what they are going to.
20. You miss 100% of the shots you never take.
21. An obstacle is something you see when you take your eyes off your goals.
22. Even if you are on the right track, you will get run over if you just sit there.
23. People who say it can’t be done are usually interrupting someone who is already doing it.
24. Luck is what happens when preparation meets opportunity.
25. Success is a journey, not a destination.
26. Attitude is a little thing that makes a big difference.
27. You are where you are and what you are by what has gone into your mind…you can change where you are and what you are b y changing what goes into your mind.

 Dr. Perry Nickelston, DC.

www.k-laserusa.com

1-866-595-7749 Ext #2 

 PS. If you don’t continually improve your skills, your competition will and then they will roll right over you!! Be the winner!

Tags: General, Practice Tips of the Day by Dr. Perry
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The two most powerful ways to build and expand your practice are by using Class 4 K-Lasers and public speaking. Why?  

1.     You have a unique high power therapy laser that gets amazing results. This separates you from all the other Class 3 cold laser providers.

2.     You will have the special capability and secret tactics to market that laser via effective public speaking. Business acumen post lecture is the key! 

Public speaking is the ‘Secret Weapon” to building a professional business. It will be one of the most important things to do with your success in your lifetime. It will allow you to achieve your purpose to help as many people as possible, and make a lot of money. Fancy “Yellow Page” ads and Spinal Screenings cannot compare to the close personal connection established with potential clients at a lecture/workshop. That connection builds trust and trust builds your practice. 

Unfortunately, most doctors don’t implement this strategy out of fear. The fear of public speaking is ranked higher than the fear of death. Can you imagine?  Believe it or not, they fear appearing like they are trying to “close” (sell) someone. Guess what doctor? You are selling! Your main job in public speaking is to get new patients, and sell Class 4 laser therapy treatments in your office. You gotta be willing to close em’. 

It’s not just about educating people. It’s about building a successful practice. If you don’t sell your services, you won’t be open for business very long. These fears won’t stop you. With the information in this report you will get all the new patients you can handle. 

Everything in life you desire lies just outside your comfort zone. The quickest way to overcome any fear is by action. Do the thing you fear the most and the death of fear is certain. In other words, suck it up and just do it. There are a lot of myths associated with speaking and these prevent many doctors from doing anything. They are immobilized. Let’s go over these myths one at a time. 

Myth #1: “You’ve got to be the best.” If you can’t be the best, there is no reason to step out on the stage. The truth is, you only have to be the best you can be. Don’t fall into the speaker tap of thinking more about yourself than the audience. Myth #1 sounds like… 

“I hope they like me.” 

“I hope I don’t mess up.” 

“I hope I don’t freeze up.” 

Are any of these phrases about the audience? Get over yourself, everyone else has! Just think about how terrified the audience would be to speak in front of you. People are far more interested in themselves than they are in you. So don’t be so self-centered. Instead become value centered. (That means thinking of your message first) 

Myth #2: “I’ve got no business speaking to this group. I’m not an expert.”

WRONG. You are an expert on your experiences and interpretations of life. There are thousands of people making millions of dollars based on their opinions. They simply know how to communicate their personal know-how. Consider the way lives will change as a result of applying your message. 

The only thing you have to do is have a definite purpose for your message and allow everything you say to support it. Communicate with purpose, passion and precision.  

Secret #1: Value

Many speakers are concerned with one thing… 

Getting their speech or presentation over with! 

They want to get up and get down. If they survive without dying, embarrassing themselves, or throwing up they feel like a success. Do you know what all that means? It means the speaker who just wants to survive is more concerned with him or herself than the audience. They are more focused on their feelings, or appearance, or nerves…instead of delivering a message that will create maximum impact in the lives of their listeners. 

Professional doctors, however, think more about the audience than themselves. Their #1 goal is to present a message of value. A message that, if applied, will deliver information and motivation that can alter the existence of those who choose to use it. Now that is powerful! 

How do you do this? 

1.     Discover the audience’s hurt or problem and address it with a solution. That would be something like promoting your Class 4 K-Laser or specialized therapy techniques. 

2.     Provide information that will show them how to produce the desired change. Offer a ‘Complimentary treatment immediately.” 

3.     Speak in format that will help the people remember and apply the information. This is done by storytelling. (Ex. A success story) Remember this for later. 

4.    Treat the audience as peers, not as superior or inferior. Drop the ‘I’m a doctor” ego trip.   

5.    Create an emotional experience during the message (laughter, tears, intense thought). Emotions produce connection. (Storytelling) 

No matter who you are speaking to, whether for free or fee, dish out the value. Saturate your audience with so much good stuff their excitement becomes infectious. They should leave with a felling of “I’m glad I came. I can’t wait to put this into action.”

Dr. Perry Nickelston, DC

www.k-laserusa.com

www.painlasercenter.com

1-866-595-7749 Ext. #2 

Tags: General, Practice Tips of the Day by Dr. Perry
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One of the most effective ways to help the #1 cause of pain is laser therapy. What is the number one cause of pain? Trigger points! Treating a trigger point with 180-250 joules of laser light combined with manual therapy is a fantastic way to relieve chronic pain. As long as you are trained in how to diagnose primary trigger points, have an accurate diagnosis, and are proficient in laser therapy clinical applications. The main reason laser therapy is not successful as a treatment protocol is lack of proper/sufficient dosage to the ‘intended target tissue.’ You can’t heal it if you can’t reach it.

Ever wonder what can be done to help headaches, neck stiffness, carpal tunnel type symptoms, tennis elbow, bursitis, frozen shoulder, back pain, low back stiffness, sciatica, shin splints?  Find a Doctor that is skilled with finding and treating trigger points and you just might find immediate relief for pain that has been afflicting you for years. 

Trigger points are accumulations of waste products around a nerve receptor. Often times they feel like nodules or taut bands of fibers within the soft tissues. Trigger points form in muscles that have been overused, injured due to an accident or surgery. Common characteristics are increased muscle tension and muscle shortening. Increased muscle tension is the primary side effect of trigger points and pain is the most common secondary effect.  

Trigger points can present themselves as referred patterns of sensation (pain that travels away from the trigger points) such as sharp pain, dull ache, tingling, pins and needles, hot or cold, as well as can create symptoms such as nausea, ear ache, equilibrium disturbance, or blurred vision. Trigger points can exist in two states, either active or latent. Active trigger points are those that cause discomfort. Latent trigger points wait silently in the muscle for a future stress to activate them. Aches and pains which began in the past become more frequent and severe in intensity as we age. It is common to attribute this discomfort to arthritis instead of our tight muscles which harbor trigger points.
 

Trigger points are not visible with traditional medical testing such as MRI or X-ray and are frequently over looked by most healthcare practitioners as the cause of your pain.
 

80% of the trigger point locations are common with acupuncture treatment locations. When trigger points are not treated, they will create satellite trigger points in the affected area. For instance, a trigger point in the trapezius muscle may cause a trigger point to appear in the shoulder blade muscle. The trigger point in the shoulder blade is the most common cause of shoulder pain, especially when exercising. And, voilà! – a case of shoulder Rotator Cuff Syndrome.  (Not good) 

To break-up a trigger point, static compression (pressure) is applied for 10 seconds, released, then pressure applied for 10 more seconds in a pumping action while the client breathes deeply. This action flushes the toxins and calms the nerves. Releasing trigger points releases endorphins so the result is elimination of discomfort as well as being energized.

Determining which “one” is causing the pain is where the specialty comes into play.  Not all knots cause pain.  That’s why traditional massages usually DO NOT work.

Trigger point massage is not a relaxing, “fluff and buff” technique. It requires the participation of the client to communicate the presence and intensity of pain and discomfort. The doctor and patient work together as a team to maximize the effectiveness of the treatment to ensure long-term relief.  It is common to find great improvement after one treatment. Repeated treatment may be necessary for those with chronic trigger points. Stretching should be done as “home work” to encourage the muscles that have been treated to stay in a lengthened position.  One reason why people may not have improved with traditional medicine, physical therapy or chiropractic is because these trigger points were never released before treatment began.  You cannot stretch, exercise, or rest away a trigger point.  It must be actively removed by specialized treatment before any other type of therapy will help.

Research lists nutritional deficiencies or inadequacies as “perpetuating factors.” A good multi-vitamin supplement that is high in anti-oxidants and is in an encapsulated form can help ensure that once treated, trigger points do not reform.

Dr. Perry Nickelston, DC

www.k-laserusa.com 1-866-595-7749 Ext. #2

www.painlasercenter.com

Tags: Class 4 Laser Therapy, General, Integrative Treatment Strategies by Dr. Perry
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