"Change is the law of life. And those who look only to the past or present are certain to miss the future." — John F. Kennedy
Change is the operative word in health care these days, and things show no signs of settling down anytime soon.
To help you enhance your practice and increase your bottom line, we ask practicing doctors of chiropractic like you for ideas and solutions that have been tested in real-world environments. Our latest question: "What features / capabilities do you believe make the 'ideal' chiropractic office in today's health care environment?" This question generated responses that touched on a wide scope of topics, ranging from design elements to specific services, to practice model / philosophy. Here's what your colleagues said when asked for their insights.
Put the Patient First
Patient-centered care is the wave of the future, and Concord, Calif., DC Dr. David Abblett believes it is a key element of a successful chiropractic practice: "There is no problem with patient retention if your technique achieves good results and your patients know they have your full attention. How many of you have gone to a medical doctor lately? Usually the MD's or staff's head is stuck in the computer instead of looking you in the eyes and listening to you. The patient should always come first – not their insurance claim."
Offering patients the services they want is another element of patient care, which may explain why Dr. Mike Fillat of San Diego, Calif., offers acupuncture and massage in addition to chiropractic adjustments.
Dr. David Robinson of New Bedford, Mass., believes "the vast majority of DCs have gone / are going 'medical," with all the accouterments of 'Big Med,' with packed waiting rooms, no promptness to appointment times, and offering everything and the kitchen sink for treatment options." However, according to Dr. Robinson, he has "taken the opposite direction to create a truly private practice, warm, smaller, inviting space that makes practice members feel 'special:' no waiting, prompt; low volume, one patient at a time per appointment."
Dr. Robinson also said he schedules appointments at 30-minute intervals with no cluster / multiple booking, another indication of his attention to patient-centered care.
Cash Over Insurance
"A cash practice is the simplest way to run a practice, with all the current headaches from EHR, ICD-10, Medicare audits, etc.," said Dr. Abblett. "It's easy to love your practice and keep the excitement going when you deal directly with your patients and also have to answer to the people who pay for your services out of their own pockets."
Dr. Robinson's practice also features "cash payments prior to the adjustment; no insurance or personal injury."
Integrate and Specialize
"Today's environment, as well as future ones, require integration of care with the medical profession," commented Dr. Vishal Verma of Las Vegas. "This not only provides the most comprehensive setting, but also increases patient compliance and reduces the stress of 'marketing' this great profession. Working within an integrative environment, my education was to the doctors I work with initially; now I am seeing patients regularly with no marketing or sales: just pure referrals from the doctors."
"The other plus will be specialization through advanced education by the chiropractor," continued Dr. Verma. "Becoming an expert in sports, orthopedics, neurology, nutrition, etc., will bring increased credibility and greater results through advanced methods."
Form and Function
For Dr. Fillat, office layout and design can't be overlooked: "We just redesigned our office because we had to move. We made the doctor's office smaller and squeezed a couple extra treatment rooms in so as to maximize patient treating space. We only have one staff member, so the patients walk themselves to the rooms and leave their chart in a chart holder outside the door.
"We are a single-doctor office, but at times have had associate doctors," continued Dr. Fillat. "We have one room with our therapy in it and the rest are just adjusting rooms. We have an area with four massage chairs that patients sit in either before or after their adjustments."
Focused on Fitness
Dr. Brady DeClerk and Dr. Mitch Green both espoused the practice benefits of fitness and performance enhancement. Said Dr. Green, who practices in New York City, "The chiropractor that has the ability to appropriately lead their patients into the world of active care, rehabilitation and performance enhancement will offer a wide array of services that addresses more of the needs of our community."
For Dr. DeClerk, whose Little Rock, Ark., clinic soon will be attached to his CrossFit gym, this unique fitness pursuit offers an avenue for chiropractors to gain new patients and expand their care:
"When people, especially chiropractors, hear about CrossFit, they immediately think about the injury concern and how it will affect the joints of the body," said Dr. DeClerk. "For this reason, many chiropractors and other medical providers snub their noses at this form of exercise. What they do not realize is what CrossFit teaches. ... Now, there are good and bad facilities, just as there are good and bad chiropractors. But for the most part, people learn how to use their body efficiently and safely, and spend numerous hours learning how to lift properly. It also teaches them a good foundation of how to take care of themselves inside and out.
"When you have people actually looking forward to exercise, actively learning about nutrition, and studying new skills and movements, it is very special.
"Fellow chiropractors, please go the local CrossFit facility. You will love what you see, and love the patients you can get from this. People will need to have maintenance from any physical activity if they stay with it long enough. Also, with your CrossFit patients, they will understand the importance of what you are preaching. They will not only want to come to you if they have discomfort in a certain area, but they will also want to come to you because it will make them better in the fitness journey.
"I promise you, it is very rewarding treating people who want to feel better, want to perform better, and want to do it for a very long time."
Practice Tip 101: Think Like a Business Owner
The bottom line when it comes to equipping your practice for success, whether it's the services you offer, the practitioners with whom you affiliate and/or the design / layout of the practice itself: Think not only about what works best for you, but also what works best for your patients and the health care marketplace in general. After all, your practice is a business first – ignore that fundamental reality and you'll find yourself out of business before you know it.
Editor's note: Interested in joining our focus pool and sharing your perspectives on chiropractic practice with your peers? Email
. Every few months, we send out a new question and request your input / insights.