As they roll you onto the stretcher, you repeat over and over, "Who changed the game?"
I receive calls from chiropractors all over the country. I hear how they've been blindsided. They asked the same question: "Who changed the game?"
I've seen entire working populations in some towns switch to some abusive HMO overnight, or a governor's signature deleting all chiropractors from workers' compensation before the ink dries. Other areas haven't been hit as hard, but everyone knows that it's a new ball game.
Reactions vary: some refuse to make any changes and suffer accordingly; others work harder, but not smarter; and some, the less hardy, give up.
The reaction I want to write about is not only sensible and viable, but exciting and successful. There are no compromises, no trimmed-down visions or dreams. In fact, 19 of 20 of our clients had practice growth in 1997 by playing this game. It can work for you.
What is this different reaction? What's the new ball game? What's this successful strategy?
First, take that silly tennis garb off and grab a helmet and some pads, fast. If you refuse to change, you'll be road kill on the health care highway. Maybe your death will be slow: let's say 10 percent loss per year. If you don't kiss the past goodbye and welcome the new game, it's only a matter of time.
Second, learn the team positions in the new game. One of the key positions in the new game is marketing director. Until you know how to play marketing director well enough to teach it, you are it.
Let's get down to bare knuckles. The number one practice problem in the nation is not enough new patients, no matter what anyone says. To have a large, enjoyable and profitable practice you need more new patients that you did before, the result of more competition and smaller insurance reimbursement. Many DCs have told me the old marketing game doesn't work anymore. One of the problems is that your referral lines are getting thrown into the managed care shredder. People hear about how wonderful you are, but decide to see someone else when they discover you're not on their plan.
As for managed care panels, the DCs I've coached who learned well how to play the team position of marketing director stay away from the vast majority of managed care. These DCs don't need this type of new patient, because they do so well at getting new patients that they won't take the cut in pay. (Yes, patients will see you and pay for it "out of plan.")
I know of precious few things in my life as easy to present and as well-received as chiropractic. The chiropractic story is life-changing and an easy one to tell. I ask my clients to rearrange their week to spend half the time they used to spend worrying about their practices in some type of marketing programs, so that they won't have to worry at all.
It's an interesting transformation to watch someone truly learn that they have the skill to produce all the new patients they can handle. I think that defensive line is starting to take shape.
Third, manage your team like a professional. I know some people don't like to think of it this way, but your chiropractic science, art and philosophy are supported by a chiropractic business. If the business doesn't succeed, the science, art and philosophy go away. In the old game, millions of insurance dollars built and/or allowed a terrible business management model.
I miss the insurance reimbursements as much as anyone else, but today we need to be better managers. Here's what I mean. You walk into an office that runs like a Swiss watch; that's very busy, low stress, happy and profitable. That did not happen by accident. It's good management. Swiss watches don't happen by accident, and neither do the best practices.
The best approach here is to find a great book for a successful practice and reproduce that success. Why reinvent the wheel? One of the best side effects of learning to manage your team is that they will invest in your goals just as much as you do. This is how the team is built.
Fourth, stay in love with the "fans" (patients), who, in some cases, are dying to meet us. I have always worked off a life-action model of helping people and having fun. When I help people, like only a chiropractor can, and remember to have fun in the process, I can be doing a hell of a goal line stand with my back to the wall and think and feel that it's more than worth all the work when a first time grandma hands me her first grandchild and says, "Doctor, will you check Christopher?"
Fifth, remember that change takes time and you cannot give up. Every time I do something new, I mean really new, I wonder, "Why?" Even if my old game didn't work I may be tempted to play the game and fail just because the new game "doesn't feel like me." I learned to snowboard recently. Ouch. Three days of torture. Each time I rode back up the chair lift it seemed like a bad idea. But on the ride up, I would watch all sorts of people having the time of their lives on those crazy things. By the time I got off the chair, I was recommitted, and by day three, I was in love with a fantastic new game. Don't give up.
Sixth, get a coach, for crying out loud. Find someone who has helped others play the game you want to play and let them coach you. Think about this for just a minute: Ken Griffey Jr., Tiger Woods and Michael Jordan all have coaches. Every year Jack Nicklaus dismantles his golf game under his coach's watchful eye and reassembles it, starting with the grip.
Here are the qualities to look for in a coach. A coach has to have been successful at helping others do what you want to do. A coach must inspire you. When a coach explains how to do something, you must see yourself doing it. A good coach cares about you, will work with you and amplify your strengths and support you in your weaknesses. You must be committed to change. The best coach in the world can't help you if you won't change. Even a fairly good coach will usually give you enough good advice to make a hugh difference, if you follow through.
Now you have your football gear on. Your teams is trained and eager to take you down the field to score. The fans are packed in the stands and cheering you on. You know you aren't going to quit. Your coach is giving you the thumbs up. You think, "I'm going to like this game. Let's kick some butt."
Dr. Noel Lloyd graduated from Palmer College of Chiropractic in 1971 and became the youngest practicing chiropractor in Washington. He is the founder and head coach of Five Star Management, a professional training, coaching and consulting service based in Seattle, Wash.