Warning: Is your practice in trouble?

No Chiropractor starts their practice mediocre; business success depends on navigating all obstacles!


Though every doctor (who owns a medical practice) we have ever met desires success. Many work more hours than they should!  Still, others attend multiple seminars to excel; they enroll in mountains of business success modules.  Have implemented every business strategy you learned?  Is your practice is in trouble?

This month an informative article appeared in the July issue of Chiropractic Economics.  The piece was titled “Warning sign: Know how to spot a practice in need of rescue.”  The article was written by

Chiropractic Economics’ editor-in-chief, Daniel Sosnoski, wrote this enlightening article.  He provides a unique insight into the concerns of his readers.  He writes that an advantage that small businesses have over large companies — they nimbly implement changes and execute strategies.

Nevertheless, that speed is relative.

Critical business decisions still require planning and take the time to develop. Is your practice in trouble?  The sooner the problem is spotted, the faster you will begin taking some remedial measures.

Do you know the warning signs of a practice in peril?

An empty waiting room is an obvious clue that things are amiss.  There are subtle indicators that can give you an early alert and spur you to take needed action—while there’s still time.

You know that patients in crisis need urgent help, and you can’t waste time with Is your practice in trouble?wrong approaches. In the same guise, a practice listing to port won’t be righted by a doctor flailing about in panic.  Practice management experts will consistently tell you they commonly see DCs doing exactly that when they enter a rough patch. A calm, steady hand and the right moves are what will save the day.

Causes for concern

We spoke with some “practice-turnaround” professionals to find out more.  Their experiences in helping DCs in trouble might resonate with those in similar straits.

Scott Munsterman, DC, observes that changes in the industry over the past decade have altered the practice landscape. So a DC who was doing well in the past may run into problems due to the implementation of the expanded Health Insurance Portability and Accountability Act (HIPAA), electronic health records (EHR), and the Physician Quality Reporting System (PQRS).

“If practices have not made accommodations to comply or adapt to these changes, chances are they are either currently experiencing problems or will in the near future,[sic],” he says. 

And that’s not all. Munsterman points to the new ICD-10 coding regime and the proper coding of CPT codes, and the new quality payment system enacted by the Medicare Access and CHIP Reauthorization Act (MACRA), known as the “doc fix.”

“We see many issues arising from post-payment audits that result from lack of proper coding and documentation,” Munsterman says. “Many DCs do not report PQRS and therefore are unprepared for the new payment system for Medicare.”

Medicare predicts that more than 98 percent of chiropractors will experience reduced payments by 2019.  And while fewer than half of DCs are using an EHR system, even those who do have one are likely not using it to its full potential.

Another expert in this area is Brett Penager, who notes the importance of detecting danger early:

Most DCs wait until they are on the downside of new patient acquisition to do anything about it, and then go into crisis mode. But by the time that happens it may be too late to recover your business.”

He stresses the importance of consistent marketing programs to avoid the
roller-coaster pattern familiar to many practices.  And Larry Markson, DC, who has coached thousands of chiropractors in practice development, finds that the most common problems chiropractors have to tend to are matrimonial or personal
issues.  It might be an impending divorce, trouble at home, or some other emotional turmoil that follows the doctor into the workplace.

“People say you should hang your problems up before going into the office, but that doesn’t always happen,” Markson says. “Perhaps it’s a death in the family. These kinds of emotional shocks tend to crash a practice quickly.” From a larger perspective, he finds that the risks a DC face reflect the personality and specialty type of the doctor in question.

Sounding the alarm

As explained above, the challenges jeopardizing your practice could be regulatory in origin, or they come from a breakdown in management or a lack of
business systems, or possibly stem from internal conflicts and turmoil.

Whatever the threat to your livelihood, the first decision you’ll need to make is: whether to try to solve the problem yourself or lean on outside help.

In Penager’s experience, many DCs make this decision based on their gut instincts or seek the advice of a friend.  They might opt to choose a consultant
depending on the results they see others getting.  Sometimes they fail to ask whether this person would be a good fit for their team and philosophy.

“Self-correction is really about having a purpose with an endgame in mind and a sound plan to make it work.  As Einstein said, ‘We can’t solve problems by using the same kind of thinking we used when we created them.’  You’ve got to get to a new level of thinking.”

Sometimes that requires the outside perspective of a consultant or practice management firm.  Markson adds that, while the self-correcting approach may appeal to many, it is unlikely to result in radically improved practice growth—even if successful. The doctor is likely to make the needed corrections.

The article is splendid!  To read it in its entirety, just click on Warning Signs: Know how to spot a practice in need of rescue.

We understand that both learning and applying techniques to pull your practice out of peril takes time.  This precisely why we are offering a free comprehensive analysis of your current patient development game-plan.

We invite you to learn how Steve and Claudio can help you immediately increase your profits, give them a call at 916.750.6319.



From the desk of Claudio Gormaz, direct: 951.294.2274, personal email: gormazca@gmail.com

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