When you first begin your practice, there is tremendous room for growth through new patient acquisition. If you understand your patient volume capacity, do a great job with your patients, and manage your practice appropriately, you will eventually hit a ceiling where you will no longer be able to accept new clientele without sacrificing your existing patient care. Some practices that continue to operate as ‘new’ practices (even after years and decades) without the appropriate patient centric procedures to create retention, will never turn the corner to a stable, mature practice.
As your practice grows, you’ll need to share some responsibilities if you desire greater stability, vacations, and professional camaraderie. If you manage to create an abundance of patients, the question becomes how to manage them; one wonderful way to do that is to bring on associates. In able to be ready for a great associate program, start early by developing a recruitment strategy, a 12 week internship program, associate agreements, and an associate reimbursement structure so that you are completely prepared when the time comes.
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If you are successful in generating more demand for your services than you have the ability to meet, you will soon begin to have a waiting list practice. Although this is a good problem to have, it still has to be dealt with optimally. I have been managing a waiting list for more than a decade and have figured out a few guidelines that allow for the successful management of this ‘problem’.
You first need to determine an order of value for appointment types; for my office, we value return patient visits over new patient consultations, and we value new patient consultations over first adjustment visits. Why bring new people into your practice if you can’t see the patients you already have? If you find that you are struggling with return visit capacity (and don’t have an associate to take the overflow), my suggestion is to remove a single first adjustment visit per week and replace it with return patient visits.
A rule that works well for us is that a new patient needs to be able to consult with a doctor within a few days of the initial inquiry. If the wait for a new patient consultation reaches 5 days or more, we have a special outlet to accommodate this situation; each DC has a few hours in their schedule each week for extra administration time that can be repurposed for a new patient consultation if the need arises. This extra administration space is also used for the patients that need a first adjustment visit urgently because their problems are acute in nature (in our practice that is 1 of every 10 presenting patients).
After a new patient consultation, we differentiate those that need to be seen immediately from those that are chronic by employing a three point rating system:
In a growing practice, new patient capacity will be very different than in a mature practice. Unfortunately, many mature practices continue to manage things as though they are still young, and therefore they never optimally turn the corner to stability. One of the key factors in making that change is to appropriately manage your new and return patient volume. Changing to managing your practice volume actively (instead of passively) will pay big dividends from both a practice stability and future enjoyment perspective.
Because your personal capacity has limits, there will be a hard ceiling on the practice volume you are able to achieve; if you are working on your practice properly, you will define this metric in advance of running into that ceiling. As you begin to approach your capacity, you will have some decisions to make around adding extra support (CA or DC).
A nice tactic is to use PVA to figure out how to ramp up (or cool down) a practice from a volume perspective. Let’s use an example to illustrate this point; imagine the practitioner has a capacity to see 220 return visits a week but would ideally not like that number to go above 90% until they can get a CA or DC trained appropriately: LOGIN TO READ MORE
WHO IS THE HERO IN YOUR PRACTICE?
Who is the hero in your practice? Many of our colleagues, filled with their own sense of self-importance and their fragile egos, forget that as chiropractors we are not healers; we are merely facilitators of healing. Chiropractic philosophy is quite clear on the interference paradigm, and although society is gradually catching up to that perspective, some of us have trouble remembering this basic truth in the clinical or business environment. The beauty of universal truths is that they can be applied in almost every situation.
When a patient feels better after an adjustment and tells you how fantastic you are, remember to reflect that back to them; after all, isn’t it their body that did the healing? Aren’t you there when it goes well, but also when it doesn’t go as anticipated? Your patient is the hero here, and they need to regain the trust in their body that they may have lost. Most people have never recognized the healing potential within their own bodies - it’s your job, doctor, to teach them. Another benefit of patients owning their healing is that they can also own their dysfunction; they can then identify you as the consultant and guide instead of abdicating responsibility of their health to you. Our gift as practitioners is the ability to free the body to do what it naturally would do without the interference created by the Subluxation.
In the business of practice, these truths also exist. Subluxations of your business also need to be cleared, and one of the best ways to achieve that is to give up control of every tiny detail to allow for alignment of your skills and purpose...
We now move into the final quarter of the year with the focus shifting to Nuts/Bolts. During this quarter we will consider business principals and a review of metrics. A Brand Positioning Statement encapsulates your unique value - how YOU will deliver a service to a customer that a competitor can’t match.
When considering your ultimate desired position in the community, you must first consider who you do your best work with, and therefore who you would ideally like to attract to your practice. To do this, you must first get out of survival mode mentality and think about what characteristics a patient would possess if you were able to design them yourself. What type of patient lights you up?
Your next step is to articulate what distinctive deliverable you can bring to that patient. That is, what can you offer that no one else can? Lastly, you need to express what that patient will achieve by engaging your services. By clearly defining your ideal patient and how you can help them, you define your niche and what sets you apart.
I’ve often heard practitioners say that if people knew what we did, patients would be knocking down our doors. This is happening to some of our colleagues, but unfortunately not to enough of us. If the public doesn’t know what we can offer, how can they make the decision to begin care? The first step in having patients come to you in large numbers is to be clear with what you will deliver when they do.
Here is an example from my office;
Brand Positioning Statement: To our open and receptive friends that are interested in optimizing vitality and aging gracefully, we are the health professionals that will help you improve your posture quickly and comfortably. When your posture is balanced, you will stand straight and therefore feel better, look better, and live better.
Have fun while you build your practice, increase your profits, and enjoy your life!
Dr. Jeff Scholten