Practice Building

It’s no secret that I do not agree with most practice management consultants (PMC’s). A particular one sends me his free email a couple of times a week. I signed up for it because his promo sounded interesting, although after reading it for a few weeks I cannot for the life of me think of what he could ever say that would be of any interest to me. Actually, I cannot think of what he could say that would interest anyone who was trying to build a succesful practice.

Recently, he wrote an article entitled “What Not to do on the First Visit.” I thought, okay, let’s see what he has to say and maybe there is one good point I could pick up on. After reading the email, I’m convinced that he is a practice management consultant because he could not possibly make a living as a chiropractor, at least not practicing the way he recommends. Basically, his whole approach is that chiropractors should give people exactly what they want from a medical doctor, only without the drug prescription, which means having a practice full of people who only want a minimum of relief care, using a minimum of therapeutic measures, for a minimum of time and for a minimum of musculoskeletal conditions without most of the tools that an MD has (medications).I assume for a maximum medical fee. That’s not the prescription for a successful practice. Somehow this PMC believes that you can build a successful practice that way. I find it hard to believe that he did that but if he did, it was probably before MD’s, physical therapists and massage therapists were manipulating spines, before insurance waned and before there were 60,000 chiropractors competing for bad backs and stiff necks.

If he wants to promote a “relief care” practice and chiropractors want that kind of a practice, so be it. In actuality, most chiropractors already have relief care practices and they are the type of practices that are hurting. Maybe this guy can teach you how to be a better relief-care doctor. In fact, there are many chiropractors trying to be better relief-care doctors…they want to prescribe medication. I’m not going to refute his suggestions point by point, although they range from downright dumb to illogical to even dangerous from a malpractice standpoint.

The bottom line: Why would you want to practice that way? Relief care patients are usually the worst kind. They all come in moaning and complaining. Half of them feel better or don’t feel better after one visit and they’re gone, especially if you tell them nothing about chiropractic and everything you have told them implies that chiropractic is about relief care. Half of the rest won’t come back because, regardless of what you tell them, they think that one visit should give them relief and if it doesn’t, they conclude that chiropractic doesn’t “work.” Suppose they develop another problem or a recurrence of the same problem that becomes chronic or terminal and they had stopped care because they thought care ended with relief. For that you may not be sued for malpractice but perhaps there should be some sort of suit for immoral behavior. If you do not know that chiropractic is not about relief care, shame on you for not investigating it. If you know and choose not to tell the new practice member, that’s immoral! This PMC prides himself in not having his clients focus on anything but relief on the first visit. Personally, I would rather lose a new person because they were annoyed at my long “report of findings,” “too much paperwork,” “brochures on chiropractic,” and “my introduction to subluxations or maintenance care,” than have them not return because they got relief after one visit and thought that’s all they needed from a chiropractor.

This PMC suggests that you do not do anything “real doctors don’t do” and says that “chiropractic consultants will disagree with all of this.” I really do not care that other consultants disagree with him. I do care that those chiropractors with common sense and a desire to see their practice members understand and avail themselves of lifetime chiropractic care so that they can build a practice which does not depend upon a constant influx of crisis-care practice members. I care that they disagree with him.