145: The Chiropractic Agreement Part 2

145 The Chiropractic Agreement Part 2

Hi everybody. Welcome to the KC CHIROpulse Podcast brought to you by Kats Consultants, helping doctors keep their pulse on success. Today, we're talking about the chiropractic leaking phone call, which is as much as anything about the chiropractic business agreement, the agreement between the doctor and the patients.

We started talking about this last time, and we talked a lot about how this starts with somebody calls up, a patient calls up. Staff takes the phone call and the patient wants to change an appointment or wants to cancel an appointment. We don't find out why and our responses well call us when you need us or Do you want to reschedule that and so we talked a little bit about how to handle those kind of phone calls through?

Training and development, but let's take this one step further. So everybody this is part two of last week's Podcast, let's take this one step further. This whole process of the doctor doing a killer report of findings and the patient gets excited about care and they're engaged and they agree to the treatment plan.

And then they go to the front desk and sometimes things just seem to fall apart a little bit at the front desk. And where they fall apart is in scheduling, in follow ups, in greetings, in patient relationship building, and so on and so forth. We could go on and on about that. Really, the whole process of getting the agreement up front really should make the front desk process so much more simple if we're managing it correctly.

I know you've got a lot of thoughts about this. I do. And I, and I want to add one caveat to that as well. And I'm going to go, I'm going to make a really big leap here as we talk about this. So what, what's one thing a lot of chiropractors think about new patients all the time, right? Right. So here's the problem.

If I'm not efficient and process it with my patient agreement. And with my follow through on my end and doing the appropriate things, even when there may be a hiccup in the plan, what I do is create a situation where the front end of the bucket, in other words, for my practice, just to be full for my practice, to be busy, I'm going to have to generate more new patients as a result.

So if I've got patients that understand care that are following through with care and that when they do have a hiccup that I follow up with them and make sure that we, we get back on track, then I don't have to rely as much on new patients coming through the door. So I look all the way back to the beginning and go, that's what I call low stress.

I want the least amount of stress when I'm in working with patients. I want to focus on patient care. I want to focus on that individual. I don't want to, in the back of my mind, be thinking, well, our practice is a little slow this month. I wonder what's going on. Right. We do that. Yeah, we do that. We wonder where, where are we leaking?

And so if you're, if you're not leaking, you don't require as much upfront. And I think that's an important thing because it makes your practice less stressful. It does. So, and I, I think the whole leaking concept is a great concept to wrap your brain around. Think of, think of your practice as a bucket and you start out in the first year and you're, you're filling it with patients, but how many are staying?

Do you have a hole in your bucket? Are you actually filling it up or do you have to keep pouring water into it with your new patients? Do you have to keep pouring water into it? Because it's leaking out as fast as you're pouring it in. Okay. That's not a healthy practice. A healthy practice is one where month in month out year in year, year after year, it's getting more and more full until it eventually runs over.

And that's when you bring in an associate or something like that, or, or raise your prices and pour a little bit of the water out and then fill it back up with higher paying patients or, or something. There's, there's all kinds of ways to manage it from there. But so oftentimes we're just chasing our tail and we don't realize.

that we got a leak in the bucket somewhere. And so, and a lot of times that leak is in one simple area. It's on the phone and patient calls up, says, I need to cancel my appointment. And are we going to handle that in a manner that keeps the bucket full or are we going to let it continue to leak? And when you, when you allow those new patients to continually drop out, Troy, you hit the nail on the head.

You're always under the gun to keep filling the practice with new patients. And you know, new patients are one of the hardest patients really to manage. We don't have a relationship with them. There's no trust built in, in the beginning. You're not. A hundred percent certain always how to talk to them or, you know, how they've been fully open with you to, for you to even discover what they're looking for with care.

And so they're harder to make a connection to. Plus, if you think about your time, cause that's what we sell. All right. I'm not saying we're salespeople, but we sell time, we sell time and we sell good outcomes. And. If you're not making a certain amount per hour that covers your overhead and your living expenses and the profitability factor that you want to be at, then you're wasting your time and docs out there.

If you haven't figured out what that number is, you should figure it out. And as a rule of thumb, we tell most doctors, it should be somewhere between 400 and 500 an hour minimum that you should be bringing in the door. Okay. So how long is the new patient exam take that patient's probably in the practice 45 minutes to an hour, roughly give or take, even if it's 30 minutes, are you charging 250 for that new patient visit?

No. So no matter what you charge, you're losing money on new patients. So it takes about three visits to four visits to get them to do the profitability factor. And that's oftentimes right when they want to drop out. If we're not careful. So we've, we've got to plug the holes in the bucket. And one of the best places to plug the holes in the bucket is with our staff.

You know, so if we can, if we can tee the ball up with the report of findings and we can get that engagement with the patient, we certainly don't want to leave our staff to then tear apart that commitment because they missed some opportunities. Now, what are some of those opportunities? Well, understanding, like we talked last time, understanding how best to handle those phone calls when somebody calls in and says, I need to cancel reschedule, not letting them just say, I'll call you back and not.

Us saying, would you like to reschedule that, but actually giving them. I have tomorrow afternoon open at 4 p. m. or I have Friday morning open at 8 a. m. Which of those two works best for you, you know, understanding how to manage those things, but more important, there's some other tactics. I'm sorry, I'm dominating this, this podcast, but there's some other tactics that you can utilize.

Like advanced multiple scheduling and, and, and I can hear it over the airwaves right now. I heard everybody just put their brakes on. Whoa. That takes a lot of time. That takes a lot of effort. That takes a lot of staff time. No, it doesn't. In today's world of EHR and computerized scheduling, it takes seconds to put together a 12 visit or an 18 visit or a 24 visit.

Schedule and you just have to know how to manage it best. And I hear a lot of docs say, well, we don't do advanced multiple scheduling because when we advance schedule, if they want to change one of their appointments, then the whole thing falls apart. We have to move all the appointments. You're not doing it right.

You need to learn how to do it right. You never make changes other than to an individual appointment. The rest of it stays where it was. So, and, and there's ways to make that work and ways to make that happen. And if you're a client, you know how to do this. If you're not a client, become a client. We'll teach you how to do it.

You know, if we tee the ball up, right. And the staff is well trained and well developed and everybody's working together and everything's clicking this whole process. of the patient agreement to become a patient really becomes very simple and it flows very well and we don't have as many leaks in the practice.

This is how the big practices are being built today. It's by creating the magic, our word retention in the practice. And we create retention when we plug all the holes in the bucket. Yeah. And you just hit on it. It's really the one, two punch. It's the doctor doing his job, making sure the patient understands care, which that doesn't always happen.

Sometimes, you know, you can do the best job on the planet. And that patient comes back and says something that lets you know that they didn't get it. And you're like, I thought you understood exactly what I was saying, but I guess not. So it gives you a chance again, to educate if they're, if they're open and they're kind of letting you know, I didn't quite get it.

But If you're doing your part of the job, then you're creating the understanding. And I like to tell patients what my overarching goal is up front on day one with a patient to let them know that our ultimate goal in this practice is to not only get you well, but keep you well. And that's, that's an important distinction because I don't want to wait until the patient starts feeling better and then say, well, you know what you really ought to do.

You ought to probably just come see me. Once a month for the rest of your life. Well, now all of a sudden I've, I've created a whole new Avenue. They hadn't even heard of, and it's like, Whoa, where did this come from? I thought we were just here to get my low back feeling better. So I talked to patients right up front, right at the beginning.

This is my overarching goal. If it's not yours, I totally understand. We'll talk about it because I have two rules of my practice. Here's rule. Number one, rule number one is. I work for you. Rule number two is we work together as a team, which gives me the latitude to be able to tell you what I feel like you need, because as a team approach, we still refer back to rule number one, that I work for you.

So you have the option to reject it if you want, but I'm going to explain to you why you need to do what you need to do. And then we're going to talk about the logistics of getting it done. Does that sound good? Then we'll do an exam. We'll find out what's going on, and then we'll talk about what we need to do treatment wise, because now we're working together as a team, right?

So there's my end of the deal. So if I do that and the patient and I both agree, this is what we need to do. Then the next step is through the staff to solidify that with advanced multiple scheduling. And I want to throw a caveat in there on that real quick. Advanced multiple scheduling takes a lot of pressure off your staff long term.

As patients aren't coming to the front and having to schedule another appointment. Yes. Schedule another appointment. And they pull their calendar out every time on their phone. If we advance multiple schedule, it's already there. They walk up front and we go, we go, Hey, Susie, you're scheduled for Wednesday of this week.

Uh, you know, if today's Monday, you're scheduled for Wednesday of this week at 9 30 AM. See you then. Have a great, have a great couple of days. You know, that's it. Yeah. I go to a dentist that, uh, Luckily, I go to a dentist, right? I go to a dentist that does not do advanced scheduling, but they want you to come in three times a year, three times a year.

I think it's fair. Happy to do that. But because they don't advance schedule, then guess what? It doesn't hit my calendar. And because it doesn't hit my calendar, I'm always getting the call. About a week later, you've missed your, your, your visit, your four month, um, okay. Or they'll call me two days before they want me to come in.

We need to get you scheduled. And then at that point, there's not a lot of, there's not a lot of appointment options. So I'm now six months out or something, something crazy. If they would just advance schedule and I've even talked to them about this, if they would just advance schedule, it would make everything simpler.

Be on my calendar. I'd be ready to go. I'd be in there three times a year as it is. I get, I get there twice a year. So, and here's some, that means they just lost one third of the visits that could have had for me that I was engaged. I was committed to, but because they didn't advance schedule, it fell apart.

So I'm going to give you guys a little tip when you're advanced scheduling. Here's what I tell patients. So here's the easiest, you know, let's say I'm going to use an example of something that's not as clear cut. Let's talk about wellness care. Let's say that I and the patient have agreed that every three weeks seems to work pretty well for you.

So I'm going to see you every three weeks. Here's what I'd like to do with you. I'd like to go ahead and schedule you out till the end of the year. Now, what, what I want to tell you as I schedule out to the end of the year is this is not a commitment for care. What it is, is a VIP treatment for you.

Here's what it does for you. It allows you to have the same appointment time on the same day, every three weeks. And so you just kind of know Wednesday, every three weeks at 9 AM, I'm coming in to see doctor to get adjusted because I'm doing something fairly consistent over time and patients often. And when I say often, almost every time, look at me and go, that's a great idea.

Okay. And they go up front and we get them advanced multiple schedule. Because I think sometimes what it's, what it looks like when we say, Hey, we're going to schedule you out is that they're committed to those appointments. And I think even though they may want to get those appointments, they're thinking, yes, I want to get care every three weeks.

People are afraid of commitment. They've been made afraid of commitment by big companies that have locked them in and then charged him huge fees or made it impossible to get out of that commitment. So when you set it up as a VIP treatment for the patient, and there is no penalty. For them, they go, well, this is a great idea.

Why wouldn't I do that? Because now I've got it on my calendar. We're ready to rock. Yeah. And it's that simple. All right. We're going to, we're going to step aside here for just a second, take a word from our sponsor, but when we come back, I want to talk about, I want to talk a little bit about how we did it in our clinic and when give you a staff perspective on it.

on, on how, what some things that staff can, can say to make this work. But, um, and then we'll talk about some other techniques as well. So we're talking about the, the chiropractic leaking bucket, basically that starts with the leaking phone call that denigrates the commitment and agreement that the doctor and the patient had from the report of findings.

So, all right, we'll be right back.

SPONSOR MESSAGE

Hi, everybody. Welcome back to the KC CHIROpulse Podcast brought to you by Kats Consultants. We are talking about the leaking phone call in the chiropractic practice that breaks apart that commitment and agreement that the doctor and the patient had with each other. And this is part two, um, of this topic today, but, um, what we're kind of diving into today.

Is this technique about advanced scheduling and how that really helps with retention, especially if you explain it correctly and your procedures in your office are spot on and flawless. And so Marissa, my office manager used to always tell patients, you know, especially the ones that were on wellness. So this is how you get wellness to stick.

She would tell the wellness patients, you know, you like every Tuesday, you'd like Tuesdays at 4 p. m. Dr. Bruch is super busy from that time of the day forward. So here's my suggestion. How about I go ahead and just schedule all these out? If you need to make changes, no big deal, but that way we've reserved your spot for you.

Everybody said, Oh, yeah, that's perfect. Great. So this is how she booked all a patient's wellness visits out for an entire year. Yes, she booked them out for an entire year for wellness. Acute patients, new patients. So you can see as we do this and as Dr. Perusich talks about what he did in his practice, what I'm doing in my practice at this point.

The verbiage may be slightly different, but the end result is the same and patient satisfaction is the same, so you don't have to have a script that, I mean, I'd recommend that you guys all kind of talk the same way in your practice about how you're going to do it. You know, if there's more than one doctor, you guys discuss how we, how do we approach this with patients and how are we going to talk about it, but from a standpoint of there being a right way.

It's kind of a template, but you can, there's a lot of leeway in the middle of that. Yep. And during a report of findings time, I would always tell the patient, now my schedule is incredibly busy. I want to make sure that you're scheduled at a time that works for you and where we have ample time to be able to work with you when you're here.

So my staff is going to talk to you about the best days and times that fit within the treatment plan schedule, and they're going to get it scheduled. I highly suggest that you let them schedule everything. Just so we make sure that we've got it all in there. We can change as they're on, but I want to make sure that at least from the beginning you have the times and dates you need.

Doesn't that sound great? And they would always say yes. When they go to the front desk, they hear exactly the same verbiage. Dr. Bruce's schedule is really busy. We want to make sure that you get the days and times that work best for you and within the confines of your treatment plan, blah, blah, blah, blah, blah.

So when you have that coordinated communication, that's when it really sticks with the patient. The doctor, oh my gosh, the doctor told me the same thing. Oh my gosh, the staff told me the same thing. Okay, that's when it starts to click for patients that this is the right way to do things. You can also throw in little things like everybody loves advanced scheduling.

Everybody always wants to advance schedule. That's why our schedule stays so busy. Yes, Troy, you mentioned this, that patients sometimes, people sometimes feel like they're locked into those kind of things and that they're committed financially. Just simply explain. There's no commitment to it. It just puts you on the schedule in part.

So you've got the reminders, we've got the reminders, and if you need to move an appointment, we can, that's not a problem. Now, I mentioned this earlier, if you have to move an appointment, you don't move the whole schedule. There's a manner in which you just move the one appointment and you call the rest to catch up schedule.

So we teach this in our coaching on how to do this. We teach this in our team workshops. So your staff, here's how to make this work. So you don't have to teach them. We teach them and coach them through the process. And when you've got everybody on the same page and everybody's developed together and you had that coordinated communication with patients, man, that's when it really works.

That's when you've plugged the holes in the leaking bucket. And guess what staff's able to do at this point. If you've got, if you've got advanced multiple schedules set up for patients, now they get to focus on rather than the calendar and when are we going to find a spot, because sometimes that is a challenge, right?

Where are we going to put this patient? So instead of having to do that now, what we are able to do as front desk or as staff members that focus on the patient. It's just what we wanted to do to begin with. Right. So it really gives us an opportunity to give better patient care when we do that. So if you look at it from that viewpoint, it's like a win-win situation.

It's a win for the patient. It's a win for the practice as well because the staff gets to focus on the patient and they're not having to do. quadruple or 12 times the work to schedule appointments, they just do it once and they're done for the next, you know, the next six months or whatever. Yeah, and wouldn't you rather have your staff building patient relationships than looking face down into a computer trying to figure out when to put a patient on the calendar?

Let's exactly talking about to patients about their anniversaries and their birthdays and hey, you just went on vacation. Where'd you go? Show me some pictures. That's how you build long term relationships. Not trying to figure out where you're going to put them next thursday. Right? We're trying to avoid confrontation.

Right? Exactly. So yeah, these are important. Yeah, go ahead. I was going to say that's, that's the other thing that it creates is because sometimes we get in these, these discussions when you're up front and you're trying to fit somebody in and how frustrating is that for them that you can't give them the appointment time that they want, right?

Hey, we're going to get you on the schedule. John, let's look at two weeks from now. Uh, you know, And I can say, Hey, I've got, I've got a, I've got a 10 AM or I've got a two 30 in the afternoon. Would either of those work for you or which one would work best? And John goes, I need a 5 PM and you at that point go, Oh, geez, you're looking at your screen going stacked at 5 PM.

Where am I going to put you on? There's no way I'm going to get him in there. And so now we create a confrontational situation where we go, sorry, John, you're important to us, but not that important because I don't have any place to put you. We're going to have to back you into two o'clock. I'm sure it's no problem for you to take off work.

Right. And come in early. So Tuesday at 5 PM, you're, you're our 10th important patient. We can't get you in. You. Yeah. And you just create conflicts. You're just reserved. Yeah. You, you're reserved. Now you're v i p baby. That's important. Yeah. I think it's important to the patient. I think it's good for the patient.

I think it lets them know that you've thought ahead enough about their care to realize that consistency and the consistency of time and day are also very important to our patients in most cases. Absolutely. So these are just simple little tactics that when you add these into your practice, your practice runs smoother, your retention goes up, the hole in the bucket goes away, you're not as dependent on new patients all the time.

And I know all these things sound great. And you're probably thinking, wow, this is probably a lot of work on my shoulders. No. Cat's Consultants offers. Team engaged and staff driven consulting. So it's not just you learning something and then going back and teaching your staff. We help the entire team and fold a lot of these tactics and strategies into the practice.

That's why the practices that we work with are doing so well right now. So go to Kats,Consultants.com. Check us out. There are some free downloads on there. If you want to talk about your practice and find out what it takes to become a member. Feel free to give us a call or jump on, jump on my schedule.

You can get to my calendar or Marisa's calendar from the, from the website, right on the front page, jump on there. Let's talk about your practice. Let's talk about you becoming a member and how you can get the coaching you need to really find your path to success. Troy, anything else to add? I'm just thinking if you didn't gather a whole bunch of really good information from this podcast and the last one, if you haven't listened to it, go back and listen to it.

These are two really good podcasts that talk about directional forces in your practice that are very important. So go listen to those and be a better version of yourself. Make your practice a better version of what it's been. Help your patients help themselves. Awesome. That was great. Close. All right, everybody.

Thanks for listening to the podcast brought to you by Kats Consultants, helping doctors keep their pulse on success. We'll see you next time. See ya.

 

 

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