AJCC April 2001


April 2001
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"The Art of Balance"

by R.J. Hammett, D.C.

The theoretical, three dimensional balance of the human spine determines its function, and any segmental misalignment can lead to global subluxation patterns.

The management of your practice is much the same. Every chiropractic office should be divided into three departments. Healing, Front Desk, and the Business Department. Each department should be focused on the primary goals of improving and increasing the practice. If one of these departments is out of balance, the practice will not naturally grow.

You, as the owner/manager, are responsible for balancing these three departments, lining them up and marching them in the same direction. Much like correcting global subluxations, it takes time, accuracy, commitment and persistence. So, what is the first step? Like correcting a spine, an examination is necessary - get your paper out. What are your last year’s averages? New patients, monthly and weekly patient visits, retention, production and collections. How many re-exams, re-x-rays, therapies, etc. were done? This is your base line. Looking at your practice numbers, maybe it’s boring to some, but they are revealing in the areas that are unbalanced and the departments that are causing practice growth interference.

First, new patients, minimally if you are not seeing 25 to 30 new patients every month, you are not even in the running. Retention should be a minimum of 25 to 35 on average per patient. Missed appointments should be no more than 10% and rescheduled appointments 80% or better. Collections must be a minimum of 95% or better.

So how is your clinic? Each statistic mirrors a staff or department. Do you have enough staff? At least one staff member for each department. That is a front desk C.A., business/insurance C.A., and exam C.A./Doctor. This is a minimal staff for any practice that wants to see 200 a week. What about training these fine folks? Who trains? You do! You train everyday, between patients until “they get it.”

Every staff should have 30 days to KNOW 80% of his/her job perfectly. If not, he/she needs replacing. Do you have pre-printed training manuals that the staff are required to take home and study? Are you quizzing the staff on your training material? Are you holding your staff accountable for the clinic minimums? For example, if the clinic’s minimum for missed appointments is 10%, and your front desk C.A.’s best is 15%, hold her accountable. Role play and drill the missed appointment scripts, tape record the calls and go over them with her.

Do you meet with all the staff at least weekly? If not, why? This is where you train, explain policy changes, and teach about chiropractic to your staff. Monthly meetings are a waste of time. They must be weekly or more. What about procedures such as welcome letters, missed appointment calls, confirmation calls and all of the other front desk details? Are they written out and monitored by you for performance? Is there a check list at the front desk?

Management of any department of your clinic should be solely based on the staff person’s overall attitude and statistics of that department. Emotions should not play any part in determining whether a team member is adding or taking away from the goals or growth of the clinic. It is recommended that at least every two weeks, you sit down with staff members individually to discuss their performance. Make recommendations, retrain if necessary, but if, after three separate meetings, this staff person’s attitude or statistics are not improving, he/she must be let go. It has been my experience, as a consultant, that Doctors more times than not, keep poor or ineffective staff way too long, not realizing that this staff person is stopping the clinic from helping more patients. In the next article, we will cover the business department and office collections.

‘Til next time. . .