Business as we know it has changed and one of the biggest questions companies have asked themselves is “Do we need THIS much space and staff?” Why space and staff? Because those are the largest portions of a business’ overhead and more than ever, companies are cutting down to work smarter. The same is true for health care and especially, private practices.
As chiropractors we enjoy the ability to have our own practices. But is bigger really better? Not in every case. Some large, high overhead operations found themselves stressed and worried for their practice’s future. The offices with lower overheads were less stressed and worried which appealed to some big practice owners. Less stress equals more fun in practice but more importantly, low overhead translates to higher profit. One way to have a low overhead practice is by reducing the need for staff. This can be accomplished by implementing 5 key systems in your practice.
Having A Paperless Office
Having a paperless office is critical for practice efficiency. How many times in the day does an office open file cabinets? Or search for patient files? So many offices are going in the right direction but few are truly paperless. So how can you get your office to an ideal paperless point?
It is more simple than you think…and includes two main components – an EHR and a scanner. The far majority (approx. 85%) of offices already have EHR systems. In chiropractic, there are dozens (if not hundreds) of EHRs and I could write an entire blog just on EHRs alone. It’s up to you to do your research and due diligence for what you’ll really need for your practice.
In my experience, many EHRs are filled with tons of features the end user will never actually use. But then the features that ARE needed are add-on charges. For those of us who already have an EHR, how can we make it work better for us? Almost all EHRs allow the user to take daily notes on patient visits. To become more paperless, your EHR should also provide the ability to send patient intake forms and agreements to be completed online. Nothing should be printed – all forms and signatures can be gathered online and attached to the patient account. This now serves as the most efficient process of obtaining and maintaining patient information which ultimately saves a significant amount of time in practice. By instilling this type of system in your practice, you can begin to see how it’s more than possible to run a one-person show…a Micropractice of your very own!
Another key tool to paperless efficiency in practice is a scanner. An EHR obviously needs a computer or laptop, which all offices will already have. But a scanner helps to make your total paperless dreams a reality. EVERY chiropractic office should have a scanner. Even if your EHR is beautifully paperless, how will you keep track of patient’s records from another office? Or have their photo ID or insurance card on file? A scanner helps store this critical patient information while attaching it to their account in your EHR, making it incredibly easy to access whenever you need. Think of it still as the “old school” manila files….just in a virtual format.
Presenting Care Plans
The next way to boost efficiency in your practice is incorporating care plans with all of your patients. The biggest advantage to a care plan is great patient compliance. More compliance from individual patients means patients stay with you year after year versus having to relying on a constant flow of new patients.
What an amazing concept, right? Keep the patients you have versus stressing on always needing new ones. Keeping your patients is the ultimate time saver – starting a new patient relationship always takes more time and attention versus keeping the patients you already have. In my experience….care plans are KEY for this to be a success.
A patient care plan includes two major components – treatment plan and financial plan. Both of these components are crucial to having a successful care plan. Patients on care plans are more compliant – always. Doesn’t that make your job easier when you are running your practice without staff? Even if you have a more traditional model chiropractic practice, having a care plan in place keeps everyone on the same page – how many visits, how frequent, and the patient’s financial responsibility. Any of these parts missing will create confusion to the patients, which ultimately increases the likelihood the patient will discontinue care.
The treatment plan with a patient is based on three factors – current health status, patient health goals, and your experience. Your first days with patients is important – investigating their condition and getting to know what is most important to them. By doing a thorough job, you will set the stage for the patient to not only expect your recommendations, but even be excited to hear what they are. Your treatment plan should always be given at the very end of your clinical report of findings. Once the patient has agreed to the treatment plan, now it’s time to review their financial care plan. This mutual agreement on treatment keeps both doctor and patient on the same page and clears up any confusion on what the expectations are.
In my experience, this is the critical step chiropractors miss. Instead of presenting a clear report of findings with goals and a plan, many still use the “lets-adjust-and-see-how-you-do” treatment plan. Starting on that type of note will create confusion to the patient, ultimately increasing your patient drop out rate. Will some patients stay and become lifetime patients? Sure. But that would be the exception and not the rule if a clinical treatment plan is not agreed upon.
So now, the treatment plan services are totaled up over a given amount of time. Let’s say, for example, 16 visits over 3 months. It’s important now to have a system that will allow you to easily create a customized financial care plan to present to the patient. These are commonly used in many other professional offices – veterinarians, specialist medical offices, etc. These reports can also include health insurance coverage, if that is something you offer in your practice.
Patients are thrilled to see this financial report b/c their financial responsibility in your practice is crystal clear. You should also give the patient options when it comes to paying for their care – monthly payments, pay per visit, or prepayment. In my experience, patients are impressed and excited with how affordable their care is in my office!
Storing Credit Cards On File
When a chiropractor is considering running a practice without staff, one worry is how they will manage all of the front desk operations, especially collecting money. The absolute BEST solution for this worry is storing credit cards on file for all patients. Not only will you collect all the money owed to you, but it will end up saving you loads of time with patients. Here’s how…
Most people think I do all the typical things with patients each visit that a traditional chiropractic office does. Traditionally, a patient walks into an office, sees the front desk, gets sent back to see the doctor, gets adjusted, goes back to the front desk, schedules, and pays. Yes…if I did that with each patient in my practice, I would spend 20+ minutes per patient which is a totally inefficient practice. Instead, I have cut out the majority of these steps – my patients walk in our office space, come back to my office, get adjusted, and leave (sometimes I need to schedule). But collecting money from patients? Nope…that happens on the back end. And by cutting out this huge time waster, the time for the patient is more focused on their health care and continuing to build a great patient relationship.
Storing credit cards for patients is hugely important, but it’s more important that it’s done the correct way. Please…please…please…DO NOT make a photocopy of their card. DO NOT keep their cards on an excel spreadsheet. Yikes…these archaic business practices will land you in a load of trouble paying out huge fines. Find an online system that can not only store credit cards for you, but ensure this storage is secure and encrypted. This means you can only access the last four digits of the card and it’s expiration date.
Now that you have the cards securely stored, how can you get paid properly? By either running one-time payments or recurring payments. At the end of the month, my practice will run one-time payments for patients who pay per visit. This system and agreement is established with the patient at the beginning of their care in my office. It’s my job to track visits (which is easily done in any scheduling software) and then run their cards for the payments owed. My software will automatically keep a record of the payment plus send the patient an email with receipt of charges. Patients are thrilled with this service and happy to pay for the great care they receive!
Some patients prefer having monthly payments. My software system also allows me to create these customized plans for patients at the beginning of their care. We come to an agreement as to what will be charged and the patient signs off on the plan. Once the system is set up (which takes minutes), the charges will then automatically process. Back in the day, we used to run charges on the 1st and 15th of the month. Not needed anymore….if the plan is set up on the 22nd of a given month, well then the future charges will run on the 22nd the following months. This way, these charges run automatically regardless if the date falls on a day you are not in the practice, on a weekend, or even on a holiday. The best part?? I receive an email confirming the charges have been run and deposited in my account. Score!
Online Patient Scheduling
In addition to the worry of charging and collecting for patients, doctors running a Micropractice worry how they will keep up with scheduling patients in their practice. Again, take out the scenario of what a traditional office typically does and get ready to incorporate a great new procedure – online patient scheduling.
Doesn’t sound that exciting, but believe me…it is! My EHR system has an awesome scheduling feature which allows me to embed a scheduling link on my website. Boom! For established patients, they can simply hop online, access my schedule, and book a time that works for us both.
In my experience, patients really do love this feature b/c so many other businesses are already going with this trend. If I want to make dinner reservations, do I want to call and wait and go through a bunch of options with someone over the phone? Or do I just want to hop online and see what times are available? The second option for sure.
Online scheduling also helps cover part of a CA’s job in a traditional chiropractic practice. But even better…online scheduling never closes. If a patient has the need for a chiropractic visit, they have the confidence knowing they can schedule with you anytime. They don’t have to wait for office hours to get on my schedule and in many cases, this has been a huge sense of relief for so many of my patients.
With this new scheduling procedure, new patients are best scheduled directly through the doctor (or an assistant). Hmmm….not online? In my experience, it’s more important for the doctor or staff to have a conversation with the new patient to first ensure they are coming to the right place.
If the ability to schedule online is available to new patients, anyone and everyone can schedule. But what if this patient needs extensive rehab on their elbow and you aren’t the elbow-rehab-expert? Then, the new patient visit becomes a waste of time for both patient and doctor.
Even though a conversation with a new patient is recommended, there is a way to help streamline this and make it more efficient. For example, when a new patient calls my practice, my outgoing voicemail asks new patients to either text or leave a message, letting me know a little more about what I can help them with. Then I either receive the text or transcribed voicemail with details so I can then follow up with the new patient.
Similar to the payments procedure, these scheduling procedures give you back time with your patients. Time to get to know them more…focus more on their care…and provide exceptional service.
Making Websites Work For You
Your practice website is the final way to increase the efficiency in your practice, especially when running your office without any staff. Most people think the website is just for marketing purposes only but there are ways your website can work for you throughout your day.
First off, your website serves as the patient’s first experience of you as a doctor. Who you are, the service you provide, and what they can expect to experience when they come in.
It’s important your site is customized for your style of practice. It should clearly communicate what the patient should expect which will attract those patients you ideally want to work with. It’s so much more fun and efficient to accept those patients you love to work. Those are the cases you are confident in and know you’ll get great results.
I don’t love working with elbow complaints, for example. So there is nothing on my website that would suggest to a new patient that I will totally help them with their elbow problems. If that is something important to a particular patient, they will likely move on from my practice to another. Which is totally great with me – I always want patients to be under chiropractic care, but I accept that not all patients are the right fit for my practice.
Another great use of your website is storing new patient instructions and forms. There should be no reason why a patient is taking time in your office to fill out forms. If you still have paper forms, these should be stored in your site as PDFs for your patients to access, print out, and fill out at home. So many other doctors offices have this similar procedure – it will not be a surprise for patients to fill out their forms at home. This way, they come in, ready to see you versus spending time writing. Plus, it helps you in a scheduling capacity – no one loves it when you ask patients to fill out forms prior to their visit and then they come in empty handed. So by instilling and enforcing this procedure and having your forms online, you will help avoid wasting unnecessary time.
Finally, your website can house your most common recommendations to patients. How many times do different patients ask you the same thing? Dozens…at least.
Hey doc! What pillow do you recommend? What supplement should I take? What pediatrician do you recommend locally? Do you have a great massage therapist you like?? And so on and so on. I found myself repeating things over and over again.
To save my time (and sanity!), I created pages on my website for patients to refer to. Check out my ‘Resources’ tab on my website – you’ll find the acupuncturist I recommend! This procedure accomplishes a couple of things:
- Saves you time with patients and increases your efficiency in practice
- Makes the patient more accountable for their overall health
- Helps drive more traffic to your website which can help with SEO (yay!)
We became chiropractors to help people AND have the option to run our own businesses. Due to high overhead and starting costs, the traditional chiropractic practice model isn’t always the right fit for every chiropractor. You can build an amazing practice, helping tons of patients in a simpler business model by cutting huge overhead costs and implementing proven procedures and systems to run a more efficient operation. This simpler model will make it much easier to start and run a practice AND you’ll have a whole lot of fun doing so!
