219 Are you paying for results, but not putting in the work?

Welcome to the KC CHIROpulse Podcast.  

This week’s topic:  Are you paying for results, but not putting in the work?

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights.  This week, the show is hosted by Kats Consultants’ CEO Dr Michael Perusich.  Dr Perusich is well known as one of the top influencers in Chiropractic business management.  This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In this episode, we discuss:

• What are the risks in managing a Chiropractic practice
• How these risks can hurt your profitability
• Why the risk-reward continuum needs to be in balance
• How to recognize the risks in your practice
• …and so much more…

In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.

Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and personalized practical advice to help you navigate the intricate world of Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.

Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.

DISCLAIMER:  The information presented in this broadcast is for educational purposes only and is not intended to offer legal, investment, accounting, or medical advice, and represents the opinions of the speakers.  Seek the consultation of a professional for advice in those areas. And remember…your results using this information may be different than described.

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KC CHIROpulse Podcast. Helping Chiropractors keep their pulse on success. Thanks for listening.

Episode Transcript

Dr. Michael Perusich (00:14):
Did you know that over 50% of small
business owners underestimatethe liability exposure, and that
includes you chiropractors?
Hi everybody.
Welcome to the KC Chiro PulsPodcast, brought to you by Kats
Consultants and Chiro HealthUSA.
I'm Dr.
Michael Perusich.
I'm your host Today, I'm in thestudio by myself and I wanna

(00:34):
talk about, I wanna really diveinto the untold risks of owning
a chiropractic clinic and whatwe can do to protect ourselves
so that we build a thrivingpractice.
Some of the risks are prettyobvious.
Obviously there's liability withmalpractice.
If you hurt somebody, then youput yourself at risk, right?

(00:55):
And that's just one of the risksthat, we just inherently take.
So how do we make sure thatwe're in good shape?
With that, make sure that youare malpractice insurance is up
to date, that you've got a goodcompany behind you and you not
just accepting the cheapestinsurance.
One of the other things that Isee is the financial risks.

(01:15):
A lot of doctors are strugglingwith overhead right now.
Rent is really high.
The cost of employees is high,and our fee strategies aren't
set to make us profitable.
We see this all the time.
We see doctors just arbitrarily.
Setting their fees or settingtheir fees to the allowables
with insurance companies.
So they're leaving money on thetable with their PI cases, work

(01:37):
comp cases, and their cash sideof their practice.
So there's huge danger inunderpricing your services, and
oftentimes I see doctors outthere just doing the race to the
bottom, just chasing the lowestdollar.
I was on Facebook the other day.
I saw a doctor advertising a$9first day, and it was packed.

(02:01):
You got an adjustment, you gotan exam, you got x-rays, you got
a massage, you got you, you gotall this stuff for$9.
Think about how long it takesto.
Make that money back up.
And if the patient drops outafter the first visit, how much
money have you lost?
So there's all these hiddendangers in practice and I wanna
dive into some more of these.

(02:22):
We're gonna take a quick breakhere, a word from our sponsors.
We'll be right back.

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(02:52):
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(03:13):
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Dr. Michael Perusich (03:38):
Hi everybody.
Welcome to the KC Chiro Pulsepodcast.
We're back.
We're talking about the hiddenrisks in practice, and I just
mentioned a big one, and that'sunderpricing your services and
just having a, an aberrant feeschedule that doesn't make
sense.
Your fee strategy should bebased on what's gonna make you
profitable based on the numberof patients and I see a lot of

(03:59):
doctors wasting their capacityin practice.
So what am I talking about?
They want to add a whole bunchof therapies, especially things
like and don't shoot me forthis, but it's true, they want
to add 20 or 30 minutes of softtissue therapy.
You've probably, if you've beenlistening to the podcast for a
while, you probably heard me saybefore that you should be making
four or$500 an hour.

(04:20):
You should be collecting four or$500 an hour in your practice.
And so if you're doing 30minutes of soft tissue work
let's take the 400 per hour.
Are you charging that patient$200?
Probably not.
So we may not be managing ourcapacity in a way that makes us
profitable.

(04:40):
I also see a lot of doctors whoare getting tripped up on the
insurance rules and billingpractices, and they're not
billing.
I.
The, the right codes, they'renot billing the right modifiers.
They're not code pointing andthose kind of things.
And they're getting bundled onservices.
They're getting denied onservices, and they're just

(05:01):
letting it go.
Or it goes to patientresponsibility and I don't think
I wanna bill a patient for that.
I don't want make'em mad.
And so you write it off, that isabsolutely the wrong thing to
do.
That creates more financial riskin your practice.
And then there's operationalrisks as well.
What if one of your teammembers, one of your staff, what

(05:21):
if they're out sick or onmaternity leave for a while?
How are you gonna manage?
Does that affect your capacity?
Are you gonna have to see fewerpatient visits?
What about you docs?
What happens if somethinghappens to you?
I can tell you a personal story.
I blew out my elbow.
Playing soccer of all things.
And I was outta practice forthree months and while I could

(05:46):
still go into the clinic and dosome things, I really couldn't
adjust patients for about 90days.
And it, it was detrimental toour revenue Now.
We made up for it.
We had a lot of other servicesand this is one place where you
avoid the risks a little bit.
We had a lot of non-doctordriven services in the practice,

(06:06):
so if I was there, patientscould still get rehab, they
could still get decompression,they could still get laser
therapy and those kind ofthings.
So you gotta really watch theoperation itself and make sure
that you've got really goodsystems in place and really good
staff.
Training in place, that's hugelyimportant.
Another place where we find riskis with our new patients and our

(06:30):
retention.
It's really on the retentionside.
Our dropouts sometimes are justway too high, and so all we're
doing is turning our businessinto a factory that's turning
out people that don't want carefrom you.
They don't want your services,they don't wanna be part of your
practice.
And what do you think people saywhen they go out in the
community?
After becoming a dropout in yourpractice, they probably don't

(06:51):
speak real highly of you.
And what we've noticed over theyears is that it seems like
every patient that drops outtells about 10 people something
negative about you.
And then, the real risk is thatthey'll write a negative online
review about you.
That's another area of thepractice where we've gotta
watch.
What we're doing.

(07:11):
So we how do we combat that?
We've gotta make sure that we'recreating a great patient
experience that we provide overthe top customer service, that
we communicate with patients ina preemptive and ethical manner.
And in a way that patientsunderstand care and find value
in the care.
And we've gotta have a staff, ateam that is on point, which

(07:32):
requires ongoing training.
That's another one of thoserisks if you don't train your
staff.
Guess what?
You increase your risks ofdamaging, hurting your practice,
decreasing your revenue, losingpatients, et cetera.
So we've really gotta thinkabout those kinds kind of
things.
Another risk factor is theemotional and relational risks

(07:56):
that we have just from being anentrepreneur.
Really.
It's not just being achiropractor, when.
When we allow the business tonegatively impact ourselves
psychologically, then that putsa strain on your relationships.
It puts a strain on your staff.
It puts a strain on your family.
It puts a strain on your kids,your friends, et cetera.

(08:16):
And so we wind up becomingisolated in, in, in regard to
that.
So we've gotta figure out waysto have mentors and people who
can not only hold usaccountable, this is what a good
business coach will do.
They'll hold you accountable,but they'll also be your
sounding board to help you healfrom those times when the

(08:37):
practice is getting to you.
So we're talking about.
The risks in practice and weneed to take a quick break.
We'll come back, we'll wrapthings up.

Kats Consultants (08:49):
Kats Chiropractic consultants, your
partner in chiropractic success.
We are dedicated with one-on-oneguidance to bring you all your
practice management needs.
Let's supercharge your practice.
Give us a call today.

Dr. Michael Perusich (09:16):
All right, everybody.
Welcome back.
We are talking about the risksin practice, the risks of owning
a practice.
There, there are many, there arethe financial constraints.
Sometimes there's, collections.
If you're an insurance-basedpractice, oftentimes we're
waiting on records.
We've got compliance issues.
And one of the big risks todayis audits.
And so you gotta really watchyour Ps and Qs, if you will, if

(09:37):
you're an insurance-basedpractice, because they have AI
models that are really watchingyou.
And if you're becoming anoutlier and there's a whole
bunch of ways you can become anoutlier, and that's a whole
nother show.
But if you're becoming anoutlier and throwing up the red
flag to the insurance company,you're gonna get audited.

(09:58):
And when you get auditedsometimes you get through'em
fine.
I've seen other doctors who.
Have big recoup recoupment billsback.
I've seen doctors who've gottenpenalized from Medicare.
Did you know that Medicare hasraised the penalty and it's now
$15,000 per occurrence?
So if you do something wrong 10times with a patient, you bill

(10:20):
inaccurately you, you billfraudulently.
You might even not, you mightnot even realize you've done it,
but if you do it 10 times, thatcould be$150,000 in penalties.
So that's.
In my opinion, one of the biggerrisks we see in practice today.
So how do you mitigate that?
We really need to move as manyservices and as many patients

(10:41):
over to cash as we can.
And one of the areas that a lotof doctors allow to be grayed
out in their practice is themove to maintenance.
And there are very few, did Isay, very few insurance
companies that cover any kind ofchiropractic maintenance care.
So you have to know what, youhave to know what the insurance

(11:05):
rules will do, what they cover,and that's part of your
verification process.
But you also have to do your owninternal audits to make sure
that you are billing correctlyand make sure that you're
monitoring your patienttreatment plans.
And when there's no reasonableexpectation for improvement

(11:25):
going forward, then there's noclinical ne necessity.
There's no medical necessity forbilling the insurance company.
You have to get that patient offof their insurance and move them
over to cash.
And there are easy ways to dothat.
And I know our members out therealready know how to do this.
So if you wanna.
Check out what we do here atKatz Consultants.

(11:46):
You can go to katzconsultants.com, but more
importantly, if you wannaschedule a breakthrough call
with us on our website, you cango up in the top right corner,
click on Let's chat and jump onone of our calendars, and let's
talk about your practice.
Where are the problems?
Where do you need help?
How can we maybe help you?
And let's just see if we're agood fit.
We do those for free.
Remember, we are chiropractors.

(12:08):
We had great success andpractice and still own
practices, and we just wannamake sure that all of you out
there enjoy the same successesthat we have.
So from all of us here at KatsConsultants, and thanks to Chiro
Health USA for being one of oursponsors, I.
I just want to thank you fortuning in every week.
We are growing like crazy, so besure to like, and subscribe and

(12:28):
tell your your friends about theca, the Chiro Pulse podcast for
us.
Alright everybody, that's allfrom us today, so take care.
We'll see you next time.