A Simple Practice Model

There are many of us who have adopted a practice model based on our philosophical belief that the best way to use chiropractic is to pay a monthly fee for either “unlimited” care, weekly care, or a set maximum number of visits per month.  

The bottom line is that we are no longer focused on a per visit fee, but make our best recommendation affordable to as many people as possible.

This style of practice is simple, ethical, fun, profitable, and legal in all states, if done correctly.  There are numerous misconceptions that float around that might keep chiropractors who might be interested in this model from investigating it, based on false information.

Some state boards don’t like the word “unlimited.”  In my practice, every time I use the term “unlimited,” it is followed by the following disclaimer,

Unlimited is defined as all of the care that I deem necessary to not merely improve presenting symptoms, but more importantly to promote optimal health, improve quality of life, and prevent further damage, dis-ease, or disease.  

We believe getting checked for subluxation on a weekly basis is the best frequency for most people. 

Another option is to offer weekly care at a set fee, or weekly care that includes additional sessions at the chiropractor’s discretion, at no additional charge.

It is not typically our intention to see our people every day, or to allow them to just come in every time they see our vehicle in the parking lot.  What it does tend to do is to get a practice member in the routine of getting checked on a weekly basis.  I typically use the phrase, “I like to see my people every week, more frequently if they are under unusual stress, injured,  or not functioning optimally.”

We address the fact that between vacations by both parties, seminars, teaching, conventions, etc, most practice members are seen 30-60 times per year.  By addressing this, in writing, at the onset of care, practice members are less likely to challenge the notion that we end up being out of town and having to adjust our hours occasionally.  Part of the beauty of this style of practice is the fact that our income remains the same even if we are at D.E., CalJam, MileHigh, or vacationing  in Cancun.

Practice members are encouraged to make weekly chiropractic care a part of their routines.  They are paying for the privilege of coming in during normal hours, without an appointment.

They are not paying for us to be on-call 24/7.  They can’t call us on Sunday afternoon, and feel like we’re going to drop everything to meet them at the office because they couldn’t get in during normal hours.

There are significant benefits to this style of practice.

Many of us have extremely low overheads.  Our practices focus exclusively on adjusting the spine to affect the nervous system, with minimal to no other focus, so all one needs is a table or two, and a place for folks to sit and wait for their adjustment.  Many of us have offices that are just 250-500 sq.ft.  We look for space similar to what a counselor, therapist, or psychologist might be interested in.  Often times, we share a common area and bathrooms, then have a studio office with a table or two, or three.  Certainly there are those of us with large offices, but low overhead is a key to the success of this model.

 

In my opinion, it is impossible to run this type of practice, without fear of legal scrutiny,  and participate in any level of insurance.

When questions of practicing insurance without a license, or dual fee structures arise it’s typically because the practitioner is trying to utilize two opposing practice objectives in different patients.

For me, the day I completely severed ties with all insurance companies was the most liberating day of my practice career.

True, I was choosing to no longer accept personal injury cases, or Medicaid, and I need to be very careful in how I deal with a patient on Medicare so that I can be fully complaint and legal, but the scrutiny is not nearly as significant as if I were playing the insurance game.

The bottom line is that since my intention of care is always to improve quality of life, promote optimal health, and prevent further damage, dis-ease, or disease, and since I recommend care long after I have the ability to demonstrate continued objective improvement, it would be unethical, and essentially fraudulent to participate in insurance.

You’re undervaluing chiropractic care!

That’s what some chiropractors assert. What you must know is that monthly fees among membership practices vary, but it’s not uncommon for a practitioner to charge $79 for weekly care.  That comes out to essentially $20 per adjustment.  Other chiropractors might feel this is out of exchange.  I completely disagree, because for every member who comes in weekly, there’s one who comes in every other week, or even once a month.  Sometimes people even skip a month, so when they come in it’s like making $160.  That’s never our recommendation, it’s just what happens sometimes.

Just run some simple numbers.  Let’s say one has 100 practice members paying $100/month.  The chiropractor’s overhead is under $1000/month, so the profit is 90%.  Let’s further clarify that she may only have open hours 8-10 hours per week.  Who else profits $9,000/month while working 8-10 hours per week.

Not only is the above scenario incredibly feasible, but she also didn’t have to worry about missed appointments, trying to convince her patient to come in after symptoms have improved, justifying care to an insurance company, waiting on payment, or worrying about her staff not showing up because their child was home sick.

It’s simple, stress-free, and good for the soul.