Q:

I have been reading them for awhile and totally enjoy them..  This one really struck home.  
20 years of practice and  I am in a bad drought.  Referrals are down, insurance is a 
nightmare.  You know the story. I have been to seminars and consultants and have read 
over 200 books on spirituality motivation and exercise. I really donžt know what is up. I 
am too lazy to computerize my office not that I really need to. I have not taken a technique 
seminar in 10 years. Maybe I am just lazy or hate the cliche burnt out but who knows  At 
my peak 4 years ago I was seeing 200+ visits per week, now I am at  about 100.  Thanks 
for the listening.

A:

Thanks for the e-mail. Ižve also been in practice for 22 years and understand that at this 
time in our lives we want to relax and go with the flow then begin pumping our practices 
like we did 20 years ago. But .. these are the cards you are dealt with and as I wrote in the 
drought newsletter .. you have to be ready. I hope you had the foresight to save some 
funds for your retirement years .. many of my friends lived day by day hoping it will 
always be okay and they are worried about their future now.. 

On a positive note .. I recommend you re-evaluate where you can augment your practice. 
Personally .. I find the ups and downs as everyone else .. I never had huge numbers and 
want to live a balanced life not just work only. Therefore success has always been a happy 
life both in and outside the practice. Material things were never my motivating factor 
therefore .. I can coast better during the ups and downs.  

But I am a survivor and resourceful and therefore evaluate the trends as they occur. There 
are areas within your office that you can change or tweak to increase volume which takes 
minimal effort but leads to „doing something.ū For instance .. I would generate some 
interest with your staff. Have the CA look through past records and begin a recall campaign 
.. letters .. calls etc. Start each new patient with increased interest in their specific problem 
and focus increased services and technique ideas .. for no other reason then again to kick 
start renewed enthusiasm. You havenžt taken a technique seminar in years .. wežll it may be 
the best investment you can do right now .. often a new interest does the trick

Itžs terrible I even write this as we both know you have had enough wins in the past and 
been to enough seminars and listened and read plenty of motivational stuff to counsel me .. 
but as an objective observer .. this is my advice. Often we need to do an out of body 
routine view our situation from above and try to counsel ourselves.

Nonetheless .. at 100 patients a week .. working on them via surveys and do a workshop a 
month or more youžll jumpstart the practice again. The patients are out there .. your 
enthusiasm there too .. they just have to meet

Have a Great Day

Dr. M