3-12-01 Sent to me and others concerning fees and practice management: I have been in modes where, for example, I had a box on the wall practice. I thought at the time, and may have been vocal about it at times, that anyone who charged a fee was not doing chiropractic. After all, we don't own it, it belongs to everyone, and so what right do we have to deny anyone care by setting a fee that may keep someone out of our office no matter how low a fee we set. It made sense to me at the time, but it doesn't make sense to me now. So as adamant as I may have been, as much as I decided to deny myself any chance of paying my bills and keeping up with my overhead (my average visit then I figured out was $4.86), I was, looking back, really bitter at others who refused to go that way. Somehow, in my mind, the system would have worked, it EVERY chiropractor did it too. And since they weren't going to, well, frustration because of how others chose to run their practices. Looking back, it was a destructive time for me. Not necessarily because of the box system, but because of the bitterness, envy, resentment, etc. attached to it. Because I was willing to suffer silently for 4 years, but by the 5th year it was getting to be too much, and before I realized it was time for ME to change, it was ,in my mind, all about EVERYONE else having to change. Now, for your info, I have a fee. If you have insurance, or not, it is my fee. It is therefore probably considered "low" for insurance, and fair for cash. I am happy, my patients are happy, I STILL practice chiropractic in its purest sense that I know how to. People work for money, people work for benefits. Therefore, if they pay me money, or they pay out of their benefits, it is STILL care that they got from me by virtue of work, an even exchange in the universe. I no longer see allowing someone to use benefits, that they bust their rear-ends to get, as turning my back on chiropractic. If someone can convince me that it is so, I will not let anyone use their insurance in my office anymore. until then, my opinion is, they work for it, it is part of their SALARY, and they are more than welcome to use it in our office. I put my dirty laundry on the line to hopefully help others grow beyond where I was in less time than it took me. love to all, ex-box on the wall, "purist", judge, My reply: Just read the e-mail concerning fees and the pressure he felt justifying them. Philosophical chiropractic does not equate with poor business judgment. Exceptions should always be built into every business transaction but the rule must rule. We are a business and as such must charge a fee for the service we provide. No need to x-ray a patient's wallet or exhaust their funds that they will use elsewhere .. but a decent and reasonable fee for your area is in order and those that have needs should receive the exception and hardship consideration. Let the most pious amongst us open their low fee clinics in the inner city where they are needed not in a usual bedroom community where people can reimburse for the valuable service we provide. How much is our services worth? For the new graduate heavy with student loans .. new office expenses .. New Beginning expenses for a dwelling .. car .. food and a humble lifestyle not to mention the beginnings of a family .. the answer is simple .. tell the story .. charge a reasonable fee .. accept their insurance if they wish and extend their care if necessary with a sound cash plan and by no means feel guilty about it. Every person deserves chiropractic care .. if it was free the same percentage of people would still be going to chiropractors worldwide .. not because the price was right .. but because most DC's are not telling the story .. it is not the fee that prevents people accepting and receiving chiropractic care. Want to start a new beginning .. start today by reviewing your patient education .. your office purpose .. your staff commitment .. your patient understanding. Generate Wellness by personally being well and feeling comfortable with the trust we chiropractors have extended to you. Your years of training and hard work doesn't end with bankruptcy court or psychological turmoil .. and others that create your feeling of condemnation should be the last person to turn to .. a mentor may prod and tweak your comfort zone but should always lead you to greener pastures not the "dark side." I receive numerous e-mails weekly from hurting DC's attempting to make a living and avoid closing their doors. It hurts me to see this and giving care away is not the answer. Yes .. there are established and some new clinics with huge numbers but they are few and far between when considering the whole pie. Review these clinics and after the overhead to maintain them is reviewed check the take home pay .. or see how many DC's are there to generate the business sharing the profits .. if any .. especially by giving care away. I am sure there are many successful clinics charging "usual and customary" fees and doing quite well. I am sorry to spend all this time replying to this e-mail .. but it hit a cord with me. If replies to this e-mail will condemn me after my 22 years of serving my community and chiropractic worldwide then so be it .. just be more understanding for those that need to be heard. For those reading this wishing to receive my weekly e-mail newsletter which presently is sent to 6700 DC's in 31 countries then request to get on board by sending me an e-mail to: joel3639@aol.com For those reading this and receiving my weekly e-mail and were so disgusted and now wish to be deleted from my address book .. just e- mail me and request to be deleted Have a Great Day Dr. M PS .. there have been many attachments to the chat line recently .. I like many others may not wish to open them .. reconsider using attachments.