Q: I have lost a few to the HMO docs. Yes I've tried for years to get on, but to no avail. The "main" DC on the list is the one we have to go through to get on, and he want even let his own 2 brothers on it! How do I gwet on the list? A: Your comcern is the same as many of my students .. listening to folks like yourself from the field helps me help them. Getting into HMO's is difficult especially if it done by demographics. I recommend calling each insurance company and speaking with someone in provider relations .. ask if they have a chiropractic panel and if it's closed ..if not get the paper work. There is a national HMO for chiropractic that offers access to many HMO's although some may not be in your area and this company is called Alignis .. call 800-863-2932 .. they also have a internal HMO for patients with no coverage or needing maintenance care .. for instance the patient pays thema monthly premium of $20 for an individual or $30 a month for a family .. of this monthly money you receive a check of $17 or $24 a month whether the patient comes for care or not .. they have to make arrangements for a year either by check or credit card. Then when the patient comes in for care their co-payment is $10 without therapy and $15 with. So .. a monthly minimum fee for you .. if they came once a month is close to and over $30 a visit .. obviously you can see them more than once a month and benefit from the co- pays. Now .. this is a fall back and a true cash plan should encourage extended care and for a more serious fee .. But .. this may help the maintnance folks you discussed in your last e-mail and those with limited to no insurance. I do recommed you visit my webpage and look under either class notes for Chapter One and read about the Community Network or look under Practice Tips for additional info. I would map out a week plan at a time and what you expect to do daily. If the practice is slow .. close the office at least two or three mornings a week and use this time to market the practice .. eitger with physical meetings .. phone follow up or initial calls or letter writing. You need to be active to establish this practice or find out before you get further in debt if this is the place you want to call home. You can always live there and practice somewhere else. But ..prior to any drastic move .. give it a kick start shot again have a Great Day Dr. M