Q: Dr. Joel, I'm having a lot of trouble getting new patients in the office. It seems that most people try to keep their distance for some reason. Getting in is the hard part. I need to expand my workshop subject matter, and want to do a carpal tunnel workshop. But my info is limited. I understand you have a workshop book that you sold at school. Can I still get it? I have gotten frustrated I guess...seems I'm putting a lot of effort into unseen returns. I know it is still early in the game of my career, but survival is foremost on my mind. We've been open 8 months or so. The HMO and PPO game is pretty big here, and we've just been added to the Blue Cross provider list. But the big one is closed to new add ones. Anyway, I'll keep plugging away. A: Thanks for the e-mail. Unfortunately .. your plight is shared by many. All business start ups has its own timetable .. with many reasons for the diversity. Rather than dwelling on the negative and impossibility try to dwell on the possibility and with each day renew your vigor to grow. There is no reason to be held back whatever the environment .. insurance or not. Pick a PR and Practice Management topic and stick with it for at least two months .. this means pour your energy into it and what resources you can spare. Lets work this together .. okay .. you want to do workshops .. great. This should be your PR project. First create a demographic plan for your area. What is available within 5 and 10 miles from your office .. labor and clerical. Begin to log the companies and what their employee base is. Check my webpage: www.chirosmart.net and look under Practice Tips and Cyberconsulting for ideas. If you wish to do a search use the search engine on the homepage but scroll down to what seems appropriate as it searches everything. Look for the links that mention 5-10 miles and the mention of clerical .. labor etc. Once you have the demographics begin organizing your thoughts and create a menu of programs. Spend time on my webpage under weblinks and then under ergonomics and begin the process of cutting and pasting data and then a workshop. It takes time but will be used for years to come. As far as Practice management .. begin collecting every patients e- mail address for twice monthly e-mail newsletters. material for these can be found on my webpage under Newsletters .. again copy and past from the Today's Chiropractic e-mail newsletters .. good and quick paragraphs to share with your patients. Next create a simple program for valentines day .. this is a great time to attract some new patients. Don't place a goal too high just have a goal this time as a completion of the project whether it is successful or not .. these are springboard for the future. Have a Great Day Dr. M