This is from Dr. Dennis Perman of the Masters. He can be reached at: 
masters9@aol.com

Dear Doctor:

Wow!  I got a flurry of feedback of widely varying perspectives from 
last week's column.  If you remember,  I talked about my lovely niece 
Michelle,  and her intention to explore chiropractic as a career.  This 
apparently touched a nerve for many of you,  thinking about how you 
would respond to a bright young person considering such a decision.

I got a note from a graduating student,  seeing his brother flounder 
in practice,  frightened that he may have made a mistake.  I got 
letters from doctors who said that,  while they loved chiropractic 
and what it could do for people,  the business end had become too 
unmanageable for them to feel good about recommending 
chiropractic to our youth.  And,  I got quite a few letters saying that 
practicing chiropractic was great,  even with whatever obstacles,  
and they would recommend it wholeheartedly.

This varied response illustrates the point that your experience in 
practice is shaped by what you bring to the experience,  and how 
well you learn to adapt to change.  At The Masters,  we teach that 
success comes from you,  not to you -- the results you create 
reflect who you are and what you do,  so focus on things you can do 
something about.  

Practice in today's marketplace is different from ten or fifteen 
years ago, when there was a third party pay system that made it 
easier to deliver services without a direct financial relationship 
with the patient.  In today's chiropractic world,  that third party pay 
arrangement is different,  if not gone.  Now,  doctors will need to 
develop effective communication skills and confrontational 
tolerance,  take responsibility for establishing sound business 
practices and policies,  and market on value instead of convenience.

You can still become massively successful in chiropractic,  when you 
learn how to create a direct relationship with many of your patients,  
without relying on third party compensation.  In every business in 
our society,  people seek providers of products and services,  
expecting to pay for them.  Somehow,  due to the machinations of the 
insurance industry who made billions on the process, the doctor-
patient relationship was warped to include another entity,  who 
distorted the delivery of the services for financial reasons.  Now it's 
time to eliminate that intruder,  and reinvent the doctor-patient 
relationship as it was intended -- to be between a doctor and a 
patient.

The marketplace will embrace this radical departure,  for one reason 
primarily -- doctors are sick of dealing with middle men,  and so are 
patients.  Across the board,  those who offered feedback to last 
week's thoughts carried a consistent message -- chiropractic 
practice isn't the problem,  the political and economic climate we 
seem to have backed into is the problem.  The way around it is 
simple -- learn to conduct your practice like a business,  lovingly 
but professionally,  and develop a complete relationship with your 
patients,  asking them to pay fairly for services rendered.  Then 
you'll see how quickly you'll reconnect with the passion and magic of 
chiropractic,  start to enjoy practice again,  and feel great about 
recommending it to our best students.

Dennis Perman DC,  for The Masters