Dr.M,

I also have a couple of questions for you.  Have you ever done a value pack clipper mail 
out?  Was it good or bad of a turn out?  If so what time of year is best for the mail out?  I 
know fall is a good time because of back to school, but what other times would be good?  
Also, how do you find out about health fairs in the area for spring time?  I have called lots 
of companies as of recent and no one seems to be having these fairs.  But I know that they 
are out there as I have done them here for the corporate headquarters for eckerd drugs and 
the local steel mill.  How do you get in the loop?  or am I doing the right things by calling 
and all just unfortunate and hitting companies with no juice?  Maybe there is a directory of 
such events 

Well, I have come to the realization that numbers when dealing with patients ain't where it 
is at.  I have come upon a crossroads in chiropractic.  Let me know what you would do.  
As you know insurance is not all cracked up to where it used to be.  We have felt some of 
the after shocks of the system recently and now I find that maybe 50% of the public has 
some decent coverage with chiro, but the other percentage does not.  I have put it in my 
mind that no matter what, I have a viable product( chiropractic health care) and feel that this 
is worth something.  The guy I work with says that if they don't have coverage he just 
treats them for a regular charge of what a copay would be.  This is not good enough for 
me.  Do you agree?  Is charging cash outright of 30$ for a 12 visit period that much to ask 
for?  And yet these people don't go on it.  I believe it is worth it, I tell them how much they 
are saving and even give them the choice of paying as they go and don't collect it up front( 
even though you should).  These people no matter how bad they're pain can not commit to 
paying cash for their health.  I have never seen something so pathetic as this.  I go back and 
forth with it all the time.  

Should I accept the $10 copay or stick to my guns?  I shouldn't even have to be in this 
bartering of a position as the adjustment is worth ten times that amount.  But you see, 
because they know nothing about chiropractic, this number or fee seems ridiculous to 
them.  How do we as chiros break that barrier?  Is it the clientel or is it chiropractic being a 
foreign situation to them?  I have a patient who has come in for an average of 2 to 3x a 
week since I started four months ago and she pays 10$ every time and she only makes 
6.15$ an hour working at the grocery store.  That is why I can't see giving this stuff away 
for free hoping that they will refer a friend in with good chiro coverage or waiting for them 
to get into an accident.  This is an absurd train of thought.  What would you do if you were 
me?  You need people for PR to get your name out on the street, yet want to get ligitimitly 
paid for your services.  Come on, these guys that are seeing hundreds of people a day are 
probably only getting paid on at best half of them.  That's why I could care less about 
seeing a thousand people a week.  I want to get paid for my services and be appreciated for 
them.  And I know that you would and I believe I am going to come up with a sheet that 
they commit and sign for paying up front for the care.  I think this is best---is it best from 
your experiences?  Let me know what you think.   


A:

As always .. you must keep up with the search for the nirvana of office procedures and 
flow. Once you reach it I recommend you bottle it and it¼ll be worth tons of millions for 
everyone. There is never one best answer for all. There seems to be a common thread that 
binds all successful people and that is persistence and follow through. You seem to have 
both so hang in there.

Health Fairs are a great idea and a win win for everyone. I recommend when calling a 
company gather their fax and e-mail address so you can send these folks a regular 
newsletter or something to this effect. The purpose is simple .. keep your name and simple 
but practical ideas on their mind. If you have an opportunity to re-call some of these folks 
or new ones .. after asking if they intend on putting on a Health Fair and they say No .. ask 
if they think it is a good idea. be prepared to tell them why it would be .. increased 
employee enhancement  programs .. done during the morning and lunch hours .. various 
community advocates attending .. creative method for a company to reduce accidents and 
increase health awareness .. and best of all ...YOU can help them coordinate it. This is 
why you should be creating a health provider referral base. If one company thinks it is a 
good idea then call a local hospital and ask for their PR department. See if they have an 
active community wellness program (they do) and if they assist with health fairs and what 
they provide. Call your local department of transporation and ask if they have a community 
outreach program for highway safety .. etc. Then get on the horn and call some local MD¼s 
in various specialties .. Optometrist for eye evaluations .. dentists for oral cancer 
screenings .. dermatologists for their stuff  .. a local internist or „doc in the box¾ facility for 
some nurse to do B/P and cholesterol screenings. The potential is endless.  If you 
coordinate all these folks and have them on line for future Health Fairs .. you literally have 
an active programs on a monthly basis.

As far as a Valu Pak .. I did it early on in practice and it never paid for itself .. it all 
depends on your area and if it has worked inthe past for others. You probablky can get the 
names and numbers of DC¼s using it and then call them. I would have the DC you work 
with pay 100% for it.

As far as fees. You cannot sustain yourself at this time of your career on $10 visits. It just 
won¼t work. You have to take a stand and create value for the care even on a less sustained 
basis. We would love to place all patients on a corrective schedule going for months .. not 
just to get them out of pain but to assist in managing the subluxation. Unfortunately .. 
people lack the knowledge and concern we have. So .. meet them half way. Place them on 
a 12 visit schedule .. tell them this is your basic patch up or relief schedule and you expect 
them to feel better even before this time but this schedule provides just enough care to 
stabilize the area and after this they can return as needed. Without the financial and schedule 
pressure many folks will return multiple times per year paying per visit.

There is a national progarm called PCD Preferred Chiropractic Doctor .. a program I tell 
them is used as a supplement to their limited managed care program or to allow them to use 
if they had no insurance. They pay $35 a year .. one time fee .. and then I can lower my fee 
20%. From a $35 visit be charge them $25 or with the rolling table $35 rather than $50. 
See if this is available in Pittsburgh .. give them a call at 1-800-239-3552. If yes .. it 
usually costs nothing to join but lets you allow these patients to take advantage and then 
have them pay over time.

Check my webpage under Practice Tips and scrool to where my stuff is and the first one is 
called Financial worksheet for extended care .. copy and work with this.

Have a Great Day

Dr. M