Didn’t take long to find out that patient compliance was very easy when the patient didn’t have to pay anythingDr. Dan Golden
Yesterday I made a post in the form of a question asking whether you would prefer operating a practice with insurance or without. Without exception, the response was all preferred no insurance. As mentioned in my post I practiced in both worlds….initially, no insurance companies provided Chiropractic benefits, then in the 70’s, 80’s and 90’s insurance was a “cash cow.” In those three decades Chiropractors were making more money than anyone could have imagined…..then the gravy train started slowing down to the point it is now at a virtual standstill. At least more trouble to deal with than the compensation is worth.
I had an ulterior motive for making that post yesterday. It provided me an opportunity to share my take on the entire no insurance/insurance eras.
During my years at Palmer College/Davenport, I was taught Chiropractic was a drugless form of health care which assisted the body in healing itself. I was taught it made no difference what the illness was called…..if the body was sick it obviously had a subluxation affecting neurological integrity. I was taught the body was quite capable of healing itself of any disease known to man so long as that disease process had not exceeded the limitations of matter. Some, today, believe those teachings are much too simplistic. Even so that is what I was taught, what my father was taught, what his two brothers were taught and what my grandfather was taught. It seemed to work quite well in all their combined years of practice treating thousands of patients.
So I, at the ripe old age of 23, entered practice hanging my hat and my reputation on what I had been taught. In the local newspaper, I advertised how Chiropractic could help those suffering from high blood pressure, bed wetting, menstrual difficulty, infertility, asthma, migraine headaches, allergies. Was I naive? Of course….however, there was never a doubt I could handle anything that walked through my doors. Slowly but surely people started coming in….were adjusted…..responded favorably and referred.
I had not a clue on how to run a business. I was taught to be a Chiropractor….Nowhere in my days at Palmer was I taught how to run a Chiropractic business. So….based on my father’s advice….I attended a seminar taught by the practice management guru of that time…..Dr. James W. Parker. What he said made so much sense. “Make your care affordable,” he said. “Offer patients different payment options,” he said. “Show the value and necessity of the service you offer,” he said. “Money is nothing more than a by-product of services rendered,” he said. “The way to serve more people is to serve people more,” he said.
So I went back to my office and formulated many different ways patients could pay for my care. They could pay for adjustments as they were rendered. They could pay for six adjustments in advance at a savings or 12 in advance at greater savings….I even had different colored punch cards…one for 6, one for 12 and each time the patient came in the CA would punch out a number. I would “sell” treatment plans with a considerable discount if paid in advance. All of these things came from the basic, fundamental, honest, business principles taught by Dr. Parker.
Then Insurance Entered The Picture. Didn’t take long to find out that patient compliance was very easy when the patient didn’t have to pay anything…they’d do pretty much anything they were instructed to do. The problem was…..to get insurance to pay I could no long treat those conditions alluded to above. Oh, I could treat them but couldn’t tell the insurance company that is what I was treating. Had to tell the insurance companies something they could relate to….something THEY could identify Chiropractic with…neck pain, lower back pain, brachial neuritis, sciatica, radiculitis, etc., etc.. If I wanted to get paid I had to play the game by THEIR rules. I no longer educated patients on how Chiropractic could assist with their organic disease processes…..all I had to do was play the game, fill out the form, use the appropriate codes….whala…..the checks come rolling in. In those 30 or so years I, like the vast majority of my colleagues, pigeon-holed ourselves and our profession into being neck and back doctors.
At the turn of the century, the pendulum began to swing the other way. Insurance companies became more critical of all doctors. Independent reviewing agencies began cropping up. Pre and post-payment audits were initiated, treatment was bundled, reimbursement became more difficult and considerably less. Now we have a generation of DC’s finding it very difficult even to exist. Student loans are massive, start up loans more difficult to obtain with the expense of opening a practice considerably greater. More and more of our younger DC’s are questioning their sanity for choosing this profession…..more and more are closing their doors
The bottom line is it appears we have pretty much come full circle. As evidenced by my post yesterday…..DC’s would prefer not having to deal with insurance. I, as one who has been in both places, think this is a very good thing…good for our profession, good for its doctors!
There is a lifeline for our younger generation of DC’s as well. Dr. Parker died in November of 1997. ChiroSushi has committed itself to resurrecting the principles taught by Dr. Parker for 45+ years to tens of thousands of Chiropractors, spouses, assistants and kids.
ChiroSushi recognizes, understands and is empathetic with the concerns of this generation of DC’s. ChiroSushi has brought together the greatest minds, leaders, coaches and teachers of management and business principles in Chiropractic today. Old masters like Willie Kindred, Charles Ward, Harris Cohen, Tim Schaub coupled with rock stars of today such as Liam Schubel, Brandi MacDonald, Beau Pierce, Carolyn Griffin, Jeffrey Cottingame. They will also have two of the greatest lay person Chiropractic champions in the world today, Keith Wassung and Aaron Lewis.
All of this will be put together under one roof in Las Vegas, Nevada May 3-7, 2017 at the Westgate Resort. In keeping with the teachings of Dr. Parker….this Summit will be like none other offering the very best at the very least….affordable for anyone wishing to attend.