First-year learning curve – Part 2

Wow, that last post started getting long – it didn’t feel like we’d learned that much in one year alone, but apparently we did–and more!  The rest follows below…

Learn to say no–fast.  This applies to salespeople requesting meetings, verifying those bogus “Yellow Pages” directory listings, and local vendors selling fruit out of the back of the pickup truck in your parking lot.

This also goes for patients who continually fail to show up, people who are repeatedly late, people who “forgot their wallet/credit card/checkbook”, or people who will “square up later” once their insurance is verified (many docs will tell a first-day patient not to worry about that day’s initial exam fees for now, we’ll just apply it to insurance – I say do not take this route!).

This also applies to the malingerers who may be falsely milking the system, PI attorneys who want to lump your bill in with the lawsuit (hint: you’ll never see a fair price–if anything–for your services!), multi-level marketing salespeople peddling water machines or proprietary acai tonics, people wanting to list you in local directories (has nothing to do with the telemarketing scams I mentioned before – the local folks are legit but often a bad return on your investment), etc etc.

If you don’t learn to say no, and fast, you’ll drain your bank account pronto.  I know someone (in a different industry) who blew through over $25,000 in 6 months on promotional/advertising avenues and got completely shafted at every turn, eventually yielding nothing to show for that investment.  I felt sick for her.

Answer your damn phone, even if you can’t hire a front desk person right away.  In case you can’t tell, it’s a thorn in my side at our office – I keep trying to impress upon my significant other who practices with me that the phone must always be answered during clinic hours, the only exception being if we’re all currently with patients.

Only spend so much time with potential new patients on the phone.  It’s not that we don’t want to answer their questions, but left to their own devices, they’ll (understandably) start telling you their life story, airing their frustrations about their previous care, and sometimes asking if there’s any quick fix (i.e. “something I can do”) for their problem.

Do not give diagnostic or treatment advice over the phone, not even nutritional advice.  If they describe symptoms and ask you what it might be, simply say you won’t know until we do an exam/lab testing.  If they say they’ve got a condition and start hinting at wanting some quick in-the-meantime suggestions, simply say that since you haven’t seen them yet, you don’t want to say anything because everyone is different.

Do not get into a long diatribe of what you do and how it’s different–keep it succinct and in plain language.  If you offer a unique service that no one knows about you, type up a quick written intro, save it in word processing format, and offer to email it to people, encouraging them to look it over and consider whether or not it interests them and if it does, to call with questions or to go ahead and get started with a scheduled appointment.  I found through personal experience that the more time I spent with a prospective patient on the phone, the less likely they were to actually schedule an appointment–every time.  In the end, all I did was tie up my phone line and my time, but it was all for nothing other than fending off requests for free advice.

If you give a certain amount of time away as a free consult, set a limit on it.  (I started out not enforcing my limit and people ended up going for almost three times my usual appointment time, all for free.)  Don’t be afraid to say, “OK, we’re at time, would you like to continue?  My usual fee is….”

And when it comes to fees and costs, do not apologize.  Apologizing takes many forms; some people set their prices fairly but feel the need to explain or justify them, while others set their fees low.  Setting your fees low is another form of apology and it sends the message that you don’t think your services are all that valuable.

Remember, the price you set your services at is typically what you’d pay for your own services.  With as much schooling under our belts as we have, I would hope by now that you know what your services are truly worth and that you would price your services accordingly.

I would also hope that you’d have enough respect for your profession, your education, your title, and your fellow brethren to charge a fair price without severely undercutting them.  You don’t want to be “that guy” who competes based on bottom-feeding pricing.

If you plan to barter, come up with a list of products/services you truly need before you’re asked to trade.  Constructing this list beforehand takes all the pressure off you and gives you a chance to think critically about what it is you really need so that you don’t end up essentially giving away your bread and butter in exchange for things that don’t bring equal benefit to you.

Don’t let someone try to run your practice or tell you how to run your office.  Sure, it’s their time, money, body, etc, but you’re also the expert, and it’s also your practice.  They have final say over where they’ll receive care, but you have final say over how you’ll run things in your office.  Please your patients and make them happy, but you do not have to cater to every whim.

There are times where I felt held hostage by a domineering patient who thought they knew everything because they had read a few books, done some internet research, and talked to their friends.  Dr. House on House MD said it best, when he made the sarcastic remark: “who needs med school when you’ve got wi-fi?”  I don’t advocate actually using that line on a patient in real life, but House made a good point – you’re the expert; Wikipedia does not a doctor maketh.

The above point brings me to: Don’t be afraid to fire or dismiss a patient.  None of us want to do it.  I hate thinking about it.  But noncompliant, domineering, manipulative, or unreliable patients or those who generate inexplicable uneasy feelings deep within your gut are toxic to you and indeed your entire practice and they need to go.

I don’t let a patient go easily but I have had to do it, and when I did, it was the best thing I could’ve done.  I felt bad that I wasn’t able to help them further, but generally these are cases in which the writing is on the wall, as these folks will not do what it takes to get themselves better – and then when they fail, they’ll blame you.

However, not all failures are the patient’s fault.  In school, we frequently discuss patients’ levels of compliance (or lack thereof) and its impact on the outcome of their case (for better or worse); therefore, when we go into practice, it’s easy to write off a lack of case success as some kind of fault on the patient’s part.

Before determining that the patient is not achieving their desired results due to their own accord, make sure your own methodologies are solid and that you’ve explored all the possible shortcomings/weaknesses from your end.  Essentially, make sure the fault isn’t yours first.

Lastly (for now), you won’t please everyone.  Some people are miserable and simply won’t allow themselves to be pleased by anyone.  Others are so pain-sensitive that they may not be able to handle the characteristics of chiropractic care.  And yet others have some deep-seated unresolved emotional issues, some of which can go way back and get very serious.  It’s a blessing when they trust you enough to open up to you and disclose this information; it’s helpful and useful on your part, as it helps you understand another dimension and potential complication of their care.

Sometimes, you can’t please someone simply because you two aren’t a match.  That’s OK.  There are many more doctors out there for them and there are many more patients out there for you!  Go git ’em.

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