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October, 2012

New Directions: Trends Changing The Profession

By Mark Sanna, DC, ACRB Level II, FICC

Do you ever feel like you can't keep up with how fast the health care industry is changing? History can be your practice's worst enemy. The rules of the game have changed. It's as though for 117 years we've been playing according to the rules of basketball and that within the last five years they have changed to the rules of football. Think about the equipment that a basketball player uses. It's as though you are on the playing field dressed in a pair of silk shorts and the team facing you is suited up in football gear. They're wearing helmets, shoulder pads and mouth guards and you're wearing silk shorts!

In order to stay in the game, you're going to have to change your gear, leave your silk shorts in the locker room and suit up with shoulder pads. A review of the trends of the new health care economy will help you suit up your practice for success.

Consolidation & Diversification

The facts don't lie: less than 30 percent of medical physicians remain in private practice. The group medical practice has become the most common model for the practice of medicine. This trend is now becoming the prevalent trend in the practice of chiropractic. Chiropractors across the country are finding safety in numbers. They understand that consolidating services in the form of joint practice is a more cost-effective, stable manner in which to deliver health care to the maximum number of patients.

The chiropractor of the future will be a member of a group practice.

With student debt running well over $100,000, the financial resources required to open a new practice from scratch are beyond the means of most new practitioners. The trend of the group practice – a senior practitioner with associate team members – is a win/win for both parties.

The new practitioner benefits from the confidence, experience, and patient base of the seasoned doctor. The senior physician benefits from the up-to-date knowledge, energy and enthusiasm of the younger doctor, who is a candidate for future partnership.

In addition, overhead costs can be shared, vacation coverage is assured, and often "two heads are better than one" when it comes to strategic planning and decision-making.

I have seen many articles on diversification as a strategy for practice success. (I've even written some!) But, too often chiropractors simplify the concept of "diversification" to "different."

Just adding other products or services to your practice is not diversification. At best, it's a waste of time and money. Worse, it can damage the profitability of your core practice by taking your time and money away from what you do best.

Rather than diversification for the sake of being different, the trend of practice consolidation is diversification at its most effective level. Practice consolidation is visible in the increasing prevalence of providers from multiple disciplines joining together in practices that respect the scope of practice and autonomy of each individual provider.

Creating a practice that provides one-stop shopping, where patients can receive multiple types of health care services at the same location, is an important trend to recognize.

The trend of multidisciplinary practice consolidation extends beyond the combination of physical medicine services under one roof. Multidisciplinary practices include multiple healing modalities, including nutrition, therapeutic massage, acupuncture and other disciplines. This trend is most appropriately referred to as diversification. The diversification of services requires a mastery of the next trend by the chiropractic practitioner, the trend of specialization, otherwise referred to as outsourcing.

Specialization Means Simplification

In the past decade, the chiropractor was a jack-of-all-trades and unfortunately at times a master of none. A diversified, consolidated practice will require the chiropractor to take on a greater entrepreneurial and administrative role than ever before in the past. While the chiropractor of the past decade focused primarily upon patient care, today successful chiropractors focus upon the effective orchestration and delivery of patient care in a cost-effective manner.

This means that the chiropractor must surround him or herself with highly effective coaches and consultants to support this endeavor. In the past, this meant possibly utilizing the services of an attorney and an accountant. In the future, it means outsourcing all of those functions that are not directly in line with the chiropractor's roles of healer, administrator and entrepreneur. Employing professional coaches and consultants such as a practice management consultant, a financial planner, a billing specialist and a marketing specialist, allows the chiropractor to most effectively assume his or her new role.

The Personal Benefits of Simplification

By simplifying those priorities that you focus on in your practice and delegating or outsourcing those activities that are not in line with your core competencies, you free up more time to enjoy your life and those things you love to do. It sounds simple, doesn't it? But how many people actually do it? Human beings are, by nature, hunters and gatherers. We instinctively go on adding things. "Pack rat" behavior is a part of the same gatherer instinct deeply rooted in us. This is true in both your life and your practice.

Examine what you can cut down in your practice responsibilities. Examine what you can eliminate from your schedule so that you can devote more time to yourself and your family. Regularly examine the processes, procedures and paperwork you use in your practice. Get rid of what you haven't used or updated in the last three years. Think carefully about how you can use your time to generate the most value in your practice. Before you take on an additional responsibility, ask yourself the happiness question, "Can I afford to take on this task/project/responsibility without compromising my ability to nurture myself, my family and my practice team?"

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