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May, 2013

Establishing a Specialized Practice: How Your Peers Do It

By Kathryn Feather, Senior Associate Editor

To help you enhance your practice and increase your bottom line, we ask practicing doctors of chiropractic, like you, for ideas and solutions that have been tested in real-world environments. In this issue, we asked: "Do you have a specialized practice? If so, what are the advantages and disadvantages of having this kind of practice?" Based on your responses, there was a wide variety of specialized practices from children to sports and rehabilitation to nutrition. But the one common denominator was a niche that worked and inspired patient loyalty and confidence.

Sports and Rehabilitation

Dr. David Morse from Little Rock has a Master's degree in Sports Science and Rehabilitation and has trained in orthopedic procedural and regenerative medicine. He also "prepares platelet enriched plasma growth factors for patient injection procedures and guides the injections under ultrasound for the medical physician. I manage these spinal and extremity cases for PRP injections. These patient's must qualify as a candidate by me reviewing their case, physicians notes, MRI, CT scan, x-ray reports if applicable, and they must have an examination with me and updated specific blood work analysis for acceptance into treatment programs. This is a new form of medicine that chiropractic needs to be associated with."

Dr. Mitch Green from New York says he has "found that an evidence-based approach to the restoration of human movement and subsequent improved performance has fired up my patient base. Engaging a patient to actively participate in their care, translates to a higher rate of compliance. They were more likely to follow through with a well thought out active protocol based on the functional paradigm."

A Nutrition Practice

Dr. Brian Walsh of West Melbourne, Florida, operates a nutrition-oriented practice. He believes there are several advantages, "such as it is an all cash service and a perfect compliment to the chiropractic adjustment as it helps stabilize the neuromuscular and endocrine systems. Patients are very open to natural therapy to avoid going the medical route. Nutrition therapy fits right in with the chiropractic philosophy of wholistic health and the innate ability of the body to heal itself. Nutrition therapy also attracts a larger audience as it can help a wide variety of conditions and people that would not normally visit a chiropractor's office." Dr. Walsh does point out one possible disadvantage: "having to track all that inventory!"

A Home-Based Practice

Dr. Loreen Daigle operates a practice out to of her home in Middlebury, Connecticut, and believes there are more advantages to disadvantages to this set up. She says a home office practice, "allows the freedom from overhead costs. The downsides are obvious: privacy and space issues. The benefits are many as patients feel comfortable and trusting in the practitioner's intent. These really nurture a healing and holistic approach. There is much less stress to impress and a stronger bond." She has also found that, "patients love to recommend care to skeptic friends," and she hasn't had to advertise in years. "Every morning is a joy to start work. It has been easy to retain employees, for things are less clinical and more like a family. Being 'retro' speaks volumes to the community!"

An Integrative Practice

Dr. Paul Rubin from Chicago, runs an "integrative practice with practitioners from many fields including chiropractic, medicine, acupuncture, physical therapy, clinical psychology, nutrition/lifestyle medicine, therapeutic deep tissue and other massage modalities, homeopathy, energy work, medical qi gong, herbal medicine, etc. We have been providing these services for 15 years and have been successful in creating a brand in Chicago. The success is having all these amazingly talented individuals under one roof and sharing our expertise for the benefit of our patients. The challenge is to remain integrative in our approach with patients and not just be a bunch of individual practitioners all under one roof."

Neurodevelopment Disorders

Dr. Monika Buerger from Ammon, Idaho, has a unique practice focusing on children with neurodevelopmental disorders. "We have a comprehensive approach that covers, first and foremost, chiropractic care. We also incorporate a comprehensive neurointegrative and neuromovement program and neuronutrition/functional medicine program. The advantages are that you can make an incredible impact on some of the lowest functioning individuals that would never stand a chance in this world. The disadvantages I have found in mentoring other doctors is knowing  and understanding one's self worth. For some reason, as chiropractors, we sometimes forget the significance of our services and the impact we have on people's lives. There is no greater gift that to give a parent their child 'back.'" (Editor's Note: For more information about the specifics involved in a neurodevelopmental practice, see Dr. Buerger's article, "Is a Neurodevelopmental Practice a Fit for You?" in the March 2013 issue of DC Practice Insights.)

Dr. Ronald Fudala from Cincinnati has, since 1993, practiced consulting neurology and electrodiagnosis. "As a result of my experiences, I have been fortunate to be responsible for the up front diagnosis of a wide range of common and uncommon neurologic disease practices. I had also been involved with the strategic and administrative aspects of this practice as we sought to expand clinical programs to better serve our patients and referring physicians."

"I also developed non-operative and post-operative structural spine care programs utilizing primarily certified fitness professionals to carry out protocols I devised. The combination of my direct evaluation management, testing and supervised services accounted for more than $1.3 million in revenue within our practice. This revenue was based primarily on developing and implementing 'in house' programs rather than outsourcing or referring patients to others. The combination of these things has afforded me not only clinical experience, but also an in-depth understanding of political, economic and administrative aspects of inter-disciplinary care," said Dr. Fudala.

No matter what type of specialized practice, there were a few important and common themes among each of these practitioners. Each of them became an expert in understanding and educating their patient base. Each communicated their practice goals and the services they offered in an effective way. And because of their efforts, they enjoy patient buy-in because when people see results and understand what the goal is, they will be compliant with your protocol of care.

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