The Realities of Establishing a Multidisciplinary Practice
By Jaclyn Chasse, ND
When I graduated, I was blessed to find an ideal practice for sale and leapt into the opportunity. The practice was filled with my desired patient type and in the location I had desired to move into. In fact, this practice would have been my greatest competition had I moved to the area. The practice was a solo practice. I worked with the doctor for six months while she transitioned out of the practice and then left. My next day in practice, in the office with only my administrative assistant, I felt full of excitement and loved that I could make all the decisions for my business without the requirement of consultation with anyone else.
That excitement was short-lived for me, as I was a new practitioner and often had questions about clinical cases, as well as marketing, web or the plethora of other things you work on as a sole business owner. My practice eventually grew as I found an acupuncturist who wanted to rent space, then we needed more doctors to meet patient demand. After three years, we grew out of our 1,000 square foot office and decided to take the leap and grow into a 5,000 square foot space. Our practice now offers naturopathic medicine, chiropractic care, massage, cranio-sacral, acupuncture, nutrition, fitness, skin care, colon hydrotherapy, infrared sauna and IV therapy. Now, after another three years in the new space, we have certainly settled in, and I would never go back to a solo practice.
Multidisciplinary and multi-practitioner practices offer significant benefits for patients, practitioners and owners. From clinical consultation to choosing the colors on the walls, having more practitioners invested in the practice can leverage everyone's strengths and help all involved to grow.
It can be difficult to keep up with all of the new information out there. We always come across cases for which we'd like some additional insight from colleagues. Multidisciplinary offices offer experts at your fingertips available for a quick hallway consult on a difficult patient. In the past, we would hold formal grand rounds at our office, inviting practitioners to join in for lunch and talk about challenging cases, gather new ideas and potential referrals. Since, we have found greater efficiency just doing this informally.
Patients also benefit from the collaboration and note-sharing offered when seeing more than one practitioner in our office. We see this synergy between our massage therapists and chiropractor, who almost always co-treat and refer to one another constantly. When practitioners can share info on a real-time basis, patients get more targeted, accurate care and can recover sooner. Additionally, patients who know that their practitioners are collaborating express a greater confidence in their care and report higher satisfaction in our own office surveys.
The clinical benefits are not surprising and, of course, patient care is our motivating driver in our practice, but multidisciplinary practices have additional business benefits to offer and can help all practitioners become more successful.
One huge benefit of a larger, multidisciplinary practice is the cost-management aspect of scaling up your operations. If you are a solo practitioner, you still most likely need someone at your front desk to answer calls, schedule patients, handle billing, etc. If you find someone sharp, you can train them to handle a lot of the business management, but you are the sole practitioner responsible to cover the cost of their employment. With multiple practitioners, the expense of administrative employees is shared among a greater number of revenue-generating providers. This allows more revenue to stay in practitioner pockets. Similarly, every mailing, marketing piece or advertisement has a savings attributable to the number of practitioners "contributing" to the cost of that piece.
Upselling and cross-selling are at the heart of most successful businesses. The best example of this is online, where you buy that new cookbook you've been coveting from Amazon, and in the checkout process, they present you with similar books from new authors or "others who bought this item also bought..." By presenting you with something they expect you'll want based on what you've purchased so far, they "cross-sell" you, getting you to buy more than you'd intended. While a chiropractic practice is not Amazon and your primary goal is not to upsell patients, with many practitioners, there's often another treatment available that would truly benefit the patient. By recommending another practitioner or treatment, the patient can deepen their relationship with the practice as a whole, learn about a new treatment that they may refer someone new for and get well sooner, which is the ultimate practice-growing technique.
Multidisciplinary practices offer additional marketing clout as well. A larger practice, serving a greater number of patients, may have an easier time attracting media attention when they hold events or wellness fairs. Additionally, more practitioners results in a more consistent stream of content if you are involved in social media, blogging or newsletters.
Leveraging the experience and perspectives of more practitioners can mean more new ideas to improve efficiency, attract new patients or make your office a better place to be. If you are thinking of growing your practice into one that is more multidisciplinary, I would recommend you think ahead about what business structure you can create such that there is an opportunity for practitioners to contribute on a meaningful level and to have an investment in the practice's success overall. I've seen this done in many ways, including a board structure to make clinic decisions that affect everyone, as well as financially incenting employees to make referrals or contribute to the practice in other ways.
An interdisciplinary practice is not for everyone. Some practitioners prefer to practice in a smaller, quieter setting where they can have complete control over all aspects of the practice. I won't lie, I've certainly thought about the "good old days" when I only had to worry about myself! But, just as the practice has scaled up, so has the level of satisfaction seeing a thriving business where my colleagues and I are able to help such a wide variety of patients.
Dr. Jaclyn Chasse, ND, is a practicing naturopathic physician in New Hampshire and is the Medical Director at Emerson Ecologics. She also holds an adjunct faculty position at Bastyr University, teaching courses on reproductive endocrinology. Dr. Chasse is a graduate of Bastyr University and has an undergraduate degree in Biochemistry and Molecular Biology. She has co-authored several peer reviewed articles in the field of medical biophysics and integrative medicine and is a frequent contributor to the Natural Medicine Journal and recently joined their Editorial Board.