162 Streamlining the Chiropractic Practice

Welcome to the KC CHIROpulse Podcast.  This week’s topic: Streamlining the Chiropractic Practice: Efficiency Tips. 

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights. Hosted by Kats Consultants coaches Dr Michael Perusich and Dr Alex Kallio, both seasoned experts in Chiropractic care and business development, this podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In this episode, we discuss:

• Tips and practical strategies to streamline your new patient process
• How to streamline your front desk operations
• How to improve your EHR efficiency
• How to create efficient procedures for compliance
• Using technology to create an efficient Chiropractic machine
• …and so much more…

In each episode of KC CHIROpulse, we delve into crucial aspects of building a successful Chiropractic practice, covering topics such as establishing a strong foundation, adopting a patient-centric approach, mastering marketing techniques, achieving financial fitness, fostering effective team building and leadership, integrating technology and innovation, and navigating common challenges in the field.

Whether you're a seasoned chiropractor or just starting your practice, the KC CHIROpulse Podcast offers a wealth of knowledge and practical advice to help you navigate the intricate world of the Chiropractic business. Join us on this journey as we explore proven strategies, share success stories, and connect with industry experts to empower you in your pursuit of building a thriving Chiropractic practice.

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Transcript

Dr. Michael Perusich: 0:00

streamlining your chiropractic business. Hello, everybody. Welcome to the KC ChiroPulse podcast brought to you by ChiroHealth USA and Kats Consultants. I'm Dr. Michael Paroosh, your host, and I'm joined with my co host today, special co host, Dr. Alex Kallio. Alex, how we doing? I am great. How are you? Fantastic. you run an incredibly efficient practice. So I thought it'd be fun to just talk about some practice efficiency tips and, really how can we streamline our chiropractic practices? So they just, they run more smoothly. And of course, along with that comes usually more patient visits as well as higher capacity and just practices a lot more fun when it's like that.

Dr. Alex Kallio: 0:41

Absolutely. Well, obviously, we'd all like our days to be run smooth and not have any hiccups. But if you're not planning or putting some things in place, that doesn't just happen on its own.

Dr. Michael Perusich: 0:51

Right, exactly. So we have to really be intentional about efficiency. And there's a whole bunch of areas in the practice where we can become more efficient. So let's just dive in here And just start with something and just run with it. Cause this is an A to Z conversation, really. There's clinical efficiencies, there's office efficiencies, there's procedural efficiencies, there's scheduling efficiencies, there's, at least I think there's EHR

Dr. Alex Kallio: 1:20

efficiencies. Yeah. Yeah. Yeah. Supposedly. Uh, yeah, there's so many avenues that you can go down with this, that really, this is a fairly long laundry list of areas to really be mindful of and put some focus and attention to.

Dr. Michael Perusich: 1:32

Very much so very much. So so where do we want to dig in

Dr. Alex Kallio: 1:35

first? Yeah, let's say Let's maybe dive in where patients are walking in right at the front. I love it. You know, yeah Yeah, and I mean from the time maybe even prior to that I mean there's things from the phone call to as the patient walks in the door that can really make or break how long and How quickly you're getting people? integrated into the office and through that first visit, even, that if you aren't starting that at the time that they're even before they're calling in, you're setting yourself up for, for a headache right off the bat.

Dr. Michael Perusich: 2:04

Right, right. That's so true. You know, if we think about efficiency, what does efficiency mean? Well, I like to flip things around. So what's the opposite of efficiency? It's chaos. And if your patients are walking in the front door and they see nothing but chaos and everything's completely inefficient, they're going to wonder if they're in the right place. So it really builds your first impression, so to speak, if you don't at least look efficient and look non chaotic. Absolutely.

Dr. Alex Kallio: 2:34

Well, in today's day and age, I mean, to really get going on efficiency, you've got to be somewhat technologically up to date. You know, it starts with patients been able to, are they able to schedule their appointment online or, are they doing it? I mean, obviously plenty are still going to call, but do they have an option to do that? Are they able to get their paperwork sent to them and fill that out digitally before they're coming in? If we're still Doing everything from, from start to finish all on paper, we're going to look pretty inefficient and that's probably not going to look great in a patient's eyes. So we've got to make sure that we're getting up to date with current tech.

Dr. Michael Perusich: 3:08

Exactly. And you brought up online scheduling. That's an interesting one. Not too long ago, I was reading a statistic and don't quote me on this. I don't remember exactly what it was, but it was pretty astounding. It was something like. 72 percent of patients prefer online scheduling. I mean, that's, that, if that's the right number, that's three quarters of your patients that are coming in want online scheduling. They want those text message appointment reminders and those kinds of things. And they, they want to see an office that looks incredibly up to date, good computer systems, and has those high tech efficiencies in the practice. That actually helps not only attract patients into your clinic, but helps Patients into your clinic.

Dr. Alex Kallio: 3:49

Well, and I mean, today's day and age, I mean, outside of really, probably the Medicare aged patients, everybody else is wanting to do things on their phone. They want to be able to do that mobile. They want to be able to look up and schedule their own appointment without having to call and talk to you without having to take the time to do that. They want to text back and forth. They want to pay their bills online. There's so many things that we're doing everything from our phones these days, that if you're not at least. Somewhat down that road. You're really missing the boat.

Dr. Michael Perusich: 4:20

Yeah, that's so true. we're actually starting to see just the beginnings of the first tech efficient patients becoming Medicare age. So we're starting to see even the Medicare patients are about to be kind of high tech. So, you know, if, if we haven't moved in that direction, we really need to be thinking about that. So, online scheduling, computerized scheduling, those kinds of things, just really help to maintain efficient operations and help make your staff's job a whole lot easier.

Dr. Alex Kallio: 4:54

Absolutely. Well, it starts with, many of the EHR systems, some will have that as options that you can just incorporate in, directly from that same company. Others, maybe you're, you're integrating an outside third party to do texting or do some of those things. There's so many different options and features. It kind of depends a little bit of what works best within, your particular practice style and certainly area. But, those options, that's what patients are looking for. And you mentioned from a staff. Time standpoint. Oh my gosh. I mean, you and I have been in practice long enough that, I remember the days of, staff calling, 70, 80 people to remind them of their appointments, tomorrow, the amount of time that took was insane. Now it's automated. I mean, you get that set up on a text reminder, it's entirely automated. Your staff spends no time doing that. Exactly. And it's, it's incredibly efficient.

Dr. Michael Perusich: 5:46

It's incredibly efficient. So, you know, those are just a few little tidbits that you can use to help, really maximize your efficiency for that new patient event for any of your patients that need to be scheduled for your staff, that whole front desk. process is amazing. And another one is when you have a new patient coming in, do you have a kiosk where they can come in and register where they can come in and maybe fill out their paperwork or sign their consent or, you know, whatever it might be, those little tools remove a lot of barriers from the front desk and make your front desk a whole lot more efficient.

Dr. Alex Kallio: 6:24

Absolutely. Well, and in our office, that new patient can, Go on and fill their paperwork out online through our website, but they also, once they're scheduled, our system automatically sends them a link for that paperwork too. So they have access to it, multiple points, they can fill it out online, submit it back digitally, it's all done. And then, yes, when they get in, we have a check in kiosk, they can fill out their symptomatic, pain levels and things, and that's uploading directly to our first, into the note. EHR for subjective you're taking that off of your plate and minimizing your time off the bat on that as well There's so many layers that can happen just off of those systems that cover, things both on the front end and the from the staffing standpoint as well as to the clinical end and the

Dr. Michael Perusich: 7:09

doctor's standpoint Absolutely. That is so true. And another efficiency in practice is having a Chiro Health USA plan. Cairo Health USA is doing some amazing things to help practices fight the financial component of care and explanation of the finances for patients. So we're going to hear a quick word from our sponsor. When we come back, we're going to keep talking about efficiency tips that we can integrate into our practices to make us much more fluid with our practices. All right. We'll be right back.

7:40

So we all feel it. Rent, or dining out, gasoline, or movies. As a matter of fact, the dollar is not going as far for a whole host of reasons. And it's impacting everybody, regardless of your financial situation. Did you know that 38 percent of the overall population is having to reconsider how they're spending their money just to afford the healthcare they need? And if you break it down further, 26 percent have actually delayed the healthcare that they need. Including going to see you, the chiropractor. So here's what we need to know about the breakdown in demographics. You would think that someone who's making 120, 000 or more would be continuing their care right now. But the actual number is 18%. 18 percent of that group is actually putting off health care. And that's a group of people making six figures. When you take that same information all the way down to a group making 40, 000. That number is much higher. It's closer to 40%. So it's never been more important than now to make sure you've made it easy for your patients to come see you, that you have choices for them, and you understand what they're going through at home. We want to make sure your practice thrives during this time, and we encourage you to learn about what ChiroHealth USA can do for you and your practice, and making it easy for patients to see you and continue care.

Dr. Michael Perusich: 9:08

Hi, everybody. Welcome back to the KC Chiropulse podcast brought to you by Kats Consultants and ChiroHealth USA. Today, Alex and I are talking about streamlining your chiropractic business and just really just bantering some efficiency tips around here today. So we started talking about, Alex, we started talking about EHR systems and trying to improve efficiency. Now, I know on some realm, that's a little bit of a misnomer because on our side of the ledger, sometimes our EHR systems don't feel all that efficient, but, and here's the, but the, but is built into your EHR system is all your electronic billing, your patient charting, your appointment reminders, your appointment scheduling systems, all these great tools are built in. And I'm telling you docs, even from a note taking standpoint, if you will spend the time. To set your system up to put in those can statements and those kind of things that you like to have in your note or need to have in your note. I call them CYA statements. If you take the time to set all that up, your system is going to be that much more efficient. So I know Alex, you have EHR system in your practice and we don't have to talk about brands, but here, but yeah. Let's talk a little bit about some things that we can do to make that process more efficient.

Dr. Alex Kallio: 10:28

Yeah. I mean, like you mentioned getting into your, your can statements or things, and this is going to be, somewhat tailored to, I mean, whether from technique or, maybe soft tissue things, for instance, we do a lot of dry needling. So. We have a button right in there that for first encounter dry needling, we click it and it populates all of the, the, the legal stuff that we need to have in there that the patient has signed their, their consent form that they've been reviewed with, they've consented to the, the whole spiel through that populates. And then for any subsequent visits, we have another button that we click that and it populates that that was covered on a prior visit. You put in, but I don't have to type it. I don't have to think about it. It's just. Click the button, but and that can be through everything from your report of findings. You've gone over the informed consent. You just you click your statement, but you have to spend a little bit of time to put those in. And most systems will come with some things integrated, but you've got to tailor that to your practice style to. the techniques and the types of treatments that you're doing. Uh, and just take that moment to set it up. And, and again, from, we go into the billing aspect of Medicare and maintenance and, those things and have your scan statements. Put in to be able to transition those things but a little bit of time one saves you Immense time later sitting in a room when you're backed up and busy and you're not trying to type out You know all those kinds of things so

Dr. Michael Perusich: 11:47

true the more you can customize your system the better and one of the things that helped me customize our system was Periodically, actually a couple of times a week, I would print notes off and actually read them. And how did they read? And I would always think of things. Oh, I should add this in there and I go back in and I could tweak it and I kept tweaking it until literally my notes were like three or four clicks and we're done. And then the next patient three or four clicks and you're done three or four clicks and you're done even you can even do that with your exam, we, we all have a tendency to do the same orthopedic exams, for example, if you have a set of orthopedic exams that you traditionally do for a low back patient, have a button that says low back exam, click it. It populates all your, all your tests and everything. And then all you have to do is say what's positive. What's not.

Dr. Alex Kallio: 12:35

Yep. Absolutely. Absolutely. Yeah, makes it incredibly easy to do. And the flip the, that's the same to the staffing end for the billing for statement printing, those scheduling a time every month to, print statements and, you following your systems procedures for that. Uh, just blocks that time out so that staff isn't trying to do that willy nilly and in the middle of patient time or, oh, we forgot to get statements out this month. When were we supposed to do that? We just that kind of thing. If we can get somewhat. precise with when you're doing those billing procedures, when you're doing statements, when you're doing collection type things, block your schedule for those activities, uh, and set that out so everybody knows when it's done, how much time is allotted for it, uh, and you'll, you'll clear up some of those kind of things too.

Dr. Michael Perusich: 13:23

Yeah. And here's another tip when it comes to EHR and just managing your patient records. Keep up with them. I, I hear a lot of docs waiting until the end of the day to do their notes. Well, that could be a lot of notes. If you see 50 people, um, a day, and let's just make the numbers simple. Let's say you see 50 people a day and you work a 10 hour day. So you see five people an hour. Okay. Reasonable. Is it easier to do five notes? At the top of every hour, or is it easier to do 50 notes at the end of the day? Just do them as you go. And I realized that if you've got a PI case or a complicated case or something like that, it may take you a little bit longer, but just keep up with them. I see a lot of doctors putting, especially PI notes, putting them, put them aside for weeks or waiting until the case closes. Okay. You really can't do that. That's you're not supposed to do that. You have a window of time that you're supposed to get your notes done, but don't wait, just. Figure out a way to create enough white space in your day to be able to keep up with them and it'll be much easier. Small bites,

Dr. Alex Kallio: 14:26

which maybe is a good segue into scheduling efficiency, from when it comes to setting up your day for success in that mode and trying to make sure, you have that, that capacity rule, that 80, 20, rule we typically talk about of having, having a 20%. Yeah. Ideally trying to have 20 percent of that schedule open. Sure. We, we'd all, as docs, we tend to look at it like I want my schedule a hundred percent full, but if you're always in a capacity, then you don't have time to get things done and you don't have time to fit more patients in either.

Dr. Michael Perusich: 14:55

Right, right. And there are ways. And so some of you are probably thinking, well, that'll reduce my revenue. If I do that, that, that, that I'm going to, I'm going to cut you off right there because there are ways to still maximize your revenue. That's a totally another podcast discussion. Yeah, exactly, exactly. I think too, one of the things that helps make your practice, highly efficient is really paying attention to your stats as well. You know, if you're just lumbering along and you're not looking at your statistical measures, your key performance indicators, if you will, then you may not be as efficient as you think you are, like, for example, how many patients are dropping out, how successful, was your recent advertising or marketing program, looking at those kind of things really can help you create some great efficiencies in your practice. Another one is,, Not just, dropouts, but missed appointments. Why are you, why are people missing appointments? Is it because, oh, we stopped the, reminder system or something happened to it? So if you're not paying attention, you might not realize that the reminder system stopped working for some reason. So really pay close attention to those things because that's really those. When you pay attention to KPIs, that's what helps you measure your progress towards your goals. So that's

Dr. Alex Kallio: 16:15

incredibly important as measuring your normal statistics and watching your collections and services and, all those types of things. Obviously those are important to track, but the other, your KPI indicators are definitely more of how are all the other things working, are you retaining those patients? Are they following through? Not just are you getting them in the door the first

Dr. Michael Perusich: 16:35

time? Right. And of course, here at kats Consultants, we do a 33 point, statistical analysis plus trending analyses, plus relativity analysis on our client stats every month. So we really dig deep and see where those efficiencies are and where they aren't and can very quickly help clients really put that efficiency back into their practice.

Dr. Alex Kallio: 16:58

Absolutely. And I would say, if you don't have any idea what we're talking about, you probably should call us,

Dr. Michael Perusich: 17:04

right? If you're not tracking your stats, give us a call. Let's talk about that. another area is, and this is one that nobody likes to talk about, but it's compliance. We have a lot of things that we have to stay in compliant with compliance with there's Medicare rules. There's HIPAA. There's no surprises act. There's making sure patients sign an informed consent every year. Or however often you need them to, there's data security. I mean, there's all these layers of, of compliance that we have to manage and how good are we at managing those things? Yeah,

Dr. Alex Kallio: 17:37

and they're obviously we could, we have things in place to that, clients and doctors can can set those things up just by following things, off of the Kats procedures. There's outside parties that you can also, pay to walk you through and establish those things. Some of them, the chiropractic profession. One of, one of Kats partners, Kathy Mills Chang, they typically have a very good compliance type program as well. We can do those kinds of things as well. I think somewhat of how much, how again, how much hands on or hands off do doctors want to be with setting up those types of plans. Uh, but, it can be either way, whichever works the best for an individual.

Dr. Michael Perusich: 18:15

Yeah, exactly. And if you don't keep up with your compliance, just pick something insurance compliance. if you're not compliant with your treatment plans, your diagnosing and your billing structure and those kinds of things, the last thing you want is blue cross to come in and do an audit because that's going to totally make you inefficient, because they're going to come in, they're going to ask for five or six records and. See what they don't like and now they're going to ask for 20, then they ask for 40 and next thing you know, they're knocking on your front door. So we want to make sure that we avoid throwing up that red flag of potential audits and potential compliance issues and compliance issues go far reaching, for example. Here's one that we ran into the other day. You have to make sure that staff that's leaving your practice knows that their HIPAA compliance, their HIPAA agreement that they have with you for PHI continues on forever after they leave. We had a client who had a disgruntled employee who threatened to disclose patient information on Facebook after she left because she thought she wasn't under the HIPAA regulations. You need to make sure staff knows that before they leave and put it in writing for him. Those little things help you help make you efficient because now you're protecting your reputation out in the community. Absolutely. There are so many different in my, my mind's just all over the place thinking about all the places where you can be efficient. patient communication strategies is another how efficient are you, for example, at delivering a report of findings? Is it clear? Is it concise? Is it understandable for patients? Do we give them an opportunity to ask questions or be engaged in the communication process? Or do we just spend 45 minutes giving them a spinal care class?

Dr. Alex Kallio: 20:03

Yeah, we're still showing the video from 15 years ago. Yeah, the procedures and the recommendations on these things have changed immensely in the last years, especially, but the days of doing a lot of that, that extra stuff and time consuming stuff are just gone. Patients aren't gonna sit for that anymore. Today's consumer is, is very short attention span, much more on a, on a time constraint and we've, we've got to get better in our communication to kind of match and give them their needs,

Dr. Michael Perusich: 20:33

meet them at their level. Absolutely. And we've got to test that message along the way and make sure the patient's keeping up with what we're talking about, that they understand that they're engaged in it, that they see that we're trying to help them solve a need. That's incredibly important. And then your staff needs to match communication with you. If the doctor's telling the patient, Hey, at home, until we get your pain under control, I want you to ice 20 minutes on 20 minutes off and at the front desk. They say that your front desk person tells the patient, Oh, maybe just take a hot shower or something before you go to bed at night. I mean, that's totally contrary to what you may have said. It's a simplified example, but it's totally contrary to what you as the doctor may have said. And that confuses the patient. So now all of a sudden the patient is so confused that they might even drop out of care. So now your whole new patient intake process, trying to get that new patient onboarded, has just been completely blown out of the water. And that's a totally inefficient process. So we have to have those coordinated communication strategies in the practice. Absolutely. But

Dr. Alex Kallio: 21:37

you can't mention, mine being all over the place, there's just so many areas that efficiency can be impacted within the clinic. And my gosh, we could sit and do a podcast for. 30 days the hour, just on this topic. Yeah. You know, just there, there's so many avenues in the clinic that it, it goes down that it's, really good to get some help with it, be able to have somebody walk through, with your office and with your staff to take a look at it rather than just trying to do it on your own.

Dr. Michael Perusich: 22:05

Exactly. Exactly. If you feel like your practice is not as efficient as it could be, or there are areas you want to work on, check us out at Kats consultants. com, jump on one of our calendars and let's do a breakthrough call. Let's talk about your practice. We do that for free. We do that because we want to give back and help doctors have incredible. Amazing, efficient and profitable practices. So on our website, we've got lots of different downloads. You can connect with some of our seminars, our blogs, and be sure to subscribe to the podcast as well. Make sure you're listening to this every single week. We put out new information every week. I also want to thank our sponsors, of course, Kats Consultants, as well as ChiroHealth USA. So check both of those out. And Alex, thank you so much for being on here today. It's always fun. Let's do this again. And let's talk some about some more efficiency tips next time we do a podcast together. Absolutely.

Dr. Alex Kallio: 22:57

Glad to be on. I look forward to it again.

Dr. Michael Perusich: 22:59

All right. All right, everybody have an awesome day. We'll see you next time.?

23:04

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