Kats Chiropractic Consultants CHIROpulse

197 Catch the Red Flags

• Marisa Mateja

Share episode

Welcome to the KC CHIROpulse Podcast.  

This week’s topic:   Are You Catching the Red Flags?

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights, and is hosted by Kats Consultants coaches Dr Michael Perusich and Dr Troy Fox.  Drs Perusich and Fox are both seasoned experts in Chiropractic 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:

  • Are you being the doctor in your practice
  • Why you should be screening for the red flags   
  • How the red flags can make you look like the expert and help grow your practice
  • Why meeting the standards of care is important whether you are an insurance or cash practice
  • …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 personalized practical advice to help you navigate the intricate world of 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.

Don't miss out on the latest insights and expert guidance. Subscribe now and unlock the secrets to taking your Chiropractic practice to the next level. Your success is our priority at Kats Chiropractic Business Advisors.


DISCLAIMER:  The information presented in this broadcast is for educational purposes only and is not intended to offer legal, investment, accounting, or medical advice, and represents the opinions of the speakers.  Seek the consultation of a professional for advice in those areas. And remember…your results using this information may be different than described.



Be sure to SUBSCRIBE to the Kats Consultants CHIROPulse Podcast
When you are ready we can help.


KC CHIROpulse Podcast. Helping Chiropractors keep their pulse on success. Thanks for listening.



Dr. Michael Perusich:

Doctors are red flags getting you down. Hi everybody. Welcome to the KC Chiro Pulse podcast brought to you by Kats Consultants and Chiro Health USA. We are your host, Dr. Troy Fox. Troy, how are you today? And I'm Dr. Michael Perusich. Good to see everybody. And at the outset here, before we get started, I just wanted to say, don't ask me about the Texas game and how we're playing this year. Okay. Just don't even go there. All right, everybody. So we're going to dive into this, Troy, this was your topic. And I think it's a great one. We're seeing a lot of clinics who are more of the maintenance wellness type care, which is fantastic. I love that because yeah, when you go to cash practice and you're working in that wellness mode, you're not an owie doctor. You're not a, you're not just a back specialist. It opens up our entire philosophy. So we love that because now we're treating the whole paradigm. But sometimes we see doctors devaluing that kind of care and maybe not always following common sense or good sense. Maybe it's a better way to put it and using your doctor authority.

Dr. Troy Fox:

Yeah, I think we're not on, at times we're devaluing it and I think it's at some point we also are in such vicious competition. We think with each other for patients that we Discount our services to dissuade that patient or coerce. And we'll talk a little bit about that with Medicare as well, but coerce or

Dr. Michael Perusich:

entice

Dr. Troy Fox:

that patient into your office. And it's a, it's dysfunctional. It hurts the whole profession and it makes people look at us and shrug their shoulders and go, I guess they still haven't learned. Honestly, you and I both have people that we know in business that aren't in chiropractic that look at us and shrug their shoulders and goes, why are you guys still doing this? Why haven't you figured it out yet? Yeah.

Dr. Michael Perusich:

Pretty,

Dr. Troy Fox:

it's a challenging question.

Dr. Michael Perusich:

It is a challenging question and so let's talk about what the standards of care are. Number one, as a clinician, I don't care what kind of doctor you are, you should do a very thorough history and exam, right?

Dr. Troy Fox:

Correct.

Dr. Michael Perusich:

And when you see red flag issues that and if you don't know what the red flag are, red flags are, don't remember what they are. You learned them in school, but if you don't remember what they are, go look them up. Or if you're a member of ours, they're in the library. But we need to identify those patients who have red flags or contraindications to care. And if we're not doing that, then what are we doing? We're jeopardizing the entire profession because those are the ones that make the news.

Dr. Troy Fox:

Oh yeah. Yeah. Those are the ones that make the news and your your hometown newspaper would love to publish that.

Dr. Michael Perusich:

Wouldn't they though? So

Dr. Troy Fox:

they want anything that's exciting and you would be exciting for that moment.

Dr. Michael Perusich:

They can, so don't let them, be exciting in other ways, because you get back to the community and those kinds of things. Don't be exciting because you're on page two of the newspaper or heaven forbid the front page, there's all these red flags. So if you're not screening for those, then at least in my opinion, I think you'd probably agree to write in my opinion, you're not being a doctor.

Dr. Troy Fox:

No, I had just

Dr. Michael Perusich:

being a technician

Dr. Troy Fox:

and you're putting yourself at heavy risk at that point, heavy risk at the, in the excuses I hear, or so and so down the street is only charging X number of dollars for an adjustment and they're not doing any exams. They just sit on the table.

Dr. Michael Perusich:

Do you okay. Do you know how many patients came to me saying, yeah, I used to go to this doctor down the street and they don't ever do an exam. And I hear you're very thorough and you do exams and take x rays. And that's why I want to come here. They're not coming to you because of cost.

Dr. Troy Fox:

I'm hearing the same thing in my practice right now. And what I'm hearing is this, they'll walk in. Oh my gosh. And I had actually a retired and I, when I say retired, she's about 40 years old. She actually got fed up with what she was being told to tell patients. She was an RN and she retired from nursing. Cause she said, I just didn't believe in it. I believe in natural healthcare, but when I got done with the exam, She's wow. She goes, I did start to look into taking some classes to be a, to either, to either be a nurse practitioner, or I was thinking about PA, something along those lines. Go to

Dr. Michael Perusich:

chiropractic school.

Dr. Troy Fox:

Yeah. Yeah. That's what I told her, but she looked at some of those things. So when I got done with the exam, she goes Oh my gosh, you're so thorough. She goes, next question. Do you have x ray facility in the office? I said, yes, I do. She goes, that's great. So if I need x rays, you could take x rays. And I said, yeah, I could. I said, except I have to ask you the question. And the first question I'm going to ask you is, are you a pregnant or is there a chance that you could be pregnant? She goes, Oh my gosh. There actually is, I go, okay, then I guess we won't be taking x ray. But I said, yes, it is. The point behind that story is that as much as I hear some of you saying patients don't want that, they don't want an exam, they don't want x rays. They just want to lay down on the table and get adjusted. Shame on you.

Dr. Michael Perusich:

Yeah, because you don't number one, you don't have the right to think for the patient. You have the right to be a doctor. That's what your license gives you the right to be a doctor and patients are not telling you that. And if they are, those are not ever going to be good patients telling you right now, if they're coming to you because they want cheap and they don't want you to investigate and they don't care if they get hurt and they don't care if they're putting you in jeopardy and our profession in jeopardy, I don't, in my opinion, I don't think those are the patients you really want. Yeah. No it's not up to

Dr. Troy Fox:

you to bend the rules of what your board of healing art says is standard of care. That standard of care is that standard of care. And if you don't know what it is, get on the board of healing arts and look it up and then look up your red flag rules and then. Seriously evaluate where you're at in practice, because quite frankly, that should scare the crap out of you.

Dr. Michael Perusich:

Yeah, it should

Dr. Troy Fox:

not do on the right thing because all it takes is one incident. You know what? You got away with it for 15 years. Good for you.

Dr. Michael Perusich:

Yeah. Good for you.

Dr. Troy Fox:

Actually bad for you. Bad for our profession, but if you're still doing it and you're listening to us now, you should have a little, your heart should have maybe skipped a beat there and you should go, Yeah. It's time for me to maybe square up and stand up and be a doctor. That's what you went to school for.

Dr. Michael Perusich:

All right. I think you and I need an ice pack real quick because we're both getting on our soapbox, so we got to take a quick little break when we come back. I want to talk about something that I think plays into this a lot and why doctors think patients don't want these kinds of things and you know what I'm talking about, so we'll hang onto that. We'll be right back. We're quick word from our sponsors.

ChiroHealth USA:

In today's economy, every dollar counts. Families are facing tough choices, having to reconsider what was once essential to them, but because of healthcare, no one should have to compromise on their well being because of financial constraints. That's where ChiroHealth USA steps in, the solution for your practice. We understand the financial pressures families are under, whether they're insured, on Medicare, or paying out of pocket for treatment. By offering discounts on care, you can ensure that your patients can still afford the treatment they need. And at Chiro Health USA, we're committed to making sure no family has to sacrifice their health due to financial hardship. We'll work with you to create a game plan that keeps your waiting room full and your practice thriving. And here's the best part. Offering affordable care not only benefits your patients, but also positively impacts your bottom line. So why wait? Join Chiro Health USA today and join the ranks of the most successful practices. Because when you put your patients first, everyone wins.

Dr. Michael Perusich:

All right, everybody. Welcome back to the KC Chiro Pulse podcast brought to you by Kats consultants and Chiro health USA, Troy, what I was leading into was sometimes we're making financial decisions for patients and we convince ourselves they won't pay for an exam or an X ray or progress exam or an annual physical shame on you out there. If you're doing that, cause that's poverty complex. You know

Dr. Troy Fox:

what? That's like making decisions after about your fourth martini. On a Friday evening, I'm telling you what that, yeah, you want to talk about poor decision making, get into that fourth martini and then start maybe a, maybe if everybody at the table's a little busy, you do a little Amazon shopping and have about 300 packages piled up your door on Monday, or you start spouting off about something, nothing about at that point, how many good things have come from that. Literally, that's where you're at when you make those kind of decisions. Because here's my thing. That is not logical, nor is it moral. No you took an oath

Dr. Michael Perusich:

to basically meet the standards of care and do no harm. And if you're not evaluating the patient and you're treating somebody that has red flags and you're treating into those red flag areas, you're doing harm potentially.

Dr. Troy Fox:

And what did you get into chiropractic or was it to pop as many backs as you could and make 25, 30 bucks a back? Was that what you know? None of you went into school for that. You wanted to be a doctor because you thought doctors of chiropractic were cool because of what we did maybe way more than cool. Almost. Superheroes. I did, I felt like my chiropractor that it worked on me. The first time was a superhero. I'd never seen anything like that.

Dr. Michael Perusich:

And that's exactly what we are.

Dr. Troy Fox:

Yeah. And I didn't go to school to become a back popper and to worry about what the guy down the street's charging and to remove exams from patients because he's not charging for exams.

Dr. Michael Perusich:

Okay. Let's talk about that because I hate hearing that everybody thinks the doctor next door is competition to you. We are not competition to each other. If you do the math, there's something like 350 million people in the United States and only about 50, 000 or so practicing chiropractors. Good Lord. There's plenty of spines in the sea. Don't worry about, and here's the thing. Here's the thing. People come to you because. You do good. People come to you because you create the experience they're looking for. People come to you because they are like minded in your approach. They don't come to you because you're cheap. When was the last time you heard somebody shopping for an appendectomy and just making sure they were getting the best deal and the cheapest surgeon. Nobody does that. So why do we think we have to do that? Don't chase the guy down the street, go out and prove your value.

Dr. Troy Fox:

That's a very good point. And we see it all the time. And unfortunately it's a race to the bottom. When you start thinking that way, that's where we get the nine 99 special that runs year round. I'm not talking about somebody trying to start up a practice and attract some practice members by giving a special. What I'm talking about is the fact that you're running a special every single month and have for about five years now. You're constantly trying to draw patients in. And what you tell us at that point is here's the game that we're playing. We're playing the big city game. They're going to come to me for a little while. Then they're going to go down the street when the price is right. And then they're going to go down the street further. And eventually a couple of years from now, they'll come back to me for an exam again. It doesn't have to be that way. It really doesn't. You have to prove your worth. So in other words, quit acting like it's just a number and actually love on your patients. Take care of your patients. Charge what you're worth. And guess what? You're probably going to see fewer patients. But that may be wrong, but you may initially lose a few pages, but you're going to replace those patients with higher value patients in the long run. It's just how it works.

Dr. Michael Perusich:

It's how it works. Yeah. And if you're out there constantly chasing the low value patients, guess what? That's all you're going to have in your practice. And you're going to, you're going to give away more of your time than you're ever going to get paid for it. And you can't, you just, you can't build a practice that way. And like you said, Troy, I get it. If you're starting a practice, you need that injection of new patients. If you're a little low on new patients, every once in a while, you need a little injection of new patients. That's fine to do. That's different when you're doing it month in and month out. And I just over here on my other screen, I just did a quick little cursory search on Facebook and I'm astonished by the number of doctors giving their services away. Here's one for 38. Here's one for 19. Here's one. It's so low. Call us to find out what our promotion is. Oh my, so Again, if you're just starting out, that's fine. Let me pose this question and maybe this is a good place to take a break for our sponsors. But when was the last time you figured out what your new patient capacity is and how many patients, new patients you actually need? And I bet you right now, a lot of you are out there scratching your heads going, what's that all about? We always need new patients. Do you really

Dr. Troy Fox:

right?

Dr. Michael Perusich:

All right. Let's take a quick break here. A quick word from our sponsors. We'll be right back.

Kats Consultants:

Kat's Chiropractic Consultants, your partner in chiropractic success. We are dedicated with one on one guidance to bring you all your practice management needs. Let's supercharge your practice. Give us a call today.

Dr. Michael Perusich:

All right, everybody. Welcome back to the KC Chiro Pulse soapbox Derby day here at Kats consultants. We are bantering something here that I think is really important. And that is. Shortening your care cycles to the point where you're kicking out exams. You're not doing x rays. You're not doing annual exams. You're not doing progress exams. Troy, we hear this all the time. It drives me nuts. Blue cross doesn't pay for progress exams anymore. That doesn't mean you shouldn't be doing it.

Dr. Troy Fox:

So what standard of care because blue cross said they're not going to pay for it. No, who cares? You still got to, you still got to go through the motions. Yeah. You know what, when blue cross quit paying for rehab, did you quit doing rehab on patients? Did I quit doing rehab on patients? No, no

Dr. Michael Perusich:

patients pay cash for it.

Dr. Troy Fox:

Yeah. That's how that works.

Dr. Michael Perusich:

Yeah, it's exactly how it works. And if you don't understand how to do that, give us a call because you need to be a client of ours because we're helping doctors over and through stuff like that all the time. But you've got to stick to your standards of care. Number one. Number two, quit having poverty complex and thinking that you have to make financial decisions for your patients. I'm going to it. Probably go out on a limb here and guess that they're not calling you trying to find out whether or not they should buy a house or whether or not they should buy some T bills or buy a CD. No, they're coming to you for one thing. Help them with their health goals. Period. End of story. Has nothing to do with their wallet. So stay out of it. Learn how to overcome poverty complex, but meet the standards of care so that you're not putting yourself in this profession in jeopardy.

Dr. Troy Fox:

Here's a conversation that you don't have with your patient. Hey Mike, I see that you have low back pain and you also want me to get into your back pain. Pocket and see what your finances look like today. I've already been in your wallet and I saw that there's 3 a dime and a piece of Linden there. So what I'm going to do, because I didn't look at your credit cards is I'm just going to recommend one visit. We're not going to do an exam and you just call me when you hurt next time. How about that?

Dr. Michael Perusich:

That's perfect Troy. Cause then I get to keep that dime in the lint.

Dr. Troy Fox:

Exactly. You're just out to three bucks, right? Up

Dr. Michael Perusich:

to three bucks. That's a deal.

Dr. Troy Fox:

This is such a pet peeve and it's not just a pet peeve. Quite frankly. I think part of this affects our existence as chiropractors agreed because we're not doing the right thing and we're skirting the edge of it and we're going everybody else is doing it. No, they're not. No, they're not. Yes. Are we seeing a trend that we're seeing more practices that are not doing what they should do? We have seen an uptick in that trend and it's a lot of pain. You're going to, you're eventually going to pay the price for that. And I hope it's not one of you that I know. Actually, I hope it's no one. I hope this gets some sense through to people and people go, you know what. I really need to start being the doctor that I'm licensed to be

Dr. Michael Perusich:

just be the doctor, just be the doctor teacher. Number one just stay out of the finances altogether. If you've got staff in your practice, if you don't, you can't follow this, but if you have staff in your practice, teach them how to talk to patients about the money side of things you stay out of it because it just muddies the water. When the doctor gets involved in the financial conversation.

Dr. Troy Fox:

Yeah. And here's an easy way to do it, guys and gals. If you've been talking to patients about money, here's how you get out of it. Really simple statement. Hey, my staff's going to go over the cost of this treatment program when you get up front today. Or if you're concerned about the cost of it, we can have a staff member come in and go over that with you right now, we have some really great programs to give them value. Possible.

Dr. Michael Perusich:

Done. Done. Love it. That's it out there. So docs out there, if you're having trouble with this kind of stuff, if you're having trouble getting patients to commit to quality care in your practice, if they're not buying into your care plans and you think that the action to get them to is to lower your prices, give us a call. Seriously, we are helping doctors all over the place develop it. Prosperous and profitable practices by taking some just a few minimal steps and changing the conversation they're having with patients.

Dr. Troy Fox:

Yeah. And you said something really important there. If patients aren't following through with care plans, I'm going to be brutal and honest with you. You need to turn the mirror back on yourself. And if you don't know why. And you still don't understand when you analyze it and turn the mirror back on yourself. Cause I don't want to hear my town doesn't support it. I don't want to hear the people in this area are different than anywhere in the rest of the continental United States. I don't want to hear any of that because it's not true. And it's not true. If you're not, if you're not getting patients to follow through with care plans and you're, or you're afraid to give them a care plan that falls in the same category, turn the mirror back on you. The problem is you, and we're more than happy to help you sort that out. Self discovery is a really great thing. To improve practices, we'll tell you what you're doing wrong. You still have to take the appropriate action steps. We'll tell you what to do, or at least coach you in the right direction as to what to do, but you have to actually want that. If you want status quo, what you got right now, good luck. When somebody comes through your door and say, and calls the board of healing arts in your state and says, Hey, this guy had me come in. Didn't do an exam. Didn't do a history. Had me lay down on the table and adjusted me and he hurt me.

Dr. Michael Perusich:

Yep.

Dr. Troy Fox:

She hurt me.

Dr. Michael Perusich:

Yeah.

Dr. Troy Fox:

That's all it takes. It takes one phone call.

Dr. Michael Perusich:

Yeah, that's all it takes. And it will happen if you're just playing Russian roulette. All right, everybody, we appreciate all of you out there. Here's the cool thing. Our podcast is growing so much which we're super excited about because that's you people out there, you docs out there driving it. And so we, we appreciate it. We appreciate the great feedback that we get. If you have a topic or something you want us to banter around, Troy and I are always happy to So get that info and we'll throw it on one of our, one of our shows.

Dr. Troy Fox:

Yeah, please do. Troy Kats, consultants. com, Troy Kats, consultants. com. And that's Kats with the K get ahold of us. Let us know what you want us to talk about, because I think we We have a lot of topics in the shoot, but I will jump you right to the front. If you send us a topic, because we think it's fun when people send in questions or topics.

Dr. Michael Perusich:

Yes, absolutely. And if you haven't done so go to Kats, consultants. com. Check out all the different programs that we have and the great things that we're doing to help doctors at the top of the front page is. A purple button in the top right corner. It says, let's chat, click on it. It'll take you to our calendars. You can jump on our schedule. Let's talk about your practice. We're chiropractors too, and we just love to talk to you guys. So no pressure from us at all, but go check out all the stuff that we're doing. And there's some great freebies on there as well. Troy, anything else?

Dr. Troy Fox:

I think that's it for today. I think we have beat the tar out of that, but we needed to, people needed to hear it.

Dr. Michael Perusich:

Yes, absolutely. And take heed of what we just talked about. All right, everybody on behalf of everybody at Kats Consultants and ChiroHealth USA, we appreciate you tuning in today. We'll see you next time.

Dr. Troy Fox:

See ya.