248 80% of Your Revene

This week’s topic: Clinic owners think 80% of their revenue is from new patients!

The KC CHIROpulse Podcast is designed for Chiropractic professionals ready to elevate their practice to new heights.  This week, the show is hosted by Kats Consultants’ coaches Dr Michael Perusich and Marisa Mateja, seasoned experts in Chiropractic business management.  This podcast provides invaluable insights and actionable strategies to help you create a flourishing and sustainable Chiropractic business.

In this episode, we discuss:

• Why most of your revenue comes from sources other than new patients
• How focusing on managing capacity can greatly increase revenue
• Why so many try to grow revenue without managing profits
• How you can improve profits by focusing on retention
• …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.

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Transcript

80 % of Revenue

[00:00:00] 

Where Revenue Really Comes From

Dr. Michael Perusich: doctors, do you know where 80% of your revenue comes from? Hi everybody. Welcome to the KC ChiroPulse Podcast, brought to you by Kats Consultants and Chiro Health USA. We are your host today. This is Marisa and I'm Dr. Perusich. We are gonna tackle, I think, a pretty interesting topic today, Marisa. Where does 80% of our revenue come from?

Marisa Mateja: Yeah, I think there's several places that it comes from, but it's knowing that most of the time it's our current patients, 

Dr. Michael Perusich: right? Yeah. 

Why New Patients Aren’t Profitable

Dr. Michael Perusich: And so we, we have this kind of a myth in our, in this profession that, uh, everybody needs a flood of new patients coming into their practice now. Are there times when you need a lot of new patients?

Yes. When you first open, first couple of years if you've taken your foot off the gas and your practice is going down, you might need an injection of new patients. But the reality is the new patient, and I'm gonna make people fall out of their chairs [00:01:00] here, so don't drive off the road if you're listening to this in your car.

For the most part, new patients are not profitable. 

Marisa Mateja: Yeah, and I think that's hard for people to understand, but it's the dollars you spend on marketing. It's all the costs that come along with a new patient when you bring them in. We can even go down to cost for paperwork and, and you know, electronic stuff and staff time and all these things add up, which makes.

Very costly on the first day, especially when the doctor spends too much time with the new patient. And I think that's a, that's something that is happening a lot in practices where the doctor's spending 30 to 45, maybe even an hour with a new patient, and you're not gonna recoup that. 

Dr. Michael Perusich: Right. So we need to take a quick little break, but when we come back, I wanna talk a little bit about really your ROI on patient visits and how your capacity plays into that.

So we're [00:02:00] talking about where 80% of your revenue comes from. We'll be right back. Okay.

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All through a compliant discount medical plan. The result, doctors stop undercharging, raise fees, and increase income by about 20% without sacrificing care. That's not a discount strategy. It's a business strategy. Learn more@cairohealthusa.com.

ROI Per Hour and Visit Economics

Dr. Michael Perusich: We are back. Marisa, this is such an interesting topic. You know, when we talk about revenue, I don't think a lot of clinic owners really. Focus enough on. How to drive revenue and how to drive it in a way that creates profit.

Marisa Mateja: Yeah. 

Dr. Michael Perusich: So we [00:03:00] drive, we try to drive collections, maybe, but collections is that, that's not your profit, that's just the inflow of money. Mm-hmm. So we have to think about, you know, what is our cost per patient? What is our cost? To have our practice open every hour. And so when you think about the new patient, we have to look at the ROI on a new patient.

So what's your, what's your new patient acquisition cost? Well, in today's world and you know this better than me in, in today's world, the cost of marketing is exorbitant. 

Marisa Mateja: Mm-hmm. 

Dr. Michael Perusich: It's super high. You know, platforms like Google are, are driving our costs up for a new patient. If a new patient costs you, I don't know, throw, throw out a number bar.

Marisa Mateja: Well, I would venture to guess, let's just say, let's use an easy number. If we are spending $1,500 on advertising just with Google your costs, if you just are getting 10 new patients a month from them is gonna be $150. So that's your easy math, you know, for this. Um, and that's [00:04:00] a great example. Now I think.

I think some of our costs are probably a little bit lower than that, but I'm gonna venture to guess that most offices are spending a hundred to $150 a new patient to acquire them. 

Dr. Michael Perusich: Yeah. And I think we, we see that $150 even to even higher sometimes with a lot of the practices that we coach. And so the cost of driving new patients in the door is expensive, so we have to, we have to think differently.

You know, we, we think in terms of patient visits and new patients too much. We need to think in terms of driving revenue and driving profit. And so if we were a business other than healthcare, what would the numbers be that we'd be looking at? Well, we'd be looking at what is our cost per hour, what is our revenue per hour?

And that's kind of a different concept in this profession. We don't break things down. And so let's just talk about the new patient. How long is the new patient in your office? Well, the average is probably about an hour. 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: So that new patient is coming in. [00:05:00] How much revenue do you need to drive per hour in your practice to be profitable?

And when you think about it in, in terms of that, and you think about what kind of revenue we get off of a new patient. And so let's just make up an example. If you're doing a new patient promotion, let's say it's $29. We'll just make up a number so that patient's coming in and it's $29 and it takes an hour to get that $29, but how much does your clinic cost you per hour?

You know, most clinics are probably upwards of 250 to $300 per hour in expenses, and so that new patient isn't really driving a lot of revenue to offset that. 

Marisa Mateja: No, and you, and you've gotta get past the expenses, obviously. So, you know, we usually recommend that doctors are generating somewhere between 450 to $500 an hour [00:06:00] just to cover your expenses and get somewhat hopefully to profitability.

Dr. Michael Perusich: And so you really have to think about that. And so we need to look more at what kind of patient really helps us drive revenue. Mm-hmm. Well. The example I just gave you, which is a, a very common example, the new patient doesn't really drive revenue. It takes a lot of times, anywhere from three to four visits before that new patient is profitable.

So at the fourth visit, for example, that new patient is no longer a new patient, right? Yep. So we start, you start coming to the realization that it's the regular patients coming in that are really driving your revenue because the 20 rule, 80 20 rule. And so because your, your expenses for that patient have gone down and your revenue should be going up.

Hopefully you're not giving away the kitchen sink, but we have to. Hopefully they're not dropping out after four visits. Right. There's that too. There's that too. Right. 

Retention and Scheduling Fixes

Dr. Michael Perusich: Well, and that, and that really leads [00:07:00] into where I was going the. The number we have to look at in a practice to drive profitability is retention.

Marisa Mateja: Absolutely. Yeah. 

Dr. Michael Perusich: And so, Troy and I talk about this sometimes and we will go to a convention or a speaking event or go to get CEUs or whatever, and, and you'll hear doctors say, you know, well, I see a hundred patient visits a week, or I have, I see 50 new patients a month. Okay. That's great.

That tells me nothing about your practice. 

Marisa Mateja: Yeah. Because how many of those 50 stayed with you? Right? How many of those made it past day one? Right. How many of those have made it to wellness care and that are really staying in your practice so that you don't have to replace them next month? 

Dr. Michael Perusich: And you know, so it all comes down to how do we create good retention procedures? 

Marisa Mateja: Mm-hmm. 

Dr. Michael Perusich: There's a lot that goes into that. 

Marisa Mateja: Yeah. There's several different fixes I think that you can do with your practice to make sure that that happens. 

Dr. Michael Perusich: Right. I think. 

Marisa Mateja: One is obviously [00:08:00] the, the scheduling aspect of patients, right?

It's making sure they understand the treatment, making sure they understand the care plan, making sure that they know that you can help them and you're going to, you know, be able to fix what they've got going on, right? 

Dr. Michael Perusich: And that's all good communication. 

Marisa Mateja: Good communication as well as structuring your scheduling platform to benefit you.

I see a lot of docs saying, oh, I spend 30 minutes with a patient. Okay, but that limits you to about 14 visits a day. So if you think in terms of that, you are never going to hit your profitability unless you're doing just some major things with the patient and you're billing $225 every 30 minutes, right?

Most of us are not. I can guarantee it. So what you have to do is figure out how can you see the patient for less time and utilize people in your clinic. Your cas [00:09:00] to be able to help generate revenue that it's not gonna cost you as much. And now you've got two people generating revenue at the same time.

Right? Yeah. So I think that's a great way to look at things. So other services are really important to your practice, but baseline, putting together your scheduler correctly, I think is is one of the things that can really help. Uh, practice. So that's one fix I would recommend. 

Dr. Michael Perusich: Absolutely. Absolutely. You know, we were working with a practice here recently that, um, one of the doctors in the practice, it sees a lot of new patients. 

Marisa Mateja: Mm-hmm. 

Dr. Michael Perusich: But their dropout rate is really, really high. And so in diving into it, we figured out that the doctor tries to spend too much time with patients and the way they're scheduling, they're scheduling every 10 minutes, but he's spending 30 minutes with every patient, and he gets so far behind that people just don't want to come back.

Marisa Mateja: Yeah, well, who does? 

Dr. Michael Perusich: Right? 

Marisa Mateja: We live in a day. In, [00:10:00] in, but everybody wants to get in, get out. They want quick, efficient service, right? I mean, quick, efficient service is definitely something everybody wants. I don't wanna go and sit and wait. I wanna know that my doctor's on time, I wanna get in, I want to get out, right?

I have other things on my calendar for the day and I don't wanna get behind myself. So we have to value people's time. And in doing that, I think it's just. It goes back to setting up your schedule correctly and making sure that you're not overloading yourself to the point where you're just losing everybody.

Right. And in that scenario, that's what's happening. 

Dr. Michael Perusich: And the structure of your schedule is incredibly important. I mean, there's really an art to scheduling. 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: And you know, if, if you're spending 30 minutes with a patient but you're scheduling every five or 10 minutes. You got a problem in your practice or, you know, the other thing that drives me nuts about scheduling is the the call-ins.

And I don't care if it's a new patient, if it's progress exam, if it's just an adjustment, [00:11:00] but just shoving them into the schedule somewhere. 

Marisa Mateja: Mm-hmm. 

Dr. Michael Perusich: Is another way that you're gonna drive your revenue down. And that may sound counterintuitive, but what does it hurt? It hurts your retention. 

Marisa Mateja: Yeah. '

Dr. Michael Perusich: cause the patients come in and they sit and they wait too long to get the service that they're expecting.

They're gonna back off. 

Marisa Mateja: Yeah. 

Dr. Michael Perusich: You know 

Marisa Mateja: for sure. And that goes back to proper scheduling. That's understanding the techniques of scheduling and making sure that you're utilizing those while you're scheduling. So a good scheduler understands that they should be looking ahead and paying attention to what's coming up and knowing where your holes are and who.

Is quick adjustments, who are fast adjustments, those kind of things to make sure that you don't put 'em in next to a slower person. Right. And we all have those, sure. We all have those talkers or we all have those people that you're like, Hey Doc, I'm gonna be on point because I know you're gonna need a handoff there.

Right. You're gonna need a good transition to get away from [00:12:00] that patient because otherwise they're going to take 30 minutes Yeah. Of your time. You know, we, 

Dr. Michael Perusich: we had one of those patients and, and you would just. Automatically stand outside my adjusting room door so that you could help me detransition from her.

Marisa Mateja: Bless her heart. She's the sweetest person ever, but she would come in with paper printed out this thick on things that she wanted to discuss, and we knew that that's probably not gonna work in the schedule. Right. So I think that's a big thing. You know, another fix that I think has to happen is good communication on your new patient and your report findings days, whether those are the same day or the, or two different days, 

Dr. Michael Perusich: right?

Marisa Mateja: I think you've got to have good communication. And of course, good communication flows from those two days all the way through. Through the treatment plan. Mm-hmm. You know, making sure that you've got some good coordinated communication between the doctor and the staff, I think is another fix that a lot of people can make.

And I, I think if you are [00:13:00] constantly reassuring, constantly showing people where they're at, constantly telling them what the next plan and the next step is, they're gonna stick with you. They understand what the plan is When we, we only talk about that on the first two days. And then not talk about it again until the end and say, oh, you're ready for wellness care.

Dr. Michael Perusich: Right. 

Marisa Mateja: They may not have a clue what you're talking about. 

Dr. Michael Perusich: Right. 

Marisa Mateja: So consistent 

Dr. Michael Perusich: surprise 

Marisa Mateja: communication is incredibly huge and a good fix for your practice in retaining people. Yeah. 

Dr. Michael Perusich: Yeah. I mean, can you imagine going to the dentist and you're just there for your regular checkup and they come in and say, okay, well everything looks great.

We'll see you in six months. And oh, by the way, next time you come in, we're gonna do a root canal. 

Marisa Mateja: Surprise. 

Dr. Michael Perusich: You know, that that's kind of what we have traditionally done in, in this profession with wellness care. Well, you're all good now. You're feeling great, and so now we're gonna see you once a month.

Marisa Mateja: Yeah. 

Dr. Michael Perusich: We'll call it wellness care. We'll call it maintenance care. And, and, and it's this big [00:14:00] surprise. So, you know, a lot of, a lot of what we're talking about comes back to good communication, 

Marisa Mateja: good communication, 

Dr. Michael Perusich: good coordination with the patient about their treatment plan, and really looking at your practice from.

What am I doing on a per hour basis to drive my revenue and more importantly, to drive my profitability in the practice. 

Marisa Mateja: Mm-hmm. Absolutely. 

Dr. Michael Perusich: So we need to take another break. Okay. Um, so just a quick word from our sponsors, but, uh, we're talking about we, 80% of your revenue comes from, and really a lot of this comes down to how do we steer our practices just a little bit more efficiently.

So we'll be right back.

Speaker 2: Patient numbers, dipping staff overwhelmed, and another marketing idea, promising the world, but delivering nothing. These pressures feel familiar to nearly every ChiroPulse clinic today across the country. Chiropractors work hard, yet [00:15:00] many find themselves stuck balancing patient care with the nonstop demands of running a business.

That's where the real strain begins. Most clinics face the same set of hurdles. Inconsistent new patient flow, operational bottlenecks, and the constant challenge of staying visible in an overcrowded digital space. National reports show that over 60% of clinics struggle with scheduling efficiency alone and even more lack of clear marketing strategy that reliably converts.

But the good news, these challenges aren't roadblocks. They're signals with the right procedures, smarter outreach and guidance built specifically for ChiroPulse practices, clinics can turn daily stress into sustainable growth. Stronger clinics start with smarter strategies. Grow your practice with confidence.

Book your strategy session with Kats Consultants.

Dr. Michael Perusich: Okay, well guess what? We are back. Surprise. 

Marisa Mateja: Welcome. 

Capacity Protection and Wrap Up

Dr. Michael Perusich: Um, [00:16:00] we're talking about where 80% of your revenue comes from in practice and, you know, I think, I think there, there are some ways we could really sum this up. You have to really protect your capacity because if you blow up your capacity and hurt it, which we see a lot of doctors do you're gonna decrease your revenue.

Marisa Mateja: Yep. 

Dr. Michael Perusich: When you don't have good coordinated communication in the practice, you have to think of your staff as. Part of the care plan. They're not just there to do tasks. 

Marisa Mateja: Absolutely. 

Dr. Michael Perusich: And so you gotta have good coordination between the doctor and the team and the patient. And then it's a trifecta.

It's, it's a three-way communication process. So 

Marisa Mateja: Absolutely. 

Dr. Michael Perusich: Your staff will drive patients away pretty quick if, if that communication's not coordinated and we hear this all the time, I was talking to one of our clients just last week and he overheard somebody at the front desk saying I know that's a little expensive, so, why don't we just we [00:17:00] just won't charge for the Muscle Stone today.

What? Yeah. Now the patient's walking away thinking, okay, the doctor's overcharging me for something that the staff 

Marisa Mateja: I may not need. 

Dr. Michael Perusich: Yeah, exactly. That I may not need. And the staff obviously thinks I don't need it. And so that is complete dis coordination that's damaging your practice. And we could go on and on about that one.

But you know, so we have to become much more efficient in our practices too. Yeah. So we can't get behind, we have to have good scheduling techniques. 

Marisa Mateja: Yep. 

Dr. Michael Perusich: In the practice. What else? Marisa? 

Marisa Mateja: Well, I think it's important that you, you also think about the types of visits that you have on your schedule.

So, you know, one of the things is definitely making sure that you've got re-exams, um, and probably yearly exams or every other, or excuse me, every six months, exams for your wellness patients. Some kind of touchpoint with the patient that allows you a moment to stop and reflect about where they've come.

Where [00:18:00] they are and where we're going. Mm-hmm. It's really important, those touchpoint happen with patients. And I hear a lot of docs that just don't do progress exams at all. They, and, and that goes away from the good standards of care. You know, number one. 

Dr. Michael Perusich: Absolutely. 

Marisa Mateja: But, you know, I think, I think so.

That was just an example, but I think you have to make sure that your revenue centers are being utilized, in other words. 

Dr. Michael Perusich: And you're managing your retention. And I, I. I'll just pose a question to everybody out there who's an easier patient to get into care or keep in care the new patient who you don't have a relationship with and you haven't built a good level of trust with, or the existing patient who's been with you for a while.

The existing patient, and so once you have that level of trust, that existing patient is going to be much more profitable on a lifetime basis than the new patient. Is [00:19:00] in, in that acute care treatment plan. And you know that, that's something to think about in practices who are trying to drive a lot of new patients who are trying to drive a lot of PI business.

PI work is great, but is there, what's the lifetime value of a PI patient? That plan typically? 

They don't, they're, I 

Marisa Mateja: mean, they're not lifers. They're 

Dr. Michael Perusich: not lifers 

Marisa Mateja: for some reason. And of course I say that's probably some of the communication that happens, but it's also because most of the time those people are not paying for care, and there's a connection between value there, right.

That has to happen. So that's why we lose a lot of those. 

Dr. Michael Perusich: You know, so we really have to think about the lifetime value of these patients. And yeah. You know, that that's where, in any business, it's not just ChiroPulse business in any business, the, uh. Lifetime value of your clients, your patrons, your patients is really an important thing to consider.

'cause that's where most of your revenue is going to come from. [00:20:00] 

Marisa Mateja: Yeah, and I think if you can fix some of these you know, I'll call them flow issues because a lot of this has to do with our communication flow, our scheduling flow, all of those kind of things. If we can fix some of those, then you don't have to pour as much money into.

Advertising. 

Dr. Michael Perusich: Exactly. 

Marisa Mateja: You know, and that's a huge win for every practice out there if you ask me. 

Dr. Michael Perusich: Huge. How much money did we spend on advertising in our practice? 

Marisa Mateja: Early days, almost. Probably a little bit early. Yeah. Just to get it. But once we had that retention going, we went down to almost zero most months.

I think the only time that we spent money was because a patient that we knew and we were close to maybe had a uh, donation or a special. Thing that we were donating to, right? Mm-hmm. For the community, right? Beyond that, if it wasn't community related, it was very, very low. Close to zero. Pretty much.[00:21:00] 

Dr. Michael Perusich: Yeah. So anyway, 80% of your revenue, and where does it come from? It comes from these touch points that we've been talking about. You know, and a lot of it's based on your retention and your capacity management. So doctors get ahold of your practices. If you need some help, go to Kats consultants.com.

Check out all the things that we're doing to help doctors really drive great practices that build great profits. That's hugely important. We appreciate you tuning in every week too, to the KC ChiroPulse podcast. I wanna thank Chiro Health USA for being one of our sponsors as well. Marisa, anything to add in closing?

Marisa Mateja: No, absolutely not. Um, we have a, an easy way to get ahold of us on our website. It's just let's chat at the very top. So click on that and schedule if you'd like to visit, we'd love to talk 

Dr. Michael Perusich: to you. Absolutely. And no pressure. Alright, from all of us here at Kats Consultants, we'll see you next time. See you.