268 Don't Be Cheap

Welcome to the KC CHIROpulse Podcast.  

This week’s topic:  Doctors…stop being so cheap!

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 Dr Troy Fox, 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 cheap pricing is likely hurting your practice
• How today’s patients are more interested in value than price
• How cheap fees actually turn patients away
• Why setting your fees strategically is important to your success
• …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

268 Don't Be Cheap

Doctors Don’t Be Cheap

[00:00:00] 

Dr. Michael Perusich : Doctors, stop being so cheap Hello, everybody. Welcome to the KC ChiroPulse podcast, brought to you by Kats Consultants and Chiro Health USA. I'm Dr. Michael Perusich. This is my co-host, Dr. Troy Fox, and, uh, we are from Kats Consultants, which is the innovative aficionado, there's a big word, of chiropractic business success.

How's that? All right, everybody, welcome to today's show, Doctors, Don't Be Cheap. Troy, we've been talking about this for a while off and on. Yeah. 

Dr. Troy Fox: Why do I feel like you're attacking me right 

Dr. Michael Perusich : now? I'm, I'm gonna attack everybody- ... today. 

Dr. Troy Fox: Here we go. 

Dr. Michael Perusich : Let's do it. Just, just remember that. 

Value Over Low Prices

Dr. Michael Perusich : We s- we see these clinics that try to be cheap.

They try to be y- low cost. They try to be... They try to give everything away, and does it really work? The answer is no. No. It does not. It does not. And I think, I think there's a whole lot of reasons for that. I think the biggest one is people today, consumers today, are looking for value in [00:01:00] healthcare, not cheap in healthcare, and there's a difference.

You know, there's, there's a reason why there are so many luxury foreign cars on the road today. It's not because they're cheap. It's because people find value in them. People think that they're gonna drive better, they're quieter inside, they're gonna last longer, et cetera, et cetera. They've, higher level of luxury in them.

They're more fun to drive. You know, what- whatever the value component is for the consumer, they're finding the same thing with, with the chiropractic profession and cheap just isn't working well. 

Dr. Troy Fox: And I wanna throw this out here too because this is kinda part of the cheap isn't working well.

In every other profession, e- every other thing that you do, we, a lot of times, based on our own belief system, are willing to take a risk to see if something works. Mm-hmm. And, and I wanna use an example here real quick. So I went and got stem cells done, injected stem cells on my shoulder a number of years back.

Mm-hmm. And when I went, the doc [00:02:00] that worked on me, fantastic doctor, very knowledgeable, also very honest with me. She said, "You have a 50% chance of the stem cell treatment working for you." 

Well, unfortunately, I, I... A- and I was, I was all for it because it was like I want results and I'm willing to take a risk on this procedure and the thousands of dollars that I spent to see if it helped because I had a pretty big shoulder problem that I was struggling with, and nothing else up to that point had...

i'd exhausted a lot of my options. So- 

Dr. Michael Perusich : Mm-hmm ... 

Dr. Troy Fox: I said, "Okay, I'm willing to take a risk on this. If it doesn't work, I'm not gonna blame the doctor." And then I got into shockwave- ... after I did this. This failed and I got into shockwave, and shockwave ended up helping my shoulder. We've talked about that before.

But here's what I noticed. What I noticed was patients' sentiment when it came to shockwave was, "I'm willing to take a risk on whether it works or not." And I was very honest with patients and said, "Hey, there's a chance this is not gonna work for you." But here's the cost, and here's what we would do with you.

Okay, let's do it. So then what I started [00:03:00] realizing is if we frame chiropractic in the same way, rather than being cheap, what we are is honest with our patients about- Mm-hmm ... here are the options, and th- i- is this 100%? 'Cause the problem is we've made a lot of guarantees in chiropractic in a lot of cases, and patients are expecting miracle results.

Now, I know sometimes we wear shirts around the office that say, "Expect miracles," 'cause quite frankly, in most cases, chiropractic works really well. But I think we have to be honest with our patients, and when we are, then that patient makes a determination, "Hey, I'm willing to do a course of care to determine whether it's gonna help or not, and I understand that it's gonna cost money out of my pocket, and I'm not blaming you if it doesn't work."

And that's a rapid and distinct departure from what we as chiropractors were processing probably even five years ago, that it was all our fault. It's all on us. We've gotta get this patient better. What can I do? And I would go home sometimes [00:04:00] thinking, "What am I doing wrong?" Or, "What didn't I come up with for this patient?"

And I would take the whole burden of a failure of care with a patient on myself. 

And then, no- so then what I wanna do then is I wanna start to cheapen care, because I, I lose the value in it as well. Yeah. And I think in a lot of cases, we as chiropractors have done that. So there's my diatribe on that, but I- Yeah

man, I got a lot of feelings about that. 

Dr. Michael Perusich : Yep. I do, too. I do, too. We need to take a quick break to hear a word from our sponsors. So we're gonna come back. When we come back, we're gonna talk about why patients, consumers, are not attracted to cheap right now, especially in chiropractic. So we'll be right back

Speaker 3: Affordable care shouldn't mean undervaluing yourself, but most chiropractors are still undercharging, especially when it comes to insurance allowances and cash patients with limited coverage. Chiro Health USA helps chiropractors charge appropriately, get paid well when insurance is available, and still serve patients with no or limited [00:05:00] benefits, all through a compliant discount medical plan.

The result, doctors stop undercharging, raise fees, and increase income by about twenty percent without sacrificing care. That's not a discount strategy. It's a business strategy. Learn more at chirohealthusa.com.

Dr. Michael Perusich : Okay, everybody.

Honesty and Treatment Plans

Dr. Michael Perusich : Welcome back. We are talking about doctors don't be cheap because being cheap doesn't work, and part of that I think is... and Troy, you, you touched on a couple of things in your, in your diatribe. You touched on a couple of things that I think are, are important. One, what you're really talking about when you say we just have to be truthful with people and they'll follow our lead, what that really is, is if we're truthful, it helps us build an honest relationship, a trusted relationship a lot quicker with patients.

When you cheapen your practice, when you give stuff away, when you try to go o- on the trek to the bottom with your pricing I think it's really easy for patients to say, "You know what? I'll [00:06:00] give you a try," but it's gonna be a short try because cheap makes it easy for them to quit because they don't have anything invested.

And so when you get patients to invest in care, and this is counterintuitive but we see this a lot, patients are much more likely to follow through with care, especially if you built that trusted relationship on top of it early on. Now it's about value. It's not about cheap. And I think we kind of get that mixed up a little bit in the profession sometimes because we think, "Well, if I just lower my prices, if I don't charge for Must-Stem and those kind of things, if I just hide it, then patients are gonna like me better because I'm, I'm not costing them a lot."

And I think we're missing the boat there. That's not the signal. The signal is are we creating value, and a trusted relationship, and a great experience for patients? I mean, I think it's that triad of things that really keep patients in care. And [00:07:00] when I say in care, and paying for care.

Dr. Troy Fox: Mm-hmm. 

Dr. Michael Perusich : Patients, today's patients are, if they're engaged in your care, they don't care what it costs. They wanna know what the value is, and that's two different things. 

Dr. Troy Fox: You're absolutely right about that. And, and quite frankly, when we talk about the cost of care, I think that brings up the topic of why aren't you talking to patients more about treatment schedules, if you're not already?

Mm-hmm. Because when we do... I, I go back to shockwave as an example 'cause it works really well. I, you know, some people do 12-visit shockwave packages. I, I happen to do six- ... to start with, and then we make a recommendation and we, we do a midway evaluation on a patient. But we start with six visits to start with, no questions asked.

You need to follow through with six visits or we don't even have any idea whether this is gonna work. Why are we not doing more of that with chiropractic, where you're creating a treatment plan, and you should be. Yeah. You know, w- especially, you know, if you're, let's say you're doing a [00:08:00] cash service. There is a legal requirement for you to let the patient know what care costs.

Absolutely. So it's really easy to do that, but you've got to get commitment, that head nod from the patient. I get what you're saying. Mm-hmm. I understand. We need to follow through with X amount of care before we even make a determination on whether this is helping you or not. We're not gonna base it off of visit one or visit two.

"Oh, I felt better on visit one. I feel worse on visit two. This isn't working." And I, I think we run into that a lot. And, and so again, we get down on ourselves because all of a sudden we shoulder all the responsibility for our 50-year-old patient that's overweight, smokes cigarettes, will not give up their doctor their diet Dr.

Pepper. I'm gonna go diet because that's even worse than regular Dr. Pepper. And won't change their eating habits, and aren't at all willing to follow any home recommendations. It's all on us to get them better at that point. How many of you have had somebody like that? We have them- Mm-hmm ... all the time. You can't take [00:09:00] the responsibility for that.

What you can do is gently reassure them, and also remind them that if they do the things at home, they stand a much better chance of success. Right. It's your money. I'm just trying to help you. 

Dr. Michael Perusich : Exactly. 

Stop Giving Services Away

Dr. Michael Perusich : And, a flip side of that is I see doctors all the time say, "Well, I'll do an adjustment and I'll do muscle stim, but I'm not gonna charge them extra for the muscle stim."

Dr. Troy Fox: Mm-hmm. 

Dr. Michael Perusich : Yeah. And so what does that do? That creates a zero value proposition for the patient with the muscle stim. So then down the road when you realize, "Oh, I really should be charging," now that patient's never gonna wanna pay for it because it was always part of what they were already paying for.

And so you really, you shoot yourself in the foot. And I see, I see a lot of insurance practices doing this. Mm-hmm. When insurance doesn't wanna cover something, like laser for example, they just they wanna give it away. They wanna hide behind the insurance and make the patient think, "Well, the insurance company, you know, is, is covering this and it, you know, it's just your co-pay.

That's [00:10:00] all you have to pay." And w- we gotta quit doing that because what we're doing is we're shooting ourselves in the foot when it comes to value. And the doctors that drive their new patient cost down, their new patient exam down to almost nothing, why do you do that? For somebody to come in and just pay $19 or whatever, whatever it is some doctors charge, um There's no value in that for the patient.

So, you know, in the patient's mind, that's an easy, "Yeah, I'll go in and see what they're all about, and, you know, if I don't walk out on day one with a feeling like I've got a trusted relationship then I won't go back." And do you have a trusted relationship on day one? That's pretty tough do.

So y- we're just setting ourselves up to lose that value component right from the start. 

Dr. Troy Fox: And on the back end of that, y- the other thing that I thought out with the... thought of as well, sometimes we create a litigious situation. Mm-hmm. Sometimes we create a situation where maybe the patient's not [00:11:00] improving and we start giving away services, going, "Well, this didn't work.

I feel really bad that you didn't get better, so what I'm gonna do is I'm gonna put you on decompression and blah blah blah, and we're gonna do several visits, and I'm not gonna charge you for it 'cause I j- I just feel like, you know, you should've been better by this point," kinda thing. Now all of a sudden, guess what?

You're putting a burden on yourself because if this person, say, gets way worse, they go get an MRI, they've got a ruptured disc, and they decide to sue you, guess what it looks like? It looks like you are now feeling bad because you did something wrong in providing services for them. So you have to be very careful on that end as well, and that's the other end of cheapening yourself that I don't like as well.

When you provide services for a patient because the patient's not improving, you need to, you need to have that discussion with the patient about, "Here are some of the factors about why you may not be improving right now, and I'd like to change gears with you," but I'm not, like, giving away the farm. 

Dr. Michael Perusich : No.

And, you know, to piggyback on what [00:12:00] you were just talking about, how you can get yourself in trouble, if that patient's a Medicare patient and you say I'm just gonna charge them for the adjustment 'cause that's what's covered, and then the laser therapy that I've recommended, we're j- we just don't charge Medicare patients for that."

Well, that may be setting you up for creating enticement for patient, and that can cost you a ton of money, um, if you get caught doing enticement. So, you know, you, you have to be careful. It's important. Just charge for your services. Y- chiropractors should get paid for what they do, period, end of story.

Dr. Troy Fox: And I 

Dr. Michael Perusich : think if we- You have to 

Dr. Troy Fox: s- you have to sit down and value what you're doing, and you have to have an honest conversation with yourself as well. If what, what I'm doing, do I value that service? Would I provide this to my own family? If you would, then there's a value to th- that. 

Dr. Michael Perusich : E- exactly. Exactly. So we need to take another quick break and, uh, when we come back, we'll kind of wrap up.

Doctors, don't be [00:13:00] cheap

Speaker 4: Patient numbers, dipping staff overwhelmed, and another marketing idea, promising the world, but delivering nothing. These pressures feel familiar to nearly every Chiropractic clinic today across the country. Chiropractors work hard, yet 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 Chiropractic practices, clinics can turn daily [00:14:00] stress into sustainable growth. Stronger clinics start with smarter strategies. Grow your practice with confidence.

Book your strategy session with Kats Consultants.

Fee Strategy and Retention

Dr. Michael Perusich : Okay, everybody, we are back, and hopefully by now you've changed your fee schedule and you're no longer cheap. That's one of the things we do here at Kats Consultants is we really help doctors dive in and create a real fee schedule that actually becomes a strategy in your practice. So there's, there's a science to it, and I think too oftentimes we're just slapping some numbers down on a piece of paper and calling it our fee schedule because we think it's competitive with the chiropractor down the street.

We have to stop doing that. Every practice should have its own fee schedule, but you have to learn how to use it as a strategy to create that value proposition for patients and to create a retention tactic in your practice 

Dr. Troy Fox: And that retention tactic gets [00:15:00] patients better, and then it creates long-term practices that are stable.

And that's... We were talking about this off-camera a little while ago. We were talking about, how do you develop a stable practice, and how do you keep a stable practice? It's not by pouring new patients into the equation every month. 

Dr. Michael Perusich : Right. 

Dr. Troy Fox: Now, yes, we all need a few new patients every month, but from a standpoint of long- 

Dr. Michael Perusich : And if you knew what practice 

Dr. Troy Fox: you do with, yeah

yeah, from a standpoint of long-term, if you're an established practice, you should hold stability without doing that because you've got a retention in practice because you've gotten results for that patient. 

Dr. Michael Perusich : Mm-hmm. 

Dr. Troy Fox: And they're getting value out of the service you provide, and that's, that's really the magic to the recipe is from a retention standpoint, is that patients feel like they're getting value from the service that you provide.

Exactly. So I spend, I spend a lot of time talking with patients that have been patients for a long time about big words like imbibition. And, we talk about how the disc doesn't have its own blood supply. What we're doing when we adjust you, what is the [00:16:00] mechanical action? Okay, yes, we're resetting the nervous system.

I love that. That's not a real tangible for patients. But I'll tell you what, when you start talking about imbibition and you start talking about mechanical function of a joint and a disc, all of a sudden a light bulb clicks on. Mm-hmm. And so I spend time. So I'll pick certain months out of the year that that's all I talk about all month long with every main- maintenance patient.

"Hey, I want to remind you of the word imbibition. You remember what that one means?" "Oh, sorta, Doc." And then we'll go through it again. So it's a, it's a great table talk thing to think your way through, what is retention all about and what makes people want to come back to my office? 

Dr. Michael Perusich : Yeah. And, the chiropractic story is so great.

Mm-hmm. If you're, if you're telling it, it well to patients, but it's so great to me that in and of itself creates value. But then why do we turn around and cheapen our pricing and bring the value factor down? So we've got to find that sweet spot when it comes to [00:17:00] our fees, when it comes to establishing value for the patient.

Real practices are built on the value proposition, the trusted relationship, the experience we create for patients, and using a fee strategy that makes sense in your practice, and understanding how to use it. If you haven't done this yet, go to katsconsultants.com, check out everything that we do.

There's some free downloads on there. There's actually a couple classes on there that you can watch for free. If you ever wanna talk about your practice, jump on one of our schedules. We do that for free because we're not trying to cheapen what we do, but we have been at this for so long, and we've had the pleasure of helping so many doctors, and we just want to transform the profession into a value proposition for everybody.

So doctors, don't be cheap. You don't need to be. Troy, anything to add? 

Dr. Troy Fox: I think this is a great topic for you to mull over in your head on your drive home from work today. If you're listening to this, just get in a quiet space, shut that radio off, and think about, [00:18:00] "How do I value my practice?" Yep. "How do I value the services that I provide, and what do I want my practice to look like a year from now?

What do I want to look three months from now? What do I want it to look five years from now?" Dream a little bit, but to be able to dream, you have to value what you do, and you guys are great at what you do. If you didn't see, uh, RFK the... Is that, is it RFK now? The- RFK Jr. His Baja speech about chiropractic was awesome.

Mm-hmm. He was talking about the, how valuable it is and how many people we've helped over the years. Here's a guy that's not a chiropractor talking about this, and you could say, oh, he's giving a little lip service 'cause he's a politician. But at the same time, he gave a really great speech on the value of chiropractic and how many people we've helped naturally.

Yeah. And I thought, "Wow." I, like I'm listening to it and I, I got goosebumps. I was like, "That is so cool." So I think we have to value what we do as well. Let's quit getting beat up, 'cause that's what we do, 'cause we're down in our practices and w- we're like, you know, on an island by ourselves. Take time, shut your [00:19:00] radio off in your car this afternoon.

Think to yourself about the value of your practice and where you wanna be. Mm-hmm. I think you're gonna have some really positive thoughts, and you're gonna get back to the excitement that you had when you first started in as a chiropractor. Yep. Let's make it happen. 

Dr. Michael Perusich : Absolutely. All right, everybody, from all of us here at Kats Consultants, we wanna thank you for tuning in each and every week, and thanks to ChiroHealth USA too, for being our sponsors.

So everybody, we're checking out. We'll see you next time. 

Dr. Troy Fox: See ya.