Episode #28: For the $$$ or the Patient

Published: August 4, 2020


Show Notes:

Speaker 1: (00:00)
What's up innovators and docs. Welcome to the simplified integration podcast. This is episode number 28 for the money or for the patient Leonardo de Vinci once said that simplicity is the ultimate sophistication. And I agree, you see the problem with the way that most consulting groups approach medical integration is anything but simple. In fact, it's the exact opposite. It's expensive, it's complicated. And quite frankly, it's exhausting enough is enough. There are far too many amazing integrated clinics that are struggling well. I'm on a mission to change that when I come to find from over five years, working with integrative practices is that simplicity really is the secret deal saying of less is more, is true through a streamlined approach. I was able to create multiple successful seven figure integrated clinics. And now I'm going to show you how you can do the same. Join me as I share with you the secrets to successful medical integration and practice growth. Join me on a journey to greater sophistication through innovation. I'm dr. Andrew Wells and welcome to the simplified integration podcast.

Speaker 1: (01:09)
Hey doc, welcome back. It's great to have you here. So today I want to touch on a subject that I've wrestled with for years I don't anymore, but for years I had trouble with this topic and I've done a lot of mental gymnastics around this subject, and I hope that some of you can relate to this. So when we first started integrating into the first couple of years, I always had this dilemma of, am I doing this for the patient, or am I doing this for financial gain? And I always like to think I was doing it for both, but in the back of my mind, I always had this, this notion of well, is it truly altruistic? Is it truly the best thing for our patient that we're adding these therapies or these services? And so in the back of my mind, I always had this little, like this question, Mark.

Speaker 1: (01:51)
And it, it, it bothered me not to a big degree, but it bothered me. And I wanted to have peace that I was operating and directing a clinic and, uh, on the business side, but also doing right by our patients. And, um, so in, in North Carolina, uh, chiropractice cannot own medical entities. So we had our integrated practice was owned a hundred percent by the medical doctor. So every time we added a service, we needed to run it by the medical doctor to make sure that he approved it and we wrote out protocols. And so we had his blessing on the protocols. And so every time I would go to the doctor to recommend adding a new therapy, I always had a little bit of like fear and trepidation that he would shoot it down. So one day we're, uh, I'm about to have a meeting with the MD.

Speaker 1: (02:36)
And I think at the time we were adding, like we were considering adding some, some lab testing and blood work and, um, to do some basic functional medicine type stuff. And I had a good relationship with the doctrine and I said, listen, doc, you know, every time I, you know, we had these meetings and I'm about to present a new therapy to you. I always have this fear that you're going to shoot it down for some reason, like either you're not going to approve of the therapy and we're going to have to at something else. And he asked me, he's like, why do you, like, why do you think that, like, what makes you nervous about that? And I said, well, I'm afraid that you're going to think we're doing this purely for the money for the profit and not for the benefit of the patient, or we're going to recommend something that really, um, you know, doesn't align with your philosophy and our philosophy.

Speaker 1: (03:18)
I just have some, some fear about that. I was really open and honest with the doc. And so he said, well, well, here's how I look at it. And the information that he shared with me completely changed my mindset. And from that point on, I never ever had this, uh, this fear or anxiety or notion of like, are we doing this for the money for the patients? So he solved this problem that day. For me, I've never thought about it since, but if you're listening to this podcast and you maybe you've had those feelings, maybe you, um, you've questioned your, uh, your motivation for integration or your motivating motivation for adding things like injections or STEM cell therapy or rehab, whatever it may be. Maybe you feel like you're selling out on your practice, your patients you're selling, not on our profession. If that's you.

Speaker 1: (04:03)
I hope that what I'm about to share with you will, will shed some light and make you feel comfortable about the decisions you made because, uh, this completely changed the way I look looked at our practice. So the doc said, Andrew, here's what, when I look at adding therapies to my clinic or to our clinic, I look at three things. Number one, he said, is it, does it benefit the patient? Number two, is it profitable for the clinic? And then number three, is it legal? And they said, so if it checks all three of those boxes, benefits the patient profitable and legal, then I'm all game and you don't have to worry about it. We should move forward with it. And I said, you know, that makes perfect sense. So later that day I thought about that and I said, okay, well what, like what could we add that wouldn't benefit the patient? And I think sometimes in our profession, especially in chiropractic, we add things to the practice, thinking of the monetary gain first and not thinking about the clinical benefit to the patient. And that's where chiropractors get stuck.

Speaker 2: (04:59)
And as chiropractors is

Speaker 1: (05:00)
All kinds of gimmicks and gizmos and widgets and strategies, and all kinds of like advertising and promotional strategies that are meant to drive traffic to your practice and build up your patient volume and make more money. And to be honest, I think a lot of it is more marketing than it is clinical benefit. And, um, and you know, you have docs like that in your town. Like, you know, them, they always have like a new niche or a new therapy that they're promoting every like week, month or year. Like they always switch from, from thing to thing. That's because they're not getting good results with their patients. And so they're always having to find new patients. So, you know, if you're thinking about a new therapy, do your research, give it some thought and make sure that there is some, some actual benefit to the patient, whether it's just getting rid of pain or improving their activities of daily living, there are a lot of great therapies that you can add to your practice that will do that aside from just the amazing benefits of chiropractic care.

Speaker 1: (05:55)
So, number one, does it help the patient number two, is it profitable? And this is I think where a lot of the, the, um, uh, like the hesitation comes in with docs. If, especially if you have any kind of like, uh, hangups about money, I think chiropractors should make a boatload of money because we help patients in amazing ways that other doctors can simply can't do. And so, uh, but it needs to be profitable. Let me give you an example of this, um, things that we've added that we're profitable. Uh, regenerative medicine has been insanely profitable. Uh, chiropractic care has been insanely profitable. Uh, things like decompression have been profitable for us. Neuropathy programs have been profitable. And so we want the practice to make money. I think sometimes we focus on things that don't make us money. Let me give you an example, uh, supplements.

Speaker 1: (06:44)
So supplements, are they healthy for the patient? Yes. Is it legal to do that in your office in the most case? Most cases, yes. Is it profitable? It can be, but the problem is if you're, if you're spending all of your time explaining the benefits of vitamin D or vitamin C or B vitamins or a whatever supplement is popular, like it takes a lot of time and energy energy to do that in your practice. And if you're looking at your time versus the amount of revenue you're bringing in, in most cases, nutrition doesn't make a whole lot of sense. Now I'm not talking about like, uh, like functional medicine type programs that can be very profitable. I'm talking about like selling vitamins over the counter. It's typically not a very profitable service center. So, uh, things like essential oil, essential oil is great. It's great for the patient.

Speaker 1: (07:28)
It's legal. We use that stuff in our office, you know, it's great stuff, but if you're, if you're trying to build a business around these things, it usually doesn't make a whole lot of sense, unless you have some kind of like multilevel marketing program that you're like on the top of that just kicking butt. But I see a lot of chiropractors make this mistake is that they focus too much energy on this small, like piddly things that don't make much sense financially. Whereas if they plug their, their efforts into the profit centers and the therapies that made them a lot of money for their, uh, exchange of time, that makes more sense. And so you have to look at this, you know, this time versus money and energy ratio to make sure that it makes sense for your business. So if you're, if your business isn't profitable and you're losing money and you're out of business, then Hey, you can't help patients anyway.

Speaker 1: (08:15)
So again, you need to be able to help the patient. Is it profitable? And the third thing is illegal. Um, and this seems like a no brainer, but I've seen so many doctors get in trouble for trying therapies that were completely illegal, or they were just going about it the wrong way. So let me give you an example of this. Um, there is a therapy for neuropathy using nerve blocks, nerve blocks, uh, have been used on thousands and thousands of patients. It's totally an acceptable therapy. However, uh, doctors started billing this to insurance when there wasn't any, uh, uh, proper code or LCD or NCD guidelines. So they were billing this stuff to Medicare, making a ton of money, but were billing it illegally. And so it was, did it help? Did it help the patient? Yes. Was it profitable? It was in the beginning until Medicare caught up audited all these doctors and not only the doctors have to pay all that money back, but they had to pay a bunch of civil penalties in some cases, criminal penalties.

Speaker 1: (09:10)
So it was illegal. And so we see that in regenerative medicine, those types of illegal practices and doctors trying to do things that they shouldn't do in terms of billing or overhyping the benefits of, um, of the therapy in their marketing or their advertising of their patient, patient, patient education. So, yeah, so obviously you have to make sure that it's legal now. How do you make sure that it's legal? And one of the biggest fears I get from doctors are I hear from doctors when I do consultation calls and discovery calls is that they want to integrate, but they have a lot of fear about whether it's legal in their state or how to set up their corporation properly or how to build things properly. And there's a way to do that. And we use attorneys, we use compliance officers. So there's a way to, uh, to essentially self audit your business or have someone, somebody look over your shoulder that is familiar with the law in your state or federal law or billing procedures, compliance and billing.

Speaker 1: (10:04)
There are people that do this for a living that will look over your shoulder and say, Hey, you're doing things the right way, or no, you're misusing this code or this therapy, you're doing it the wrong way, and it's going to get you in trouble. So you don't have to be when it comes to the legal aspect aspect of it, it's a very serious thing, but you don't have to do it alone. There are experts and professionals in our field that consult and help doctors in a practice management and an integrated offices, uh, that for, for a fee will help to make sure that your office is, uh, is operating legally. And you're not getting sideways with Medicare or private insurance or your patient's state or federal law. So, so those are the three things. So if you're adding a new therapy, so if you're thinking about integrating or thinking about adding a new therapy lead with those three things, does it help the patient?

Speaker 1: (10:48)
Is it profitable for the clinic and is it legal? So once you check all those three boxes, in my opinion, you're, you know, you're, you're okay to move forward or proceed with that type of practice model or that type of therapy. So that's a, that's how I evaluate therapies before we add them into our offices. That's what I look at as a main sort of framework before moving forward. So I hope you found this topic helpful. I hope you find it beneficial. If you have any questions about anything that I just discussed today on this podcast, you can, you can email me. My email is info@simplifiedintegration.com that's info@simplifiedintegration.com. Uh, shoot me an email. If you just want to say hello or have a question I'm happy to, uh, uh, to speak with you anyway, have a great day doc, and we'll see you on the next podcast episode. Take care. Bye bye. Hey innovators. Thanks for listening to the simplified integration podcast fact that you're listening tells me that you're like me, someone who loves simplicity and the truth is those who embrace simplicity are some of the greatest innovators. So hope you got a of value from what we

Speaker 3: (11:54)
Covered on today's episode. Be sure to subscribe and share with other docs that you feel could benefit from greater sophistication through simplification and innovation. If you've got specific questions that you'd like answered on this podcast, or you've got specific topics that you'd like me to discuss, just shoot me an email at info@simplifiedintegration.com that's info@simplifiedintegration.com.

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