Dynamic Chiropractic – September 18, 2000, Vol. 18, Issue 20

Body Count

By Stanley Greenfield, RHU
The Vietnam era was a very interesting time in our nation's history. During this conflict, one phrase stood out in my mind: "body count." This was the amount of dead enemy soldiers found after a firefight.
There was a lot of controversy concerning these numbers, which we found out later were exaggerated to make each battle seem a greater victory than it really was. The numbers piled up, and the body count was one of the figures the military touted to the American public.

By now, you must be wondering what all this has to do with chiropractic and this column. It has everything to do with chiropractic and this column! I get the opportunity to speak and visit several state association conventions around the country. I am always amazed at the "body count" I hear being thrown around by the local DCs. I hear "I adjust over 500 patients a week" or "That's nothing; I adjust 500 a day," or "Well I've got you both beat. I adjust 500 people every morning!" Of course, this is topped with, "I do that many before breakfast on a slow day!"

Does this sound familiar? It should. This goes on and on, and the body count gets higher and higher - it's enough to make Robert McNamara jealous! (For those of you not old enough to have heard of McNamara, he was the Secretary of Defense during the Vietnam war.) Why all of the boasting about patients being treated each week? I know the numbers are important, but the most important thing is not the gross number of patients seen. The important thing is what each patient visit is worth.

Let's assume you sat down and figured out what the average patient visit is worth in your office. I hope my assumption is right. You've calculated not what you are billing, but what you actually collect. It is easy to figure out. Take a month and divide the collections by the number of patient visits during that time period. You now have a value of the average patient visit in your office. I know there may be some "personal injury cases" and initial office visits included, but it all averages out. You want that average number.

That average number can be increased without having to resort to a "body count," which may, in fact, lower your average. Now that you have that number, what do you do with it? I am a firm believer in knowing how many patients it takes to cover your overhead. Now it is easy to see how many office visits it takes to cover this. It's nice to know, but is that all for which this exercise can be used? No!

The next step is to see if you can increase the value of each patient visit without a major increase in overhead. What if you had the room to put in a rehab area? Would that increase the value of each patient's visit? Can you get reimbursement for rehab treatment? Let's assume your average patient visit is $40. You now have a rehab area and bill it out for $12. Let's also assume that you only get partial reimbursement so that it only adds $8 to your average patient visit. You have just increased your average patient visit by 20%. The percentage is great, but the most important thing is that you have added another $8 per average visit into your wallet!

Have you ever walked through a grocery, convenience or department store and seen one of your patients buying vitamins from a store clerk? Did you feel dumb? You should have! If they are buying vitamins and supplements and if you aren't the one selling them, you are dumb! Who can give them the best advice: you, or the clerk at the local supermarket? I would think that you could do a better job of telling your patients what they need and what they don't need. Can this also increase the value of the average patient visit? You know it can.

You now have two areas to consider that can increase the value of an average office visit by 25% to over 50%, without a similar increase in overhead. This means more dollars to the "bottom line" and translates into more money for you. It also means that your patients get better information, and probably better products and a better quality of life. That's what I call a fair exchange!

Do you offer your patients orthotics? If not, why not? Someone else will, and that someone may not be the best person to fit your patients. You are that person, and you should offer those products!

I could mention other items or services you can offer, but I am sure you are well aware of what you could be doing in your practice. It is a "win-win" situation. Your patients benefit, and in turn, so do you. It is time you "did the math" and figured out what your average patient visit is worth; then sit down and see if you would like to offer other goods and services to your patients. If you decide to do this, you may recalculate at the end of the year and see if the value of the average patient has increased. I am sure that it will - and you'll deserve it!

Stanley Greenfield,RHU
Jacksonville Beach, Florida


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