From the viewpoint of the medical person, I will tell you a true one that a medical doctor shared with me one time. He said to me, “You know, this is the reason I got involved in healthcare was to help people.” He said, “In family practice,” which is his background, “we have to rush through the visits because we do not get paid a lot for family practice. On the business side, I had to see more people than I felt comfortable within one day to make a profit; otherwise, I would go out of business.” So, he said, “The number is between 40 and 50 patients a day, and I have to do an exam on these people.” He said, “Most of them were existing patients that I had not seen for years that are coming in with a problem, and saying, ‘fix me,’ and they are giving me one visit to do it.” They are expecting to go to that doctor, see the doctor, and have the doctor write a prescription that will fix them.
Unfortunately, that is not what happens. The doctor comes in, he has to rush through the visit, and then he has to write a prescription, which is going to alleviate their symptoms temporarily, but most likely, create more symptoms. Moreover, he said, “I became a little bit of a recluse and stopped going shopping with my wife because I was afraid I would run into a patient whom I would not recognize because I rushed through the visit, and I did not want to run into them.” He said, “Now, in this model, people are coming in with genuine problems, facing surgery, and I work with them over several visits. It could be four to eight to twelve weeks, whatever it takes to fix the patient, and I get to know them because they are coming in on a regular basis. I am doing my re-exams, and I am seeing these patients get well. These are the reasons why I got involved in healthcare.”
When chiropractors finally decide to start this business, other than the communications, what are the most challenging parts of getting the business up and running?
Dr. Mike Carberry: You have different licenses. The most significant challenge, especially as a chiropractor, is that they are bringing on people who have a higher license than they have, which means they must turn over the control right away. There’s also the facility. The ideal facility to handle something like this is between 2,000 and 3,000 square feet. Many people come to us with that much space, but many chiropractors come to us with smaller practices. The smallest one we ever put a model like this into was 1,100 square feet, and they ran that way for a year. That was in the Chicago area. What happened was that at the end of the year the clinic was doing well enough that they could expand into a larger facility. I believe they went into a 2,500 or 2,600 square foot office, which gave them the room they needed to perform optimally.
If there’s a rehab facility, rehab facilities are like a mini gym. So, they have to have the required space. You must be compliant, because you become a medical office, and there are different medical standards involved. For example, in Tennessee, I had to be inspected by Blue Cross Blue Shield to make sure that we met the standards of a medical practice according to Blue Cross Blue Shield standards. However, that was not hard to do. It is just another step. We help guide clients through these difficulties that they run into.
It is not that hard. The most significant obstacle, I believe, is dealing with the unknown, because these healthcare professionals are working in a realm, they have not worked in before. Chiropractors are bringing in people that they have never worked with previously or interviewed before. Some of the doctors, some of the chiropractors, are afraid to talk the medical people because they are, like, “I have never worked with medical people.” When they do it, they find out the medical people were afraid to interview with them, because a chiropractor has never interviewed them.
It is interesting, but none of the barriers are insurmountable. It is just a matter of walking people through the unknown. That is what we do. We have been doing it for a long time, several decades, or two decades, and we have done it in different states for our clinics. We have encountered the various obstacles you can run into, all of them are “overcome able”. That is what we do; we help our clients overcome those challenges and help them to realize it is just different. It is change, and the greatest barrier is people resist change because they do not like change. Once you overcome that, it is not that hard.
It sounds like your program works with them side by side until they do get up and running and get through that transition. How long does that take?
Dr. Mike Carberry: We start with a two-year contract, and we work with our clients over the course of two years. We have a training checklist. We employ coaches that are trained in my facilities. To be a coach, you must have worked in my facility at various posts to understand how these systems work. My wife, who’s brilliant, she is a physical therapist, but she is also an excellent administrator, created a training system. Our coaches are following a 585-point training checklist that they go down to make sure all these things are put in place correctly over the course of two years. Usually, what happens is most of our clients finish before the two years, and they have the facility up and running. What they will do is, at the end of two years, we say, “Well look, if you want to stay connected, we have options to extend that contract.”
