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Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
August, 2002, Vol. 02, Issue 08
Exploring New Paths: Starting Your Own Business
By Perry Isenberg
So, you want to start your own business and be your own boss? There are quite a few considerations to keep in mind as you branch out on your own. Location; expenses/overhead; insurance; payroll; taxes; business licenses; depreciation on equipment; cost of supplies; etc., all influence how much money you need to start.The major reason smaller businesses fail is an insufficient amount of money (start-up capital). You need a budget, which should include your salary. An accountant can help you handle things smoothly.
Where you set up your new practice depends, among other things, on how much money you have to rent a decent office. Maybe you want a small office in your home, or just want to see clients in their homes (sort of a mobile therapist). You need to research how close your existing clients will be to the office, and if there are any high-traffic areas that may complicate their visits. No one wants to drive 20 miles to the therapist's office; decide how far you think your clients are willing to travel, since they are going to be the staple of your business in the beginning. Also check the zoning laws, and don't forget the business licenses and insurance! Find out how much insurance you need to carry; this varies depending on the state in which you are starting your business. You will need a fair amount of equipment, including massage tables; linens and towels; a washer and dryer; phones and phone lines; computers; desks and chairs; etc. Depending on how big you want to be, you may also need waiting-room furniture and decorations, office supplies, a copier, fax machine... the list goes on and on. Shop around for these items, so you get the best deals and spend the least money (without sacrificing quality). The plan is to research, budget, implement and market.
OK, so you've determined your approximate office costs... are you going to have any staff? With employees come payroll, federal and state tax, unemployment tax and workers' compensation obligations. Are you going to offer any benefits for long-term employees? Think about it first! If you have a few bad months financially, you'll still have to pay these benefits! Good therapists are hard to find, and you get what you pay for. You also need to be careful about the people you hire. You should do a background screening, and definitely check references. If you accept insurance from clients, you will need to have staff that knows insurance coding, medical billing, etc. Paperwork takes up too much time. It is worth hiring someone with this expertise (maybe part-time at first) to help free up your time to see more clients. Also, are you going to sell any products? Retail sales are vital for the financial health of the practice, and to expand client services. This may generate extra income for you... but don't forget the bookkeeping!
How do you get the money to start your practice? Some of the start-up money may be yours, a family member may help, or perhaps a friend has a little extra cash... of start-ups take the Small Business Administration (SBA) loan route. If you choose this option, you will need a good business plan in writing (a three-year projection is usually required) to be considered for one of these loans. The Small Business Administration has a fabulous website that can answer many of your questions, including how to apply, who to contact, what the business plan entails, and why you need one. You can visit the SBA website at www.sba.gov. There are numerous small business seminars you can attend (some at local community colleges). Usually a seminar is only two days long, and it's worth the time invested. A good seminar will provide such information as where you can apply for loans, and how to design your business and marketing plan.
Having your own practice has its upside and downside, but if you plan, research and prepare yourself to work hard for yourself, you will be successful.
Until next time, be healthy, be good, and stay focused and motivated.
Click here for previous articles by Perry Isenberg.
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