Electrotherapy Gives Hope for Patients With Spinal Cord Injury
There has been little optimism for recovery from a spinal cord injury because the central nervous system does not repair itself well. The severity of the injury depends on the affected area.
Malpractice Insurance: Understanding the Cover Letter
Purchasing medical liability insurance is quick, easy and not terribly expensive. The benefits are clearly listed on a certificate—but do you really know what you are getting with that peace of mind?
Exercise Therapy Following Motor Vehicle Trauma (Pt. 2)
In cases of cervical spine trauma, particularly trauma related to a motor vehicle accident, my plan is to teach the patient one exercise per session and build a progression. This is an effective approach I call an "activation circuit."
VA Choice Claims Denied? Here's How You Can Get Paid
The VA Choice Program (PC3 as well) indeed pays for chiropractic care including manipulation (CMT 98940-98943) and some physical medicine services.
Map It: Understanding the Customer's Journey
One of the biggest marketing mistakes most practice owners or administrators make is not putting themselves in their prospective or current patients' shoes. How do they think and feel about you and your practice? What makes them take action?
A Simple Miracle: Treatment for Mysterious Foot Pain
Under the old ICD-9 diagnosis codes, there was actually a diagnosis for "adventures in medical mismanagement" to describe patients who had been run down the rabbit hole of poor case management and care. I encountered one of those patients in my office today.
A New President for AOMA: A Conversation With Mary Faria
Dr. Faria was formerly a health care executive for over 30 years, the last 17 of those years as vice president and chief operating officer of Seton Southwest Hospital in Austin. She chairs the board of Austin Mayor's Health and Fitness Council.
Year in Review: DC's Best of the Best for 2018
As 2018 winds down, let's highlight the most popular articles in Dynamic Chiropractic by month (December – this issue – excluded, of course).
Knocking Down the Doors: Big Media Success for F4CP
Three articles authored by a DC or a chiropractic organization and promoting the value of chiropractic care – par for the course if you're Dynamic Chiropractic, but if you're Forbes, BOSS Magazine and Becker's Spine Review, three media outlets tailored toward high-level executives and decision-makers, we're talking about an entirely different story.
Acupuncture in Hospital Systems: Transitioning From Tolerated to Celebrated
I've had the pleasure of working with Susan Luria, Director of University Hospitals Health Systems Connor Integrative Health Network (CIHN) for the past year on the Integrative Health Policy Consortium (IHPC) Board of Directors and Federal Policy Committee.
Reaching for Our Roots: Healing Digestion With a Simple Traditional Therapy
Are you ignoring a powerful tool in your doctor's bag? Many acupuncturists realize that Spleen Qi deficiency has reached epidemic proportions in the U.S. Yet, we don't prioritize educating our patients about the importance of warm, cooked foods.
A Soy Isoflavone That Packs a Punch: Genistein
Soybeans contains unique substances called isoflavones, most notably genistein and daidzein, which have been shown to block the buildup the dangerous type of testosterone in the prostate gland linked to prostate enlargement and prostate cancer.
Cynicism and Burnout: It Can Happen to You
Trying to achieve fulfillment as a doctor in today's health care environment is a "rigged game" and physicians are programmed to burn out. At least this is the opinion of Dike Drummond, MD, in his thehappymd.com blog.
Reality Check: Do We Need to Try Harder?
While waiting for a flight to a recent chiropractic event, I overheard the ticket agent at the gate next to mine on his cellphone. His side of the conversation went something like this: "Where are you now? How long before you think you can be at the gate? OK, that will work, see you soon."
The Truth About Malpractice Claims Against DCs (Pt. 1)
Over the past 20 years of active practice, I have seen a number of scary case scenarios regarding signs, symptoms and patient presentations in my office. These presentations scream, This patient is going through an event or This patient does not need chiropractic care, they need emergency care.
When Computers Cause UCS: Adjusting Strategy
With the widespread use of mobile devices such as smartphones and tablets, the incidence of "text neck" has reached almost epidemic proportions. But there is another challenge to the spinal health and well-being of our technology-driven society.
Acupuncture is a Science-Based Medicine
A longstanding patient of mine came in for a routine treatment after she recently began seeing a chiropractor for neck pain. She saw him a couple of times and wasn't getting the relief she had hoped for, so he recommended she let him do dry needling.
A Guide to CBD Dosing: The Correlation Between Dose & Potency
There is an abundance of information available about the daily use of whole plant hemp CBD oil to help maintain and support a healthy lifestyle, however there remains a lack of sound guidance on CBD oil dosing.
Goodbye, Year of the Dog: Two-Thousand-Eighteen Comes to a Close
As Year of the Dog (2018) comes to a close we can look back and see the progress this profession has made. For example, the International Classification of Diseases (ICD) added traditional medicine codes, which were released in June.
News in Brief
A Comprehensive Model of Spine Care; Dr. Christine Goertz Appointed Vice Chair of PCORI Board of Governors.
The Raw Food Debate: Practitioners Discuss Nutrition & TCM
Licensed acupuncturist and fellow blogger Elissa Gonda joins this month's column for a conversation about raw food diets. She brings her perspective on the healing potential of a raw primal diet.
ACA Champions H.R. 7157; ICA Voices Major Concerns
While the American Chiropractic Association recently penned an open letter – signed by not only the ACA, but also the Congress of Chiropractic State Associations, Association of Chiropractic Colleges, Clinical Compass and a number of state associations.
Bad for the Back! Exercises That Can Prevent Healing
The questions "Who gets well? Who doesn't? Why?" prompted the following observations based on my close to 40 years of chiropractic practice.
The Top 5 Strategies to Manage Your Reputation Online
You don't need an acupuncture website anymore! Okay, maybe that statement is a little over the top. But it's not that far from the truth. A recent study on Google searches revealed that 34 percent of all searches resulted in no clicks at all.
Dietary Supplements That Help Restless Leg Syndrome
It is estimated that 7-10 percent (possibly up to 15 percent) of the U.S. population has restless leg syndrome. It is a bit more common in women than men.
VA Chiropractic Reduces Veterans' Use of Opioids?
Utilization of pain medication – particularly opioids – has been massively high in among veterans for decades, but Veterans Administration guidelines that recommend nonpharmacological first-line treatment options create a greater opportunity than ever for VA chiropractors to make a dent in the opioid and overall pain-management crisis.
March, 2015, Vol. 15, Issue 03
Is it Okay to Fire a Client?
By Daniel Ruscigno
It's noon on a Wednesday when your phone rings - your two o'clock can't make it and they have to cancel. That time slot is going to be incredibly difficult to fill, meaning you are going to have to take a loss.
The same thing happens next month, when this same client calls in to cancel last minute. You are frustrated and the lost revenue is starting to pile up. It might be time to fire that client. But before you go to those lengths, consider all of the following steps to reduce your last minute cancellations and no-shows.
Develop a Cancellation Policy
The first step toward reducing those last minute cancellations and missed appointments is to develop a cancellation policy. A fairly common practice is a 24-hour cancellation policy. This gives you an adequate amount of time to try and fill that now empty time slot, while ensuring some compensation if you are not given fair warning.
Some clinics will charge the full amount, others 50% of the amount, or even a flat rate fee for a cancelled or missed appointment. Choose the option that will make you feel fairly compensated for the lost time.
Lastly, when developing your cancellation policy, keep a friendly tone and remind the client why the policy is in place. Here is an example of well-written cancellation policy: Please be aware of my 24-hour cancellation policy. Because it is very difficult to fill a cancelled appointment without sufficient warning, appointments cancelled without 24 hours notice and missed appointments will be charged a fee of $50.
Now that you have developed your cancellation policy, you have to make sure your clients are aware of it. This is crucial if you are going to enforce the cancellation policy because a client will have a hard time agreeing to pay the fee if they weren't made aware of it.
Make sure to include an explanation of your cancellation policy when a client first books an appointment with you. It's a good idea to mention it on the phone when they book their appointment and include a signed agreement on your intake form – it's hard to dispute the fee when you are able to show the client their signed agreement.
Additionally, include a note in your appointment reminder emails and on a sign in your waiting area as gentle reminders for existing clients.
Keep a Cancellation List
While a solid cancellation policy is a good defense against cancellations, your best defense is to have a list of clients you can contact last minute when an appointment opens up.
Find out which of your clients are interested in being on your cancellation list and be ready to call or email them when you have a last minute cancellation. You may be surprised by how many people are willing to be contacted, especially people who have unpredictable work schedules that make it difficult to book an appointment in advance.
Enforce, But be Flexible
Cancellation fees are a tough pill for clients to swallow. It will likely cross their mind that an alternative to paying the cancellation fee is to find a new practitioner. So, while you want to enforce your policy so people respect your time, you don't want to lose a loyal client over it.
It's important to have some leniency. For example, you may not want to charge the cancellation fee on the first offense. In this case, you can remind the client of your policy, let them know that you'll waive the fee this time, but next time you'll have to charge them – and remind them it's because a last minute cancellation directly affects your business. Once a client has had two or three offenses, you can start to enforce the cancellation fee.
Additionally, if there are extenuating circumstances, like a death in the family, it's in your best interest to show some compassion and not charge the cancellation fee.
Because cancellation fees are such a touchy subject, it may be in your best interest to not actually charge the cancellation fee at all if the client is giving you some pushback. After all, you really don't want to lose the client, and you want to keep positive word-of-mouth in your community.
If no-shows and cancellations are becoming a regular occurrence for the client, you may want to consider an alternative to charging a cancellation fee and have them pre-pay for future appointments instead. This is a good way to keep your relationship in good standing – you are showing your commitment to the client by waiving the cancellation fee in exchange for them showing a commitment to you.
Many reasonable clients will have no issue with this compromise and will appreciate it. Those that have had several cancellations and no-shows and don't agree to pre-paying or paying the cancellation fees are clients you don't want.
Fire the Client
Your very last resort is to fire your client. If they are constantly cancelling or not showing up for their appointment, then it's time to let that client go. Let them know that you've appreciated their business, but you've just lost too much money from their cancellations and no-shows.
There are several steps to take before getting to the point where it's necessary to fire a client, but once a client's lack of respect for your time has led to a pile of lost revenues, it's in your best interest to part ways and focus your attention on the clients respectful of your time.
Daniel Ruscigno is the co-founder of ClinicSense (previously PatientCal). ClinicSense offers practice management software that helps with scheduling, soap notes, billing, electronic insurance claims and more. For more information, visit www.ClinicSense.com.
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