Blog, Live Events January 26, 2022

The Key to Growing Your Practice & Saving Chiropractic

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Hi, I’m Dr. Mark Studin. And welcome to this episode of ChiroSecure’s let’s chat. Today we have a very special program. Usually when I’m on I’m teaching with a slide deck, and I want to share with you. Different things about MRI or how chiropractic adjustment works. But today I have something extremely important to share with you and talk to you.

And it’s about utilization and chiropractic utilization, and it starts with your practice. And we’re going to talk about growing your practice. Which will grow chiropractic. We’re going to talk about helping chiropractic breakout or the perpetual seven to 10% utilization cycle in our industry. There are so many different things we need to chat about.

How do you get MDs to bypass physical therapy? You go to a chiropractor, how to get a lawyer to bypass MDs to go to a chiropractor, refer to. All of these things are important to position yourself, not just for 2022, but beyond. It’s not business. As usual today, I have a special guest that I’ve asked to join us.

Dr. Tim, Weir from Raleigh, North Carolina, the hi Tim. How are you? Tim is is I’m happy and I’m practical and a friend and someone I’ve worked with for many years and we laugh and we share, and we make fun of each other. And, he keeps reminding me that I’m older than him. Thank you very much.

But Tim is one of the. Most honest, ethical, nicest people I’ve ever met in my life. My only regret is he lives in Raleigh and I live in New York. I wish we lived closer so we can hang out together. That will be a lot of fun and be awesome. That would be incredibly awesome. That five years sitting up pretty probably worked together about eight years ago was when we started.

But about five years ago you hit some tough times loving chiropractic wanting to leave. So maybe you could briefly tell your story. I graduated from Palmer in 1981 and got out failed and practice failed in practice again, and then got hooked in and it’s an associate and learn some ropes.

Started my own practice. And at that point that we you’re talking about here, I had already been practicing for a long time and I bought into to a couple of things. And one of those things I bought into was the MD DC practice. And I thought, oh my God, this is going to save my life. And this is going to save my practice.

Wow. Horrible. Horrible. We built an incredible practice. It was huge. Got on a front cover of the American chiropractic magazine don’t ever do that because they’ll come after it ever subpoenaed from that point on. But when I finally talked to you Mark and said, listen, this thing is dragging me down.

You, you told me I had, we just gotta get rid of it. And so I got rid of it and actually the practice. I saw more people in chiropractic at that point than I did in the MDC practice. And I’m having a blast doing it, but it took me hooking in with you and not becoming just a chiropractor, but become becoming a doctor somebody who could listen to somebody and figure things out.

And it is the academy program that put me back on. And I had, I looked into things like you got to do the Colossus thing and I did that for a while. And just, if you haven’t figured it out by now, there’s a whole bunch of bull crap in chiropractic. And I just got tired of the bull crap and wanted to give up and just be done with chiropractic.

And then I got hooked into becoming credentialed and doing all the programs through the academy and. Literally saved my life changed well, and that’s why I’m here today and loving. I get it. I get up every morning at four 30, I’ll be turning 65 this year. And I get up every morning at six 30, start my day with reading some Napoleon hill and some meditation and and then studying.

And then I get to the office. We opened our office at six 30 every day. And I’ll tell you I’m on fire. I’m more on fire now than I was 20, 30 years ago. And I’m so grateful for the steps that I did to become credentialed and become a real doctor. Finally. You know what I mean? Yeah. Let’s put our slide up and take a look at what we’re going to talk about today.

And we’re going to segue into some of those things. You talked about Tim, but Tim, if we just look at your credentials and the bullets up top, we’ve talked about. When you grow your practice, you’ve broke chiropractic. When you grow your practice, you help chiropractics utilization. And I’ve heard a myriad of things where, oh we’re a 10, 15%.

That’s what percentage of the population we’re saying it’s all nonsense breaking into all of these different things. I’ve heard every gimmick out there for Tim. You’re a fellow on primary spine care joint providing. The state university of New York of Buffalo school of medicine and biomedical sciences.

And in conjunction with Cleveland university college of chiropractic your MRI interpretation review qualified your trauma, qualified your primary spike here. Qualified. You’ve got all of these real critical. And every course is Coke credentialed through both chiropractic and medical academia. Now, if we talk about your journey and let’s take the screen this slide down.

If we just talk about your journey. How long did it take you to earn all of those credentials? Sometimes I pussyfoot around with it and it took me a little longer than it should have, but it took me basically two, three years to if I were to put it all together to finish all of that.

But, and I’m telling you, it, it isn’t easy. We’re used to going to a seminar on the weekend, sleeping through it, and then getting course credit after that. And that’s not how it is here. It’s really work. But you learn this stuff. I’m telling you, you go into a room now with I go into a room now with in fact I was just in with some orthopedists and some neurosurgeons.

And you’re right up to par. You know exactly what to, what they’re talking about. They know what you’re talking about and it puts you on a level playing field. When you say put you on par with them, w could you expand that a little bit more? If we’re going to be honest in upfront here, I’m going to tell you something.

Before I get into the academy, I don’t think I had maybe. Two to three MRIs. That’s all I ordered in my whole practice career. I just didn’t know. And the more doctors I talked to who are a little bit older like we are, and that’s a common thing, they just don’t. And and so when you, when I would get into and again, it’s the old Cairo one step, two step that you talk about, you get in somebody’s vicinity and they start talking to you and you, we’ve got to the point where we know how to get their attention off onto something.

So that we’re not talking about what they want to talk about, but now I get in the room with him and we’re talking on the same level. We’re talking the same nomenclature. We’re talking about the same things. As far as medicine goes and it literally changes how you practice when you do that. Does that change how you deliver chiropractic care or just how you look at chiropractic?

As far as the chiropractic care. I’m a little bit more careful who I provide that chiropractic care to be, I want to check everything out before I do some anteriors or do whatever I’m going to do, but no, it’s still the same old chiropractic care. In fact, I was telling my staff yesterday, the most important thing for us is what happens in the exam room.

It’s not so much what happens in the chiropractic. Because insurance companies don’t care if you do an anterior or they don’t care if you do, Hey, H I O that has nothing to do with them. They don’t give a flip. Neither do attorney. What they’re concerned with is what happens in the orthopedic exam, the neurological exam, the consultation, what am I going to do?

When I find the findings that I find them, I go to order an MRI. Am I going to send the patient off for a neurological consult or a neurosurgical consult? Those are all things that I picked up. And and I’m telling you, I probably am. I know that I am the number one refer of the. The MRI center here in town, and I never would have done that if I hadn’t taken the MRI courses through the academy.

I tell you, you walk out of those with a, you feel like you’re walking on a cloud because you know that, and that’s, what’s important. How has this equated to your bottom line finances and your. Wow. Yeah, we went from barely being able to pay bills to now. We’re buying land, we’re buying different things.

It has completely taken away the finances. And that’s really important because if that’s laying heavy on you, man, you can’t sleep at night. You can’t think everything every time you want to do something that pumps you in the face. And you’re looking at that instead of the amazing future that we all can have.

So did it make a change? Yeah, my wife loves me. Do you ever worry about getting a new patient again? No. It, that’s the fun thing about it is that you become really picky. If they don’t have a police report or if they don’t have something else, I just don’t wasted my time. I don’t take them and I don’t take the small accidents I’m going to, I want to focus in on those people who my credentials can help them all.

So it has made a world of difference with that. We had we had, and you know what, when people talk about December, they said December was a really bad month. New patients go down, collections, go down. I had my largest month ever last month. Crazy. If you don’t mind me asking how many new PII cases only did you get.

And that’s all I treat SPI. I don’t treat Medicare, Medicaid, blue cross, anything else? We had 76 new ones last month. And you attribute, so let me just connect the dots because it’s easy in your head. So when you thought the solution.

Your mind is a very dangerous place. It’s easy for me because I get the 30,000 foot view of you. It’s easy for me because I speak to you almost every. It’s easy for me because I’ve guided your your program, your academics your I’ve managed, how you’ve managed your practice only because I’ve done this for so long with so many people.

So you started looking for Colossus that didn’t work. The MDD, DC, that wasn’t the answer. Then you went back into your practice and just was adjusting your numbers went up because you became a chiropractor again. Then you started with the academics and learning about trauma. Patient management MRI interpretation connective tissue, pathology, spinal biomechanics, all the things that are vertically integrated with trauma care.

Cause that’s what your passion is. Then as a result of that, you started communicating and working. With medical specialists, not primaries, but specialists, orthos, neuros, neurosurgeon, pain management doctors ER, doctors, et cetera where you’ve got those relationships and they communicate with you because you’re talking about case management, slice acquisition sequences th the thin or thick levels of slices with MRI, how you’re triaging the patient.

When you’re treating a patient versus not versus a cord compression, a myeloma Malaysia, a accorded DEMA all these other different comorbidities that you’re now aware of, that you’re co managing with the medical specialists. And conversely, now, because of your credentials through medical academia, you will one of the first doc, one of the first three doctors in the United States.

To be certified as a fellow through medical school. So you are certified as a fellow in primary spine care through the state university of New York at Buffalo Jacobs school of medicine, office of continuing medical education and joint providership with Cleveland university, Kansas city college of chiropractic.

You’re the first of three to do that. So those are the credentials you bring to the. Now lawyers can use you. It’s just simple. It’s not, will they use you? What’s can they use you? And now they know they can bring you to the witness stand and you have no fear in doing that. Your reports, your documentation is pristine and your documentation is pretty easy right now because we worked on documentation.

Maybe. And we worked on diagnosing, being consistent with your care, your treatment and what this, what the complaints are. You’re practicing old time, chiropractic your patients come in and you adjust them. All of them. It’s just that doesn’t change. You’re adjusting them. It’s just how you manage them.

Change the little bit, how you doc. It’s become more thorough but easier. And now you’re communicating because you’ve positioned yourself in front of the referral sources, which is lawyers, medical specialists urgent cares, emergency. You turned down an emergency room to work with. You turned them down.

It’s just, it’s just too much. Could you handle another 30 or 40 new cases a month right now?

Yeah, please. God strike me down.

But no, but you know what, when you’re faced with the challenge, you just find the answer to the challenge. And so when faced with that, we would find just the answer and just, boom, go that way. I really believe my greatest years, my greatest advances, my greatest wealth is ahead of me because what I’ve, I have invested into myself the past eight years and I am excited about it.

It’s funny. We talk about dealing with medical providers and you chat with them. Why in God’s name, where they bypass physical therapists, which they’ve been used to do. For almost essential and not dealing with chiropractors. Part of that is getting to understand and communicate Blanchetts work.

And if you look at blanche, it Revard Dionne hog Johnson and steam straw in 2017 from the journal of occupation. Journal of occupational rehabilitation. I’m reading from a research article. They wrote that reported that medical care and did spinal related compensation, 12% longer than chiropractic and physical therapy requires.

239% more time to end full compensation versus chiropractic and physical therapy took 313% more time versus chiropractic to end partial compensation where medicine and took a 20% longer. In addition, we look at opiates and according to I’ll look up their reference in a moment, but it shows that.

But blah, blah, blah, blah. As a result of these studies and many others outcome-based studies have positioned chiropractic to be considered the best first line treatment, primary spine care provider for mechanical lesions Wheaton at Al. And that was in, let me see when we did that, we reported this in 2018 we’ve net out reported the annual charge per person filling an opioid prescription was 74%.

With chiropractic care versus medicine and physical therapy. They also reported the adjusted likelihood of filling the prescription opioid and the GC was 55% lower for the recipients of chiropractic care versus medicine and physical therapy. So all across the board, it’s just simple.

We talk about non-specific back pain. There’s a tool out there called SIM Virta and actually demonstrably show. Where the primary lesion is in the spine. So when we’re dealing with these medical counterparts and we share with them, what’s going on, there is no such thing as nonspecific back pain.

It’s very specific. Tim, have you ever had the opportunity to have that conversation? I haven’t asked you this up front of screens. You I’m just curious if you ever had that question with a surgeon or pain management about back pain being specific. There’s no such thing as non-specific. They don’t, they’re in, they don’t know.

And so for us to talk to them, it’s just totally out of the picture. And it, to them, it’s when we come in and talk, it’s a bright light for them. Cause they don’t know how to deal with it. Yeah. There’s here. Here’s the train. MD either primary or or specialist sees the back pain patient sends, sends them to the orthopedic surgeon.

First, they give them a prescription for payments, usually not opiate. Then they send them to the ortho. They do an MRI. There is no fracture, tumor infection or herniation, nothing. Give them an opiate seventh to physical therapy. Now we just read the research results that physical therapy really doesn’t work for.

Then they do a course of physical therapy. They go back to the ortho, gives them another prescription with a physical therapy, another prescription for opiates, then their physical therapy. That’s the second course of physical therapy. Now their benefits are exhausted. Now they go back to the peak of the orthopedic surgeon, doesn’t send them back to the PT for the third time, send them to the pain management doctor for legalized drug addiction to put them on something, to take care of their pain, to manage now.

Now what happens is for one or two or three prescriptions of opiates, they’re hooked. They cut them off because they’re in the system. Then they’d go to the emergency room. They were in the system, they can’t get opiates. Then they go to they’ll give them Robaxin or some nonsense. Metro those packs, none of those things work.

Then they go to the walk and medicals think they’re going to beat the system, but they’re in the national database. They cannot get the opioids. Now, what do they do? They go to the street? Here’s your answer ahead of Oxy on the street is about a hundred bucks. It hit of heroin on the street is 10 bucks both take care of the pain temporarily.

Where are they going to turn? And that’s part of, that’s a piece, not a big piece perhaps, but a piece of the puzzle of what’s happening in our society. So we actually play a very important role from the get, go on quelling, that opiate issue and the opiate addiction problem. But we answer what’s going on with pain and spine.

We should be prime. You just got a fellowship in primary spine. You’re a fellow and certified through medical school. You’re only, there’s only three doctors right now in the world. Who’ve earned that the program has just released a little while ago and knowing about what the requirements were previously, you started taking them a while ago.

So you, you were one of the smarter ones and your courses were accepted. Still having all of this prep, let’s talk about primary spiker because by the way, that is the solution to utilize. When we market, historically, when we market, we go to the public. You do health fairs and ads and leaflets.

What crazy things have you done? Because I’ve stood in. I stood in fairs and football fields in a booth with a crooked spine and handed out and pens. I never did a free chicken dinner, but I heard that was a big. Jim SIG foods to Manaca hill, Pennsylvania, CheckFree Quicken dinners spaghetti, last band that they came by the bus fall.

And I met Ziggy and I spoke to him and he said he adjusted 650 people that day from the bus, from the adjustment to the spaghetti dinner, the bluegrass band. That’s what he did. That was.

But those old guys were willing to stand up for what they believed in. Yes. And so are we, we’re not we’re standing up for something that not everybody’s for, not everybody’s for getting a fellowship from a medical school. I am because I want it to be the best of the best.

Here. Here’s the thing. And that’s a very good subject to discuss for a moment. What’s the difference in my office, but listen, I’ve been through the gamut of chiropractic. I saw 650 patients a week. I was ultra straight. I hate that term by the way, I even put I even put I took the electric outlets out of my office, so my colleagues wouldn’t have.

Make fun of me that I was a mixer, which is the stupidest thing in the world. Then I broke my back. I broke my back, treating patients to compression fractures, 650 patients is 1300 side postures a week. And I laid on the floor for three months. I couldn’t move. I was in agony and someone came over with two Advil and a stim machine and it was like, the devil incarnate showed up at my door.

I want them to throw them out. My wife said, you take these two out. And you put that machine on you. I can’t listen to you whine anymore, or I’m not going to help. I’m not going to take care of you. I had no choice and you know what? I put the stem machine on. I took two Advil and an interesting thing happened, the pain went away.

I could function. And at that point in time, there’s a word of Jewish called rock Mona’s rock Maness means the sympathy, the deepest of sympathy for the bottom of my toes, for every patient that I adjusted. That I could have held feel better along the way. And that really opened my eyes to, there was more than just an adjustment and every, almost everybody got better with the adjustment, but they could have felt better along the.

And then into, and then I started adding modalities and rehab to my office. And then I started consulting and I stopped practicing. Totally. I couldn’t adjust anymore. So I shut my offices down and they started doing consulting nationally. And I S and then my wife had got a diagnosed with cancer.

She had cancer three times. She’s fine now, but I had to find the right cancer surgeon for her. So I humped it from an I’m in New York. I went from Boston to New York, to Philly, to Washington. If you can’t find the right cancer surgeon between any of those four hubs, you can’t find them anywhere in the world.

We found someone in New York city in Columbia Presbyterian hospital, I called to make an appointment. They said, it’s going to take six months to get an appointment. Six months. I said, she’ll be dead by that. I’m sorry. The doctor’s full. Then I had to play the old game. Who do I know? Politics friends.

Favors you name it. I pulled everything I could, and it took me two weeks. I’ve got an appointment. The guy saved her life and that’s just the moral of the story. But she had some issues going along. We had to find the right hematologist. We had to go to Harvard. We had to go to LA. We had to go here.

We had to go there and all along, I couldn’t get an appointment and it dawned on me why aren’t our referral sources running after. Do I run after that cancer doctor and it had nothing to do. The fact that we cancer nothing. Tim, when you treat patients that you help them, you give them their life back.

They can’t function. If they’re in pain they’re, they can’t function and not, it’s giving people their life back. What makes Tim. He’s handsome. I was the former president of my state organization in politics. You have a wonderful person, none of that matters. So what I realize it was credentials and knowledge.

And why do I want to tap into the public where we’ve been perpetuating for decades almost a half a century. I think since this statistic was matter was maintained. Why do I want to fight for 7% utilized? Or even 10%, I want to tap into the medical community who sees 99% of our society. So you, without giving up your chiropractic identity, you adjust every patient that comes into your office.

All you’ve done is learn how to better diagnose triage and manage your case. By understanding that when you have a ligament, that tear is what we call a sport. Collagen any last dinner in there, the micro th the fibroblasts activate after puberty, they can no longer produce elastin, only collagen. And now that tissue grade is weaker.

It’s stiff. And it creates joint laxity. And now that person’s going to have a perpetual problem and through Wolff’s law, the bones are going to degenerate and remodeled based upon the PA’s have electric effect. And if the bone’s remodeled, your patient’s gone from corrective care to patient now. And understanding thin-slice technology.

You could acquire an accurate MRI interpretation and understanding the relationship between the desk, the court, the root, whether there’s inflammation in the cord or bleeding up to Marla, Malaysia, or any type of court Aquinas issue, you can now have that relationship and conversation with the surgeon will say, you’re the guy I want to manage the case.

Now, Tim, how many referrals do you get from the medical established? We get, I get probably four or five, six times a week from the urgent care, so they don’t know what to do with the people neurosurgeon sending people in. So it has completely changed how I practice with that too. They’re looking they’re really looking they’re really good.

So they’re between a rock and a hard place, and they’re looking for help to so they’re looking for somebody who can help them with these cases that they don’t know what to do with them. And that’s where we jump in with our knowledge of what we have. It’s amazing. It’s an amazing way to practice.

Yeah. It’s. Fred barge years ago wrote a book practice without fear, something along those lines. It was about understanding, having belief in the chiropractic adjustment, which you do. And I do we’ve lived with it. We both been doing this for 40 years. We both graduated the same year 81.

We’ve been doing this a long Laura, 20, 41st year doing it a long time. Age gives us perspective. We see where the profession has been. And I spend every single day communicating with doctors in 49 states, not 50. I can’t get North Dakota for some reason with lawyers. I speak to people every day and I do a serious amount of market research.

And you are the most. For what needs to be in our profession, because you don’t give up your chiropractic identity, you don’t, but you don’t talk about that identity. When you go to a surgeon, they don’t talk about their let’s see, I do a double trend DeLeon. Triple blade Schick incision on the, they don’t talk about their technique, but I’ll talk about their philosophy.

If you have a tumor, would the, just send them to us, we’ll diagnose it and see if we can treat it medically. If not, we can take it out. We’ll get. We’ll see what we could do. You want to go alternative that’s up to you, but you want to come to see what I can do. Same thing with you, Tim, you have there’s patient as a pain.

I identified it. It’s not nonspecific. I’m going to get a thin slice MRI and identified. If it’s, if there’s nothing I can take care of, it’s going to go right to the. ’cause let me tell you if the significant quarter compression and suing Laura logical, Def is a discipline level of leisure. That’s a myelopathy, and that patient belongs in a neurosurgeon’s office.

We don’t treat everyone and everything. And when you’re part of the team and the medical community, you know what, you can take your philosophy, which means the study of truth. By the way, according to the late Frank Zali who shoved that up my nose, he said, philosophy is the study of truth. Dr.

Student study the truth. The final word, and Tim will let you get the final word after this. The final word is the truth. You can sit in your office on your high horse, as my father would say, pontificating about how you’re the most philosophical you’re the most, this year, the most that on your small practice, because you can’t get enough patients or you can have the exact same treatment in your office.

And be collaborating with all these doctors because you’re smarter. You’re, well-credentialed, you’re tapped into that 99%. And you had 76 new patients in December. If I said you could take another 20, 30, 40 cases, you said, yes, you’ll figure it out. You ain’t figure it out so quickly.

You’re going to need a whole lot more help. But the point is you can do the same thing on more patients than lesbian. That’s it, same thing on more than less, only by becoming smarter and formerly credentialed. That’s how you save the chiropractic profession. That’s how you add chiropractic colleges and more students in there because it’s all hands on deck.

You need a lot more chiropractors in your pipeline, in your offices. I’m going to give you the last word before I thank ChiroSecure. To me, it’s again, and it keeps saying that you’ve said it before Mark being the best of the best. And I don’t care how old you are. People say I’m 65.

That would take me five years. I’m going to be 70 and you’re going to be 70 anyways, you might as well do it, but just step out of the boat and do this. And Mark, I’m telling you. 70% of my patients have never been to a chiropractor before, in one of my past lives. I was a pastor. I don’t know if you knew that Mark, but I would say we, we had church growth this past month and it was people hopping from another church into my church.

And then from this church, that’s not how we are. We don’t have. People who have been to chiropractors. And now they’re jumping into our boat. There’s 70% are brand new, never been to a chiropractor before. That’s what I want. That’s the audience that I want to go after and you can do it too. You just got to jump on.

Tim. Thank you so much. It’s it’s been great. And again, I’d like to thank ChiroSecure for giving you this platform, because my goal, we love chiropractic and we want to increase utilization and help people that have never had access to chiropractic at all. Because if they’re not in your office, What can you do nothing when they’re in your office, do whatever you want, practice, how you choose it.

Doesn’t matter. Get smarter, get credentialed, increase your practice. Increase your income, increased chiropractic utilization again, ChiroSecure. Thank you very much. We’ll see you next time.