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Hi, I’m Dr. Mark Studin, and first I’d like to thank ChiroSecure for the opportunity to share this information with you. Today we’re going to do something a little bit different, and I’m seeing a significant shift in our industry. We’ve caught up to where medicine and all the other professions have been to, but we’re With respect to a significant trend.
So let’s get right to it and go to the, and go to the slides. Now, with respect to that if you’re watching the the slides on the side, you might see me turning my head just a little bit. That’s me changing the slides. But when we look at the first slide, we’re going to go, competing.
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And the answer, by the way, is corporate chiropractic. So when we look at corporate chiropractic, we’re looking at competing in 2024 and beyond, and corporate chiropractic is here. And I’m starting to see it on my side of the industry with a lot of the doctors that I have, with looking at where doctors are shifting their focus.
But you have to understand the history and the history is, years ago, maybe a decade, medical doctors started with hospitals, going hospital based. And then the corporates came, and then they went corporate based. And corporate medicine has been around, really since the 1800s. It’s been around a long time, where corporations owned doctors and what they did, and in the 20s and 30s, it started to become more of both.
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But over the last 10 years, it’s really become prevalent. Then dentistry followed and I have a lot of friends who are dentists in my community, my region. There’s hardly a private dentist anymore. They’re all corporate. Almost all. Then podiatry and my sister in law is a podiatrist and I see what’s going on in her industry, again, all corporate.
And one of my dearest friends is a veterinarian. They’re all going corporate. So why would it leave chiropractic out? It hasn’t, and now it’s our turn. So when we look at it, they’re starting to infiltrate chiropractic and it’s just starting at a very high level. probably over the last year or two.
And I’ve had the fortune of speaking with COOs and corporations bringing chiropractic in about five different states right now, one specifically of multiple different states, and I’m starting to see doctors move over. Now, why do they bring chiropractic in? Are they really interested in turning life on, the vitalistic energy?
They could care less. They could care less. But they also don’t care how you treat your, how you treat your patient or why. Here’s what they do. Corporate will come in with a hedge fund or private equity group behind them with 5, 10, 20 million dollars in revenue to spend to build these entities, these facilities.
But really it’s about the technology. They will bring in highly credentialed surgeons. And they’ll probably overpay just a little bit for them. But what they’ve done is they’ve needed a lot of mid levels, nurse practitioners and physician’s assistants. The PAs are relatively useless. They’ve got a bachelor’s level education, but the nurse practitioners in the physical medicine world really don’t have a lot of training or experience.
It’s more a family practice, midwifery or surgical assistant, but not in the musculoskeletal world. They’ll come in, they’ll do evaluations and do some trigger points if they need to, and that’s about it. But then they looked at chiropractic and they realized, in the musculoskeletal world, we’re highly trained.
But we also, should they not need surgical, they want us to get them in to do those evaluations, the mid levels we’re doing. To do the work of the nurse practitioners or the PAs and screen for the surgeons or the pain management doctors. That’s what they look for. Neurosurgeon, orthopedic surgery, pain management, anesthesia, that’s their big ticket items.
Imaging, who refers in, we have the ability and training to do that if they don’t need surgery or pain management or any of those specialized procedures. They don’t care if we treat them. They’ll make more money on our repetitive care regardless of the reason you’re bringing them in. They could care less as long as the referrals are getting over to the surgical group when clinically indicated.
And they don’t want you to do something that’s not clinical. And they’re making a lot of money because they’re saving millions in each individual practice on not using the mid levels, the nurse practitioners and PAs. replacing that with chiropractic, bringing in the whole chiropractic practice when you sell out to them.
And by the way, a lot of corporates are not paying you for your practice. They’re giving you a salary with a little bit of a bonus on productivity and they’ll give you a piece of the pie at the sale. That’s the carrot. That’s the carrot. Whether it happens or not, who knows? But they’re giving you what the possibility and a great top number could be when you walk away with millions and that rarely happens.
But if you get enough, and I’ve seen some fair deals and I’ve seen mostly horrible deals that are one sided, so be careful, but nonetheless, it’s here. But the real issue is, how do you compete with that? But more importantly, here’s the corporate argument as to the benefits. There’s stability and security.
You’ve got steady income, you’ve got a benefit package, reduced administrative burden, focused on, on just the healthcare, whether it’s medicine or chiropractic, and legal and regulatory support so you don’t have to look over your shoulder all the time. You have predictable hours. Where you work, life is balanced, and you have a leave policy in case you want to take a vacation.
There’s professional development. They include continuing education. There’s mentorship with corporate and collaboration with other doctors in the group. You have access to resources that you can’t afford in an individual practice. There’s a Tremendous amount of technology, which we’re going to talk about in a little bit.
And you can do a little bit of research because they like to get their doctors involved in research. There’s no overhead. You reduce your financial risk. There’s no overhead. You have job security, clear career path. You have, they’ll give you a level for advancement. You produce this much, you’ll get that much.
You have a structured environment. There’s a network, an influence. You have a professional network. of working in certain hospital groups and other large groups. And you get to influence the policy of what’s going on with respect to what you do. You have consistent patient flow because people are feeding patients into you.
Marketing and reputation management, brand recognition and online presence. Some of these companies are spending 100, 000, 150, 000 a month just for online branding. So there’s a lot of benefits. The downside, you’re not your own boss. You’re punching a clock and your income ability is usually a lot lower than if you were on your own, but you get rid of a lot of the other stress, a lot of the other stresses.
And most of the doctors who’ve gone corporate really it’s because their spouses have pushed them out of their office. They wanted to make up with that. That’s been my experience. So that’s not the total truth, but that is what that is the truth of my experience. But I don’t know if that’s the truth of the industry.
But I can tell you that there’s a lot of upside, but there’s also downside. Would I go corporate? No. That’s just the bottom line. I wouldn’t do it. But for others maybe it’s a good option. Maybe it’s a good opportunity. Maybe you’re not a good business person. Maybe you’re just a great healer.
You know how to adjust patients. There’s a lot of benefits for some people. And for others, no. But for those who would not go corporate, you need a pathway. You need to compete against corporate chiropractic in 2024 and beyond. Because if you can’t compete against it, which requires technology, there is mandatory technology to compete in corporate chiropractic.
And by the way, this is not about personal injury cash, managed care, it’s not about finding a better mousetrap. You’re going to work in a corporate environment that’s top heavy medical down, and that’s where you’re going to be. Once it gets to you, hopefully you’ll be able to function as you choose in their game of technology and how they choose to see you.
But here’s how to compete with big businesses. Various technological applications are essential for lowering costs and increasing productivity. To remain competitive against larger corporations, you must choose between significantly increasing your staff, upgrading your technology, or accepting a contraction of your practice.
Maintaining the status quo is no longer an option in today’s rapidly evolving marketplace. Even just to stay where you are, there’s things you’re going to need to do, and you’re going to need to increase your staff to do it, or increase your technology. Those are your choices. Now I want you to know that I looked at that carefully, and I’ve spent the better part of, actually I’ve spent all of 2024, and about half of 2023, So it’s been almost a full year looking at this issue and looking and researching and checking the marketplace.
And I found that within chiropractic, with respect to billing companies, the EHR companies, no matter who they are, the biggest in our industry, and many of them have gone corporate and many are going to go corporate, can’t support the needs to compete. with big business, with corporate chiropractic. They can’t do that.
Even the largest EHR system in our industry just recently went corporate within the past two years. They dropped their support staff in half and doubled their marketing staff. Just want to suck as much as they can out and I’m getting calls every single day. And the second and third largest ones are poised to sell also and do the exact same thing.
Probably sell to the same company. So you’ve got to be careful about what’s going on and take a good hard look at the industry. So here are the tools required and it’s about economies of scale. So you need digital tools. Digital tools to use for your business. Digital tools. Now, I have to share with you, I’m sitting here in front of four computer screens.
I have two main servers. I deal with a tremendous amount of technology. Even to send an email. I spend close to 100, 000 a year for that one tool. So it’s expensive to really stay competitive with a corporation, including corporate chiropractic, a corporation who will spend, we’ll put 20 or 30 million in to gain market share.
So you have to reduce, and here’s what economies of scales mean. You have to reduce the per unit cost. to increase the profits so you could grow your business and your business credibility, your reputation will improve and increase and the improvement existing processes meaning that if you have more people doing the same thing and in corporate chiropractic it’s the chiropractor, the PT, the acupuncturist, the orthopedic surgeon, the neurosurgeon, the pain management doctor, the anesthesiologist, all of these things are using the same systems.
And that’s economies of scale. And that’s important. So you need to find the same thing. And it has to be cost effective. And in our industry, you could find all of those things splinter. But even if you go to some of our programs, they charge you piecemeal, they nickel and dime you. And at the end of the day, you are spending a lot of money.
And that’s really important. So when we look at it, here’s your technological requirements. And I put I believe, I have 11 or 12 up here. So here’s your requirements. Number one, you have to be visible. So to maintain your visibility and to remain competitive against larger corporations, you must choose between significantly increasing your ZAP, upgrading your technology, or accepting a contraction of your practice.
You have to automate the sendings of your reports to MDs and lawyers, or you’re going to have a staff to do every single one, whether you fax, email, hand deliver, snail mail. It’s time consuming. You have to automate those things. And there’s technology which can do it by you setting it up once and then it goes.
Always for every eval, re eval, it’s sent. That’s number one. Number two you’re verifying or qualifying insurances. You have to automate insurance verification before your patient comes in. No phone calls. If you’re not qualifying that insurance with a verification, that person could come in, that evaluation procedure can end up being pro bono for free, because they might not have benefits.
So you need a system which could go to the insurance company’s computers. Without picking up the telephone, because you’re not going to get through on a timely basis, where someone can real time click on, look at Blue Cross Blue Shield, look at Cigna. Look at Kaiser, look at all of these things and go into their systems.
This is expensive, but if you don’t have that, you’re going to be treating or bringing in populations of patients which have horrible insurance, only to find out too late. You need a patient portal, and that’s just a given. You go to a hospital right now, they all have patients, almost all have patient portals.
It’s really important when the patients have the ability to schedule their appointments. Your front desk staff does also, but you know what? I have a horrible history with kidney stones, so I visit my urologist on a regular basis. And he’s in Mount Sinai Hospital in New York City, which is the number one hospital system in the largest city in the world.
No matter how much staff they have, I can’t get through without having a 20 minute hold. That’s a horrible thing for any industry to have, a 20 minute hold. But you know what? I go on to the portal, I went to my appointment, and I changed it. It took about a minute. It was easy. It was simple. I felt good about that.
I feel good about being there and having control about that. So they find that the automation of the ability to schedule appointments is a very user friendly, patient centered process. And patients love that control. And it has less missed appointments because it’s done real time where they could change it.
And they’re very happy. Then in addition, there’s automatic text reminders. I get text reminders for every single appointment. Everything. You need that. It’s important and there are places, there’s one company that does it and they charge three and a quarter or three fifty a month.
Automatic text reminders. It’s great. Okay. It’s what you need. I have someone who has, I have a really good, this is what I heard yesterday. I have a really good person. She’s a 20 something year old, really tech savvy. She takes our 50 visits for the day and cell phone, cut pace, takes her 20 30 minutes.
She’s done and she reminds every patient for the next day. What if she gets sick? What, why are you spending 20, let me get the calculator out. So watch, we have someone who’s making 25 an hour. It takes her a half an hour of practice day to do that. So that’s 12. 50 times 4 days a week times 52 weeks a year.
I’m spending 12. 50. 2, 600 a year on something which can be automated and cost nothing, or even if you use those expensive services. It just doesn’t make sense. So you have to increase your step, but you have to do this to stay competitive and it makes people feel good. Next is integrated technology.
You have to integrate all facets of care and communication between the doctor and the patient or doctor to doctor or doctor to lawyer. And all of that, and that comes with the automated setting of reports. The ability to communicate to patients. You also need, with seamless integrated technology, creating a seamless revenue cycle management for unpaid claims.
How do you know when your claims are not being paid? Is it personal injury? Is it managed care? Is it cash? Am I doing good here? Am I doing there? You would need insight to the financial health of your practice. People think, oh, it’s statistics, big deal. People believe in you throw as much as you can against the wall.
If the money sticks, you’re good, you don’t need to go beyond that. That’s absurd. That’s beyond absurd. And the next thing you can barely pay your bills. The next thing you’re working crazy hours. And you’re behind, and things aren’t working. Or you’ve got a staff member not doing their job.
Most people, by the way, should, I believe everyone, should outsource your billing and collections. There’s too much going on. You need too much automation. And that’s critically important. And we’ll talk about that in a moment. But your reports need to be integrated. Your documentation needs to be integrated with your billing, which needs to be integrated with your ability to communicate.
This is what corporate chiropractic is doing. And they’ve got the systems to do that. They’ve got the systems to do that. Automated, so automate social media reviews and build a strong online reputation. Folks, you need to be able to control your reviews. You don’t want patients to put a one star review out there and a terrible comment about you.
They’ll do it on, they should be able to do it on your portal and you should be able to determine what goes on to the review sites. So there are systems that allow you to do that and they are exceedingly costly, exceedingly. So you need to have control over that. And they’re, and corporate America, corporate chiropractic, they have those systems.
You need those also. And through economies of scales, you can get that. You need also the automated scrubbing of claims before your submission to carriers. Let technology cross check your claims against known insurance rejections and maximize first pass claim submissions. Look for cross coding edits. You need to know what that is, as well as proper modifiers.
There are systems to do that, and you need the technology for that. If you’re just billing in your office and sending it out, where’s your staff trained? Are they part of the AAPC, the American Academy of Professional Coders? Does your system have the ability to cross check these things? It’s really important.
Computer to computer resolution of denied claims. To automate first pass payment of claims, your system has to have access to all records so that your computers can retrieve required elements for satisfying the carrier’s bot denials, their computers. And this goes in with number seven of scrubbing the claims.
So it needs to be computer to computer communication by giving people. This has to be a little bit of human interface, which is why you really should have a professional billing company so they know how to get all this information. Use technology to be able to resolve that quickly. Because you’re not going to be able to sit on, it used to be when I was in practice, I’m in the game 43 years, 10, 15, 20 years ago, we could resolve 8, 9, 10 claims a day, now maybe 1 to 2.
Because you’re talking to computers all day long. It’s crazy. In office communication. An automated system at the front desk that communicates with the doctor in the treatment rooms for the next patient. Or a piece of information about the next patient. You reduce waiting time. The person’s upset about something.
You’ll know about that before they walk in. Patients like that. It’s patient centered. It makes them feel good. It just is, it works all the way around. It takes the stress off of you, your staff, and your patients. To know what’s going on around you at all times. So there needs to be a system for that. And all of it is a technological requirement.
Seamless notes in a fraction of the time. You invest in an EHR system, specifically programmed by chiropractors for chiropractors, that’s intuitive, integrated, and engineered for certain notes to be completed in under one minute to increase production and reduce documentation time. Folks, the reality is there are programs out there that are specifically engineered and enhanced.
By chiropractors, for chiropractors, not a programmer. And it’s out there. So most people tell me, Oh, I’m spending weekends in my office, hours after patients, just getting the stuff in the system. You should be able to do it real time. And there needs to be guardrails. There needs to be compliance and reimbursement guardrails.
That’s important. Wait, got to take a sip of my Dunkin coffee, wet my whistle. Notes that have compliance and reimbursement guardrails built in. and updated for you. A system that knows future trends of carriers to prevent audits, lawsuits, and claim denials. There are, there’s technology that does that, and you need to be tapped into that technology.
And last, and certainly far from least, is AI ready. AI is here. There are companies that I work with that are already AI ready, and not splinters, fully integrated, huge companies. I’m working right now with a company that’s close to a half a billion dollar company. Actually it’s publicly traded. It’s more than a half.
It’s a multi billion dollar company, but they’re AI ready. They’re ready to release in a fully integrated system. And when you just walk in, you chit chat with your patient, it gets rid of all the banter. It knows what banter is and it knows when it talks about a foraminal compression. It knows when it’s talking about reflexes.
You talk through that and how are you doing? How are the kids? How’s this? All of that is filtered out Automatically you walk out of your treatment room into your office. The reports written for you in perfect English. It’s already done. It’s here So those are the next steps folks. That’s what’s coming.
That’s what’s not coming down the pike. It’s here That’s what the corporate chiropractic has. There’s a lot of systems out there Medicine has had them for many years and they’ve had more money to invest You Chiropractic can now take care of those systems. I’ve been working with a company on the medical side for years.
Let me rephrase it. I’ve been working with a company who’s been working independently from me on the medical side for years. That develops this, that goes into hospitals and large medical groups. All of this is there. Chiropractic is trying to recreate it. So I’ve tapped into what’s there and through economies of scale and using my knowledge of chiropractic, I’ve able to create in a.
In a cost effective way for you to tap into all of this stuff. So you need to have and understand all of these things to be able to compete and take advantage of those systems. So before we pop out of the screen, take a picture of this QR code. It’s going to bring you to a passworded site, or by the time you look at it, maybe not passworded, but Call me if you have any questions.
I’ll be happy to talk this through with you. I’ll talk about your office, but this is where you need to be to compete with corporate chiropractic because it’s here. So folks, listen, I’d like to thank you for sharing a few minutes with me. As always, I am so appreciative of ChiroSecure to be able to give me this platform.
I love working with them. It’s a great hands on company. I really don’t talk a lot about them, I’ve been in the game a long time and I’ve seen the good, the bad, and the ugly. And I’m just honored and privileged to be able to even mention their name. And I’m happy to share this information with you.
Thank you so much. And we’ll catch you next time.
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