Practice-Building Advice from the American Chiropractic Association

In 1984, the American Chiropractic Association (ACA) published a 500-page book called Developing a Chiropractic Practice, which covers almost every conceivable aspect of opening and managing a chiropractic office. The book was written by R.C. Schafer, DC (a former ACA Director of Public Affairs) with help from an editorial board that included the president of the ACA Council of Delegates, an ACA board members, and faculty members from seven chiropractic colleges. Its preface states that the book was designed to enable senior chiropractic students and recent chiropractic graduates “to make a smooth transition from the purely clinical sciences to applying this knowledge within a small business environment.”

The book’s twelve chapters cover establishing a chiropractic career; getting started; basic office policies and systems; financial management; office economics; human relations in professional practice; patient education and motivation; getting known within the community; insurance relations; chiropractic jurisprudence; management of paraprofessionals; and personal money management. The advice is generally straightforward and sensible. In fact, many members of other health professions (and their patients) could benefit from some of the details on how to communicate with patients. However, the section on practice philosophy in the chapter on patient education and motivation includes questionable advice on how to turn the office into a “referral center”:

Impress your patients with the results they have realized. When a patient mentions how well they are feeling, learn to expand on this. It will help the patient learn to vocalize their feelings. If they can testify before you and receive an enthusiastic response, they will be more inclined to testify before others. When patients feel better, they want to tell others but may be timid in such self-expression. You can help the patient overcome this reluctance by being a good sounding board and offering subtle responses that will give the patient some key words that will help him express his feelings in words. The patient will automatically incorporate them into his story when it is repeated.

Take the initiative to suggest chiropractic health care when anyone mentions a sick or disabled friend or relative. When patients tell of a sick friend or relative, give them some appropriate literature on the subject that they can pass along. You will be assisting the patient to be a helpful friend. Rest assured that the patient will mention where they received the literature.

Have a system of motivational communications. Use office communications freely such as appointment reminders, thank you cards, follow-up letters, handout literature, and congratulatory notes to reinforce your interest and concern.

Suggest to patients that they mention chiropractic to their friends, relatives, neighbors, and associates when patients are at their peak of enthusiasm.

Change just for the sake of change can be a motivational factor. Periodic changes in office decor, furniture arrangement, routines, professional attire, and so forth, indicate to many patients the office’s attempt to keep “up to date.” They also tend to stimulate staff attitudes.

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