Money in your practice

A dollar saved is a dollar earned
Anthony Lombardi
September 25, 2017
Written by
Rising chiropractic association fees, dramatic hikes in minimum wage, and the elevation in inflation are only some of the factors that negatively affect our small business practice.

In a business world where the only constant is change, we need to find the golden nuggets hiding under mounds of proverbial coal. I’d like to share five things that will make your practice more profitable by simply saving money.

1. Point of sale (POS)
In recent months, the Canadian government has structured laws to prevent POS companies from changing your contract and terms of agreement without your knowledge. This was a common occurrence among POS firms and I myself experienced that.

In March, I discovered a Canadian POS firm that broke my contract with my previous provider, waived all fees, and on average reduced my bill from $1,100 per month to $582. For the past seven months I have continued to save an average of 45 per cent on my POS bill. I am not affiliated with this firm and I declined to be a part of any referral program. I’m simply telling you this because my savings have been significant and I have found a way to save $500 per month. Please email me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it if you have any questions.

2. Hire staff and save
Without a doubt, in light of the recent government changes to minimum wage, it seems unlikely that a program would exist to help the employer. I’m happy to say I have found a government organization that helps the employer. For over 80 years, Goodwill Inc. has assisted individuals in overcoming employment barriers by offering services that meet or exceed the expectations of our customers. Translation: Goodwill will help you find the solutions to your employment needs, and they will pay for at least 50 per cent of your employees’ salary for the first 10 to 12 weeks. I have used this program myself and it is the real deal. Contact them at goodwillonline.ca.

3. Text your way to savings
In what is an emerging research topic, the available statistics on missed appointments are staggering. The cost of missed appointments to the U.K. National Health Service (NHS) has tripled since 1999. In 2009, non-attendance was estimated to cost over £600 million (around US$970 million).

Since 2012, we have used text message reminders in my clinic to remind patients of their appointment the following day. Today, almost 97 per cent of all patients receive text message reminders and our no-show rate due to forgetfulness is nearly zero. It takes five minutes to remind 50 patients and it costs me about 65 cents in labour to do it. If it saves one person from forgetting an appointment then it is well worth the investment.

I also use my smartphone to notify the front desk when to put the next patient in the room, saving me the time to walk over the front desk.

4. Education videos
In 2012, Maxine Gignon et al published a paper in BioMed Central that examined how and why doctors should use their waiting rooms to educate their patients while they wait. The authors concluded that the waiting room “was a useful vector for providing health information.”

In my office, I have a continuous 1.5-hour loop video that delineates our clinic services and demonstrates treatments like the chiropractic adjustment and acupuncture. By doing this, I prime the patient for when it’s their turn in the treatment room, and the videos “break” any apprehensions they might have or what others may have told them.

I find the presence of these videos have shortened the necessity of spending additional time explaining things in the treatment room. My video education does not stop there. On my Hamilton Back Clinic YouTube channel I have more than 75 demonstrative videos to educate and inform current and prospective patients. Patients would much rather watch a short video than read a few pages of text from the computer screen.

5. Assessment saves time
The conventional assessment of musculoskeletal injuries has traditionally been performed in a vacuum. A chiropractor treating a patient with elbow pain typically performs elbow orthopedic testing, while a patient with low-back pain undergoes an exam that focuses on straight-leg raise and sacroiliac joint tests. Conventional assessments are not only unreliable (Jensen, 1994, Cadogan, 2011, Contant, 2003) but they take far too much time, which means less time is spent on treatment. Planning how one approaches the musculoskeletal assessment is key in being efficient with your time. Using a consistent approach will allow more hands-on therapy time with your patients, which will yield fruitful results. Becoming more efficient at achieving quality clinical results will generate more referrals and more revenue in much less time.


Dr. Anthony Lombardi is consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic in Hamilton, Ont. He teaches his fundamental EXSTORE Assessment System and conducts practice-building workshops to health professionals. Visit exstore.ca for information.


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