practice management seminar - doane online …...– “on a scale of 1 to 10, 10 being someone who...

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© 2014 Doane US/Doane EU, 18870 8th Ave NE, Poulsbo, WA 98370 Shall not be copied, duplicated or distributed in any form or to be used for teaching without prior written consent of Doane US and/or Doane EU.

PRACTICE MANAGEMENT SEMINAR

Robert Doane, EAMP, L.Ac. Owner, Acupuncture & Wellness Center, P.S.

Fellow, American Academy of Pain Management

find us online:

doane.us doane.eu


Overview of the Course

•  Morning – Successful Aspects of a Practice – Protocol Video Samples – Q & A

•  Afternoon – Medical Aspects of a Practice – Protocol Video Samples – Q & A

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Successful Aspects of a Practice

•  The 3 honorable motivations for entering the field of Chinese Medicine

•  Importance of Pre-payment for Long-Term Care

•  The Five Day Report of Findings •  General Tips on Running a Practice


The 3 Honorable Motivations

•  The 3 honorable motivations for entering the field of Chinese Medicine – 1. To help as many people as possible – 2. To master the medicine – 3. Making a decent living for yourself and your

family

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Pre-payment for Long-Term Care

•  Key: Commitment to health –  Need placebo effect (Western Dr.’s have it already) –  Positive attitude –  Money & Ethics –  Saves clinic time & money –  Saves patient time & money –  Improves patient flow –  Estimate treatments (give more if need to) –  Refundable –  Pay as you go patients = dabblers


The Five Day Report of Findings Protocol Overview

•  Day 0 – Free consultation/Free visit to the clinic

•  Day 1 –Medical history Intake; Establish Chinese diagnosis; a frank and honest discussion of the patient’s current state of health

•  Day 2 – Thoroughly explain Chinese Medicine to the patient; clear up the energy misconception; 1st acupuncture treatment; have patient take home a form to record how long the effect lasted and to mark down exactly what problems they want addressed in a treatment plan

•  Day 3 –2nd acupuncture treatment; if patient responds well, develop a treatment plan to address their main complaints “both relief and stabilization care”; have the patient commit to their treatment plan; if results are unsatisfactory, treat 1 more time and wait till Day 4 to present a treatment plan

•  Day 4 – 3rd acupuncture treatment; develop a treatment plan to address their main

complaints “both relief and stabilization care”; have the patient commit to their treatment plan

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The Five Day Report of Findings Day 0 – Free Consultation

•  Length of visit: Approx. 15 minutes •  Have patients fill out short information form

– Have them mark down some of their problems – Do a Chinese Pulse Diagnosis

•  Show them the clinic – Treatment rooms – Needles – Herb room

•  Have the patient commit to 4 visits



•  Need to make a good impression – Schedule them to come in when the clinic is busy à Psychological effect

– Look professional – Make sure office looks nice and clean

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•  Commit patients to the next 4 visits – Tell patients that you need 4 visits to determine

their “rate of response” – 1st visit: No treatment, consultation only

•  Unless they are really in pain or live far away – Check their insurance for them

•  If no insurance, give them a major discount – Have patients schedule and pay for all 4 visits in

advance


Video Lecture Protocol Day 0

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The Five Day Report of Findings Day 1 – Consultation/Health Intake

•  Length of visit: 1 to 1-1/2 hours •  Comprehensive Health Intake

–  Very thorough paperwork needs to be used in order to document patient’s symptoms & health history

–  Visit used to establish their Chinese diagnosis •  No treatment

–  Exception: Patient is in a lot of pain or lives far away •  Goal of Day 1: To challenge the patient about their current state of

health (health denial) –  Patients need to “admit” and face their health problems in order

for them to realize that they have to do something about it so they can live a healthier and longer life


The Five Day Report of Findings Day 1 – Consultation/Health Intake

•  Crucial question to ask after patient realizes their health issues –  “On a scale of 1 to 10, 10 being someone who will do

anything, go anywhere, pay anything to get better, where are you on this scale?”

– You want to get a “10” from the patients •  Committed to taking care of their problems

–  Patients who say “6 or 7” will be difficult patients •  Might not follow through with commitment •  More skeptical •  Many times the reason for low rating is money issues

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The Five Day Report of Findings Day 2 – Education

•  Length of visit: 1-1/2 to 2 hours •  Schedule a group of patients for this visit •  Goal: Educate patients on TCM and how it

differs from Western Medicine (WM) •  Explain Chinese medicine from a biomedical

perspective – Donald Kendall’s “Tao of Chinese Medicine” – Makes TCM more scientific and credible



•  TCM vs. WM – Same physiology – Same anatomy – Different focus

•  TCM: Health-based medicine – Improve quality of life

• WM: Trauma-based medicine – Decrease morbidity

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•  Western medicine – Based on Greek system – Started around 1200s

•  Average life span during that time – 30 years old – Generally were called to treat the dying

•  1300: 1/3 of people died from the plague (over 30 million people)

– Focus: Diagnosis and treatment of serious diseases



•  Western medicine – Run tests to see if patients are sick

• Often tests come back normal, so Dr. tells the patients that they are healthy, even when the patient feels terrible

• WM tests are skewed to detect serious illnesses, not for detection of patients who do not feel healthy

– WM is a medicine to save lives, not to promote health

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•  Chinese medicine – Started about 3500 years ago

•  Average life span of the ancient Chinese: approx. 60 years

– Best doctors worked for the royal family – The focus of the medicine was to increase the

life span of the Emperor



•  Chinese medicine –  Four main concerns of Chinese medicine;

•  Flow of qi (oxygen) •  Flow of blood and ying qi (nutrients) •  Organ function, especially the Heart, the emperor organ •  Function of the nervous system

– Health in Chinese medicine is highly oxygenated, highly nutritious blood coursing through the body.

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•  Practical explanation of Chinese medicine •  4 main concerns: qi, blood, organ function, nervous system function •  If all 4 are functioning properly, patient is very healthy •  If there is any stagnation of qi and blood flow in the body a

malfunction begins to occur, usually at the cellular level •  If this problem is not rectified by increasing blood, nutrient and

oxygen flow, the malfunction progresses to a disease process growing in the body

•  If the disease process in not fixed by increasing blood flow, the disease process results in chronic symptomology

•  This is the condition of most patients – symptoms that simply will not go away

•  The main thrust is Chinese medicine is to correct any reduction of blood flow in the body due to organ malfunction or vascular inefficiencies or restrictions


•  WM -for the most part- is treating symptoms and then hoping that the cause of the symptom somehow “magically” goes away

•  Chronic symptoms are managed; any hope of cure seems to have been forgotten about

•  CM – for the most part- is treating what we think is the root-cause of most chronic issues; we treat this root-cause and then we hope that the symptom somehow “magically” goes away

•  If the tissue damage is extensive, then even coursing more blood/oxygen/nutrients into the damages area will not fix the problem; surgery then becomes a viable alternative


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•  Chinese medicine –  #1 etiology of TCM: Blood Stasis

•  Vascular functioning decreases as we age – Decreases to the point where the body no longer heals

itself –  Body loses its ability to heal itself b/c all the healing

agents of the body are found in the blood, but the blood is not circulating to the injured area

•  TCM helps increase vascular blood flow to the point where the body regains its natural healing ability

– Major symptoms often disappear –  Chinese medicine is truly a health medicine –  Western medicine is a trauma-based medicine


Video Lecture Protocol Day 2

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The Five Day Report of Findings Day 3 – 3 Phases of Care

•  Day 3 is also done as a group session •  Explain to the patients the course of treatment

and the 3 Phases of care: – 1. Relief Care – 2. Stabilization/Corrective Care – 3. Maintenance Care



•  Phase 1: Relief Care – Symptomatic relief – 90% of the time, problems will come back

when the treatment stops – Treatment: 3 times a week (1-2 months) – End of Relief Care: Patients tell you that they

feel 90% better in more than 2 of their consecutive visits

•  Relief of major complaints •  Vascular functioning is above the 30% level

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•  Phase 2: Stabilization/Corrective Care –  Increase the blood flow from the 30% level up to

100% – “Stabilize” the Relief Care so that the problems do

not return – Treatment: 2 times a week (2-4 months)



•  Phase 2: Stabilization/Corrective Care – End of Stabilization/Corrective Care

•  Every month, there’s a “Re-exam”: Patients fill out the same intake form they filled out on Day 1

•  Cross out the problems that are now 90% better •  Graph their improvement progress on a monthly

basis •  When the graph stops going up, but has flattened

out and moving horizontally = Stabilization (End of Corrective Care)

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0102030405060708090100

% of Blood Flow

Months (of Treatment)

End of Relief Care

End of Corrective Care



•  Phase 3: Maintenance Care –  Maintains the result received in Stabilization/Corrective

Care –  Treatment: 1-2 times/ month for 6 months

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The Five Day Report of Findings Day 3 – Care Plan Options

•  Option 1: Simple Plan (4-6 months) – Patient wants us to focus on only 1 or 2

health complaints • This plan is usually chosen because they do

not have a lot of health complaints or for financial reasons

• Plan may not include herbs • Plan does not include re-exams


The Five Day Report of Findings Day 3 – Care Program Options

•  Option 2: Emperor’s Plan (4 – 6 months) – Patient wants us to treat all or most of their

health complaints •  This plan usually includes most of the services

offered in the clinic: -Acupuncture -Herbs & Herbal Consultations -Re-exams -Massage -Liver Cleanse/Weight Loss -Nutritional Consultations -Acupressure Training

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The Five Day Report of Findings Day 3 – Plan Payment Options

•  Key: Commitment to health –  Need placebo effect (Western Dr.’s have it already) –  Positive attitude –  Money & Ethics –  Saves clinic time & money –  Saves patient time & money –  Improves patient flow –  Estimate treatments (give more if need to) –  Refundable –  Pay as you go patients = dabblers –  Payment & Financing options are available


The Five Day Report of Findings Day 4 – Decision Time

•  Day 4 is an individual session •  No more lectures •  Before treatment ask patient which one of the

2 care plans they want:

– 1. Simple Plan – 2. Emperor’s Plan

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•  Patients who decides on Care Plans – Need to have a positive attitude and strong

desire to get better •  Tell them that in order to get positive results they

need a positive attitude

– Pay in advance (covers acupuncture, herbs, massage, etc.)

•  Commitment to health by the patients •  Give discount for paying in advance

– Pay twice as much for pay as you go



– Pay in advance (covers acupuncture, herbs, and massage)

•  Do NOT use the pre-paid money, put the money in a bank/escrow account

– Withdraw the money only after the service is rendered for each visit

•  If patient decides to drop out of care, refund them the remaining amount in the account

• Need to estimate how many visits necessary for the patient

– If mis-calculated and estimated the # of visits wrong, provide free treatments

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– Pay in advance (covers acupuncture, herbs, and massage)

•  Check with legal counsel or account on how best to do this for your practice


Video Lecture Protocol Day 3/4

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General Tips on Running a Practice

•  1. Move to where there are little or no acupuncturists

•  2. Answer the phone! •  3. Group patients together •  4. On the 2nd, 3rd visits, explain to the

patients what you are going to do and why, and what the result will be

•  5. Have a receptionist


General Tips on Running a Practice •  6. Hire out your billing •  7. Create a beautiful space to practice •  8. Be confident – even if you are not •  9. Payment at the time of service •  10. Collect 1000 names of interested

people before you open your doors •  11. Make friends with local pain specialists

– Send them patients you cannot fix and they will send you patients they cannot fix

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General Tips on Running a Practice

•  12. Join the local Chamber of Commerce and sponsor an open house. Also join the Rotary Club in your area.

•  13. Do acupressure workshops •  14. Hiring of employees •  15. Speaking engagements •  16. Think SUCCESS •  17. Attend public events in your area for

marketing purposes


Marketing Events •  Attend as many local events in your area as

possible, anywhere they will let you set up an informational booth! – Expos

•  Health, Safety, Wedding, Women’s, Kids, etc.

– Local Festivals – County Fair – Local school district benefits fairs – Holiday Craft Fairs

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Marketing Events •  Your goal

– To expose people to the benefits of TCM •  Best option: Free Chinese Pulse Diagnosis •  Alternative options: Ear or tongue diagnosis •  Can do acupressure, never give them needles

– Ask them “What do you want help with?” •  Explain to them that your medicine may help them

– Sign them up at the event for the Free Consultation at your clinic


Marketing Event Booth Set-up

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Booth Checklist •  STRESS SURVEYS (form used to collect their info) •  PATIENT SCHEDULE (PRINT THE NEXT 2 – 3 WEEKS) •  CLIPBOARDS •  PENS •  BROCHURES (CLINIC) •  INFO CARDS (TREATMENT INFO) •  APPOINTMENT CARDS •  MAPS •  CHAIRS •  TABLE •  TABLECLOTH •  TENT & EQUIPMENT TO SECURE TENT •  CLINIC INFO SCREENS •  EXTENSION CORD(S) •  PULSE DIAGNOSIS SIGN •  FLOWERS FOR TABLE •  CANDY •  CANDY DISH •  TOYS •  TOY BOX •  BALLOONS


Today’s presentation was an example of many of the training webinars available at

www.doane.us For only $59 per month you will have

ACCESS TO ALL OF

ROBERT DOANE’S WEBINARS EVER RECORDED!

As a member you will also be able to view

“The Office” weekly videos about difficult to treat case-studies, DNA tips and tricks, specific pulse-

diagnostic scenarios, and much more!

Want To Watch Robert Doane’s Webinars?

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Doane Online Educa9on


Q & A

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Today’s presentation was an example of many of the training webinars available at

www.doane.us For only $59 per month you will have

ACCESS TO ALL OF

ROBERT DOANE’S WEBINARS EVER RECORDED!

As a member you will also be able to view

“The Office” weekly videos about difficult to treat case-studies, DNA tips and tricks, specific pulse-

diagnostic scenarios, and much more!

Want To Watch Robert Doane’s Webinars?

practice management seminar - doane online …...– “on a scale of 1 to 10, 10 being someone who...

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