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What about the old Box on the Wall idea?

Dr. Jim posted this question on Facebook:

"I have had this same thought for a while and am wondering if I am crazy or would this really work. The old box on the wall system where we suggest a fee schedule $15 - $40 a visit pay what you can afford, no insurance billing, just pay what you can afford, no worrying about "my insurance only gives me 12 visits per year", "no PI issues" just unadulterated chiropractic, tell what they need, give them what they need.

I believe we could be twice as busy as we are now, with less time and cost spent on collections and billing, adjusting our fees down on managed care schedules, no dealing with insurance issues. I could see more time for just taking care of people, teaching and adjusting.

In your opinion why might this work or not work and would this be a real option. I would appreciate your thoughts on this. Thanks."

Aloha Dr. Jim,

This is a great question. The whole trick is to help you discover what is best for you and what you are trying to accomplish, and we would really need to talk that down!

As always we need to look at headspace and procedure. From a procedure perspective it is pretty darn easy. Figure your capacity i.e. 100 pv per day X avg. of $20 per person (or whatever you would average… which is a huge variable!) and that equals how much you will make per day. Multiply that times how many days a month you are in the office and viola you have your monthly income. Then figure out your overhead. Now ask yourself, "Am I happy with that net profit for the work I delivered?"

This is what I call a "high volume" financial plan. In other words if you are not doing at least 100-200 people per day it can lead to financial ruin. Again it is just a math question.

Now for the much bigger issue, headspace! The first question I like to ask is, "Am I considering doing this because I want out of insurance or because I just want people to pay what they think they can afford?"

If the answer is "I just want out of insurance" there is a much better way! Get them to value the work help them understand the difference between sick care covered by insurance and health care they pay for and charge a fair and reasonable fee.

If the answer is "I want to remove all financial barriers so people can get my care" there is much to discuss. Much more than we have space for in this post, but the long and the short of it is that Emanuel Kant "Selfless" philosophy has ruined more chiropractors than just about anything else! "Everyone needs my care, everyone deserves my care, just adjust and it will all work out" has lead to more chiropractors going bankrupt than just about anything else. Dr. Gentempo goes into great detail about this subject in his "5 Branches of Philosophy lecture" I cannot recommend it enough!

I hope that helps and thank you so much for this great question!

Much love and aloha,

Russ

Dr Rosen - May 26, 2010