Running a business by phone, pen & pad

This is an interesting read about how one smart cookie stripped conventional systems from his business (he’s a chiropractor) and wound up vastly more profitable AND enjoying a three day work week as well.

If your industry software doesn’t quite fit; what do you do? Most businesses stick with it. Labour over it, spending time, money and staff managing it. Or (in a real departure from my normal columns of thou must computerise)’ you can be very clever and do what Euan did.

X years ago Euan McMillian left a group practice to start his own and is now the envy of many in his field.

In starting his own practice, Euan decided to leave behind all the negatives. First he reviewed the business processes required. Next determined what kind of lifestyle he wanted. Then he went to the drawing board to create the flows and processes that would be most effective for him.

Before we outline what Euan created, let’s detail the norm of a Chiropractic practice

  • Capacity to see 47-53 patients a week, in 5.5 days.
  • A full time receptionist or two part time ones job sharing.
  • The receptionists answered the phone. Took payments, patient details, issued receipts. They worked with and around the computer system and co-ordinated insurance co-payments.
  • Time and money was spent working with and customising the industry software. Frustration.
  • Most practices book patients visit by visit. This situation created long conversations and confusion about “when should I come next” between each and every patient and receptionist.

Now let’s talk about Euan’s practice.

It’s just him; his iPhone and his appointment book.

He eliminated the industry software which he said was inefficient, required duplication of entry and costly customisation. By eliminating the software he also decided to dump the computer full stop. He devised a simple, workable solution using a smartphone and a few apps, combined with the good old pen and paper diary.

His second break from convention was eliminating a receptionist. Why? As you’ll see below, his systems didn’t require one.

The third element is his whole of patient gentle, holistic chiropractic method. This allows him to see several patients at once.

You could say the proof is in the pudding with the fact that he has great referrals word of mouth and has very few ‘time slots’ to fill

In review:

  • He’s removed the cost of the computer and software – $5,000
  • He’s removed the receptionist – at least $45,000
  • He’s removed gross inefficiencies that were wasting time, money and requiring staff.
  • Instead of 50ish patients a week, he sees 70 patients a day, between 200-250 in his three day work week

Let’s look at the processes he’s put in and see what ideas you can steal.

  1. Database of patients – all on his phone. He uses mailchimp if he wants to email them enmasse. The phone is backed up in the cloud.
  2. He vets all new clients by phone first to (ensure they are proper candidates for his gentle network system).
  3. He offers clients one visit or a book of ten visits. 90% take the book of 10 and pay in advance. This means one receipt instead of 10.
    He doubly benefits by getting more appointments per patient 10 as opposed to 5 to 6) and the time saved issuing receipts (each patient has one as opposed to nine. At two minutes a receipt that is 18 minutes per client)
  4. He’s simplified his billing with only four variables. Adult/child. Single/Ten.
  5. He’s created templates for everything, held on his phone as PDFs. ‘When one needs to be printed, he’ll email his printer who has then on file. New clients are emailed their forms and asked to bring them in with them filled out with the first visit. This is normally done on a clipboard in the office). He emails the form (remember held on his phone) with the app DocumentsPro.
  6. All his records are kept in paper in the office. Not a problem as they’re kept in a vault.
  7. All appointments are on a paper diary because it’s quicker and easier to access then a phone one. Euan has timed it.
  8. Payments are taken through eftpos and online
  9. Some patients have HICAPS co-insurance, which means the insurance co-payment would be taken off their invoice at time of payment. Euan decided to simplify and not do insurance payments at all. It hasn’t been a problem with patients – they can submit their reimbursement online afterwards.
  10. He uses text messaging with all patients.
  11. Each day he takes a snapshot of his current day from the appointment book. If a patient texts or phones him – it’s immediately accessible. Where? Yes, you guessed. On his phone which he has with him and looks at in between patients.

There we have it. Now you know my theory of Fluff walks. Money talks so let’s quantify this – just in the realm of operating costs.

5000 computer and system

45000 receptionist

9 less receipts at 2 minutes each

Two days a week NOT working – what price would you put on that lovely freedom?

While it’s not fair to compare practice style, 200 patients vs. 50 a week. Lets say at an average of $50 a visit, 150*50=7500 x 45 working weeks =$337500