Annies back…

If you are a long-term subscriber, you might remember

My patient Annie. You can read about her on my blog

from late October 2007.

Anyways, Annie had presented with a constellation of

symptoms which I ultimately referred her for an

ENT emergency visit.

I was her last doctor stop before her

husband wanted her admitted for a workup.

In short, she had been having

headaches, neck stiffness and pain, and when I queried,

she divulged fatigue, otalgia, and Sinusitis like Sx, attributed

 to “allergies” lassitude and on and off

respiratory Sx for many months. She also had about

three rounds of antibiotics, with no lasting changes.

She had previously seen 3 PAs, an RN, and her

PCP, (5 office visits) and when I put the otoscope in my

hand she said none of had looked in her ears

or checked her sinuses. I was dumbfounded by that.

When I examined her, in addition to her spinal findings

she had an acute otitis media, but when I looked at her

sinuses with the otoscope, she had acutely swollen turbinates

with nearly complete nasal obstruction on the side of

the OM. Certainly the nastiest I had ever seen.

After I adjusted her and got her more comfortable,

I immediately sent her to MGH, Mass Eye and Ear.

A CT confirmed nearly complete nasal sinus blockage

and acute infection.

Long story short, she had subsequent surgery for

multiple polyps with obstruction.

I saw Annie again for the first time in months yesterday.

Now fully recovered, happy, incredibly

thankful, talked about how long she suffered before getting relief,

now comes in with her six year old daughter for

evaluation of foot and leg pain.

Keep in mind, almost 20 years ago, I cared for her two then young sons, with similar issues.

Callie is a cute, funny eight year old.

 Unfortunately, she has significant valgus alignment and pronation, which is asymmetric, thus affecting her pelvis and back.

Anyways, she ended up her visit to us with

temporary orthotics and a DPM consult,

and will be back Tuesday for spinal/pelvic adjustments and

exercise instruction).

Doctors, this is the stuff of which long term careers,

and life long referrals are made. It can be this simple.

I have tons of these examples after 27 years, and you

probably do too.

Like everything in a powerful practice, these are systems.

Simply excellent care, totally focused history, clear communications, tangible benefits and staff that can direct your movements during your day, collect your fee and schedule patients.

Referrals that flow like a river.

With the right systems, it is this easy.

Without, the office can be a chaotic nightmare.

High Performance Tools and Toys


High Performance Tools and Toys


Some time ago, I wrote “Core Strength and Balance”, after the first ski trip of the year. I also told you about my new high-performance tools and toys (my new skis).  These are the most powerful skis I’ve ever owned. I’ve probably skied stronger and faster than any time in my last 60+ years. So much so, I scared myself to the point of nausea.


Well, tons of stuff has happened in the last 6 weeks, jut an incredibly busy stretch. Practice is off to its best January in several, thanks to the marketing tweaks and performance tuning we did in the last quarter.


Despite my heavy schedule, I always block out me time. This week it was Fri 5PM to Sunday 6PM.  I have written extensively on the power of creative energy and where it comes from, (and its not the office-day). I have also preached the value of blocked scheduling, and how powerful a concept that one is.


So, when one of my attorney friends called Friday night and asked me to spend the day Saturday at the boat show, I didn’t even bat an eyelash.  We really had a great time. Literally, we spent hours at one exhibit with factory personnel from Grady-White.  I was like a kid in the candy store. I have owned and operated Grady-Whites for years.  They really are the Rolls Royce of 20-30’ boats. It was so awesome to talk with engineers and designers, as I so admire their commitments to continual improvement and ultra high performance.


We also spent lots of time reviewing the latest marine navigation equipment and software, and talking with the factory reps. Garmin, Furono, Navtec, you name it.


The advances of the last five years are nothing short of phenomenal. Touch Screen technology, TFT displays with higher resolution graphics, polarized lens compatible coatings on the screens, smart routing that works like your car navigation. Really cool stuff.


Boy, Sunday was one great day.


So what’s the point?  And why the name-dropping?  Believe me, its not to impress. 


The fact is that there comes a point in time and life to move beyond just basic skills and tools, and yes even possessions. When you really start to crank things up, the best tools really shine, and  allow you to push your limits further than you ever imagined.


 Practice is no different. Once you have mastered all the basic skills, applied  the principal of Constant And Never ending Improvement, (CANI)  you find yourself ready and capable of producing so much more. By using only the highest performance tools, skills, and staff, your output is so much greater and your level of satisfaction  rises substantially as well. This is so true, regardless of how long you have been in practice, the type of practice you have, and the systems and people you employ.


Many years ago, while writing, “Creating your Perfect Practice”, I spoke extensively about the concept of blue printing. Blue printing involves taking an engine, typically from a racecar or other fine machine, and rebuilding to very precise tolerances, just as the engineers intended. Essentially, you start with exactly the same size engine, but end up with one that produces so much more horsepower, torque, fuel economy, performance, as well as a phenomenal sense of satisfaction when you really put it through the paces.


 Again, practice is no different.  Blue printing like we do with clients really can produce enormous gains. Absolutely everything The Perfect Practice Web team has written and designed allows you to accomplish so much more, with much greater efficiency, high performance, satisfaction, producing infinite rewards in exactly the same amount time if not less than you may ever had thought possible.


In this day and age, higher performance tools are so necessary to accomplishing more in less time. Besides, as your skills improve, just like my toys, you will enjoy these so much more.


This is also the secret to having a life outside of practice, being able to pursue your other interests and aspirations, or being stressed out, burned out, and financially dissatisfied.


 In the reality is, when you use the appropriate high performance tools and toys, input effort correspondingly decreases. So not only do you accomplish more, but also you save time, have more fun; less hassles with repairs and maintenance, and produce better results, you actually end up expanding less energy.


 So, with virtually all your office systems, see what is outdated. See what needs to be replaced, and then, only invest in the highest performing tools and systems available today.

And you too can learn these exact systems to incredible success by learning The 12 Secrets of Private Practice Mastery


Holding Yourself Truly Accountable in Private Practice

As we talk about all the time, the private practice of healthcare is radically different than the public sector.

There is no one telling you when to arrive, or when to leave. If you need to work nights and weekends you do so. If you need to hire outside experts you do that too.

For too many people the stress is unimaginable.

But not you.

With this vast degree of difference comes an extraordinary degree of responsibility. And the most successful private practice owners actually thrive in this environment.

Make no mistake about it being prosperous and happy in private practice requires multiple skills.

To have any longevity at all, you need to truly master the most effective private practice marketing, staff training and discipline as well as essential CEO skill sets.

But here’s the kicker.

It’s all up to you.

It is essential that you realize this every single day. Yes even on your off days. Your patients and your employees are dependent upon you to do the very best you can.

But how to avoid becoming totally overwhelmed? It’s a big job any standards.

The most successful private practice owners remain organized, focused, and borrow from all the greats in business. No, it’s not always easy. And often times it’s one of the most difficult things we do in life.

If you’re finding yourself feeling unrewarded or perhaps even just knowing that doing a little better to give you extra income, time off and satisfaction it’s time to go on to developing CEO skills.

One more thing.

All the great CEOs use their peers to help keep them accountable.

How about you?

Just make sure your “peers” are at least if not more successful than you are!

For more on private practice building visit us at


Adding Preventive Services to Your Private Practice

Adding preventive services to your private is one of the most important things that you can do.



Establish yourself as a community leader by adding preventive services to your private practice. For example, weight-loss strategy groups and self-care classes done inside your practice and outside in your community can go along way towards building you as healthcare authority.

The most important thing however is to carefully plan out your strategy.

For example, I have always maintained that if I were going to bring a class or presentation to a group or organization they need to reciprocate in kind.

At the very least, you should be able to bring business cards, post flyers and leave brochures etc. There should be no problem asking for referrals.

By designing a strategy this way all parties benefit. There is a real reciprocation rather than a one-way street.

Unfortunately, too many private practice owners undervalue their time and thus waste vast amounts of energy on referral sources that never will develop.

So where do you begin?

As always, begin with a written game plan and strategy.

One of the most important things you can do is research first. You should be reading your hometown newspapers, doing local web searches, and surveying your patients etc.

All this will provide valuable information for you to ultimately develop a powerful game plan to work from.

Ask patients in your own practice as well as those from your fellow referral medical professionals what types of patient training programs they would like to see.

Some examples include early morning stretching and yoga classes, chronic pain control groups that you sponsor and train exclusively in as well as the time tested, twice monthly healthcare classes for all new patients.

Whatever it is you embark upon make sure it is well worth your time and effort but most especially, that these programs provide something special and engaging for your patients and your community.

As Walt Disney once said, make sure it’s so powerful that ‘patients can’t resist telling other patients!’

Let us help! Join us on Facebook !

Helping Your Diabetic Neuropathy Patients

If you have patients who are living with diabetes, chances are you are no stranger to making diagnoses of neuropathy.  While some patients (even those who do have nerve damage) might experience no symptoms at all, about 60 to 70 percent of diabetics experience pain, soreness, loss of sensation, tingling in the extremities, and even digestive problems—or other conditions related to organ complications—all symptoms of peripheral neuropathy.  Diabetes is, in turn, one of the most common causes of neuropathy overall.

A patient’s risk of developing diabetes-related neuropathy actually increases with age and extenuating health considerations (such as being overweight), partially because patients who have problems with glucose control for extended periods of time—25 years or more—are more susceptible.

The best defense against diabetic neuropathy is to get and keep blood sugar under control.

So, what causes a patient who has diabetes to develop neuropathic symptoms?  Research is occasionally unclear on the subject, but it is generally agreed that exposure to high blood glucose (high blood sugar) has a negative effect on nerve condition.  Of course, this is in addition to other conditions or lifestyle factors commonly associated with causing or exacerbating neuropathy, such as injury, metabolic inconsistencies, inherited traits, or substance abuse.

There are a few kinds of neuropathy associated with diabetes, the most common being peripheral neuropathy (this is the type usually referred to when people simply say “neuropathy;” but we’ll get to the other types in a moment).  Peripheral neuropathy is characterized by pain, numbness, tingling, and loss of motor function, among other sensation-related symptoms.  This type is written about extensively, and can greatly impact quality of life for its sufferers.  Most treatments available to medical practitioners target peripheral neuropathy, so the good news is, there are plenty of ways for you to treat this type.

Focal and proximal neuropathy result in muscle weakness and pain, and typically target a specific nerve grouping.  These types of neuropathy are commonly characterized by weakness in the legs, causing difficulty standing and walking.  This type of neuropathy often accompanies peripheral neuropathy, so be on the lookout for patients who experience weakness alongside loss of sensation or soreness.

Autonomic neuropathy, as the name implies, causes changes in autonomic bodily functions.  These include bowel and bladder functions, sexual responses, and digestion.  Autonomic neuropathy can be life-threatening in extreme cases, as it also affects nerves that serve the heart, lungs, and eyes.  Especially troubling to diabetic patients is the resulting condition of hypoglycemia unawareness, which can obliviate the symptoms most diabetics associate with low glucose.

It is recommended for any diabetic patients to receive at least an annual foot exam.  If neuropathy has already been diagnosed, a patient’s feet should be examined much more frequently.   Additional to diabetic amputation concerns, you should test your patient’s protective sensation by pricking their foot with a pin, or running monofilament across their skin.  If your patient has lost protective sensation, he or she could be at risk to develop sores that might not heal properly, leading to infection.  If you have any questions about the proper methods to use in examining diabetic patients for neuropathy, contact NeuropathyDR®.  We can be sure you have the tools and knowledge you need!

For other types of neuropathy, properly-trained clinicians should perform a check of heart rate variability to detect how a patient’s heart rate changes in response to changes in blood pressure and posture.  Ultrasound imaging is also useful to diagnose autonomic neuropathies and to ensure other internal organs such as the kidneys and bladder are functioning properly.

To control diabetic neuropathy, it is important to advise patients to maintain a tight blood sugar control and a healthy diet (this methodology is advisable for diabetics in general, of course).   Even if a patient does not have symptoms of neuropathy, regular checkups are wise.  NeuropathyDR® can train you to spot warning signs of factors that could endanger your patients’ nerve function or even be life-threatening.  In addition, we can help you treat pain symptoms by providing valuable information about appropriate medications.

If your patients have diabetes, they are at risk!  Don’t let neuropathic symptoms go unchecked.  Remember, the sooner neuropathy is diagnosed, the easier it will be to treat and to slow the progression of this degenerative condition.  NeuropathyDR® clinicians are trained to identify the various types of neuropathy and recommend the treatments that help their patients retain their quality of life.  If you have any questions about treating patients who have or might have diabetic neuropathy, contact us!



Helping Patients with Alcohol Induced Neuropathy

One of the most serious—but rarely discussed—conditions resulting from extended alcoholism is alcoholic neuropathy.  One of the reasons for its relative obscurity in the public discourse, aside from difficulties inherent in any discussion of substance abuse, is that much of the empirical evidence linking neuropathy and alcoholism is somewhat vague.  Still, there is ample correlation to assume a causal link.

Alcoholic neuropathy presents in patients similarly to other forms of neuropathy, with tingling and numbness in the extremities, loss of heat and cold sensation, loss of fine motor control, impotence in men, and so on.  All this is accompanied by the chronic pain typical in cases of peripheral neuropathy.  Because of the areas of the mind and body targeted by the alcohol, it is common for alcoholic neuropathy patients to exhibit outward signs of intoxication even when sober, such as slurred speech, stumbling gait, and clumsiness.  The American Journal of Clinical Nutrition says that, in severely affected patients, the legs and hands may be nearly useless to the point of paralysis and sensation may be entirely absent in extremities.  In these cases, the skin can also be dry and atrophic.

The specific causes of alcoholic neuropathy are difficult to pin down, and thus, the case can be tricky to diagnose.  If a patient has a known history of alcohol abuse, that is, of course, a good place to start.  Generally, a pattern of heavy alcohol use for a period of ten years or more will be accompanied by neuropathy symptoms.  A leading theory contends that the cause of alcohol-related neuropathy may be the combined effect of direct nerve-poisoning by the alcohol itself, coupled with the long-term poor nutrition that often accompanies alcohol abuse.  Alcoholics typically exhibit erratic eating habits, resulting in poor overall nutrient intake, and the damage to organs reduces the absorption of nutrients from food.  Of course, difficulty in motor control resultant from neuropathy often exacerbates the malnutrition, as the patient becomes socially uneasy about mealtimes and self-conscious about feeding themselves.

Nerve damage from alcoholism is usually permanent.  The first order of business in treating patients with alcoholic neuropathy is to bring the drinking and nutrition problems under control.  If alcohol consumption is not severely limited and adequate nourishment is not supplied, additional treatments will be futile and symptoms will almost invariably compound. Beyond this, treatment seeks three main goals:

  • To control symptoms
  • To maximize and restore function (quality of life)

    Alcoholic Neuropathy requires extraordinary measures to slow or treat…

  • To prevent further injury to the patient due to neuropathic vulnerabilities

Most treatments address these three tenets simultaneously.  Pharmaceutical treatments include the use of painkillers, either prescription strength or over-the-counter (such as analgesics).  When treating patients with alcoholic neuropathy, it is advisable to recommend the lightest use of pain medication possible, as the patient in question is by definition susceptible to habitual substance abuse.  Be sure to monitor use of any medications very carefully.

Because of the underlying nutritional deficit usually at the root of alcoholic neuropathy, some patients may benefit from a system of nutritional supplements.  A dietician or other qualified staff person in your office should be consulted to ensure the proper replenishment of nutrients necessary to prevent the spread of neuropathic symptoms.  Parenteral multivitamins are also useful in many cases to assist nutrition.

Several new lifestyle habits can help patients adjust to living with alcoholic neuropathy, such as carefully monitoring the temperature of bathwater to prevent burning, inspecting themselves and their clothing and footwear for points of rubbing or wear on the skin, and so forth.  In alcoholics, the establishment of these habits (which are themselves advisable for all neuropathy patients) can be instrumental in the replacement of the undesirable dependency that caused the problem.

Although nerve damage is usually permanent, the prognosis for sufferers of alcohol-related neuropathy can be very good if the alcoholic successfully refrains from indulging the dependency and works to replenish nutrition.  It is important to emphasize to patients that substantial recovery from degenerating neuropathic symptoms will not be seen for a period of several months.  Of course, subjective improvements in lifestyle and health will begin almost immediately when abstaining from an alcohol dependency as a result of general detoxification.

If you have patients you believe could be suffering from alcoholic neuropathy, we are here to help you determine for certain how best to proceed!

Contact NeuropathyDR® and we can give you even more information about how to help your patients suffering from alcohol abuse-related neuropathic symptoms.




Doing Everything You Can For Your Cancer Patients

Cancer brings many challenges into the lives of your patients…

Treatment options…

Disruption of normal activities…

Fear, anxiety and depression…

When treating your cancer and post chemotherapy peripheral neuropathy patients, it’s easy to become focused on just the disease itself and the symptoms.  But don’t overlook their emotional and psychological issues.  These can be as debilitating as the disease itself and seriously affect treatment outcomes if not addressed.

Depression caused by chronic pain and frustration can derail an otherwise successful course of treatment.

When treating your cancer patients, strive to become a one stop shop for addressing not only their post chemotherapy peripheral neuropathy and other physical side effects from treatment, but also a great resource for supportive services and information that can provide a tremendous benefit to your cancer patients.

Help them address some of the serious obstacles to successful treatment that most health care professionals don’t think about.

Patient Information Resources[1]

Make your office the one place your cancer patients know they can go to for current patient information and education about cancer treatment options, specific types of cancer, long and short term side effects of their chosen course of treatment.  When preparing your patient information materials, include education on cancer diagnosis, treatment, clinical trials, treatment side effects from chemotherapy or radiation and questions they should ask their doctors.  Provide them with a list of local resources that are available to assist them with the challenges they face as a cancer patient.

Support for Lifestyle Changes

A cancer diagnosis can mean serious lifestyle changes for your cancer patients.  Smokers will probably have to quit smoking; athletes will have to curtail some of their physical activity; patients who live alone may have to stay with family members while undergoing treatment.  All of these changes can lead to serious emotional issues.  Provide counseling to your cancer and post chemotherapy neuropathy patients on dealing with these lifestyle changes proactively.  Provide tips on what they should expect and the best ways to handle these short term challenges.

Don’t Be Afraid to Talk About Money

For cancer patients with no insurance or even less than adequate insurance, a cancer diagnosis can be especially devastating.  They may forego necessary prescriptions or even skip appointments. When trying to pay for their cancer treatment, they may find it difficult to even pay for the most basic necessities of life.  Become familiar with programs in your area that can assist your cancer patients with paying for medications, providing home health assistance, or even services that can help them with transportation to and from their health care providers.

Any assistance will help.  Fighting cancer is hard enough without the added worry of financial issues.  Just knowing that there are resources available to help might ward off the serious depression that can make recovery that much more difficult.

Keeping Track of Medical Information[2]

When a patient is undergoing chemotherapy, radiation or other treatment for cancer, they have mountains of information to keep track of.  They need to monitor when to take their medication, how to take it, keep up with medical appointments, monitor their symptoms, and make note of any and all side effects their experience.  They need to keep a written record of everything.  Provide them with a record book or specific forms to make it easier for them to write everything down and keep it in one place.  It will not only make it easier for your cancer patient to manage their medical information, it will make it much easier for you just having all their notes together in one place.

By providing all these additional support services to your cancer and post chemotherapy peripheral neuropathy patients, your practice will become their go to health care provider for information and support.  Two things that they desperately need and will greatly appreciate.

When you are ready to provide these services, let them know you’re there to help them.

For more tips on growing a successful chiropractic, physical therapy or pain management practice, log on to http://perfectpractice to download a FREE E-Book Copy of my 5 star Amazon  “Living and Practicing by Design” at



Still Ignoring The Social Media Revolution?

Still Ignoring The Social Media Revolution?




Online articles…

Search Engine Optimization…

These terms are becoming as much a part of the modern chiropractic, medical or physical therapy practice as Preferred Providers and deductibles.

We all know that people are looking for everything online but chiropractors and physical therapists have been some of the last to join the Social Media Revolution.

But join they have and they’re using the internet like every other savvy business owner.

What Does This Mean To Your Chiropractic or Physical Therapy Practice?

Two studies conducted in 2008 showed that 41% of all the research medical professionals are doing is now done online (and that number was expected to double in 2009) and that the large pharmaceutical companies were gearing much of their marketing efforts to the online community as the best way to communicate with and educate their target audience – health care providers, including chiropractors and physical therapists.

Just take a look at some of the more popular social networking sites for medical professionals – Ozmosis, SocialMD and DoctorNetworking – each of these sites has literally thousands of members.

If you’re going to develop a presence online and reach your potential patient base, now is the time to do it if you haven’t already.

5 Trends In The Use Of Web & Social Media by Chiropractors and Physical Therapists

1. Increase in Social Networking.

There are a growing number of sites that give healthcare providers the opportunity to connect with other professionals in their specialty to share knowledge, network, and support each other. Most of these sites are protected and allow users to communicate and share opinions and results in a safe online environment.  Check out our own NeuropathyDR site as an example.

2. Scholarly Medical Journals Have a Presence Online

Newspapers are not the only print media suffering the effects of online information.  Many scholarly medical journals have opted for an online-only format to save printing costs and to reach a broader base of readers.  Even beyond the convenience of their information being a mouse click away, many of these sites are increasingly interactive with Q&A sessions and even online classes and seminars for CME credit, perfect for the busy chiropractor or physical therapist trying to build a practice.

3. Blogs and Online Articles.

Many chiropractors and physical therapists are now blogging and publishing online articles to reach potential patients and educate the public about their particular specialty.  Where it used to take months to be published in a medical journal, now you can set up your own blog, sit down and type a post (or have someone else do it for you), and you’re done.  This allows you to share a unique perspective about your specialty, local events, even the health care system. All from the vantage point of a practicing chiropractic or physical therapy professional.  Your patients and future patients see you as a human with particular expertise and a voice they recognize.

4. Twitter and Facebook.

Do you have a Twitter account? A Facebook page? If you don’t have at least one of these social media tools working for you, you’re missing a huge marketing opportunity that’s virtually free.  The only real cost is time.  If you don’t have the time to post to your own Facebook page or send regular “tweets”, we’ll  do it for you!  In fact, I can help you get all of this done, and even get an ezine in the hands of YOUR patients for just pennies a day, automatically. “Frequent, relevant content” as my friend Nitin Chhoda DPT says, will keep you in constant contact with your patient base.

That puts you first in their minds when they, or someone they know, needs your specialty.

But if you are doing it all yourself, an important thing to remember about either of these tools – don’t use “doctor speak” when posting your messages.  Imagine you’re talking to your next door neighbor at a barbecue and keep that tone in your social media message.  You’ll get your point across and impress rather than intimidate your patients.

When diving into the social media scene, the first thing to consider is exactly what you’re attempting to accomplish.  Don’t go in without a plan. You’ll do nothing but send mixed and scattered messages.

Post strategically, wherever you post, and you’ll be amazed at how quickly you profit from this new social interaction.  Join the Social Media Revolution and make this year the best your chiropractic or physical therapy practice has ever seen.

Don’t Delay! Download a FREE E-Book Copy of my 5 star Amazon “Living and Practicing by Design” at

New Year’s Resolutions for Your Private Practice – Part 5

And finally, the last two suggestions for making this the best year your practice has ever seen:

Be a perpetual student

You don’t have to break the bank on continuing education but you do have to continue to learn.  Business today is changing constantly – not just in the health care field but in marketing, technology, accounting, you name it.  Resolve to learn continuously to take advantage of the latest trends that will build your practice with the least effort.

10. Have Some Fun

Concentrate some of your marketing efforts on things you really enjoy.

If you’re a runner, sponsor a marathon.

A golfer? Sponsor a local tournament for a charity.

Have you dreamed of being a writer? Start that blog you’ve been thinking about and start expressing yourself.  Your audience is probably full of potential patients.

But, above all else, have a good time with whatever you do.  Your passion for it will come through and speak volumes to your current and prospective patients.

Marketing can be a pain but it doesn’t have to be.  You may think you don’t have time to devote to it but you’ll be pleasantly surprised how much time you find for it if you actually enjoy what you’re doing.

Right now, before you turn off your computer, write these resolutions down somewhere…

In the back of your Day Planner…your smartphone with alarms and reminders

Type them into Outlook…your ipad calendar…

Just the act of writing them down will place them in your subconscious mind and you’ll be amazed at how much you can actually accomplish.

Resolve to make 2011 the year that you really learn to live and practice by design.

Think about how your practice (and your life!) would be different …

Think about how your practice (and your life!) would be different if you were to be the only game in town, with a solution for a problem afflicting over 20 MILLION patients nobody else around you has!

Dear Doctor,

I spent most of this past Tuesday recapping 2010 with my top-level clients and it really got me thinking.

Not surprisingly, my best consulting moments this past year came with clients who were the most prepared to grow. No matter what the third party, economic and political climate was nationally, or locally.

This special group of clients understands that private chiropractic practices everywhere are dying.

Just look at the facts…

The US Government Health and Human Services Website Says Chiropractors fail on their loans more than any other health profession…

Discipline Total Amt Due

Allopathic Medicine

111 $14,196,277


527 $51,485,514

Clinical Psychology

25 $2,218,048


193 $32,210,813

Health Administration

1 $47,411


19 $1,264,118


28 $6,986,081


13 $761,709


69 $13,470,880

Public Health

3 $297,978

And if this isn’t bad enough, they even tell the public (your patients)that the school you graduated from can predict who’s failing in practice!

Now, our own (economic) Journals are talking to DCs about bankruptcy! *

What used to work for Chiros getting more patients no longer does.

Nor will it.

Chiropractic is being commoditized. You only have to look at the latest issues of the chiropractic magazines to figure this out.

However I digress.

Think about how your practice (and your life!) would be different if you were to be the only game in town, with a solution for a problem afflicting over 20 MILLION patients nobody else around you has!

But, success leaves clues!  Our Clients are seeing some incredible results professionally, clinically and of course financially with everything becoming a NeuropathyDR™ Treatment Center has to offer.

This unique treatment system is a combination of spinal manual therapies, extremity mobilization, electric and mechanical neurostimulation, and other peripheral manual therapies combined with a specialized nutrition and metabolic rehab program with several key components.

This is a powerful tested and replicable treatment system.

And currently, patient demand far exceeds the number of trained doctors and therapists. Many more qualified chiropractors are needed!

Do this right, and it is one of the most gratifying things you will ever do as a DC.

Here’s the point. This letter is being sent to many of the DCs in your area, but only a few will qualify…

There is even an option for area exclusivity.

If you are a private practice owner who is ready to have a steady stream of qualified, profitable patients, I invite you to pick up the phone TODAY. Lets have a talk together and see if you qualify to become a NeuropathyDR(TM) Treatment Center.

All you need to do is contact my assistant Jes by phone TODAY at 781-754-0599.

She’ll take your info and set us up a private phone consultation ASAP.

And if we have a fit, great! If not, I wont BS you.

Why not give me a call, and lets see together if this makes sense for you?

Yours for a better future,




John Hayes Jr DC MS DABCO

353 Washington St.

Norwell, Ma, USA


PS. There’s way more for you including info on our 2011 NeuropathyDR Treatment Center Opportunities and program enhancements


Harnessing the Power of Private Practice Email – Part 3

The holiday season is a great time to utilize email to stay in touch with your patient list.  Here are a few suggestions:

1. Special Events or Happenings

If you’re going to be speaking at a particular event or you’re being recognized by your peers for a particular achievement, let your patients know about it.  Everyone likes to know that they’ve chosen well in choosing their medical practitioner.  If something exciting is going on with your practice, include your patients on the list of “who needs to know”.

And, if your practice is growing and you’ve added staff or even an additional location, make sure your patients get an email about it.  Your new place may be more convenient for them or, better yet, more convenient for the new patients they refer to you.

2. Confirming Appointments

When your patients call for an appointment, send them an automatic email confirming the appointment.  Then send them another email the week before their appointment and yet another one three days out.  Always include your office phone number so they can call to cancel, reschedule or get directions to your office.

3. And Last, But Not Least, The Holiday Email

The holidays are a perfect time of year to connect with your patients, engage them and let them know that you’re thinking about them.  And, even more importantly, to thank them once again for choosing your practice for their chiropractic, physical therapy or other medical care.

Any of these marketing strategies are cost effective, easy and fluid.  It’s easy to change or adapt an email campaign for specific treatment groups and let them know that they’re getting this email because you’re genuinely interested in their outcome and care.

REMINDER: TODAY is the time to be finalizing how you hit the ground running on January 3rd. This is the best time of year to institute office changes, especially fee structures. And if you love taking care of challenging cases and incredibly grateful patients, consider becoming a NeuropathyDR(TM) Treatment Center.

Harnessing the Power of Private Practice Email – Part 2

You can also use the power of email for:

1. Sharing Good News

When you have a patient with a particularly outstanding outcome, ask them for a testimonial and if they are willing to let you share their results with other patients.  Few things will ever build confidence in your practice faster than the timeless patient testimonial.  If you don’t want to send an email every time you have a great outcome, include them as part of a monthly newsletter to patients. These should ultimately end up on your blog and website too!

2. Special Events or Happenings

If you’re going to be speaking at a particular event or you’re being recognized by your peers for a particular achievement, let your patients know about it.  Everyone likes to know that they’ve chosen well in choosing their medical practitioner.  If something exciting is going on with your practice, include your patients on the list of “who needs to know”.

And, if your practice is growing and you’ve added staff or even an additional location, make sure your patients get an email about it.  Your new place may be more convenient for them or, better yet, more convenient for the new patients they refer to you.

Next time, we’ll give you two more final suggestions for creative ways to stay in touch with your patients.

Harnessing the Power of Private Practice Email – Part 1

In our last article, we talked about the importance of effective communication in growing your practice.

This week, we’ll talk about one of the most effective communication tools available to the chiropractic, physical therapy and medical practice…

The almighty email…

If you have a patient list (and who doesn’t?), you have at your disposal one of the most valuable marketing tools you could ever hope for.

Just by effectively using your patient list, you can reach out and interact with your patients on an ongoing basis and make sure that you remain first and foremost in their minds when they think of your specialty.

Here are a few suggestions on exactly how to harness the power of email to grow and market your practice:

1. The Welcome Email

When a new patient comes to you for chiropractic, physical therapy or other medical care, make sure that your patient information sheet collects their email. Immediately following their visit, have your staff send them an email thanking them for choosing you for their care.  This can be done as a part of entering their information into your computer system.  Make sure the email includes information about your office hours, your phone number for appointments, any particular information they need or steps they need to take in preparation for their appointment and an opt-out option of they don’t want to receive future information from your office.

2. Patient Education

Once you have your email list in place, you can use the list to educate your patients and let them know about any of the following:

•      Recalls on prescriptions they take

•      New chiropractic treatment options available to them

•      New drug approvals from the FDA

•      Results of physical therapy clinical trials or studies

•      Medical or health trends affecting your private practice

•      Diet tips or recipes for particular conditions

Next time, we’ll share more ideas on ways to use the power of email and access to your patients’  In box to pave the way to a thriving practice.

Secrets of Treating Patients With Multiple Health Issues – Part 3

Today, we’ll talk about the third and final piece of the treatment of multiple health issues puzzle – making sure your patients understand what to expect in their treatment and what the process entails.

Third – Explain The Healing Process

Take it for granted that no one before you has really explained the physical causes of their pain and/or loss of sensation.  At least not in a way they could understand.  All they know is that they’re in pain.

Neuropathy and chronic pain patients very often don’t understand their suffering because nobody ever took the time to explain the basics. And this is even more true for patients having been treated in large institutions!

For example, we suggest that you use multimedia tools. I’ll very often use simple diagrams aided by powerful interactive software to demonstrate that nerve cells being deprived of oxygen causes them to shrink, widening the synaptic junction between the nerves and preventing the impulses from reaching from one nerve to the next.

Break it down into terms they can understand.  Picture a motorcycle trying to jump from one side of the Grand Canyon to the other.  There is virtually no way it will make it to the other side.  That’s the same with nerve impulses trying to reach from one nerve to the next when the synaptic junction is enlarged.  Tell your patient that effective chronic pain care may help restore neurologic function, even where other systems have failed.  Often times you can explain to them that your treatments are like building a bridge back across the Canyon. And that like a bridge under construction, this is not going to happen overnight.

The Final Caveat

Trust and Empathy Helps Patients Get Better Faster

Your patients have been through a lot.

They want to finally be free from pain.

They want their life back!

But they must completely understand the process, game plan, and their responsibilities in recovery.

You must take control, fully assess their intentions from the outset, and involve yourself completely in their treatment.

And then watch your referrals and practice revenues growing every week.

It’s a win for everyone involved.

The Most Powerful Marketing Piece Ever (Part 2)

Now, I am giving you a whole new reason to disconnect, and kick up your heels! Regularly.

It will help you build an enormous practice! Why? Because you can use your play to market yourself while feeling more rested, creative and inspired to be your very best.

Yes, that’s right! Especially now a days while it’s so easy to create media. Flip Cams, iphones, you name it.
This recently was reinforced in my practice when I sent out a reminder card to patients. I uploaded an image of me sitting on my motorcycle with a caption “Time to ride on in?”

"Time to Ride on In?

Patients loved it, and it was one of the most effective recall pieces I have recently done. And I have lots of fun photos of my adventures and likes around the office for them to see too.

Here is a strategy any practice owner can use. Do this right, your practice grows, as does your wealth account.

Step 1-
Make sure your practice is set up around your life, NOT the other way around! What do you like to do outside of practice? Where do you want to live, travel to or experience? If it’s been a while since you’ve done this, take your time, and be honest with yourself. Be sure to write or dictate all of this.

Step 2-
Start recording snippets of your adventures in media- a smart phone (iphone) is idea because you can take decent photos, video, heck even record great conversational sound bites. Of course, its even better with a good camera and an HD cameral like the FlipHD.

Be sure to keep these devices with you all the time. Some of my best marketing pieces and images have come from weekend ski or motorcycle adventures, and of course my vacations. The more impromptu the picture or video the better.

Next, Make storage and organization of your files easy. That’s why I am very partial to the Mac products like imovie, and iphoto.

Step 3-
be sure to use this material creatively. Put photos in your office news, flyers and especially on the web. This is why Facebook and other social media can be so powerful. It helps make you a real person.

Step 4-
Get some help. Too often, there is no solid marketing strategy, steps to follow or calendar for team members to focus on.
You’ll do far better to have a staff person help you with the implementation, but you’ve got to have a strategic plan they can follow. This is one of the very first things we teach in our Platinum sessions.

Step 5-
carve out regular time to make sure you are living your dreams, and your practice is supporting it! This is crucial. It’s also
why administrative and creative time must be on YOUR checklist, every week, and if you really want to accelerate your personal growth, every day!

Living and Practicing by Design

This is living and practicing by design, not default (which gets stressful and ugly quickly).
Remember, we are here to support you with the personal coaching, systems and tools that help you create the practice (and thus life) of your dreams!

For a FREE Downloadable version of my 5 star Amazon Book, “Living and Practicing by Design-Saving the Hearts that Care for Our Lives”,

Go To:

Consider this an appeal. Neuropathy patients need much more…

This is from my email inbox . And this does not include social media interactions I moderated all week long.

All of these came in between Friday Midnight and Monday morning to NeuropathyDR Headquarters.

Jes is already forwarding info and calling patients closest to our Ndocs.

However, more docs like you are NEEDED NOW to help stop the misery these patients experience…

Patients WANT what you can deliver. If you are already serving these patients with our NeuropathyDR System, I personally thank you.

If NOT, consider this an appeal.

Patients voices are getting louder and louder. These people are miserable, or someone they love is. I guarantee you, they did NOT have a great weekend.

“…I am very interested in your product but was informed there are no doctors in my area that are trained for its use.  I don’t know how to proceed.

…As we have no one here that practices your methods we can only do the best ourselves. It seems a lost cause here…


And inquiries from prospective neuropathy patients, some of whom actually called my office…

Can You help Doctor?

Providence RI
Bluffton SC
Northumberland PA

Salem Oregon
Midland MI

White Pine TN

Howell Michigan
Brighton MA
Princeton IL

One lady even quoted my book “Beating Neuropathy” in her email about her sick husband…

“We firmly believe that one of the greatest reasons for our success has been that we insist our patients undergo a five-week clinical trial in the office prior to being discharged with the homecare unit.  This trial includes often a nutritional evaluation and extensive clinical baseline and follow-up exams…. Our goal is to get you feeling better and SHOW you how to do so before we send you home…we have found the vast majority of patients that we treat are far better off having an initial period of supervision…Furthermore, it is our opinion and experience that peripheral neuropathy patients need to be very thoroughly evaluated and monitored by a central treating licensed health care professional.  This allows the patient to have one person to coordinate their care and ensure that any necessary diagnostic tests that should have been done have been done and that the patient’s other healthcare conditions are fully addressed.

Doctor, Please help us help these patients! These are people who WANT your guidance, what they DON’T want, is to buy a device on-line and be thrown to the wolves without experiencing everything you can help provide to them.

If you are already helping, thank you. BUT, please make sure you are using all the tools we have given you to help these patients!  Know you’ll never have a lack of patients who want and need your help.

If you are NOT interested in becoming a NeuropathyDR™, please do me a favor.

Consider forwarding this to another DC, MD or PT in your town.

Just don’t say I did not give you a heads up as their practice expands, despite what ever else is going on.

Our patients will thank you.

Have a great day!

Neuropathy Treatment Programs and beneficial consequences for patients…

Two things we are seeing in patients doing our ND metabolic rehab programs are significant weight losses without changes in diet or deliberate, heavy exercise, in patients new to our programs.

A recent patient reported a 13.5 lb wt. loss in under 4 weeks. This was in a 50 YO male with Metabolic Syndrome.  And of course his chronic neuropathy is improving very nicely too.

Patients are also reporting better exercise and walking tolerance, and as a consequence, far better levels of well-being.

Slashing Private Practice Revenues

Look who's cutting your income stream now...

June 1st almost here, if you Practice in the USA, both CMS and some private insurers will attempt to welcome you back after the long weekend by potentially slashing your reimbursements.

It could be huge hit if you are unprepared.

And, its not just DCs…

This week, we’ve heard from several MDs looking at our approach to help them transition as well. We talk to members of health care in almost all professions now who are fast deciding there has got to be a better way to live and practice than what the rank and file might tend to accept.

But, if you have been paying attention to us, saying “NO” as review companies disguised as agents of “Change” attempt to slash reimbursements by insurers you’ve had decent relationships for years, you’re doing better than ever! You’ve prepared your patients that they’ll be paying more to stay healthy starting Tuesday.

Well finally, this will be a turning point.

Its either stand up and just say “NO” as my staff has for weeks, even as executives are actually begging us to stay on as providers.

OR, you continue to develop the powerful private practice and rich, rewarding personal life you deserve. By providing the services patients want, need, and can not get in any other office around you.

And as our doctors are finding out, this approach is emotionally and financially liberating. Teach patients your reasons why and most of them get it.

Be silent, and…well lets not go there.

I salute you as you move forward and welcome the opportunities to help you!

For More info, CALL us ASAP  @ 781-754-0599 or go to Perfect Practice Web

One of the most amazing things happened in our clinic last week.

One of the most amazing things happened in our clinic last week.

We actually set a record for OVs, and I didn’t even know it ’til all
was said and done.

When my staff put the stats on my desk Tuesday, I did a double take,
and yes, even got the calculator out.

Why? Because our practice is rocking even as I put in an equal
number of hours consulting, writing, creating media, etc.

The bottom line as to how and why?

I always do what I advocate for clients.

And it’s created a smooth running, profitable machine that patients
love to come to and bring their family and friends.

And with Neuropathy patients averaging
an hours drive one way to see us, passing 75 other offices along the way…

In any event, after yesterdays email we were besieged with faxes and questions
So I added a call in hour today from 1-2PM EST, for clients and prospective clients
who want to take advantage of the HUGE bonuses which expire at NOON FRIDAY EST.

But, I’m gone ’til Tuesday after today, so if you have questions, get to me today.

Call me on the bypass line at 781-659-7980 ONLY 1-2 PM EST Thursday 5/27/10.

New Neuro Docs Needed ASAP!

Doctor, these are patient requests for our NeuropathyDR Protocol from just the last week!  Please help these patients! Log on for more info!

W. Moreland, NH

Poulso, WA

Longview, TX

Hertfordshire, England

Columbia, SC

North Port, Fl

Laconia, NH

Ft. Lauderdale, Fl

Pheba, MS

Howard Beach, NY

Proctorville, OH

Normandy Park, WA

Randolph, MA

New London, OH

Westland, MI

Victoria, Australia

Bayle, MS

Taylorsville, NC

Carver, MA