Physician Scope of Practice

Your Scope of Practice

Have you ever considered exactly what your  scope of practice is? If you haven’t, you are most likely cutting your own proverbial throat when it comes to your earnings statement.

Wow, that sounds powerful don’t you think? We want it to!

This is a no BS wake-up call for any doctor who is not making the dollars you expect. That said, we will be the first to acknowledge it’s not all about dollars. Money in the long run means nothing if you don’t have happiness and pleasure in what you do.

Yes, dollars are nice, but satisfaction and happiness are critical as well. So, don’t think we are only talking about money here as we address your physician scope of practice.

What Is Your Scope of Practice?

Sometimes it’s easier to state what your scope of practice is not. As a matter of fact, this is one of those instances. In your practice, you should not take out the trash, make appointments, draw blood, work on computers, file, etc. Of course, this list goes on and on.

What you should be doing is seeing and treating patients, period.

You should delegate the rest of the tasks of the office appropriately throughout your staffing makeup. But, then again, you must have the correct staffing model in your office. It’s also critical to make sure everyone works to the top of their license and skill level.

There are hundreds of staffing models out there. Many of them put together by people who know absolutely nothing about running a physician office.

If you want to learn how to do it correctly, you want to turn to someone who has walked in your shoes and knows where you are coming from on all angles.

Is that possible? It most definitely is!

Our team over at Perfect Practice Web has put over 30 years of knowledge together to help others learn to achieve the success we have discovered. These are tried and true and time-tested success methods.

We’d love to help you take yourself to the next level, so you always stay within your scope of practice. Come see what we have to offer HERE or give us a call at 339-793-8610. We’d love to chat with you!

Multi-Modality Treatment Plans

Do you have time to keep up to date on multi-modality treatment plans?

Most likely, your answer to this is no. That’s what we used to think too. Then, something happened.

As a team comparing notes, we began to realize we all felt the same way. We were not treating patients. Consequently, what we found was, we were just treating disease with medicine. In a nutshell, that’s what practice had become. Most importantly, we realized we wanted more.

Sure, some patients will keep coming back. Because, they don’t know what else to do. But…are you really doing what you want to do? Are you happy and content with the way things are or did you go into medicine for something different?

Personally speaking, I went into medicine to help people; to make patients better. Of course, I also want to make a nice living, but there’s more.

But, what does it really mean to make people better?

Here are a few things it doesn’t mean:

  • Cure everyone
  • Cure everything
  • Make everything perfect
  • Satisfy everyone

Certainly, we could only wish!

But…there are a lot of things we can do differently that will move us further along the continuum toward really helping patients. Of course, done well, we will also achieve greater financial success without near the battle. Therefore, embracing other options and putting together a more holistic approach to treatment, you will help many more patients. Then, your private practice will grow like wild fire.

Multi-modality treatment is the answer.

This means moving beyond simply one approach to new horizons. Besides, we need to learn what school forgot to teach us. Yes, I know you don’t have time. I didn’t either. Or so I thought. Now, I know I didn’t have time not too.

What Does Multi-Modality Treatment Mean?

Simply put, multi-modality treatment is about using all the resources at our disposal. For us, that means a lot of new learning and an exciting time. Here are just a few of the options out there:

  • Multi-modality pain management
  • Nutritional Counselling
  • Exercise as Medicine
  • Laser therapy
  • Medical practice marketing (People must know about it)
  • Word of Mouth advertising

And yes, the last two bullets are part of an effective treatment plan. Besides that, what you do must be known!

In case you haven’t already figured it out, there are few shortcuts in life. We’ve learned mentors are one of the best in existence. Besides that, I’ve had some great ones in my life and I wanted to share that with others. That’s why I’ve developed a team and a method to help others. We are here to help you. I’d like to talk to you about joining up with my team of experts.

Finally, here at Perfect Practice Web, our intent is to help you to grow your practice. Most importantly, we will help you be much more satisfied practitioner.

How do we do that?

We help you to continue grow and evolve in your approach, Then, we help you grow your practice to new heights. By allowing us to partner with you, you will benefit from over 30 years of hard-won experience.

Don’t be satisfied or become complacent. Because, if you still feel you have more to achieve, there’s no time like the present. Reach out and Let Us Help!


Are You Guilty of Underpricing Your Future in Private Practice?

A key business skill is pricing and collecting for your services appropriately.

Hands with scissors cutting money

If you work inside a public health system this article is not for you.

Here at Perfect Practice Web, our concern is helping those who have decided to stick it out in the private sector delivering healthcare services to their community directly day in and day out.

It is a sad fact that physicians and other healthcare providers often times have been vilinized by the press as overpaid uncaring professionals.

Now of course as with any profession you will find some of this for sure. But the bottom line is that most are dedicated professionals with years of schooling whom have given up massive amounts of their personal lives to help the patients they serve every single day.

But many end up unfulfilled as so many private practice owners lack both the freedom and income to support this professional life style, which is so essential in todays world.

It doesn’t make a difference what letters come after your name.

It’s no secret this is now more challenging than ever before.

Why though?

Despite the fact of massive government and third-party rules, regulations, reimbursement, and schedules, many private practice owners continue to thrive.

But why do so many find it’s so difficult or worse yet, fail in private practice? Nowadays it’s because of the lack of effective marketing and most especially the lack of current or inappropriate business skills. One of these key business skills is pricing and collecting for your services appropriately.

Harsh words? Yes, of course. Make no mistake about it this is your future! AND IT’S THE COURSE YOU CHOSE FOR YOURSELF!

Remind yourself every day that it is a decision to stay in private practice or to try and secure a job in the public sector.

So why not fix what’s currently not working in your practice today?

Provide yourself and your family with the future you so deserve. Make a decision now to get the business help you need to order to move forward in a constructive and profitable way!

That’s why we are here. Let us help. Facebook !

“Susan’s pain was so bad that she had trouble telling hot from cold, and even experienced trouble walking.”

A lot of your patients have heard that there is no cure for neuropathy, and they get discouraged.  As someone in the medical profession, you want to be able to dispel this misconception that your patients will just have to live with their symptoms!  NeuropathyDR® can teach you the non-pharmaceutical means to lessen their pain and improve their life.   “No cure” isn’t the same thing as “no help!”

A great example of a patient we have been able to help with the NeuropathyDR® methodology is Susan.  Susan is a diabetic in middle age who has suffered for more than twenty years with neuropathy symptoms.  Most prominently, Susan has tingling and severe pain in her feet, with the same problem less severely in her hands and arms.  Susan’s pain was so bad that she had trouble telling hot from cold, and even experienced trouble walking.

When she came to us, Susan was taking prescription-strength Advil several times a week for the pain in her hands and feet.  Medication has its place, and can be effective in some cases, but it is too often the first—and last—course of action medical professionals resort to when it comes to neuropathic pain.   NeuropathyDR® promotes newer, non-pharmaceutical methods that have been proven to reduce pain and numbness in cases like Susan’s.  After we applied the NeuropathyDR® protocols, Susan’s symptoms subsided drastically and her quality of life began to improve.

Especially in the short term, we want to help reduce the overall level of chronic pain and restore any mobility that might be lost.  In a case like Susan’s, the NeuropathyDR® protocols target three specific areas of treatment:

  • Specifically-directed manual therapies to correct aberrant motion or misalignment in areas of the spine and pelvis, as well as addressing the soft tissue contractures in the neck, legs, feet, arms, and hands.
  • Our NeuropathyDR® nutrition protocol, consisting of a daily regimen of combined nutrients that have been proven to be supportive of the nervous system in slowing the progression of neuropathy and healing damage.
  • Finally, the application of neuro-stimulation in the affected areas.  We use a waveform treatment in the office and at home that opens up nerve pathways to let them heal.

Susan’s treatments recurred three times a week for five weeks, for a total of fifteen treatments.  Following each treatment, Susan reported that the level of pain and tingling had subsided by two-thirds or more.

Powerful Manual Therapies are Key…

After applying the NeuropathyDR® protocol, Susan noticed a terrific improvement in her lifestyle.  In her own words, her energy level tripled, and the inflammation and pain in her feet had reduced by ninety percent.  Our objective tests, going by a round before and after the treatments, showed that Susan’s spasms in the lumbar and thoracic paravertebral muscles had improved by seventy percent.  Her range of motion without pain had also increased by seventy percent, and her ability to sense heat, cold, and vibration had drastically improved.  Perhaps the biggest lifestyle-boost of all, Susan experienced much less pain when walking after applying the NeuropathyDR® methods for five weeks.

We followed up with Susan three months after her treatments with us, and she was continuing to do extremely well.  She has been diligent about keeping up her assigned home-care treatments, and she visits her clinician as-needed for checkups.  Especially in-light of her twenty-year struggle with neuropathy, the degree of Susan’s success is remarkable.

If you treat patients like Susan who suffer from neuropathy symptoms, we are a valuable resource to help you treat them.  Contact us with specific questions and to learn the NeuropathyDR® methodologies we have developed.  Our protocols are proven to work—don’t let your patients go without proper care!

Another Niche: Become an expert in Entrapment Neuropathy Care!

Entrapment Neuropathy:  More Than Just Carpal Tunnel!

Last week we discussed carpal tunnel syndrome (CTS), one of the most common forms of neuropathy affecting a single nerve (mononeuropathy).  What many of your patients might not know is that carpal tunnel syndrome is only one of the entrapment neuropathies common in the upper limbs.  The other entrapment neuropathies are not as well-known in the mainstream as CTS, and so patients who suffer from nerve symptoms in their forearms and hands frequently jump to conclusions!  We’re here to help you set the record straight.

An entrapment neuropathy, also called nerve compression syndrome, occurs when a nerve is wedged or “pinched” against a bone, inflamed muscle, or other internal mechanism in the arm.  Aside from the median nerve (the one associated with CTS) there are two main nerves that help to control the arm and hand: the radial nerve and the ulnar nerve.  Both are susceptible to compression, and the results can be painful!

Entrapment occurs under a number of conditions, most commonly:

  • When there is an injury originating at a patient’s neck or a disease of their cervical spine
  • When your patient’s elbow has been injured due to fractures or improper use
  • When your patient’s wrist has been injured due to fractures or Guyon canal alignment problems
  • An aneurysm or thrombosis in the arteries

    Make no mistake, entrapment neuropathy patients need non-surgical specialist care!

  • Factors commonly associated with peripheral neuropathy, such as diabetes, rheumatism, alcoholism, or infection

The radial nerve runs the length of the arm, and is responsible for both movement and sensation.  Radial neuropathy usually occurs at the back of the elbow, and can present with many of the common symptoms of neuropathy such as tingling, loss of sensation, weakness and reduced muscle control (in this case, your patient will often complain of difficulty in turning the palm upwards with your elbow extended).

A number of palsies affect the radial nerve, such as:

  • Saturday night palsy (also called Honeymooner’s palsy), where the radial nerve is compressed in the upper arm by falling asleep in a position where pressure is exerted on it by either furniture or a bed partner
  • Crutch palsy, where the nerve is pinched by poorly-fitted axillary crutches
  • Handcuff neuropathy, wherein tight handcuffs compress the radial nerve at the wrists

Two main conditions affect the ulnar nerve: Guyon’s canal syndrome and cubital tunnel syndrome.  Guyon’s canal syndrome is almost exactly the same in symptoms as carpal tunnel syndrome (pain and tingling in the palm and first three fingers), but involves a completely different nerve.  Guyon’s canal syndrome is caused by pressure on the wrists, often by resting them at a desk or workstation, and is frequently experienced by cyclists due to pressure from the handlebars.

Nearly everyone has experienced cubital tunnel syndrome: it’s the “dead arm” sensation we’ve all felt when we wake up after sleeping on top of our arm!  Sleeping with the arm folded up compresses the ulnar nerve at the shoulder, causing it to effectively “cut off” feeling to your arm.  As you and your patients all probably know from experience, this sensation is unsettling but temporary.

Diagnosis for all compression neuropathies is fairly consistent.  We advise a visual and tactile examination of your patient’s arms, wrists and hands, along with a test of the patient’s independent range of motion (as mentioned before, difficulty extending the elbow could indicate radial nerve damage).   Blood or nerve tests can help establish underlying conditions that may contribute to neuropathy.  The Tinel and Phalen tests will also help determine loss of dexterity and sensation that could indicate a compression neuropathy.   MRI or x-ray scans are common to pinpoint the specific location of a compression.  Contact NeuropathyDR® if you have any questions about your patient’s symptoms or the correct way to check for compression neuropathy.

Similar to carpal tunnel syndrome, most cases of entrapment neuropathy are mild. Treatment for these mild cases involves ice, rest, and a change in habits of motion or stress that are causing the symptoms.  For more severe cases, you might choose to prescribe painkillers or anti-inflammatories, and in extreme cases, a surgical solution is sometimes justified.

If you would like to know more about how to treat patients who suffer from compression syndrome or other types of neuropathic pain, NeuropathyDR® can help!  As a training resource we can help you treat your patients, as well as help the patients you can benefit find you!


Alternative Therapies for Your Chemotherapy Induced Neuropathy Patients

Alternative Therapies for Your Chemotherapy Induced Neuropathy Patients

One of the more challenging patient populations you can treat is the chemotherapy induced peripheral neuropathy patient.  They’ve already been through the cancer diagnosis and are either in the midst of chemotherapy or they’ve finished their treatment.

Just when they think they’re done with all the side effects of chemotherapy, they’re visited with[1]

–       Shooting pain

–       Burning and numbness

–       Tingling in the hands and feet

–       Inability to sleep because of the pain

These Patients Require All Your Skills!

Can you imagine the frustration?

Chances are really good that no one told them that chemotherapy induced peripheral neuropathy (CIPN) was a potential side effect of their treatment because, let’s face it, no one can really predict which patients will develop chemotherapy induced peripheral neuropathy.  Why bring it up if you don’t know for certain that it’s going to happen?

For many, their symptoms last well beyond their chemotherapy.

For your CIPN patients, the first option is, of course, drugs to deal with the pain.  But many chemotherapy induced peripheral neuropathy patients are choosing to be more proactive and do everything they can to alleviate their current symptoms and lessen the possibility of permanent nerve damage.  They don’t just want to take a pill to make them feel better. They want to give their bodies the best treatments available.

What Else Can They Do?

More and more CIPN patients are opting for what used to be called “alternative medicine” treatments.  While many think of anything outside of conventional medicine as “alternative”, that’s really not accurate.  Alternative treatments are defined as anything not approved by the Food and Drug Administration.  The treatments we’re talking about here are more complementary or integrative therapies.  In other words, they’re therapies used in addition to and to complement traditional medicine, not taking the place of it.

Because of the growing popularity (and effectiveness) of these complementary and integrative therapies, the medical community has actually named them – Complementary and Alternative Medicine.

Some complementary and alternative therapies providing good results for chemotherapy induced chemotherapy patients are:

–       Cancer treatment specific diets

–       Herbal supplements

–       Non-herbal supplements (like Vitamins B6 and B12, alpha lipoic acid)

–       Acupuncture

–       Massage therapy and Reflexology

–       Exercise

–       Homeopathic and ayurvedic medicine

Any of these therapies, in the hands of skilled practitioner, is a great complement to your chemotherapy and other cancer treatment and can provide substantial relief from chemotherapy induced peripheral neuropathy pain.  Offering these services to your chemotherapy induced peripheral neuropathy patients is an excellent way to treat the whole patient and not just the symptoms.

Involve Their Oncologist

Before you start any Complementary and Alternative Medicine treatments with your chemotherapy induced peripheral neuropathy patients, talk to their oncologists.[2] Make sure that what you’re planning to do will not have an adverse effect on their chemotherapy regimen (some antioxidants do).  Always keep the oncologist in the loop on what you’re doing to complement or following a chemotherapy regimen.

Why These Complementary and Alternative Medicine Treatments Work

Many of the Complementary and Alternative Medicine regimens we mentioned above will help deal with and even alleviate some chemotherapy induced peripheral neuropathy symptoms.

The body is a finely tuned instrument and all the systems work together.  Massage therapy, acupuncture and Reflexology can help with muscle pain and stimulate the systems within the body to fight the cancer.

Certain supplements can help give the body the nutrients and vitamins it needs to repair itself and eliminate the possibility of permanent nerve damage caused by chemotherapy induced peripheral neuropathy.

Treating the Whole Patient By Working With The Whole Team

None of the medical specialties treating chemotherapy induced peripheral neuropathy patients operates in a vacuum.  You all need to know what the others are doing.

Luckily, most oncologists these days are familiar with the Complementary and Alternative Therapies chemotherapy patients are turning to for relief from the chemotherapy induced peripheral neuropathy symptoms.  Make sure that you involve your patients’ other treaters in your care by communicating with them.  By integrating your Complementary and Alternative Medicine treatments into the overall treatment program, you have a much better chance of giving your patients the optimum results they deserve.

When you are ready, 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



Helping Patients with Acute Kidney Failure

Most people think that acute kidney failure would present with symptoms too obvious to ignore.

They expect to be bedridden…deathly ill…in and out of the hospital…

What they don’t realize is that acute kidney failure often doesn’t cause noticeable symptoms.  Many times it’s detected when the patient is already in the hospital for something else and evidence is found through tests.

As a clinician, especially a NeuropathyDR® clinician specializing in treating patients with neuropathy, that makes your job especially tough in reaching out to these patients and getting them in for treatment before it’s too late and permanent damage is done.

Most of the time, you won’t see these patients until they have[1]

∙           Swelling, especially in the legs and feet

∙           Cramps, muscle twitching or muscle weakness

∙           Little or no urine output

∙           Thirst and a dry mouth

∙           Dizziness

∙           Rapid heart rate

∙           Nausea, vomiting and loss of appetite

∙           Confusion

∙           Anxiety or restlessness

∙           Pain on one side of the back just below the rib cage but above the waist

∙           Fatigue

These are all symptoms of acute kidney failure.  And the root cause of many of these symptoms is a serious complication of kidney failure – uremic neuropathy.  Uremic neuropathy or neuropathy associated with kidney failure is a very common complication of kidney failure.

The sad thing is that by the time they’re exhibiting several of these symptoms, their uremic neuropathy may have already done serious damage to their body.  If you have patients with conditions like lupus, diabetes or hepatic (liver) failure, they’re especially prone to acute kidney failure and uremic neuropathy.  Your best bet to treat them effectively and keep them off dialysis and off the transplant list is to educate them.  The more they know about the possibility of developing uremic neuropathy from acute kidney failure, the more likely they’ll be to show up in your office for help before they have irreversible problems.

First, explain uremic neuropathy…

What Is Uremic Neuropathy[2]?

Uremic neuropathy is a type of neuropathy caused by an increase in uremic toxins in the blood (the toxins urine usually removed from the body when the kidneys function properly.) The severity of their uremic neuropathy is directly linked to the severity of their kidney failure.  If their kidney failure is acute, their uremic neuropathy is pretty serious.

How Can Kidney Failure Lead to Neuropathy?

Neuropathy is one of the worst results of chronic kidney disease.  Acute kidney failure damages the kidneys.  When the kidneys are damaged fluids, waste products and toxins build up in the body.   Because many organs and bodily systems (particularly the nervous system) are directly affected by this build up of toxins, acute kidney failure leads to overall poor health and inflammation and nerve damage.

Once the nerves are damaged, they cease to function properly.  One complication leads to another and, in 20% to 50% of patients with acute kidney failure, they’ll develop uremic neuropathy.

Treatment and Prognosis

Your patient’s best course of action is to catch their kidney issues before they become acute and they develop uremic neuropathy.  Unfortunately, once the kidneys are that severely damaged, dialysis and possible kidney transplant are virtually inevitable.

That’s why you need to impress upon your patients how vitally important it is that they not ignore symptoms and that they seek treatment immediately once they notice a problem.  Acute kidney failure and uremic neuropathy are not conditions that just get better on their own.

As a NeuropathyDR® clinician you have a wonderful protocol to assist you in working with your patients and their whole medical team to treat and manage your underlying condition before they become acute.

Some programs you can offer your patients are:

∙           Diet Planning and Nutritional Support

They need to give their bodies the nutrition they need to heal.

A low protein diet is best for patients with kidney disease.

If your patient has diabetes, they need to follow a diet specifically designed for diabetics and to control their blood sugar.

∙          Individually Designed Exercise Programs

If your patient is experiencing dizziness, rapid heart rate, extreme thirst or issues with impaired sensation in their feet and legs, they have to be very careful with their exercise program.  You can design an exercise program specifically for them that will allow them to exercise but not push them beyond what their body is capable of.  And, even more importantly, continually monitor their progress and adjust the program as needed.

These changes in conjunction with medications and possibly more involved medical intervention will make it easier to live with acute kidney failure and uremic neuropathy. Early intervention with a NeuropathyDR® clinician is still the best policy if they have any of the underlying conditions that can cause uremic neuropathy.  If they already have symptoms, start treatment immediately.

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








The Whole Package – Nutrition Planning for Your Post-Chemotherapy Patients

Treating patients in the recovery stage of cancer, the post-chemotherapy patient, can be incredibly rewarding.

They’ve already been through the fire.

Now they’re looking for your help in dealing with issues of recovery – coming to terms with the side effects from

∙           Chemotherapy

∙           Radiation

∙           Experimental treatments including possible hormone therapy

Chances are your post-chemotherapy patients are suffering from

∙           Loss of appetite

∙           Nausea and other digestive issues

∙           Post chemotherapy peripheral neuropathy

∙           Dry mouth

Or some combination of these post-chemotherapy symptoms.

One of the most important pieces of the post-chemotherapy recovery puzzle is nutritional support.

If you’re not already offering diet and nutrition counseling to your post-chemotherapy patients, it’s time to start. More and more research is confirming that proper nutrition is key in successful recovery from chemotherapy and other cancer treatments, as well as recovering from the cancer itself.

The body requires essential materials, vitamins and nutrients, to heal.  Without them, no medical treatment has any hope of succeeding.

Helping your post-chemotherapy patients with planning their diet and making food appealing again will work wonders for the success rate of your treatment in this patient population.

Here are some things to think about when designing a cancer recovery nutrition program:

Basic Cancer Nutrition Tips[1]

The post-chemotherapy patient’s body (or even the patient preparing to start chemotherapy) needs increased support for the immune system.  The best option for doing that is a diet rich in whole foods that are easy on the digestive system.  Make sure your patients’ cancer recovery diet includes foods that are high in anti-oxidants and protein.  Your post-chemotherapy patient diet plan should include foods rich in vitamins, especially vitamins C, D and E and nutrients like soy isoflavones, amino acids, folic acid, l-glutamine, calcium and carotenoids.  Encourage your patients to drink as much water as possible and don’t worry about keeping their calorie count low.  This is the time to take in all the calories they need, as long as the calories come from beneficial foods.

Chemotherapy and radiation may affect your post-chemotherapy patients’ ability to digest foods so encourage them to invest in a good food processor and/or juicer.  Both of these tools will allow them to prepare foods that are easy to ingest and digest while still getting the nutrition they need.

Foods To Rebuild The Post-Chemotherapy Patient’s Body

It’s easy to say “eat foods that are high in vitamins” but your post-chemotherapy patients may not know exactly which foods they need.  Here are some suggestions for foods to aid in cancer recovery and fighting chemotherapy symptoms[2]:

Vitamin C

∙           Red cabbage

∙           Kiwi fruit

∙           Oranges

∙           Red and Green Bell Peppers

∙           Potatoes

Vitamin D

∙           Salmon and tuna

Vitamin E

∙           Nuts, including almonds and peanuts

∙           Avocados

∙           Broccoli


∙           Apricots

∙           Carrots

∙           Greens, especially collard greens and spinach

∙           Sweet potatoes

Soy Isoflavones

∙           Soybeans

∙           Tofu

∙           Soy milk – this could also be helpful if you need to go lactose-free

Folic Acid

∙           Asparagus

∙           Dried beans

∙           Beets

∙           Brussels sprouts

∙           Garbanzo beans

∙           Lentils

∙           Turkey

These are just a few examples.  If you’re unsure about other nutrition recommendations, talk to us.  We can help assist you in devising diet plans that will help rebuild their immune systems.

Use Herbs and Spices to Give Your Food More Flavor

Herbs and spices are a natural way to flavor food without adding man-made chemicals.  And many herbs have natural medicinal properties of their own.  Suggest these herbs and spices to help your post-chemotherapy patients make their food taste better.  If it tastes better, they’ll eat more:

∙           Cinnamon

∙           Basil

∙           Coriander

∙           Cumin

∙           Ginger (natural anti-inflammatory properties, too)

∙           Garlic

∙           Mint (great for fighting nausea as well)

∙           Fennel

∙           Turmeric

We hope this gives you some insight into diet planning and nutrition counseling for your post chemotherapy patients. Offering these services to your cancer patient population can be the missing piece in the puzzle of successfully treating the patients in this growing specialty and help you build a successful medical practice as well.  The combination of your medical expertise and proper nutrition support and counseling is a win/win for doctor and patient.

When you are ready, 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



Marketing the Specialty Medical Practice – Part 1

You know the issues…

Your chiropractic physical therapy or medical practice offers a myriad of special services…

•      For women to combat the effects of osteoporosis and/or hormonal issues

•      Sports rehabilitation services for the athlete

•      Recuperative and NeuropathyDR™ Treatments for seriously ill patients

Any of these specialties should be bringing in the kind of varied patient population that would not only keep your practice exciting but do great things for your bank balance as well.

Still, day after day, you treat the strained back from the construction worker or the sore knees of the weekend warrior.  And there’s nothing wrong with that.  You just know you could be doing more.

You know the demand for your real expertise and special services is out there but for some reason you’re not reaching them.

It’s not a lost cause…

Try these tips for reaching the kind of varied patients you know you can help:

Get In Front Of Your Prospects

You know you can help all these patients but if they don’t know you exist, you can’t help them.

You have to take your message to them.  Go where you know they are.

If you want to treat sport injuries or athletes, advertise with the local marathon organizers.

If you want to specialize in senior care, get your message out to the local senior centers and retirement communities.

For chiropractors and physical therapists:  If women are your target market, start networking with ob/gyn’s referrals or speak at local professional women’s clubs on the benefits of specialty care for common female complaints.

Stay tuned for more tips on growing your specialty practice and living and practicing by design.

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 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.

What Drives Your Practice? Part 2

Turning Obstacles Into Opportunities

Knowing the purpose of your practice allows you to see the larger picture and meet obstacles head on and plan for a successful resolution to problems.  Every practice, regardless of size, location or specialty, faces obstacles.

Do any of these potential problems sound familiar?

  • Funding
  • Staying ahead of competition from other physicians and specialties
  • Planned growth and expansion
  • Managing patient outcomes and measuring success of treatment

Once you’ve determined your overall purpose and goals, you become more of a “big picture thinker” – anticipating problems and planning solutions before they occur.  If you know where you’re going, you have a better idea of how to get there.

Having a clear picture of your purpose allows you to do your homework and take appropriate action when opportunities present themselves.  You don’t circle the drain, studying the problem, asking for more information and letting opportunities pass you by while you “think about it”.

‘I like his stuff but I hardly know this guy…’

‘I like his stuff but I hardly know this guy…’

Jes is hearing this more and more from docs around the country, who is this guy on Nantucket, Marthas Vineyard, Washington one week, then tooling around on the Bimmer?

This guy is me, a 54 year old with a 12 year olds passion for motors and baseball.

I’m the guy who pioneered the no bull way to run private practices.

Look, here’s the real deal I have never shared publicly.

5 years ago, I became instantly disabled, had to close my second office I had recently opened.

For 9 months, every movement was constant pain. During this time, I showed up in the office as the coach, every day except for the hospital admission. Spent half the days or more, between MRIs, EPs, neurosurgical and neurology consults on my back, in my office. More on that another time.

My associate doc who I pulled from the second office worked with my coaching using my systems, seeing most patients.

My practice did not drop. Not a beat! In fact, my disability insurance company ultimately gave me a real hard time because my practice income stayed up!

Why you ask? Because the real power in practice, and yes indeed life, real freedom, is in the impeccable sytems.

Now, you too can learn all of this, practice it, end up free and financially independent like our successful member docs.

Or miserable and unfulfilled in one of the greatest healing arts. It pains greatly when docs call me with those stories.

If you are ready, the teacher has appeared.

Pick my brain or just introduce yourself on Special Call in Day (781-659-7989) this Wednesday 8/5 1-2 PM EST.

I’ll take my helmet off long enough to answer your questions, first come. 5 mins max.


Watch More from the seat of my R1150RS to learn about the NO BULL way to run your life and practice…

Then Go To

Have a Great Day!


It’s now or never: Fixing Healthcare with Common Sense

Fixing HealthCare with Common Sense

What it will finally take is anyone’s guess. Our candidates for public office are great at talking a good game, and oh what a show Wednesday on ABC promises to be, but what ultimately it will take is a combination of “Common Sense” (written in 1776 from Founding Father Thomas Paine*) and a return of major corporate ethics, with effective, consumer driven oversight and simplified regulation.

Assuming we keep a private, free enterprise system, lets finally put the consumer in charge, just like with other types of insurance. Lets simultaneously expand HSAs and FSA programs and benefits to further breed responsible healthcare consumption.

It is likely the best solution, easiest to implement without burdening us with bigger government. I say let companies like Geico, Progressive and others that market auto insurance direct to consumers into the ring. Let consumer choice drive them to cut costs by uncoupling dollars from non-benefits payment. Give them simple rules to follow, nationwide, exempt from state lines. This could be huge, and would not take any dismantling of our major delivery systems.

Remember, Medicare runs on 4% administrative overhead, but currently private health insurers are closer to 25%. Much of this goes to the questionably ethical profiteering of extreme proportions, exorbitant salaries for executives and contributes to ridiculously poor provider reimbursements.

And, how about adding return of premium benefits to reward the healthiest while not penalizing the seriously ill. This is a tremendously powerful idea that would reap huge benefits for the consumer. It’s already done with disability and some other types of insurance and mutual insurance companies regularly pay dividends to payees. So, Lets make sure that some of insurance premium dollars can be returned if consumers stay healthy.

Lets also finally de-link health insurance from employers and employment benefits once and for all. This has been an absolute catastrophe. Even the Boston Globe recently acknowledged this. The extreme burden on US businesses of all sizes from health care premiums is well known. The trickle down benefits to business, like the automakers, municipalities and others could also be a huge economic stimulus.

Uncoupling health insurance benefits from employment would make consumers ultimately more fiscally savvy and responsible. This could quite likely increase their wages simultaneously as employees would now purchase all benefits outside of their work. Uncle Sam can help with deductibility and tax exemptions, maybe larger in the beginning to help foster the transition.

I also believe that there should be real consumer dollars available for CAM (Complimentary and Alternative Medicine) that can be used in the treatment of our most common and non-life threatening disorders especially if the consumer does not utilize more expensive traditional pathways for the same condition. Back pain and headaches are two very real examples that both happen to be still the most common reasons for doctor’s visits, and are at least in part linked to stress and unhealthy lifestyles.

This mechanism alone would foster consumer education to choose their own healthcare pathways with taking an additional financial hit in addition to premiums.

Any effective system must simultaneously provide equitable reimbursement and other incentives to all licensed doctors of all disciplines as well as ancillary providers for our society to keep great healthcare providers in the system.

This must include simplified reimbursement schedules, equal across the professions for identical procedures. I strongly favor a diagnosis-based system with utilization review only for those cases outlying the norms. This could be a technological piece of cake with a national electronic healthcare database for all Americans.

Of course, there are other issues that need to be simultaneously addressed. These include malpractice provisions (some experts suggest in a separate healthcare “court” in addition to capped awards). Better awareness of poor outcomes vs. malpractice by society at large would really help as well.

Drug costs, competition and widespread availability of tested alternatives to prescription drugs all need to be handled. Again, a consumer driven Wal-Mart type of distribution may be what already does it.

So, how can we help? Lets make sure we educate ourselves first and foremost as to what’s wrong with our current system and push our lawmakers toward better consumer choices. Take a real hard look at their differences on these topics when you vote and support any politician, as some are huge. Let your patients know who these consumer friendly elected officials are in your area are too.

Utilize cost effective preventive screenings in your practice, and advocate the same for our families. Lets make sure we teach our kids and our patients all the rewards of better health choices like non-smoking, stress management, diabetes prevention, relationship choices including illicit drugs and sexual behavior, and permanent weight control.

How it will all turn out is anybodies guess. I continue to be as vocal about these issues with my patients and community, and urge you to do the same.

Not Unlike Thomas Paine did over 200 years ago.

(*Society in every state is a blessing, but Government, even in its best state, is but a necessary evil; in its worst state an intolerable one: for when we suffer, or are exposed to the same miseries BY A GOVERNMENT, which we might expect in a country WITHOUT GOVERNMENT, our calamity is heightened by reflecting that we furnish the means by which we suffer.)