Chiropractic + Naturopathic Doctor

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It’s (probably) your fault: Taking responsibility in your healthcare practice

March 1, 2020
By Anthony J. Lombardi

© fizkes / Adobe Stock

In business practice, success is usually due to a team effort, but underachievement is almost always your fault. The first step is to understand that a business problem is nearly always a personal problem in disguise. Our health, the health of others, our relationships, and financial issues are all common roadblocks to business success. Or sometimes it’s because we don’t love what we do. It could even be that we entered chiropractic school because we felt pressure from our families, ourselves, or society to do “something.”

Whatever the problem is, we must recognize how it is preventing us from achieving our business goals. Here I will outline and review four common practice issues that you can correct once you realize it’s your fault.

1. Practice is slow, and you are not generating referrals
Practices do not become slow or successful overnight – what we do daily makes it so. Your practice could be slow for many reasons. But slow patient flow doesn’t reflect your lack of business acumen, it demonstrates your ability as a practitioner. You may be a lousy clinician, you do not have a systematic approach at assessment, or your history taking is inconsistent. Whatever it is, it’s you that is the common denominator in the lack of patient flow. Some chiropractors blame the construction on the street that decreased car traffic or the changes in insurance coverage – but many practices experience those hiccups and still produce successful outcomes.


If you are not offering the patient a quality experience, they mostly have nothing to talk about. Talk generates buzz and buzz produces patient referrals. It would help if you aspired to be significantly better than the majority of your peers. It would be best if you strived to give your patient a consistently positive patient experience that they have never had at any chiropractic visit before you.

2. Patients are not re-booking after an initial assessment
The failure of patients to adhere to the treatment plan and book subsequent visits could very likely be due to part of what I spoke about in number 1. However, many times it’s because of the disconnect that happens from the time they leave the treatment room and arrive at your front desk. If your front-end staff does not correctly direct the patient, they can quickly go without re-booking. For instance, I have a routing slip, which leads my team as to when I need to see the patient again. Let’s say the slip reads: 2x next week with Dr. Lombardi. My staff then tells the patient how many times they are coming in next week and gives them two available time slots. If you read carefully, I said they tell, they do not ask the patient when they want to return. Asking confuses patients because before they leave the treatment room, I tell them when they need to come in. Being direct reaffirms my recommendation and gets more patients re-booking subsequent visits.

3. Your practice is failing because of your poor business management, and chiropractic school did not prepare you before you left it
To become a chiropractor, you took hundreds of tests and examinations and then you passed gruelling licensing standards. You are no dummy! Business practice is not as difficult as chiropractic school – or at least it shouldn’t be. Success in business is essentially this: You buy something and then you sell it for more. Further, you cannot blame the chiropractic schools because they have been providing sub-standard business courses for decades! Yet thousands of chiropractors took those classes and are wildly successful in spite of them.

4. Your staff is leaving for other jobs
People leave jobs all the time; this is nothing new. The reasons they leave are usually over money, promotion, or proximity from their home. However, even if employees get a better offer, the culture of their current employer often prevents them from leaving your place for another. Mostly, do your employees feel valued? It’s a simple question, and if the answer is no, then it is your fault. It’s your fault because your work culture or lack of it is predicated more on dollars and cents as opposed to the emotional connection of the team. I have been guilty of treating the work environment more like a mechanism and less like a cohesive unit.

To become better in business practice, it takes the ability to accept your faults, which takes self-reflection. It requires planning, and above all, hard work to determine where you are failing and what avenues you need to take to get better.

Anthony LOMBARDI, DC, is a private consultant to athletes in the NFL, CFL and NHL, and founder of the Hamilton Back Clinic, a multidisciplinary clinic. He teaches his fundamental EXSTORE Assessment System and practice building workshops to various health professionals. For more information, visit