Lawyers PI Program
“Building a PI Practice”


 From the Desk of:


“Break the Barriers of Volume Growth….Get to That Next Level...

It Is Really Easy…Just Get Out of the Way”


If you haven’t introduced a written report of findings along with a video for patient education, then go back, read the consult and create the system. Unless you have taken those steps, your practice will be stuck in the same place. Remember, the definition of insanity is to do the same thing again and again and expect different results!


“The key to success in any business or activity is to have a systematized infrastructure that is reproducible. If you do not have systems in place that are based on success principles, you are practicing failure technology and you will not succeed…ever”

Mark Studin


In the previous consultations I have discussed the critical steps of educating your patients and then tracking their visits with a “Made-Up-Missed” (MUM) system. Incorporate these steps with a clinically accurate treatment plan, and you have a winning formula for a successful practice. The MUM system has been the least embraced nationwide, yet it is the single best system for increasing volume, as long as it is done ethically. I want to expand on the concept, so that you can see it from another perspective and then embrace the concept with either my paperwork, or your own. Either way, it must be done.

Here is feedback from one of the doctors that has embraced the MUM system.


“Dr. Mark

I want to give you some props. Your scheduling and MUM (Made Up Missed) systems have worked very well. Usually during the holiday week my numbers drop considerably but this year because my staff has better tools to use, our numbers have actually increased each day. After 7 years in practice I thought I had scheduling all figured out but I am happy to learn that there are even better systems. Thank you for helping my practice grow.

Dr. John”


The MUM system is simply a concept that captures each missed visit and then tracks the patient, so that they make up each visit. Computers are great and extremely efficient; I personally am a computer nerd and work very hard to automate everything in my life. In fact, it is the computer that allows me to offer my services at such a low fee because everything is automated and my overhead is very low, as a result. The goal in your office is the same; automate everything you can, so that you do not have to hire the staff where technology can take over.


This system is one place that technology is too efficient and paper is actually better (I get hives just writing that). When a patient misses an appointment, historically your computer spits out a report for the day listing who missed their appointments. If you are on a paper appointment book, then you have a note in the book, or create a post-it that is pasted somewhere, or you write it on a sheet.


The next step is to get to those patients on the phone and have them re-schedule the appointment. If the staff can’t get the patient on the phone that day, most offices turn the page in the appointment book, or keep the computer sheet in a log and place today’s misses over yesterdays, having to go back. The truth is most staff member DO NOT GO BACK TO CALL THE PATIENTS. Do not believe me…Go look yourself and ask your staff very pointed questions. I have been there and my staff hated to recall patients, so they made very little effort because in their minds, they felt the patient was going to come in anyway, the next day.


The staff is actually correct, as most patients will eventually return. However, what they don’t do is have them make up the missed visit. The second problem is that 10% of the patients will not come back and will terminate their care. You usually don’t find that out until you “feel” them missing. By then it is too late, as too much time has elapsed and they choose not to continue. If that continues over time, you lose 10% of your practice each week and that can be catastrophic to your practice.


Look at the numbers; if you see 100 patients per week and you lose 10% of your visits, that represents 4-5 patients averaging 2 visits per week each. Therefore, in order to maintain your practice, you need to add 3-4 new patients per week, capturing those lost visits to simply maintain your volume. In this typical scenario, your practice will perpetually stay in the same place; stuck in neutral at 100 visits per week (or wherever your volume is), and you will constantly scratch your head not being able to break through the volume barrier. If you have a bad stretch of 2-3 weeks where new patients are very low, then your volume drops dramatically.


The MUM system creates a form where every patient that misses a visit gets posted on the form, and each week the staff works to get the patient to make up the missed visit. A phone call is critical, not to say, “You missed your appointment.” That is like saying to the patient, “Moron, where were you?” No…We call and say, “I am calling from Dr. Studin’s office and we were worried about you because we didn’t see you at 11 AM. Is everything OK?” Come from a posture of concern and love. 1000’s of patients over many years and in many offices have personally told me that it was the nicest feeling to know that a doctor’s office actually cared enough to call and see if they were simply “OK.” It was also their best experience with a doctor’s office and let me know that they would tell their friends, as well.


At the end of the week, tally the missed appointments and the ones that rescheduled, and create bonus systems for your staff. I created a system that bonused my staff at 50%, where each front desk staff member (I had 3 front desk staff members) got a $25 bonus.








Look at the numbers…If I was at 100 visits per week and I made up 6 visits and averaged collecting $100 per visit, then I captured $600. It was worth a $40 bonus times 3 for me. I paid $120 to get $600, a great return on investment. You have to work out the right numbers for your practice.

Dr. Pellegrino in Florida, just yesterday, wrote me a great twist on the MUM system and it is a powerful twist:


“Dear Mark

What I was writing about (and you can share this if you like) was to tell you how much I love the MUM concept. I do not know how much power there is in just the form, versus the dozens of other capture forms I have developed or seen and used over the years, but there is real magic for me when I take my existing patients and say to them that when we need to make a difference in their condition, they have understood it all wrong. They thought it was about 2x a week or 3x a week but it is really how many visits in a period of time that makes the difference. This works great on a Monday or the first visit of the patient for the week. First I direct and they help choose the number of visits we should have over the next 4 weeks to make good progress for their condition. Using my printed calendars which I could never get the power into over the years this easily, I help them choose appointments to get that number for the time period then (The Magic of MUM) helps me get them to easily understand that it is the total number of visits in that time period that matters and write it on the top left (6 visits in 4 weeks). I then circle the 4 weeks and tell them that if they need to move an appointment or make-up one they missed I care that there are 6 visits done within that circle. And we then set a goal for what we want accomplished in that 4 weeks.

Dr. Rocco P.”


Rocco has captured the essence of the MUM by creating a total number of visits over a time period. As long as this fits your clinically appropriate treatment plan, remember it’s the number of visits over a specific time frame that makes the structural corrections. Not the spacing of visits spread out in any given week. Therefore, if a patient has to be out of town on business, or is away on vacation or any other reason valid to the patient, you are giving them an opportunity to reach their individual goals of getting well by using a number of visits in your treatment plan over a finite time frame. This does not mean that patients do not make appointments, they do. However, they get the opportunity to complete all of their visits and feel good about their accomplishments by not limiting them to one week intervals.


THE NEXT CRITICAL COMPONENT is how long in advance you make appointments. They should be made one month at a time. Your appointment book should not go week to week and always be empty the following week. It doesn’t work. If you want to grow, fill your appointment book for a whole month. You need to get the patients to cooperate by creating a paradigm shift within the patient. It’s simple, tell them that you are getting busier and you want to ensure they get the appointment times they need to fit their busy schedules. Also, let them know that they can re-schedule if they need to, so they don’t feel trapped into a time slot.


As a note, move the patient, if your front desk has a choice, to a “non prime-time” appointment. That means off of the lunch hour and drive time home hour. This will increase your capacity.


THE GOAL is to have the patient come the same time everyday, so they get used to having a given adjusting time. It will add to compliancy of your appointments by the patients having a set time and your care becomes part of their everyday routine.


All of the above are part of building a reproducible infrastructure within your practice. This is what success technology is.


The definition of INSANITY is to do the same thing again and again and expect different results.