Academy of Chiropractic

Quickie Podcast 1227
Office Systems 119 OS

From the Desk of Dr. Mark Studin
Academy of Chiropractic

Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time. -Mark Studin 2006

"I am getting a lot of PI cases but cash flow is low"


Dr Studin: your personal injury side of your practice is growing. A cashflow hasn't caught up yet. So you did your first lawyer seminar How long ago?

Guest Dr: About a year.

Dr Studin: and did you use other people's money to do that or did you use your own money?

Guest Dr: I used two orthopedic surgeons and an MRI center.

Dr Studin: That's good, did you use your own money ? That's not good, some people never brings a sponsor ever. Other people bring in sponsors, Everyone does it differently. But in your particular scenario, the thing you should not do is use your own money. And the other thing you should do is you should do a seminar every six months, not every year. Because what happens is more than six months They don't want to be around you. It's an imposition, but longer than six months they start to forget about you and you need to be on the inside one of them. And regardless of your cashflow, the surgeons and imaging centers, they've got great cashflow with this stuff going on. So they're thrilled to pay as long as the lawyers are in there and you constantly keep your referral sources going. But because you're going to get that this urge of people who like you and then you're going to get a sudden drop and then you got to start all over again and you don't want this to happen, that's important, the other thing is that as you start to grow with personal injury and you've got lean money up there, where's cashflow? So I always tell people you're not changing your practice from this to that. You're adding this to your practice while maintaining what you've been doing. And as cashflow starts to come in, then you can let go of the manage care and the cash and all that other stuff as your finances are starting to upwards because you still have to pay your bills, you have med pay for most of your cases, correct?

Guest Dr: No, I would say maybe 10% actually have medpay.

Dr Studin: are you getting from attorneys Fresh cases or old cases?

Guest Dr: fresh cases

Dr Studin: and only 10% have MedPay? are you capturing that med pay or was the lawyer controlling it?

Guest Dr: we're capturing it now.

Dr Studin: How many visits a week are you seeing?

Guest Dr: 150 a week.

Dr Studin: and what percentage is personal injury?

Guest Dr: Probably close to 50%.

Dr Studin: What's your rent per month?

Guest Dr: $3000 a months.

Dr Studin: do you know your percentage of overhead?

Guest Dr: No.

Dr Studin: here's the thing, you don't know your business. What percentage is your overhead? How much of real dollars does it cost you to bring every patient in? What are you asked to collect per patient? Whether it's lean or not Lean to pay your bills. Do you meet with your accountant every month?

Guest Dr: No, I do not.

Dr Studin: you're like everyone else, you meet with your accountants at the end of the year and you give them just your paperwork and maybe every quarter you give them information they file and you can call and ask a question if you have, right?

Guest Dr: That's correct.

Dr Studin: that doesn't work, and your accountants to CPA, correct?

Guest Dr: yes

Dr Studin: You have all the pieces that do not work for business, are you on a paper checkbook or QuickBooks?

Guest Dr: QuickBooks.

Dr Studin: Now here's what you must do. You must meet with an accountant every single month who understands your business. He doesn't have to be from your city, from your County or for your state, you need to have that accountant guide your business with you month to month. In addition on QuickBooks. Your accountant needs to go into your checkbook every month and rising, what categories your expenses are going to. Then your account needs several conversation with you about how you're spending your money for retirement accounts, what you're spending for this and that so you can make better financial decisions. You do not want a CPA, a CPA often is like an IRS agent, That they worked for the IRS because they're licensed precludes them from doing things or they're concerned or they're afraid. The person who helps me, his name is Maurice Mauner, his phone number is area code (631) 661-5252. He takes care of doctors in 20/30 States right now that he work with. at the end of the day, he's worth his weight in gold, And he's less expensive than any CPA I've worked with. So you'll probably save money there as well. Number 2, I need to know the following statistics. I need to know what your overhead is and what percentage is your overhead. So what you need to do is you need to go into your QuickBooks, take your gross collections, and then deduct all of your hard expenses, Your telephone, your cellphone is really not an expense. I mean you could deduct it, but it's not, electric, heat, fungible supplies like head rest paper, toilet paper, staff insurances. I need to know PVA, I need to know OVA, what's your patient visit Average. How many times did the average use patient comes in? What's your office visit Average. What are you average collecting per visit right now? What's your expense per visit? Now you could start running a real business. So that's where we start. The second thing is you need to do the seminars every six months, but you need to get sponsors to cover 100%, cause you can't afford to lose that momentum because it's going to start shrinking and dwindling, another thing is Did you send them a copy of the lien and do you have verification that they received them?

Guest Dr: Yes.

Dr Studin: That's good. the next thing I want you to do is I want you to contact mighty. Did you know about them?

Guest Dr: No.

Dr Studin: is where you need to go. They are a software company on wall street in New York city and they've developed a document service portal where when your attorneys want documents, you informed them to go on It's free for them to go to and you upload your documents into that portal. Number one, it'll save you time so you don't have to have a staff member send it , you just load this up into a HIPAA encrypted portal. You just scan it, loaded in, then you inform the attorney that they go on there, the attorney goes on and they could download the documents. It's free for the attorney, it costs you $10 a case in perpetuity, if you let mighty know you work with this, they give you every previous patient that you have worked with you could upload for free and then they give you a month for free, but what they also do is they prompt the attorney to upload the status of the case. Now you're in control of your case. How many times do you or your staff members have to call the lawyers office and say, what's the status of the case? Where's my money? and you shouldn't be doing it every other month calling every case out there, so the system prompts the lawyers to put this on there. So the average lawyer has four doctors per case, on a monthly basis, a lawyer potentially is going to get 800 phone calls if they juggle 300 cases, which is not unusual, that's 1200 phone calls and then they have to have a full time person just looking up the status of cases. So 70% of the attorneys right now are uploading the status of the cases. So that's a phenomenal solution to control your money. The second thing is, I’m working with some programmers and We're going to take all the attorneys in the country and then we're going to start profiling them. What percentage of the cases do they offer in their initial settlement offer and what do they pay at the end of the day? And that's something you're going to be entering in as you move on. And hopefully other doctors in your region, Now you're going to know who the good lawyers are. So we're giving you data, you've got to produce a lot of your own data. So this is the first step that you need to do get me those statistics. you need to 100% have that lawyer seminar It's just cause your practice, once a couple of those checks start perking and then all of a sudden that's going to dry up. You're going to be right back where you are now, you've got a lot of action steps to take and I'm sure none of them were in the direction that you expected. Lastly, Cause February 27th we're getting together in the Hamptons and I'm going to have three or four offices doctors there who have been in your footsteps, it would just be a great way to shorten the distance between point a and point B. 

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