Your office as a business, by Dr. Ogi Ressel

Thursday, June 4th 2009

Warm hellos to all,

You've noticed that this THOT is a bit late - I just returned from teaching
Module II in Philadelphia.  What an awesome city!

Dr. Tedd Koren gave a fantabulous presentation on Friday evening,
a lecture sprinkled with his customary wit and charming sarcasm - and
some of you missed it. I have to give Dr. Tedd much credit. He has amassed
a vast amount of info on the Chiropractic approach to helping people with
any condition you can imagine - and all of this is referenced. Anyone who is
in practice needs to get their hands on this material. Tedd has it available
for you - please contact him at: TKOREN1@aol.com.
You still don't get it do you? You need to get in touch with Tedd TODAY. Not tomorrow.
Now!
Are you writing to him yet?
That's better!

Ok....enuf babble....let's get to the THOT - Your office as a business. What a concept!?
"But it is a business", you say!
Let's look at it closely.
One thing that I have noticed is that those doctors who are finding practice a
challenge do not approach it as a business. No.

Here are some things you need to consider and give weight to:
Your CA is not your best friend. No. She is hired to do a very special and
important job in your office. Anyway you slice and dice it, she works for you -
not the other way around.
You sign her paycheck - this means she is an employee. This also means
that you need to treat her as an employee - not as your best friend
and confidant.
This also means that you need to have her agree with your office policies
and your employee policies - which she needs to sign.
Her employment is an agreement, a business contract, and it states
everything you expect; her duties, hours, salaries, bonuses, seminar
attendance, etc. However, having said all that, you need to treat your CA
with great warmth, caring, understanding, empathy, etc. because you are a
team. She should also be under care with you and go through the same
protocol as your patients - this needs to be in your agreement.

As strange as this may sound, you need to keep your staff at arms length
though. That means no dinners out together unless the whole office is invited.
There must be boundaries in your relationship - these need to be made clear.
You cannot be best friends, BUT you need to be friendly!

The same principles apply to patients. You are the best doctor they have
ever seen - you are thoughtful, clinically excellent, caring, warm, honest,
and place their health above all else.

You are not their best friend. Patients do not come to see you to make friends. No.
They come to see you for help. This is also a business arrangement.
You help them - they pay you. Period.

It is inappropriate for you to go to the bar with your patients (or CAs),
or to the game, or the Club, or out for dinner. If you do, you are eroding
that sacred trusting relationship between you and the patient. Patients are
not your best friends. Friendly, Yes. Best friends, No.
However, sometimes, occasionally, now and then, you develop a sense that
you'd like to have this patient change their relationship with you - and the
feeling is mutual. That is perfectly Ok as long as the guidelines are delineated
first so that it is not awkward for either party.

You may even suggest that you value their friendship and would like to
develop it further, but fear that you may need to step down from being their
doctor - in order to maintain objectivity.
Ask your patients how they feel about that. They will appreciate your integrity and honour.
It's your call.

Having said that, though, how would you handle your CA becoming friendly
with your patients?
Friendly is wonderful - that is part of her job.
Often, though, CAs become so friendly that they sometimes may want to go
for lunch with a patient, or dinner, or a date, or bar, club, etc. Or the patient
will often ask your CA to go out with them, or to do some other business
transaction with them - sell something, or get involved with a patient's business, etc.
I have very strict policies on this. The answer is no. As long as your staff is
employed with you, they must politely decline such offers from patients.
That is one of the agreements your staff sign upon acceptance of their position.
Any breach of this policy means immediate dismissal. There is no negotiation
on this point.

The reason is simple - familiarity breeds contempt. Imagine your CA asking
a patient she had dinner with the previous evening, about his/her overdue
account - professionalism begins to unravel here and so does her authority.

The last point that I want to make is that your office should be profitable.
(I can already see you all stand up and cheer).

Yes. Yours is a business. And it should make a profit - just like any other business.
So, treat what you do as a business.
You wear two hats in your office - the doctor hat, and the business hat.

You are good at this "doctor thing" but lousy at the business side of it - If you
like, I'll be happy to help you with both hats.

...And this is a big topic - we'll talk again.

Warmest wishes to all,
Dr. Ogi Ressel