I saw another associate employment contract today.  Another example of all the things that are wrong with some chiropractors.  Instead of being negative, though, let me be positive and talk about the top 7 things that make a good employment contract:

1. It’s in writing.  Remember, if it’s not in writing, it doesn’t exist.  Sounds obvious, but there should be no questions about the employment situation.  Everything should be spelled out completely and clearly.  In this instance, there was no mention of how the associate doctor (employee) could terminate the contract, except if the employing doctor breached the contract (broke a promise).  I can think of at least 1000 reasons why you might need to get out of an employment situation.  In this case the employer wanted $50,000 (I’m not joking; I’ve seen this before) if the employee left.  So your grandmother dies and you need to go back home and take care of your grandfather, and you’ll have to pay $50,000 ?!?  Crazy.  No matter that the employer might say, “We won’t make you pay this,” if it’s not in writing it doesn’t exist. 

2.  The parties are identified.  This includes contact addresses.  Look at who you are making the contract with, to be sure it’s who you think you’re working for.  If this is a corporation, you’re working for the corporation. 

3.  The details are spelled out clearly.  Remember, “the devil is in the details,” meaning that if everything isn’t spelled out, you could be SOL when it comes to getting what you need.

4.  Payments are specified completely.  Who pays what to whom and when?  Under what conditions?  How are payment amounts verified (I often see this left unspecified)?  In other words, if your pay is based on collections, you have a right to an accounting of those collections.  Verify that you are being paid appropriately.  Keep your own records on patients seen and procedures performed, and double check with the records you’re shown.  If you have questions, don’t hesitate to ask.

5.  Termination is spelled out.  It should be very clearly stated how and when both parties can terminate the contract.  You should be able to terminate with a reasonable notice (60 days? 90 days?) and no penalty.  The employer should be able to terminate for cause, which is spelled out.

6.  Dispute resolution is specified.  Some doctors want to use an arbitrator, to save money.  Both parties agree to be bound by the arbitrator’s decision.  This means you don’t get a jury trial.  Think carefully about whether you want to agree to this.

7.  Writing in clear language.  The language should not be so much “legaleze” that you can’t understand it.  Make the employer write in clear language. 

If you don’t understand something, ask.  Take the contract to an attorney for review, if you want.  Finally, don’t sign until you’re certain you can live with the terms of the contract.  If you have problems with the contract now, what happens if you go to work for this employer and need to get out?   It could be difficult and costly. 

For more information on associate and independent contractor situations, buy Planning for Practice Success.    Better yet, avoid the whole contract thing and start your own practice.

You can start your own practice - we can help!

“All realtors are not alike.”  Believe it.

I hear horror stories all the time.  Here are some tips to help you work with realtors to find the office you want for a reasonable price.

1. Be certain of your specifications.  What is the minimum square footage you want?  What is the maximum?  Will you need an x-ray room?  What kinds of rooms will you need for patient exam and adjustment?  Will you be doing open bay adjusting?  Will you have a massage therapist?  Will you be doing acupuncture?  Will you be selling products
 

2. Having determined your specifications, then be prepared to be flexible.  You can start out thinking you MUST have something, only to find out it doesn’t exist in your area.  Be ready to consider other alternatives.  Whatever you decide you will have for a long time (up to 5-7 years), so be sure.
 

3. Sit down with your realtor before you go shopping and be sure he/she understands what you want.  You will probably have to explain how chiropractors work, and how chiropractors are similar to other health care professionals (dental offices, for example, work well for many chiropractors).  One DC told me his realtor said, “Well, there are no former chiropractic offices in your area, so I can’t show you any.”
 

4. Your realtor should listen to and abide by your specifications.  If he/she persists in showing you unacceptable offices, feel free to change.  For example, if the realtor keeps showing you very large offices, this is a tip-off to the realtor’s not getting your message.
 

5. Don’t take more space than you need unless you have a specific profit-making use for that extra space that legitimately fits with your business. For example, if you want a 1200 square foot space, and the realtor shows you an 1800 square foot space, be very clear on how that additional 600 square feet is going to make you money (NOT just to be used as a place for new patient orientation lectures or to be “donated” as a community room).  Figure the extra per-month cost of that extra space to see what you’ll have to generate in revenues to make it at least break-even.
 

6. Realize that the realtor is not working for you, but he/she is working for the landlord, and to get the biggest commission possible.  Be prepared to deal directly with the landlord to make your deal, if you don’t feel the realtor is working in your best interest.
 

7. Finally, recognize that EVERYTHING IS NEGOTIABLE.  That includes leasing terms.  I talked with a DC who said the landlord presented a pretty good deal, but should he (the DC) try to get a better one.  Absolutely!  He wrote a few days later to tell me he got free rent for 3 months during build-out.  You don’t know until you ask.

For more information on Leasing an Office, buy Planning for Practice Success.  We guarantee your satisfaction or we’ll refund your purchase price. 

I recently talked with a new doctor who said he finally got his business loan, but that he was dismayed by the finger pointing that went on between the bank and the SBA.
The bank blamed the SBA for not approving the loan.  The SBA said, “We think your education and experience as a professional are a valuable asset and we would gladly guarantee your loan.”  When the grad took the SBA letter to this effect back to the bank, they hemmed and hawed and said they still would not give the loan.  So who was the culprit here?  As usual, it’s the bank.

I have heard of SBA people saying “We don’t guarantee new businesses” (then why are they in business?!?!) but for the most part, it’s the bank that drags its feet.

The grad didn’t go to three banks, because at first the bank was very welcoming and made lots of promises.  When it became clear they weren’t interested, he quickly went out and got three more banks.

Bottom line:  Even if one bank promises you they love you, go to several banks and check out the SBA yourself. 
And report back to me! 

More on “Sources of Funds” and strategies for getting a bank loan in Planning for Practice Success.

I heard it again the other day:  “I don’t know why I have to worry about the competition.  I don’t have any competition.  What I’m doing in my practice is unique.”  Well, that’s true.  And not.  What you are doing may be unique, but that doesn’t mean your prospective patients know why it’s unique.  To them, you’re just another chiropractor, unless you have “competitive advantage.”  The concept of “competitive advantage” is just like it says: something essential that gives you an advantage over your competition.  It answers the question “Why should I go to this chiropractor?”  True competitive advantage relates directly to the benefit your prospective patients perceive.  How do you get it? 

1.  Look at the other chiropractors.  What are they advertising that’s special and unique?  I’ll be they have little that sets them apart.  Perfect opportunity for you.
2.  Look at your chiropractic services and products you sell. What can you talk about that would make people come to your practice?
3.  Look at special services and conveniences that add value in the minds of patients.  Convenient office hours?  Pampering?  Make it easier to come to your office.

In other words, you may have no competition, but you will need to do some creative marketing to get prospective patients to understand what makes you unique. 

If you want the complete story about marketing, here is a great book, written by a friend of mine:  Beyond the Niche.  It is an entire marketing course in a nutshell, full of helpful tips and good stories about what works and what doesn’t. 

Q: I just started my practice and I’m not making any money yet, but my CPA wants me to start paying estimated taxes. Why?
A: This is one of those tax things that seem to make absolutely no sense. Your CPA is being extra cautious, but he/she is right.
Here is what the IRS says:

Sole proprietors, partners, and S corporation shareholders - You generally have to make estimated tax payments if you expect to owe tax of $1,000 or more when you file your return.

Corporations - You generally have to make estimated tax payments for your corporation if you expect it to owe tax of $500 or more when you file its return.

In other words, if you will be making a profit by the end of the year, it’s best to start now by paying estimated taxes. I know cash is tight as you start out, but you really don’t want to have a big tax bill at the end of the year. Pay quarterly whatever you can, to lessen the impat at the end of the year.

I talked to a new practitioner the other day.  He said he was invited to be a spokesman for a professional group on a TV commercial.  On the spot, he was asked to give a short speech for the cameras.  Yikes!  Talk about impromptu! 

He said he was not nervous, but he was energized and excited.  He used a short promotional speech that he remembered, and the marketing person loved it.  So my question to you is…

 Are you ready?  What if you were asked tomorrow to give a speech to a group in your town?  Would you know what to do?  What would you say?  Would you have to decline because you were nervous? 

How do you get past these scared, terrified, feeling?  One word - TOASTMASTERS. 

I have been a member of two Toastmasters clubs over the past year and a half, and I’m a believer.  Even though I’ve been speaking for years in front of classes and groups, and I’ve given formal presentations and graduation speeches, I felt I needed more polish and “pizzazz” in my speaking, so I joined Toastmasters.  I’m really glad I did.

I am proud to announce that I have completed my first 10 speeches and I’m moving on toward my goal of the ultimate achievement in Toastmasters - the Distinguished Toastmaster. 

Stop a minute and get this picture:  You are at your first Chamber of Commerce meeting in the town where you have established your practice.  You are being introduced to someone, who comments, “You’re wearing a Toastmasters pin, I see.  You’re a Toastmaster too?”  “Yep,” you say, and away you go.  You have made a new friend and possibly a new patient or client for your practice.  In any case, you have instant credibility because of your Toastmasters affiliation. 

I talked to one health care provider who has a steady stream of Toastmasters people in his office, and many of them are not even from his club.   I met my coach and a business partner through Toastmasters, and I have many great friends in the clubs I have been a member of.

So, if  you’re looking for a way to conquer your fear of public speaking AND develop some great business contacts, join Toastmasters.  (go to www.toastmasters.org) to find a club near you. 

Ever have a dog? We’re dog-sitting with my son’t 9-month-old lab/shepherd mix, named Cody, and having a ball. I love Cody’s wide-eyed optimism. He’s perpetually positive. When we’re in the kitchen, he follows us around hoping for some food to drop, and yes, there is occasionally a bit of food as a reward. He spends his days on the sun porch, waiting patiently for someone to come let him out and play with him.

I guess dogs have the Law of Expectation figured out. This law, according to Brian Tracy, states that you get what you expect. If you expect good things, you get them. And vice versa.

If you expect that your new professional practice will be successful, by golly, I would bet it will. I’m not sure who is more right- optimists or pessimists - but give me optimism any day. Next time you’re having a bad day, state positively that tomorrow will be better. I will bet you it will be better.

As Sir Winston Churchill said, For myself I am an optimist - it does not seem to be much use being anything else.

Remember Cody - expect the best.

I hear lots of health care professionals talking about “overhead.” As in, “We have to keep overhead down.” “We need to look at reducing overhead.” Well, it certainly is true that overhead, i.e., your fixed expenses, can get away from you if you’re not careful. But this is “cup half empty” thinking. Let me explain what I mean:

Which would you rather have:
A. $500,000 gross collections with 70% overhead
B. $400,000 gross collections with 50% overhead

B. gets you $50,000 more profit/revenue than A. In the end, it’s more about how much you bring in and less about how much you spend to get it. It is about increasing revenue with the same overhead.
How do you do that?
1. Improve your collections rate. Get those patients to pay you faster.
2. See more patients.
3. Find more revenue sources (like products).
4. Make your space more productive. Bring in an independent contractor or hire an associate and put him/her on a percentage.

Think “cup half full” rather than “cup half empty.”

Someone recently referred to a colleague as a “cup half full” kind of guy. I like that kind of thinking. I believe I’m also a “cup half full” person – a positive thinker.

Here is what Norman Vincent Peale said: “A positive thinker does not refuse to recognize the negative; he refuses to swell on it. Positive thinking is a form of thought which habitually looks for the best results from the worst conditions.”