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How Ancillary Services can add value to your practice

What are your averages?

Our goal with our clients is that they would collect more than $100 per visit as an average, something we call the CPV (collection per visit average). Consider someone who goes to a normal medical visit. For that assessment, which isn’t much, they’re going to pay an average of $120-$150 for a medical doctor to do relatively nothing. As chiropractors, we’re going to do a lot of work to get them well so we believe you should be over that $100 line every time somebody walks in your door.

Efficacious Services

There are several ways to reach this average. One way is providing ancillary services that you provide in addition to a chiropractic adjustment. Ancillary services help raise those average fees for every visit. The first doctor I worked for had a package when you started care. I came from a very straight chiropractic background so the packages I was used to only had an adjustment. To have over $100 per visit average, your adjustment would have to cost more than $100. That’s kind of hard to do. This doctor had a package of things that you got, so you came in for your visit and you got your supplements, you got maybe some supports or an ice pack, or a pillow. When you looked at the average per visit for his plan it was over $100 per visit. With this method, I got to see right off the bat in my first job how you could drive those collection per visit averages up by offering some ancillary products and services that go along with the care.

Gonstead’s Method

Many people have heard of Clarence Gonstead, an icon in chiropractic. My mentor, Dr. Tom Owen worked for Clarence Gonstead. His family were patients of Dr. Gonstead, and when he first went to the clinic, they were surprised that there was a lab there. Dr. Gonstead was lab testing for the patients there. Based on those lab findings you were given supplements or food recommendations in addition to maybe one of the best adjustments you can get in the history of chiropractic, an adjustment from Clarence Gonstead.

At the front of the clinic there was a gigantic golden cash register and Dr. Owen said to Dr. Gonstead, “Hey, what’s that giant golden cash register for?” Dr. Gonstead said, “It’s for all the money.” Even back then he was probably collecting over $100 per visit based on not only a very powerful adjustment, but also a lot of additional services.

You can collect a fair amount per visit

We have many doctors who collect over $120 per patient visit on average. When you include a program similar to my first boss or similar to Dr. Gonstead with that sort of approach you’re actually adding in other products other services. When it all adds up and you divide the total number you have collected from the patient by the visits, we end up well north of the $100 average.

These are high quality products and services. When we talk about ancillary services these are from organizations like Vitalleo Health, where you’re getting the right nutrients into that patient’s life to help not just with their case but their overall health. We also have testing that a lot of our doctors do. For example, we have doctors who, as part of your first visit ask you when you were last x-rayed. If it has been more than 90 days, they will do that x-ray, which is a service in addition to an adjustment. Additionally, they will ask if you had your inflammation and CRP tested, or if you have had Vitamin D testing because these are really foundational needs. If your CRP is high you have a radically higher risk of heart attack or stroke and other things like cancer. If Vitamin D is low then you’re more susceptible to everything including infections like Covid.

Nutrition, Diagnostics, and services

Of course there’s an ongoing assessments and education that go along with this testing and these products, but when somebody adds an ancillary service like Vitalleo Health, the average care plan is going to be an additional $700-$3,000 on top of the chiropractic care plan. Now you are talking about a cost per visit for those patients that may be $300-$400 per visit on the average. It is not hard to see with the sort of plans that include these ancillary services and products, particularly like an entire testing and series of products and protocols to manage the findings on that test. It is easy to see how a practice can radically increase what they are collecting every visit on an average.

I came from a volume background. I saw 2,000 patients a week and taught hundreds of others to see 1,000-2,000 adjustments a week also. In those cases, usually you see people only collecting $30-$50 at the most per visit. However now we have really looked more to, “How do you help somebody who is seeing 200 patients a week make $1,000,000 a year?” In fact, how do you help somebody seeing 100-150 patients a week make $1,000,000 a year?

Our goal is to help doctors that are not going to see thousands of people every month still put $500,00 to $1,000,000 a year in their pocket to take home to their families. That is the whole goal of our program. It’s quality care at a high cost per visit without this need to see a mass number of new patients. Again, it’s not just a theory or philosophy, it’s what we’re doing with hundreds and hundreds of doctors right now.

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