The American Chiropractor Interviews Dr. Todd Singleton and Nancy Singleton Dr. Todd Singleton and Nancy Singleton have become two heavy hitters in the chiropractic market over the past 30 years. The secret to their success is one learned the hard way, though, through trial and error, a journey into real estate, and then back into the business of helping people live happier, healthier lives. In this interview with the unique, dynamic duo for The American Chiropractor, Nancy and Dr. Todd share their story and where they see true opportunity for chiropractic growth in the years ahead. The American Chiropractor (TAC); Dr. Singleton, as a chiropractor, you have a rather unique way of practicing. Why have you chosen the path of running nutrition clinics? Dr. Todd Singleton (TS): This is a time of great change in the health care of our country. People arc worried about Obamacarc. Doctors report tliat their insurance reimbursements arc being slashed. In spite of all the unrest. I"\ c never been more excited or energized about practicing than I am now! Our practice continues to grow every year, despite the fact that surveys indicate that the number of people utilizing chiropractic care is going down. TAC: So it sounds like there are some problems out there for many chiropractors, but you seem to buck the trend. Nancy Singleton (NS): The good new s is that, as a chiropractor, you have every reason to be encouraged about the potential growth of your practice and the stability of this profession, in spite of the numbers that may lead you to believe otherwise. A 2002 study showed that 7.7% of the US population utilized chiropractic care.1 By 2006. another study showed that 12.6 million US adults, one out of 226 million, visited a chiropractor. That is only 5.6% of the population. That means the number of people seeking chiropractic lias actually dropped.: Unfortunately, while only 5.6% of the population seeks chiropractic care, chiropractors offer services that would benefit the majority of the population. To add insult to injury, the amount of money spent by chiropractic patients on chiropractic care has remained relatively unchanged from 1997 to 2006. Yet during that same time period, expenditures per patient and per office visit to medical physicians increased more than 30%. ' TAC: What have you done to combat this and continue to grow your practice? NS: We are taking a different approach. We arc also working with hundreds of doctors who arc doing the same thing—that is. bringing people into a chiropractic office for the first time for something other than chiropractic, and then turning them into chiropractic patients. For example, years ago. we would have never even considered doing weight loss, but because only 5.6% of the population seeks chiropractic care, we need a way to get in front of the masses. While statistics show only 5.6% of the population seeks the care of a chiropractor, statistics show that 69.2% of the population needs to lose weight. So we target the masses, thereby introducing even more people to chiropractic. TAC: Weight loss is not something that people typically associate with a chiropractic office. How have you been received by the general public? TS: The response has been incredible. People who never would have conic to sec me as a chiropractor now come to sec me for weight loss. And the interesting part is. after I help them lose weight, they "11 typically say something like. "So you arc a chiropractor, right? What can you do to help me with my lower back?" I"vc now taught the system I use in my office to more than 600 other doctors, and I keep hearing over and over again from other chiropractors using this system that bringing people in for weight loss has turned out to be one of the best ways to build a thriving chiropractic practice they've ever found. Previously. I would have never considered treating weight loss as a chiropractor, and I certainh would never have guessed that weight loss could be a lead generator for chiropractic treatment, but it is! I now believe weight loss is a perfect therapy to add to a chiropractic office. I have a lot of friends who arc MDs and they arc the first to admit they haven't studied nutrition. They, of course, can prescribe weight loss dnigs. but our goal with our patients is not just weight loss—it is to get them healthy. As chiropractors, we learn about nutrition in school, and we arc offered a lot of nutritional courses for our continuing education credits. We know how to help our patients get healthy, and therefore we should be the ones offering health-promoting weight loss programs. There are so many businesses out there promoting weight loss. It's a billion-dollar industry, but the programs and pills that arc available for our patients do not promote health. Most weight loss businesses make money by selling prepackaged foods from boxes, bags, and cans. These businesses focus on restricting calories. While people do lose weight by restricting calorics, as chiropractors, our focus is on getting people healthy, and when they arc healthy, weight loss follows. But I. like most doctors of chiropractic, didn't have weight loss on my radar at all when I got out of school more than 20 years ago. After I graduated from chiropractic school in 1990. we opened a chiropractic office. My wife. Nancy, had already been helping doctors to market their practices, so by the time I was ready to open, she had a great marketing plan for our business. Because we always made marketing and practice growth a big priority, our practice boomed. In the mid-1990s, we switched from just chiropractic treatment to an integrated chiropractic model. We hired a full-time medical doctor, a physical therapist, more support staff, and increased our marketing. The result was that we grew so much that we expanded to multiple locations, hired more doctors and staff, and continued to grow. We ran insurance-based practices. Unfortunately, the more we grew, the more the audits came from insurance companies. Our solution was to hire a full-time attorney as an employee to help us fight the red tape tliat came our way in the form of additional paperwork, denials, and audits. My job changed from being a treating chiropractor to becoming a compliance officer and fighting with insurance companies even- day. Each day. I faced mounds of paperwork to prove medical necessity and to fight insurance claim rejections. Rather than seeing patients. I would spend my days fighting to get paid for medically necessary treatments, which we had performed, and which had been preapproved by the insurance companies. I would spend a great deal of my time studying CPT codebooks to ensure we were performing all of the mam treatments we offered according to the precise guidelines. More often than naught, we would follow their rules only to find out our claims had still been denied, or worse yet. that the insurance companies wanted money back from claims they had already paid. Because we focused highly on grow ing our practice and because our systems were so solid, we became more and more successful. Not only did our clinics grow, but the scrutiny and unfair treatment from insurance companies also grew. We did everything in our power to expand our practices and be successful, but ultimately, our financial success was in the hands of the insurance companies that had a financial interest in seeing we didn't get paid. I realize not all chiropractors have such a terrible experience with insurance companies, but when you have the biggest clinics in your state, you arc constantly a target. After years and years of fighting, we became completely disillusioned with the unfair tactics of insurance companies. We actually considered getting out of practice all together. I hated what I was doing—fighting day in and day out with insurance companies, treating patients according to what their insurance companies would or wouldn't allow. I was finished! I was done! So I reasoned I'd better find a new profession because all I really knew how to do was run an insurance-based practice. My wife and I actually started attending real estate seminars as we had decided it was going to be impossible to have a large, thriving practice in the insurance climate in which we lived. One morning. I woke up after having recently attended a real estate seminar and it hit me like a ton of bricks! I hated real estate. I hated insurance billing. What I did love was being a chiropractor, and I especially loved helping patients get better using nutritional protocols I had learned and used through the years. I turned to my wife and said. "I hate real estate. I hate billing insurance. Let's open up a nutrition clinic! That's what I really want to do!" NS: I thought he was crazy! We had always had a small nutrition room within our practices, but we never made any money doing nutrition. We did it because my husband's real passion was helping patients nutritionally, but it was not ever profitable. So when he said he wanted to open a nutrition practice, my first thought was that it was a terrible business idea. But one thing I had learned after doing business consulting for so many years was that in order to be successful, you have to have passion for what you arc doing! I knew my husband was passionate about helping people nutritionally, so I gave it some serious thought. I realized that if we got the proper systems in place and if we got the marketing just right, our nutrition practice would succeed. Once we decided to focus on nutrition, we realized that in order to have a viable practice, we needed new patients who wanted to "buy" what we were "selling." We knew that most people weren't searching for help with nutritional protocols, but we knew that a lot of people were "buying" weight loss. We knew if overweight patients were put on a nutritionally sound program and got rid of the toxins that they were ingesting, they would lose weight. So. purely for marketing purposes and for the purpose of building a viable nutrition business, we opened up our nutrition clinic "disguised" as a weight loss clinic. We reasoned that only 5.6% of the population seeks the care of a chiropractor, but 69.2% of the population is overweight.4 We liked those higher numbers. TS: My goal was to change lives through sound nutritional protocols, so one thing I was sure of was that I was committed to offering a natural, healthy, and effective weight loss program. I could sec mam problems with the weight loss programs that were already being offered. There were so many schemes, so main' "lose weight quick" claims, so many "miracle" pills, so many multilevel marketing programs, so mam network-marketing products, so much hype—how could we possibly cut through the clutter and stand out? Our plan was simply to be transparent. We would advertise for weight loss, bring potential patients to a seminar, and be direct by saying. "Yes. we can help you lose weight, but the miracle here is not a magic pill or potion. The miracle is pure nutrition the way nature intended it." I put together some health-promoting eating protocols, combined them with some incredible whole food supplementation, and added some therapeutic hands-on weight loss and inch loss therapies. In the mid-1990s. I became acquainted with the work of Dr. Linda Nelson of Solutions 4". She had a fonnulation. a cream that she used with a detoxifying body wrap. This fonnulation was developed by doctors out of UCLA more than 30 years ago. They originally used this fonnulation to help patients with neuropathy. (We use it with our neuropath}- patients today.) They found tliat the areas of the body that were being wrapped were becoming smaller. Dr. Nelson was the one who pioneered these therapeutic body wraps in our country, using this fonnulation. In fact, back in the 1970s she did a body wrap on Phil Donahue during his television show. He was wrapped during the show and lost several inches—and an industry' was bom. We use her same fonnulation with our patients who want to lose weight and inches. Through the years of treating weight loss patients, we have tweaked our protocols and now have a system that patients go through on each visit that includes whole-body vibration, the use of infrared saunas, body wraps, light and sound technology to address emotional eating, and one-on-one accountability coaching. The results have been incredible! Patients are not only losing weight, but most importantly, they are getting healthy and feeling better. Their lives are changing! TAC: You say you started your nutrition practice with weight loss, but now also offer neuropathy and other programs. How did that happen? TS: A few years back, one weight loss patient presented in my office with a severe case of neuropathy. She was scheduled to have her leg amputated because her neuropatln was so severe. She didn"t come in for neuropathy originally; she came in to lose weight. She came in because she was afraid that she would be too large to get around on her new prosthetic leg shc"d have to wear after her amputation. She was more than 100 lbs. overweight. She went on the eating protocol I recommended, and within five weeks, her foot had started to heal. Shortly thereafter, her doctor canceled her surgery. She continued with the eating program. She ended up losing weight and her leg was completely healed. After seeing the role that nutrition played with this neuropath} patient. I decided also to focus on more neuropatln patients. Patients suffering with neuropathy are helped with a sound nutritional program because neuropatln' is caused by malnutri- tion. This was brought to light in World War II when prisoners of war developed neuropathy due to malnutrition.5 So now. in addition to weight loss, I currently have a thriving practice full of neuropath) patients. TAC: What would you tell other chiropractors who are considering adding nutrition or weight loss to their practices? TS: Helping patients overcome illness and change their lives through sound nutritional principles has been the best thing I've done in 24 years of practice. I have been able to open my practice up from just the 5.6% who seek chiropractic to the 69.2% who want to lose weight. Along with helping people to lose weight. I'm helping them with their neuropathy, fibromyalgia, insomnia, lack of energy, back pain, neck pain, and other conditions they want to overcome. And although the nutrition patients come in for reasons other than chiropractic, once I"vc helped them with their initial problem, thev incvitablv ask me about chiropractic. And there it is! Its the best way I've found to introduce the masses to chiropractic. So it turns out. that rather than advertise to the 5.6% of patients who seek chiropractic. I"ve found it's more cost efficient to advertise to the 69.2% who want to lose weight—and when they need chiropractic, they'll ask me because they are in my office! Running an all-cash practice feels very liberating! I enjoy hard work and the opportunity to succeed. I am in control of my success: it is not controlled by insurance companies. As a result of opening up my practice to the masses, to the 69.2% who seek weight loss. I"vc built a million-dollar cash practice and maintained that success since I switched to an all-cash practice nine years ago. And while the financial gains arc very rewarding. I have found that there is an even greater reward. Watching patients" lives dramatically change for the better day after day after day is extremely rewarding. I have a renewed sense of excitement about practice. I am excited to go to my office each day and sec the changes that are liappening in patients" lives. I am more passionate about being a chiropractor today than I was almost 30 years ago when I decided to go to chiropractic school! ► To contact Nancy or Dr. Todd Singleton email contact a DoctorsGoldminc.com or call them at: 801 -903-7141, or learn more by visiting www.DoctorsGoldMinc.com References 1. Complementary and alternative medicine use amount adults: United States. 2002 PubMcd.gov (National Institute of Health) Barnes. PM, Poucll-Grincr E. McFann K. Nahin RL. Adv Data. 2004 May 27; (343): 1-19 2 & 3. Utilization and Expenditures on Chiropractic Care in the US from 1996 to 2006." Davis. Sirovich and Weeks Health Sen Res. 2010 June: 45(3): 748-761. 4. US Depl of HHS. CDC. National Center for Health Statistics, Health. United Stales. 2O12.Trcnd Tables: 205. 5. Neuropathy and the Gastrointestinal System. Russell L. Chin. MD. The Neuropath) Association. 2013 http://\v\v\v.neuropathy.org/site/ DocServer/nutrilionGI-RusscllCMD.pdf
