Is Now the Time to go Cash?
FEATURE
Interview with Miles Bodzin, DC
TAC
Dr. Miles Bodzin is founder and CEO of Inc. 5000-listed company, Cash Practice® Systems. He is a chiropractor who became known as “the king of patient retention.” He’s appeared in the Wall Street Journal and on The Brian Tracy Show, contributed to the number-one bestselling book SuccessOnomics with Steve Forbes, and speaks internationally on the topic of client retention. Some of his speaking engagements include, The Wave, Parker Seminars, The Master's Circle, ChiroFest, chiropractic colleges and at state associations and philosophy groups all over the nation. His company offers web-based software for chiropractors to implement his 4-Step Process resulting in increased patient retention. The Wellness Score® System, Cash Plan Calculator® System, Auto-Debit System®, and Drip-Education® Email Marketing System all work together to help free a doctor from the shackles of insurance dependence. In an interview with The American Chiropractor Dr. Miles explains how he got here.
TAC: Tell us about how you got into chiropractic.
Bodzin: In my senior year of electrical engineering at San Diego State University, I had an epiphany at the start of a very
After all, the nervous system is the electrical system of the body. ï Ï
difficult class. I thought, “I don’t want to be an engineer.” I left class and went surfing. After which, I sat on the beach contemplating my triture. It was in that moment I took a pad of paper and a pencil from my backpack and started to write a story of whom I wanted to be when I finally grew up. Putting pencil to paper helped me become clear in my vision for the first time.
Not long after this, I was visiting my chiropractor, whom I had been seeing for quite some time for better sports performance. I was first exposed to chiropractic at the age of 12 when I injured my neck diving into a pool. The thought of being a chiropractor never entered into my mind until that recent visit. With a clear vision in my head of who I wanted to become, it suddenly called to me, and like a lightbulb flashing above my head, I said to myself, “I should be a chiropractor. This guy is having the time of his life, helping lots of people, running a
successful business, and people respect him.”
Leaving engineering to pursue another career was a scary idea, but I couldn’t get it out of my mind. I found myself in the college library looking thr ough medical books until I found one about chiropractic. In that book, I read something that changed my life. It was so simple, yet so profound, I knew I would spend the rest of my life embodying the idea.
What I read went something like this, “The nervous system is the master system of the body. It controls and coordinates everything. Interference to this master system causes dis-ease in the body, ultimately leading to illness if left unresolved. The role of a doctor of chiropractic is to analyze, detect, and remove these nerve system interferences, thus allowing normal function to return to the body.” This spoke to me not only because of its simplicity, but also because I had been studying electrical engineering and software development. After all, the nervous system is the electrical system of the body.
So in a moment that is forever etched in my mind, I remember asking my girlfriend, who I would later marry, “What do you think about me becoming a chiropractor?” Let’s just say her initial reaction was less than favorable. Looking back, I guess I could see her point. She was prepared for me to graduate the next year so we could get on with our lives. But to her credit, she said, “If you feel it’s your calling, let’s do it!”
And just like that, we made the decision and I went to the
head of the engineering department to share my news that I was leaving the program. He looked at me like I was insane!
In 1990,1 started my classes at the Los Angeles College of Chiropractic, and I loved it. It was so refreshing to study human sciences instead of engineering. I absolutely loved learning to adjust, although I required a lot of tutoring in technique. It was also in school where my entrepreneurial spirit was reawakened. The way I studied was to type out my notes from class. They were so helpful that I ended up selling them to my classmates and to the classes that followed mine.
By the time I graduated, I had written notes for more than 30 classes, employed two classmates, and earned over $40,000. Not a bad way to eam a few bucks in school. I became known as “Miles Notes.” I remember after the first set of notes I published, the powers that be at the school tried to stop me. Many of the professors ended up later teaching from Miles Notes. I bet the current LACC president, Dr. John Scaringe, who was one of my teachers, remembers them.
TAC: Tell us about your life as a chiropractor in practice.
Bodzin: Here I was, a new graduate, married with a brand new daughter, and I was over $100,000 in debt. With a family to support, the pressure was on to get my career going fast!
So after graduating in 1993,1 briefly worked as an associate. Like many recent graduates, the plan was to work there for two
years and eventually open my own practice. However, within a short time, I ended up buying a practice from a doctor I knew from a local chiropractic philosophy group. In fact, we signed the contract the day my chiropractic license arrived in the mail. After a whopping one-week transition, I was alone in practice!
In those early years, I had a lot to leam. The biggest was: How was I going to get paid when every patient was on an HMO or PPO, and I wasn’t on any of their plans? This was the early 1990s in San Diego, California, where managed care began and every chiropractor in town was doing back and neck pain care and chasing ambulances for PI cases. Meanwhile, I had named my practice the “Chiropractic Wellness Center.” Mind you, this was 1994. There weren’t any other businesses in San Diego with a name that had “wellness” in it. I was the first.
The first two to three years were a real straggle. Not a single patient of mine went on to wellness care. Really the only highlight of those early years was being awarded “New Doctor of the Year” in 1995 by the California Chiropractic Association. Then, in 1996, something happened. A friend of mine in practice was doing really well collecting over $40,000 a month in cash. I asked him for help. His advice to me was, “Offer your patients a program of care and let them pay it monthly.” That was it. Very simple.
It wasn’t long before I was signing up patients and their families for care plans from as few as three or four months to as long as 12 months. It was somewhat shocking to me how easy it was. The patients seemed to really appreciate the way we made it affordable for them. Eventually, I ended up growing the practice to over $60,000 a month, seeing over 220 visits per week. Now I know some readers who see that think that’s a lot, and others will think that it’s not that big of a deal. Well, it was perfect for me.
I am proud to say many doctors have taken these ideas and done even better than I ever did. But what I am proudest of is that many of the patients I left behind when I sold my practice in 2011 are still coming in on those same payment plans, and still getting great value from their chiropractic care.
TAC: How did this lead you to the business you've created?
Bodzin: It all started with putting my own patients onto longterm care plans and having them pay for their care with monthly payments. The only problem I ran into was that my patients didn’t all need the same care plan. I needed a way to easily customize the plans. The idea shuck me when my wife and I were buying a new vehicle. After we agreed to make the purchase, they printed this simple and easy-to-read contract for us to sign. I remember thinking how cool that would be if I could do that with my patients. Print a custom contract for them to sign.
It was 1997, and I decided to put my engineering hat back on. I was going to create a way to offer a custom contract. Í ended up developing software that did exactly that. Well, it was really just an Excel spreadsheet synced to a Word document, but it worked great. Looking back, I kind of laugh at how easy it was to create. Even to this day, I still hear of DCs using spreadsheets in a similar fashion, although with today’s extensive regulations,
I’ve yet to see any that aie hilly compliant. But at the time, this product solved a major problem for me and resulted in hundreds of thousands of dollars in collections.
So how did this lead to my business? If you recall, in 1997 there was this new company called eBay. This was right at the beginning of people getting Internet access or knowing what an e-mail was. I found myself spending quite a bit of money on eBay for a variety of things. I thought it might be fim to sell something on eBay. So, what was I going to sell? I decided to name my software the Cash Plan Calculator® and offer it on eBay. To my surprise, in just a few months, several hundred chiropractors bought it.
It wasn’t until a few months into it that I started getting feedback from the doctors telling me my program was one of the best things they had used. They sent me e-mails saying things such as, “I’ve signed up more new patients on care than ever before,” and, “I’ve increased my collections a ton.” One of the first I received was, “I will bring in almost $6,000 in revenue for the same work. A nice 50% increase.”
Once I got this positive feedback, I realized I had stumbled upon something of great value to chiropractors. And having such a strong entrepreneurial spirit since childhood, I decided to put some serious effort into turning that original idea into a full-blown profession product.
I stopped selling that original product on eBay and created one of the first online software programs of its kind. Today, we aie on version 4.0 of the original Cash Plan Calculator® and soon will be releasing version 5.0. We’ve introduced three other modules to the software, including The Wellness Score®, Auto-Debit System®, and Drip-Education® Email Marketing System. All four modules help our clients increase patient retention and collections and help free the doctor from the shackles of insurance dependence. Hence our company’s name, Cash Practice® Systems.
TAC: What types of practices tend to benefit from this model?
Bodzin: That’s an easy question to answer. The practices that benefit the most from our software are the ones that want to offer long-term care plans to correct a patient’s problem and eventually transition them to ongoing wellness and maintenance care. Of course, the doctor wants to reduce their dependence on insurance as well. In my own practice, by following these systems, my average patient stayed with me over five years and had more than 300 visits. If a patient was coming in once a week for five years, that would be more than 250 visits alone. So when you add in their additional care from their initial treatment plan, you can see how they go to more than 300 visits. I often say to doctors that if your goal is to have patients stay longer and follow through with your treatment plan, then you really need to learn these systems.
TAC: How do you see the profession evolving with the Affordable Care Act?
Bodzin: Eveiything associated with the Affordable Care Act reminds me of the early 1990s. Back then in Southern California, everyone thought the new managed care system was
the answer to our prayers. Just get your name on the HMO and PPO provider lists. Well, instead it turned out to be most doctors’ worse nightmares. We all know the story. Doctors work harder, do more paperwork, and get paid a lot less money. Many states are just now being hit with the insurance plans that we saw in the mid-90s in California. I don’t know what the future holds, but my instinct tells me the same will be true with the Affordable Care Act. If you were to ask me if I would stake my practice’s future on the Affordable Care Act, I would say my odds of success would be better in Vegas.
TAC: Can you think of one change that a chiropractor can do to significantly impact his/her practice’s growth immediately?
Bodzin: I can think of numerous things, so here goes. Stop being emotionally tied to the decisions your patients make. Stop caring for them more than they care for themselves. They need you more than you need them. Learn how to effectively get patients to say “yes” to your care recommendations without the traditional hard-core sales techniques often taught. Give patients affordable payment options, including monthly payments, so they can afford your long-term care plans. Stop reminding patients they are paying you. This includes not sending them statements, not using third-party financing, or having them stop at the front desk to pay. Instead, automate all of their payments. Just doing these things will have a tremendous impact on your bottom line. You will have more new patients start care. More patients who start care follow through to the end of the treatment plan. And more patients who complete treatment transition to wellness care.
TAC: What does it mean? Do you have to be all cash? Can you do insurance?
Bodzin: The idea of being a cash-based practice may imply that you’re only collecting cash and not billing any insurance. Although that way may work for some, you do not have to exclude insurance. In my practice, we were 80/20. What we prefer to say is, “Free from dependence on insurance. If insurance disappeared tomorrow, your practice won’t.” It’s totally up to you. However, if you’re going to accept insurance, make sure it does not create stress for the practice. To reduce the stress, I recommend using an outside billing company. We found that to be the best solution so we didn’t have to deal with day-to-day insurance issues and payroll costs. Additionally, you must be 100% compliant in your fees, discounts, and collections. Let me be clear: there is no such thing as a “cash fee.” If you’re confused by that, you need to ask for help in understanding what I mean. This is why we work with compliance experts, such as KMC University, and a discount medical plan organization, such as ChiroHealth USA.
TAC: Where do you see the future of chiropractic headed?
Bodzin: In my 25 years in the profession, one trend I’ve observed is that the middle class of chiropractic, like America’s middle class, has been getting smaller and smaller. Chiropractors these days are either having their best years ever or are struggling more than ever. It seems there are fewer and fewer in the middle. Why? I believe it’s a result of less
insurance and a greater need to be good business people. Chiropractors must become ongoing students of business and masters of communication in order to succeed. The future of chiropractic depends heavily on how good chiropractors are at communicating a clear, concise message to the public. I am hopeful for the future. As I travel the country, I see more and more doctors who are great communicators. There’s also a number of great coaches who help doctors improve their communications.
TAC: Many doctors do prepay programs with their patients. Do you recommend prepay programs?
Bodzin: At first, prepays sound like a great idea. My experience in practice tells me otherwise. Here’s why: it all stalled when I had three military families cancel care in one week due to deployment. I had the pleasure of writing $10,000 in refunds to those families, ft was then that 1 realized 1 was supporting my practice and family on money that was literally borrowed horn the patients.
Not only that, I observed that few patients who completed care that prepaid went on to wellness programs. It was always a surprise to me when I knew a patient got the big idea but didn’t stay on for wellness. Although other doctors and I collected cash with prepay, it was not a successful model for lifetime wellness. However, over the years, I discovered the one thing that the patients who were with me for many years had in common. It was that they were paying for their care in monthly payments. I wanted to understand why this was.
This lead me to study more about business and behavioral psychology, which teaches what drives people’s behavior to do things they do. I came to the conclusion that our payment model had the biggest impact on patients following through with care. Through my studies, it became very clear that only a small percentage of the population prepaid for anything in life. When it came to large purchases, such as furniture, cars, boats, expensive clothes, and homes, most people justified their decisions based on their ability to make the monthly payments. They did not make a decision based on if they could pay the whole amount up front. The fact is that, from a psychological perspective, most people are wired to look at what they can afford per month. It is for this very reason that the doctors who do prepay plans have to learn how to use sales techniques and “close” the deal.
TAC: Any final thoughts?
Bodzin: It is 100% possible for doctors to run a successful cash-based practice and not be dependent on insurance. I understand there is often a lot of fear for doctors who are used to the insurance games when it comes to going more cash. We have successfully helped thousands of chiropractors free themselves horn insurance dependence. With the right mind-set and systems, it is totally possible.
Learn more at www.CashPractice.com or call 877-343-8950. To book Dr. Bodzin for interviews and speaking, call 877343-8950, ext. 201. QQ
