The 500 Club

It’s a unique practice that can serve 500 or more patients per week. It reflects a special discipline, both in the doctors’ own attitudes, as well as in the fiscal management of such a high-volume business. We caught up with Drs. Abeckjerr, Fenster, Andersen and Hedgelon recently to gain some insight on their practices. Here’s what they had to say:

Dan Abeckjerr, D.C.
Cloverleaf Chiropractic Clinic
North Miami Beach, Florida
Weekly Rate: 650-700 patients
Years in practice: 20
Graduate: Life Chiropractic College
Staff: Three fulltime, three to four part time
Schedule: Three full days, two half days

Today’s Chiropractic: Was it your goal to have a 500+ practice?

Dr. Dan Abeckjerr: It was actually a goal that I had. First I worked for one of the Dynamic Essentials (DE) doctors, so I learned a lot of the ins and outs of running a busy practice. So basically I learned pretty much what he did and I applied it to my office about 20 years ago and it has worked for me.

TC: How did you get there?

DA: We do a lot of promotions where we go out into the community and talk to a lot of people. We do a lot of spinal screenings at different community events that has helped me build my practice. We do lectures; I think lectures are basically the key to educating the patients and basically getting them to understand what chiropractic is. We go to the schools, we do career days, we also do radio shows. We just tell the story, very simple, very to the point. It has worked quite well for us.

TC: Explain how your office processes work.

DA: I start at seven in the morning and all I do in my office is adjust. I don’t do any X-rays or anything else. I have an X-ray technician. All I do is go from room to room and do adjustments. I have the CAs set up everything for me, and I have the technicians do everything for me. All I do is walk in, the patient is lying face down and I just adjust them. I go from room to room; I have little doors between rooms, so I don’t even have to go in the hallway. I just go back and forth, back and forth. It is really simple [in terms of the] procedures that I use; I just do the adjustments. It is nothing really fancy; it is really not impressive at all, I just adjust people and I go in the next room. My lay lecture is very strong, so when patients come into my office, they know that all I am going to do is adjust them.

TC: Do you talk to your patients when they need special attention?

DA: We sit down with them and we talk right there and then if they need to talk to me. But most of the time my patients know what we need to do is adjust them and they really understand that because we explain it to them during the lecture.

TC:
Do your patients feel like they get quality care?

DA: Most of my patients, I would say 40 to 50 percent, have been with me about 10 and 15 years, they are long-term patients. Most of them are patients that have been very satisfied with my care, and they consider us like family members. They don’t really want to stay in the office a long time, they like getting in and out. They know I am not going to keep them waiting in the waiting room more than five minutes.

TC: Is your practice mostly cash, insurance or a mix?

DA: It is about 60 percent cash and 40 percent a little bit of everything. I accept all patients regardless of their financial ability to pay.

TC: How do you deal with the physical strain and stress?

DA: I have a rhythm in my practice, I feel like I work long days, so on my off days I spend a lot of time with my family. I like to go out on the boat, so we spend very quiet times just going to little islands near our house. The balance is there and it is really nice.

TC: Who manages the office?

DA: My wife is actually the office manager and she runs the front and I take care of the back. She takes care of everything and writes the checks, and all I do is adjust and take care of the patients. Mostly I don’t get involved with the paperwork—I try not to.



Dan Fenster, D.C.
Fenster Chiropractic
Manhattan, New York
Weekly rate: 500+ patients
Years in practice: 18 years
Graduate: Life Chiropractic College
Staff: Four employees

TC: How did you get grow your practice to the size is is today?

Dr. Dan Fenster: Getting here is like winning the world championship—work, practice, work, energy, work, money, work, training and work. Did I mention work?

TC: Explain how your office processes work.

DF: Processing of patients is very simple. On the first visit, patients fill out a card that folds and becomes their travel card. It also has room for both clinical and financial info. That’s the card that is used on every visit to the office. I have five adjusting rooms. When the patient comes to the office, they are sent to one of the rooms, lie down and wait for me. After I adjust them they take the card back to the front desk.

TC: Do your patients feel like they get quality care?

DF: I hope all of my patients feel like they are getting good quality. I feel that the quality is based on the product, not the process. Getting results has always been chiropractic’s strength.

TC: Do you talk to your patients when they need special attention?

DF: When a patient has a special need, I do my best to deal with it right then and there. It’s rare that I would schedule a special time for them to come in, but it does happen. In general, patients get the rhythm of the office and I’ve learned to deal with special needs quickly.

TC: How do you deal with the physical strain and stress?

DF: Taking care of me is an important priority. I get adjusted as often as possible. I used to be a runner, but have switched over to biking to reduce the pounding on my body. I also try to stretch as often as possible and get massage frequently.

TC: Is your practice mostly cash, insurance or a mix?

DF: The practice is 50-50 cash-insurance.



Andersen Family Chiropractic
York, Pennsylvania
W
eekly Rate: 460-520 patients
Years in practice: 12
Graduate: Life Chiropractic College
Staff: Three fulltime

TC: Was it your goal to have a 500+ practice?

Dr. Darcy Andersen:
It was my goal. I had gone to DE since 1982, when I was working for a chiropractor down in Miami as a chiropractic assistant for five years. He would take me to DE and I would listen to Dr. Sid saying, “See yourself doing 500.” That is what I visualized myself doing. So after about a year in practice, I was seeing 500 patients a week.

TC: How did you get there?

DA: My primary focus was to see the people and by preparing myself innately, inwardly, it just manifested. The first year I sent out 5,000 flyers and in my first week I had over 125 visits. From there it just kept growing. I don’t do any promotions now. I will periodically speak to a group of people when they ask me to, but other than that it is all referral within the office. I think it is because I prepare myself, I do mediation two times a day, if my intent is to reach and teach the people about chiropractic and how it can make your life better.

TC:
Explain how your office processes work.

DA:
It is actually very simple, I have three CAs that work for me and I keep it simple. The patients come in, they just receive an adjustment. I think a big part of the practice is that I do an orientation one to two times a week, sometimes three. I always do them Wednesday nights, sometimes Friday morning or sometimes Thursday evenings depending upon the new patients. It gives people a better understanding of what chiropractic is about. Although it is symptoms that might bring them into the office, I am not taking care of them based on their symptoms. So I don’t have a lot of patients that will tell me all kinds of things, and I don’t take care of them based on their symptoms. So when they come in it is very easy.

Now there are always certain patients that address you based on symptoms, and my only response is, “Okay, let’s have you lie down and I will check your spine.” I relate to the patients well and I think that is why it was easy for me to build a practice. I listen to what they are saying, but I know what I am supposed to be doing as a chiropractor.

TC: Do you talk to your patients when they need special attention?

DA:
I address them as a whole person, I explain to them that my main emphasis is on correcting the subluxation, but I will address things. I don’t turn their questions away if it is not chiropractic.

TC: Do your patients feel like they get quality care?

DA:
When I am with a patient, I give them my total attention—real-time presence—and they react to that and appreciate it. Also, my (C.A.s) will do a thorough case history, because when we do a periodic reevaluation, the patients will realize that all these other health things that came in with that they didn’t even think chiropractic could help, all of a sudden they’re gone or much improved.

TC: Is your practice mostly cash, insurance or a mix?

DA: Some of the insurance might only cover 12 to 15 visits, then after that the patient goes on a cash basis. That is not a lot of care when you are in it for the long term. If someone is just in for symptoms, then their insurance covers it. But I would say I probably have about 40 percent insurance and 60 percent cash basis practice.

TC: How do you deal with the physical strain and stress?

DA: I get adjusted a lot. When you do take care of a lot of people, your body has its wear and tear. I do a variety of techniques, but I use drop tables, so I utilize the table to be able to put the force, so I don’t have to expend as much energy. I work out two or three times a week, but I think the biggest thing is the mediation helping me to keep centered. One of the most important things is that I attend DE four times a year which helps me reenergize.

TC: Who manages the office?

DA: My office manager (a C.A.) can do everything in the office, so she kind of oversees everything. She will process the new patients before I go back to see them, she’ll take the X-rays and she is at the front desk when she is not doing re-evaluations or things like that. It really frees me up.



Paula Hedgelon, D.C.500_club
Hedgelon Chiropractic Center
Pompano Beach, Florida
Weekly Rate: 750-800 patients
Years in practice: 17 years
Graduate: Life Chiropractic College, 1985
Staff: Two fulltime, one parttime

TC: Was it your goal to have a 500+ practice?

Dr. Paula Hedgelon: I wanted a high-volume practice, always from the beginning. When I started taking care of people, I worked at Franks Chiropractic Life Center and saw lots of people. Also, my brother (Dr. Armand Rossi) has a high-volume practice. Basically I just followed the way they did it, and I went to DE. Just by taking care of people and focusing on people getting chiropractic care, principled chiropractic care, it just kind of happened. But my roots were from DE when I was a student.

TC: How did you get there?

PH: First I was with Dr. Rick Franks, and then I went to Florida after I had my daughter, I was in practice by myself in 1988. It took my about five years to get to 500 patients, and I did spinal screenings and yearly open houses. We have a family-oriented practice and people feel warm, they feel welcomed when they come in and they come in groups. They know each other. I have a big referral practice and that is important to because they already know what to expect.

TC: Explain how your office processes work.

PH: I don’t have set appointments; patients come in and I just adjust them. The patient comes in, they lie on the table and I look at them, palpate them, and I adjust them, mainly I start with the atlas. I have a very family-oriented practice, I have lots of children, so I have lots of people come in groups. All of the patients are like family. They come here on a regular basis, just to get checked. We love and care about them, that is the main thing that we do here. We just stick to chiropractic.

TC: Do you talk to your patients when they need special attention?

PH: Naturally I will sit with them, but if they want extra time, I will make an appointment time away from work to have them come at a certain time when it is not so busy.

TC: Do your patients feel like they get quality care?

PH: They don’t want to wait a long time. They come, they get their power turned on and then they go out and they function better. A specific chiropractic adjustment with the extra something and that is what makes them feel loved and that what heals the body. The healing comes from God, it doesn’t come from me, and all I do is step aside and let the healing come from God. The body heals itself.

TC: Is your practice mostly cash, insurance or a mix?

PH: Actually it is 30 percent insurance and the rest is mostly cash.

TC: How do you deal with the physical strain and stress?

PH: There is no physical stress. The more people I adjust, the more energy I have. It is like a spiritual place here. When you are in the flow of adjusting, I don’t have a physical stress at all because the more you do, the more energized I become. It’s like running, you stop and you run, you stop and you run, it is just easier to jog and keep going.

TC: Who manages the office?

PH: I have someone who takes care of everything and has for 10 years. We have a billing service, but she takes care of the insurance that has to go to billing service, the patients, collecting the money, the phone and more.

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