Thanks to Today's Chiropractic for permission to reproduce this article!
Joel E. Margolies, DC
You know you need a chiropractic assistant (CA), but how do you make that step
and allow your office to make that transition? Will that position expand your
practice or exasperate you? How do you train a successful CA and how do you
keep them motivated once the novelty has worn off?
First and foremost, the most successful step in creating and sustaining a successful
clinic is hiring the best staff. These professionals usually create the first
impression of your office, which may be the most lasting or simply the last.
Besides the need to welcome a new patient, your staff plays a huge role in linking
every concept of practice management, including patient scheduling, payments,
missed appointments, referral, internal marketing and public relations. It is
crucial that you give thought to this and appreciate the importance of each
member of your staff prior to hiring and training.
The road towards a successful chiropractic assistant is littered with failed
attempts, throwing good money after bad, offering training material without
proper training and then expecting both knowledge, caring and responsibility.
This article will outline a few ideas to both stimulate your existing staff
to develop their potential, as well as stimulate you to either re-train or re-hire
new staff if necessary.
Prior to hiring a new employee, you must first outline your office purpose and
mission statement. Adjustments aside, what does your practice say? Will it be
a warm and family oriented clinic welcoming patients of all ages or will it
be structurally biomechanical with rehabilitation and strong patient control?
Will it be insurance driven or cash-based, requiring business sense and money
management? Once you establish your practice karma, so to speak,
you will create the right atmosphere in which to promote training and instill
like ideas in staff. Too often people are hired on pure emotion and appearance,
rather than their ability to be a strong team player and advocate of your purpose
and professional goals.
I will start at the beginning for either a new practice or one that simply needs
to hire a new CA. Assuming your advertising efforts have been successful, you
now have a few potential candidates for consideration. The question is who to
choose and what criteria are best to follow. Many doctors use skill or personality
profiling tests, while others hire the first person breathing through the door.
Hiring techniques are an article in themselves, but it is sufficient to say
that the most important part is the fit. Will this person click and be in step
with you and the flow of your practice? Will they work in tandem with present
staff members and be supportive of practice growth? With these questions answered,
you now come to the most important component of a successful staff member and
the most neglectedstaff training.
Patient management starts and stops with education. A quality patient understands
the value of the adjustment and the ramifications of spinal neglect. They should
question you about proper body mechanics to sustain a healthy spine and maintain
a correct posture. We are obligated to answer their questions and anticipate
some blips on the radar screen when they feel neglected or wary of their care.
Without proper staff training, including an intensive educational process, how
do you expect your staff to be alert to the patients needs as well as
be an advocate of chiropractic care? They must be attuned to the practice as
if it were their own and appreciate the need for proper chiropractic care both
for themselves, the patients and their extended family and friends. Although
the intensive educational curve will not exceed a few days, the process will
When hiring a staff member, especially for the front desk, let them know that
they have been provisionally hired, which will last during a training period
between four to six weeks. During this time, they or you may wish to discontinue
the training process for any reason. It will soon be clear enough if they get
the big idea, or will be a burden to practice growth and sustenance.
During this training period it is your obligation to offer them the tools to
become an extension of you and an excellent representative of your office and
chiropractic. These tools may include books, video and audio tapes, but they
never replace your personal attention with knee-to-knee discussions, script
review and interactive scenarios they may encounter.
Careful attention must be given to their learning curve, personal attitude and
quick response to given scenarios. Resistance to the training process or chronic
partially-resolved issues will eventually prove detrimental to the end result.
In other words, a less desirable candidate will soon prove obvious. It is at
this point that many doctors fail in their effort to create the proverbial perfect
CA. Rather than cutting their losses and looking for someone else, they actually
become a hostage to their staff by accepting less rather than more, and allowing
complacency to rule their practice. As hard as it is to look for and train someone
else, it may be necessary for the sanity of the office, as well as the bottom
initial introductory training cycle begins with the basic philosophy of chiropractic;
the role of chiropractic within community health and wellness, the difference
between allopathic medicine and chiropractic; and your professional choices
for care. If the potential CA cannot appreciate your desire to transform the
mindset of the patient concerning healthcare and appreciate the difficult but
necessary task to offer the message of chiropractic to the community, than he
will be useless to promote and maintain your office base. Why go further in
training if they cannot get past first base?
Try as you might, the perfect CA might elude you if you feel that they will
never be transformed as an advocate of chiropractic because they miss the simplistic
but complex matrix that is chiropractic. To warmly and compassionately welcome
new patients, prod those on the edge of compliance and reach out for new ones
requires a person with intense understanding and the desire to fulfill the office
goals and mission purpose. This may sound idealistic, yet it is within every
doctor and staff member to desire more, and as a team it can be accomplished.
The trick is getting through the initial knowledge phase of training by making
it real, alive and fun.
Assuming the initial phase of training has passed muster and they have been
awarded their position with honors, the task now is to maintain their freshness
and purpose. If you consider how easily you get sidetracked with issues unrelated
to patient care, you can appreciate the difficulty of running the front desk
while managing the offices inherent complex issues. Consider for a second
what they must accomplish each day, including scheduling, answering phone calls,
removing and returning files, handling money and financial concerns, dealing
with insurance companies and managing the personalities of your patients. It
is no wonder that the seedling you nurtured into a perfect flower can soon wither
quickly on the vine.
The key to keeping staff excited and willing to add more to their task is continued
education, philosophy discussions and attendance at chiropractic conventions
and seminars. Chiropractic is an honored profession that must continually swim
upstream to garner community respect and understanding. We need to support each
other and share our wins and losses in order to collectively find the paths
of least resistance. If it is necessary for you to rekindle the flame, it is
doubly important for the staff. Keeping them excited and within close distance
to other chiropractors and staff will result in staff longevity and productivity.
I recommend you review each staff member and determine if they need retraining
or additional tools to make their job easier and more productive. Ask them if
they feel comfortable with their level of knowledge and ability to answer questions
posed by the patients. Determine if there are roadblocks to their performance
such as massive paperwork, repetitive activity or workplace material. Maintain
regular staff meetings with structured agendas that add to patient understanding
and office interaction. Review each new patient and determine their level of
education and where gaps of knowledge can be bridged.
Consider cross-training staff so that each staff person can appreciate the complexity
and necessity of the others position. Create fun activities such as patient
appreciation days and participate in holiday and community events. Take advantage
of staff hobbies and allow those with creative skills to decorate the office
and maintain a living breathing office that speaks of wellness and care. This
will keep the practice active and allow the staff to interact with the patients
and foster referrals. Create a financial or material bonus system as an incentive
to achieve their goals and reward them with praise and appreciation often.
In conclusion, I recommend you question your desire to achieve your goals. If
they are shared with your staff and you have created action steps towards achievement
that can be reached, your initially intense CA training will pay dividends for
years to come. Be wary of the complainer or reluctant CA who might sabotage
your goals and literally suppress office growth, and never become hostage to
a staff person who will compromise your goals and patient care as you appease
their lack of enthusiasm or understanding. Keeping an eye out for these pitfalls
during the training phase and maintaining a relentless pursuit of staff excitement
and education will always be your ticket to success.
Dr. Margolies has maintained an active practice in Atlanta, Ga., since 1978.
He was an adjunct instructor at Life University from 1995-1999 and has taught
at the Karl Parker and Fernandez Seminars. He has also authored four books:
Smart Start, Chiropractic Marketing and Public Relations, Workshop Workbook
and the Personal Injury Workshop Workbook. He is also the author of a free weekly
email newsletter concerning practice management, public relations and philosophy
that is read widely. To receive his newsletter, visit his web site at chirosmart.net.
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