Cash-based business: the chiropractic-dental success formula

Utilizing cash-based business lessons from the most successful dentists, applied to doctors of chiropractic

I want to share a secret with you. For years, much like so many chiropractors, I too was always very envious of what the dental profession had a lock on with cash-based business. That being the ability to instill in a patient the importance, want, need and desire to practice a preventative lifestyle with regards to their health care, especially in the case of oral health (dentistry), or in our case spinal health, (chiropractic).

Conversely, the chiropractic profession has always been fighting an uphill battle to instill in our patients the need for maintenance or preventative chiropractic care. That often stems from the fact that insurance companies do not provide benefits for maintenance chiropractic preventative care. That “old-school” chiropractic insurance-dependent mindset was never beneficial for patients and practices alike.

The reality, however, is this

Many chiropractors may not know this, but the dental profession has always wanted what chiropractors have had a firm grip on for the 35+ years that I’ve been a chiropractor. That is the ability to provide our services in a multi-dimensional way, utilize great business acumen, create powerful and lasting doctor-patient relationships, and have an amazing passion for what we do.

What both professions share in common is the dynamic changes that now lie before us, with the most amazing opportunity to do something historic in both professions.

As a whole, dentists have mastered the ability to create primary cash-based business practices. So much so that enrollment at dental schools is at an all-time high, with applications far exceeding the amount of available acceptances.

Many students have now changed their desires to apply to medical school in lieu of wanting to become a dentist. The benefits to becoming an independent practice owner as a dentist are unlimited. Yes, these are so many of the same benefits as to why chiropractic college enrollment has recently been much higher as well.

Specialization and cash-based business

Chiropractors and dentists are similar in the sense that dentists can “specialize,” whether it’s orthodontics, endodontics, periodontics or general practice (all cash-based business). Much like chiropractors who also can “specialize,” whether it’s in disc care, nerve care or joint care (all cash-based).

As successful chiropractors well know, the cash-based business model of chiropractic is the future. Fact: It is better for our patients and better for our practices.

The primary group of chiropractic patients that this relates to are the patients requiring spinal disc treatment, nerve treatment and joint treatment, which all fall under the cash model of chiropractic “cash package” success. Dentists have owned this cash-based model for decades and have taken a giant leap forward in the past few years with the ability to package cosmetic dentistry, general dentistry, implant dentistry and restorative dental care with proper case fee patient presentations.

Their ability to utilize multiple payment patient finance options that include credit cards, checks, in-house financing and outsourced financing is the key. In our practices we utilize a “lending tree” which includes seven different finance companies as each of our individual patients’ needs and situations are different. Thus, we can provide our patients with the finance option that easily fits them best.

Positioning for success

I have seen a large number of chiropractors who have now positioned themselves for success for years to come — simply by having the ability to market, package, process and deliver incredible results and patient outcomes with nonsurgical spinal decompression care.

There is an abundance of chiropractic patients who have a primarily “disc-centric” condition, validated and verified through history, examination and diagnostic testing. The most common and popular diagnostic tool we use to diagnose a degenerative, bulging or herniated spinal disc is an MRI. This definitive diagnostic test, which is often underutilized in most chiropractic offices, is very special. What patients love and appreciate is the automatic “built-in medical second opinion” that an MRI provides, as the medical radiologist who interprets this most important patient diagnostic readily provides.

The other reason is less obvious unless you are a part of my “inner circle.” That reason is that I actually have two children. One is completing his dental education, and in a few short months he will be a doctor of dental surgery (DDS). He has worked and interned in one of the most successful dental offices in the country — a 13,000-square-foot state-of-the-art dental center that features a large patient base that includes Tony Robbins, MLB players, NBA players, UFC fighters and more. A practice that presents cash-based patient packages for tens of thousands of dollars on a daily basis.

Patients love going there and yes, not only am I a patient there, but my whole family are also patients there and much like you reading this, we simply want the best in health care, and we are willing to pay for it. Your patients are no different. They want the best in chiropractic care and yes, they will be for it if you simply do one thing — under-promise and over-deliver your patient care and patient experience.

Our other son is well into his successful journey as a chiropractic student at a great chiropractic university and has embraced all that our amazing profession provides to doctors and patients alike.

Figure 1

Patient communication

One great tool that we utilize for fantastic patient communication in our practices is a combination of a “Phases of Tooth Decay” model in conjunction with the “Phases of Spinal Disc Decay” in one single chart (see Fig. 1). This has allowed so many patients to be able to get the “big idea” in one single graphic. It is so important that we actually include it in the patient forms package in every cash-based business package we present to our patients.

In addition, because of our affinity for making such a simple and singular connection for patients, there are an abundance of dentists in our market who provide ongoing referrals to our practices as they love our ability to connect the two areas of anatomical specificity, the oral cavity and the spine. We have also found that our ability to explain the results of a spinal X-ray in simple dental terms has also allowed our patients to recognize the “medical necessity” of spinal care, and encourage their friends and family to schedule an appointment for preventative spinal checkups.

The communication secret

Communication is the secret to the chiropractic-dental success formula. Be exacting in your approach.

Treat every patient like family. Use the right patient educational tools to explain why your patients need your care right now and always envision your practice through your patients’ eyes. Raise your game and fall back in love with why you became a chiropractor. Your patients need you now more than ever.

PERRY BARD, DC, is co-CEO and president of DISC Centers of America, the largest group of nonsurgical spinal decompression centers in the world. A 1986 graduate of Life College, he is a state and chiropractic university CEU national lecturer. He serves as co-chairman of The International DISC Education Association (IDEA). He can be reached at 888-990-9660, by email at [email protected] or at


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