Brimhall Puzzle Piece

Increase Your Results and Income by Overcoming Practice Obstacles by Streamling, Fine Tuning, and Integration

February 2, 2009


Hi there doctors and practitioners. An essential part of all of our seminars in ‘09 is to teach implementation of all of the techniques and office procedures.  Total Practice Resources has been an incredible addition and will participate in almost every seminar this year to assist us in teaching you and your entire staff.   Those who were at Homecoming we overwhelmed by the number of mistakes they were making; such as inadequate coding, billing, follow-up calls, proper scheduling and rescheduling on missed appointments, causing them to leave money on the table and lose revenue.

Upcoming Seminars
( see Complete 2009 Schedule )

February 7-8
Atlanta, GA

Basic, Interm
Dr.John Brimhall
NW Blue Ridge
or 843-342-3688

Feb 27- March 1
Dallas, TX
Basic, Interm & Adv.
Dr. John Brimhall
NW Texas
or 214-733-8838

March 13-15
Cincinnati, OH
Basic, Interm & Adv.
Dr. Brett Brimhall
NW Ohio
or 937-644-8129

So below is an example of Brandy of TPR on a call, giving a doctor step-by-step procedures and a timeline on how to do it right.  This particular doctor wanted to cut his visits to a five minute office visit and was about double that at the time of this call. This information is relevant to you to enable you to streamline your office visits, no matter how long they are or how long you may want them to become.

Dear Doctor,

We discussed this in detail:  having a five minute visit is a great goal; however, action steps must be taken in the meantime to work and build toward this goal.  Current obstacles such as lack of staff training, some disorganization in some front desk, and patient processing systems due to moving, changing software, training, uncertainty in what is being done with the patients, and follow up from previous visits with patients (missing nutrition rescans, etc) are currently limiting the possibility of reducing visit time. 
Recommendations for improvement and streamlining:

  1. Implement regular training so that the doctor has complete confidence in what is being done with the patients.  Having the staff trained to do a nutritional scan will be an asset and about the only way to achieve the desired outcome. 
  2. Walk through all office systems (entire staff should do this) to look for other areas of breakdown or inefficiency and take notes of these observations.  Seek help for improvement where needed.  These systems are all taught by TPR if help is required.
  3. Everyone should be cross-trained to have at least an understanding of each department.

    1. There are things that we do or don’t do in each department that can help or hinder other departments as all departments.  Discover and correct.

  4. Take baby steps in correcting these things….too much to change at one time does not help. 
  5. Determine exact patient protocol.  (What is standard of treatment to be done with every patient, every visit?)  In the Six Step Protocol you may want to break down the testing, treating and education to different days in the beginning to allow proper flow.  Again the staff must be trained to accomplish this outcome.


A second obstacle is the inability to make and follow a schedule to know for certain when and if a patient needs a re-exam and re-Total Person Nutritional scan for nutrition as well as other services.

Actions to correct and improve:

  1. Document date and day for recommended re-scan (or other services) like every 30 days.  Front desk should keep track of this and make reschedule the patient in advance.

    • Good scheduling systems are often color coded or able to be marked, flagged or tagged for special notes.  Utilize this to its fullest extent.  This missed opportunity or missed services is lost income as well as lost focus on patient care.

  2. Briefly review (for approximately 10 minutes) the schedule each day of work prior to opening the office for the day.  View and review with your staff circumstances, additional services, etc. 
  3. Front desk (scheduling) systems may need to be evaluated to aid in improvement of this obstacle as well.  Multiple appoint schedules are the best for the patient and the office to allow ample time and services for healing.
  4. Doctor note taking (recommended rescheduling, necessary services, etc) may need to be evaluated also.  Front desk should be able to look at this and know exactly what to schedule for and when.


Obstacle number three is the Nutri-West nutrition sales/ therapy recommendations can conflict because doctor is trying to recommend everything to patients at once and struggles with what to recommend and when.  
Steps to correct/improve:

  1. Not everyone needs absolutely everything.  When you make recommendations to patients, you should not be recommending it because the service is there and available for them but instead should be recommending it because the patient will benefit by receiving this/these service(s).
  2. You must be very clear when making recommendations.  Meaning… you must describe to the patient what the service is and how they will benefit by receiving it.  ALWAYS explain the benefit to the patient.  Otherwise, all they can see is the sales efforts of the service, additional expense that they don’t know their own necessity or benefit too and therefore feel as though they are being sold rather than cared for.  If you have N-Compass or the new eWellness you can print out fact sheets that are extremely helpful.  Your Nutri-West distributors also have fact sheets on each nutrition.
  3. Avoid trying to educate the patient on everything all at once.  You did not get your knowledge of Chiropractic or the 6 Steps to Wellness in one or two days.  Tell them what they need to know at the present time and give them this information in easy to understand, easy to remember increments in a manner that makes it ‘personal’ to them.  Use Dr Brimhall’s Charts, Pamphlets, DVD’s and CD’s in this department.  They do much of the work for you.
  4. Follow Dr. John’s advice:  “Give them what they ask for, while you educate them on what they need.”


Additional notes:

  1. Additional call screening may be necessary when patients call in so you know what type of care they are seeking.  Have a form that asks the patient if they are seeking pain relief, corrective care or wellness care.  Be sure to evaluate this before seeing your patients so you are in complete understanding of what their needs are so you are best able to meet their needs.
  2. Care plans should be put together of your usual and customary treatment. .  This would be done instead of individual plans for care credit that are very time consuming and confusing for your office. Copies of these are available to TPR customers and can be secured easily on even a Pay Per Call.  They can be used for pre-pay purposes, or  be used for care credit, etc)
  3. A reminder here that an educated patient is a good patient and use the CD’s and DVD’s as stated earlier.

OK Practitioners, this has been a mouthful and there is much more that can be taught and implemented for you and your staff.  So get to a Nutri-West/Brimhall soon and give TPR a call for your individual office evaluation at 303-242-8901.  Also we will have DVD’s of the Homecoming Seminar.  If interested call our seminar office at 866-338-4883.  Come and see the new Zerona laser information.  Many offices have added it to their practices to great success.  Call Dr Luke at 678-350-5914.

John W. Brimhall, DC and the Whole Wellness Team

Brimhall Wellness Seminars
(866) 338-4883

Total Practice Resources
(303) 242-8901


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Brimhall Puzzle Piece

Dr. Brimhall's Health Puzzle Piece is a weekly email newsletter distribution that has been brought to you by the collaborative efforts of the Brimhall Wellness Team. All newsletters are published and available at a division of Health Path Products, LLC.

The above statements have not been evaluated by the FDA. The nutritional information, suggestions, and research provided are not intended to diagnose, treat, cure, or prevent disease and should not be used as a substitute for sound medical advice. Please see your health care professional in all matters pertaining to your physical health.