Calling the Shots on Your Contract – by Dr. Jen Faber

Dr. Jen Faber

Dr. Jen Faber

When new chiropractors kick-start their career by working in a practice, they’re eager, hungry and ready to learn from a mentor who knows the ropes. On the surface, this path can offer training on the job and get you prepared to build your own practice someday. But just because you want someone to “take you under their wing,” doesn’t mean you should feel like you have no say in what you get in return.

Yet it oftentimes does.

Why? Because it’s easy to go into defeating thoughts that take away any chance you have to negotiate. Ask yourself, if you’re an associate or want to be, have any of these thoughts run through your mind:

“What say do I have?”

“I have no idea how to negotiate.”

“I have no experience, so I’ll just take the best offer I can find.”

“All I want is a job that’ll pay the bills, and I’ll figure out the rest later.”

This is a confidence gut check. It’s an opportunity to reframe your mind on how you go into a job offer and give yourself the personal power on negotiating and knowing how to do it.

Let’s set the stage here. Our profession gets a bad rap on “eating its young” when it comes to associateships. Sadly, that’s because chiropractors feel overworked, underpaid and taken advantage of by the practice. But that end result doesn’t come fully from the boss. The employee (a.k.a. the associate) also needs to set standards before day one so you go into that job with a contract that works for you …

And not one that was just created for anyone who will sign it.

Having come out of a job that nearly drove me to leave the profession all together, I know that feeling all too well. In hindsight, had I known even one tip on how to negotiate, I would have put myself in a level playing field and perhaps even the wisdom to walk away from that job before getting hired and find something better.

So I want to share with you the tools that I would’ve told my younger self back when I graduated. Negotiating is all about the approach and implementing key strategies to create a contract that actually works in your favor.

Step 1: Go Shopping

Typically the first question that runs through your mind is, “How do I even know what to ask for?” And if you’re right out of school, it’s hard to know the baseline for what’s a standard contract. So the first step here is to do your research. Go on chiropractic job boards and read the offers. Identify what the opportunities are in your location or comparable areas if you don’t know where you want to practice yet. Look at the incentives and compensation to determine what works for you and what doesn’t. Create a list of what you’ve see in offers that appeals to you so you can bring that knowledge to the table on interview day.

Step 2: Know Your Conditions

After you’ve done your market research, you’ll want to create your own job offer. Design an ideal contract that matches what you want. This is a concept known as ‘conditions of satisfaction,’ which is all about developing standards for yourself.

And this is vital because chiropractors typically go into a job offer with no preparation or strong identity on what that ideal offer looks like. You don’t want to go into this process blind, because it will make you feel like you have no say in the game, and you will come across that way when a contract is presented to you.

So think about the standards you want to create for your job contract. This relates to three key areas: compensation, benefits and vacation. For compensation, know what the standard of living is in your area and what you need to make to match it. Also think about the structure. Do you want bonuses or incentives as you grow your patient base? What benefits do you want to receive in addition to your income? How much time off do you want to have? More importantly, how much time off do you want to give your work-life balance?

What exactly will cause you to be satisfied with your job offer? Be honest and specific. And then know those conditions before the interview, during the interview and especially when you negotiate the offer.

Step 3: Don’t Accept the First Offer

Any job offer that you get will be in the practice owner’s favor. It’s not necessarily because an employer is trying to take advantage of you. It’s because that employer is looking to bring a doctor into their practice and ultimately wants a new hire to be a good fit for them. This is no different than listing a house for a higher price, because the status quo is that the price will get negotiated down. That’s just smart business sense.

So don’t accept the first offer thinking that the employer won’t budge or that you have no voice in the matter. This is how any business contract works. There’s an offer. Then a counter offer. Then an agreement.

Use the conditions you’ve set to let the employer know what you want and what will make the job and offer a good fit for you. State what you need in order to move forward so both of you can have a dialogue and come to a mutual agreement. This sets such a stronger dynamic then just signing on the dotted line and hoping for the best.

The big takeaway here is this:

Don’t be willing to just take any offer just to get the job now, because you could spend years stuck in a contract that ultimately stunts your future growth. And you are worth way more than to just settle for some job when you’ve spent time, money, effort, and passion to become a chiropractor. So know that not only can you negotiate, but you should. And when you do, you’ll be able to see red flags, figure out the best fit and attract a job that matches what you want.

Jen Faber, D.C.
’06 Davenport campus graduate

After breaking away from burnout and frustration early in her career, Jen Faber, D.C., is now on a mission to coach freedom-seeking chiropractors on how build a practice they love through her individual coaching and online training programs. She is the creator of the House Call Practice Program and the Unleashed Coaching Program to empower chiropractors with the guidance, tools, and strategies to build a successful practice. Visit her online at www.drjenfaber.com.

Chiropractic changed my life

Chiropractic changed and saved my life. I remember I was in 6th grade. I was rough-housing with my sister and fell off the couch. I hit my head on the coffee table and subluxated my upper thoracic vertebra. It had been a couple of months when I started developing severe asthma, and I had never had asthma before my entire life.

Dr. Greg Johnson adjusting one of his patients.

I went to every allergy and asthma specialist in the tri-state area. All they did was give me pills and allergy shots for the next two years. My asthma got so bad that I was taken to the hospital and put in an oxygen tent, shot me up with epinephrine, and I had to quit playing all my sports activities.

Finally a friend of my mom’s referred her to a chiropractor who was a Palmer graduate that had helped another child with their asthma. She took me to him, and within three months of being treated by this Palmer graduate, I had no more asthma.

I knew in the 8th grade I was going to be a chiropractor. Traditional medicine failed me miserably. I knew I wanted to go to Palmer College of Chiropractic in Davenport, Iowa because I wanted to go to the best school for chiropractic in the world. Palmer has always been The Fountainhead of chiropractic, and I graduated from Palmer in Davenport in 1981.

I have treated tens of thousands of patients in my 32 years of practice. I am as passionate about chiropractic now as I was then. I see chiropractic changing people’s lives every day and have had several patients go to Palmer themselves after being treated by me. I believe strongly that Palmer College chiropractic teaches their students how to adjust the spine better than any chiropractic college in the United States. I am now sharing what chiropractic benefits are for people on YouTube.

I encourage every Palmer graduate to continue to educate the world about the benefits of chiropractic care. Continuing education is also very important for your continued development and skills. Becoming a chiropractor and going to Palmer College was the best thing that could’ve ever happened to me. I believe every chiropractor should visit Palmer  in Davenport  just to see where chiropractic actually came from.

If I could pass any tips along to Palmer students, it would be to study hard and really learn about the spine and the nervous system. Chiropractic is about so much more than just “cracking” necks and backs. Chiropractic philosophy is exactly the way B.J. Palmer taught it in his day. The vertebral subluxation complex does exist, and correction of this disorder will save many lives. Chiropractic is the most rewarding profession anyone could ever be in. Don’t forget to keep getting adjusted yourselves throughout your professional career. Keep changing lives through chiropractic care.

Sincerely,

Your Houston Chiropractor

Dr. Gregory E. Johnson D.C.

Davenport Campus, Class of 1981

 

What I’ve learned after 30 years in practice

I graduated from Palmer in Davenport in December 1982. After graduation, I associated in an established practice for 2 years and then struck off on my own. I began my practice with a typewriter and a copier.

Most of our bills were done by hand on paper. Mountains and mountains of paper. Faxes had not been invented yet. There was no email. The social media was called a telephone. Most people wouldn’t have modern “off-the-shelf” desktop computers for another 5 to 10 years or so. And when computers began to emerge for the public, their operating system (on “modern” TRS-80 computers from Radio Shack) used CMOS. Instead of colors and icons, you were greeted with a black screen and this: C:\.

Photo from hoolawhoop.blogspot.com

There were no clicking on icons or “copy and paste” shortcuts. There wasn’t even Solitaire or Mine-Sweeper. There were some naissant black and white T.V. video games (Pong and Tanks). Pac-man would soon arrive and add color! Video arcades were on the horizon. Bill Gates would start marketing Windows in late 1985, and I bought my first “real” computer in 1987. It was a little more powerful than a calculator today, with memory measured in kilobytes, not gigabytes.

Prior to then you made duplicates of things with carbon paper and typed on a manual typewriter. Word processing would come later. In that era, “white-out” was as close as it came to word processing. Billing was time consuming. Paper work was a chore that consumed most of your clinic time. It was a very different business environment. New graduates can probably not imagine a world without DVD or Blu-ray, but this was actually even before VHS! Family memories were preserved on super-8 cameras and usually without sound. Cars had cassette players or an 8-track player.

Palmer was also a different place. Lectures were illustrated by the professor writing on a rolling sheet of acetate while the overhead projector shone it’s weak light up on the wall.

My biggest clinical observation therefore is that the modern practice is as different in day-to-day operations in 2013, as airplanes have made the world since the horse and buggy days. Information is almost instantaneous. Phone books are arcane today. Even snail-mail is on its way out. Sending out the clinic billing now goes through a clearinghouse where it’s checked, corrected, sorted and instantly delivered via the Internet with a turn-around from billing to resolution of days, not months. Patient record keeping still usually involves some paperwork, but that also is being phased out for EHR and verbiage-generating software. (Not always a good thing, BTW.) We design our own forms on our own word processors. We print them on our own color printer. We fax records. Our phones are cordless. We digitize X-rays. We back up on carbonite. We email newsletters to all our patients with the click of a button, and we track our billing through the Internet. And sweetest of all, the computer re-paginates my typing automatically, letting me add, delete and spell check my work with a simple mouse click.

As with all invention-based revolutions, from gunpowder, to the steam engine, to the Wright brothers, to the repeating rifle, to the silicon chip, the world is not the same place that it was even just 30 years ago. Everything has changed. We can do twice as much in half as much time! Our modern world is amazing, and we can only presume that our grandchildren will look back on our “modern” era as quaint and archaic, as new inventions come along.

“Grandpa, you actually watched movies on a plain big-screen television instead of in the 3-D hologram portal chamber?” But the one thing that hasn’t changed, and hopefully will never change, is the need for ethics, morality, honesty, integrity and altruism that chiropractors must generate with their patients. No amount of technology can compensate for sham treatments, unethical care or short-cuts when it comes to patient care.

Patients are also more sophisticated now. They expect to know the “how” and the “why,” not just the “what” of the care you’re giving them. Sadly, with modernization has also come some short-cuts in patient care among some chiropractors. Junk science is sadly still too alive and well within our profession. Treatment plans that plan out a year in advance on the first visit are not ethical. Ignoring X-ray guidelines to generate a revenue stream into your clinic when films are not needed is dishonest and immoral.

We have been slow as a profession to modernize our thinking. We still fear guidelines and fight to find our own true identity as a profession. While we want to embrace the modern world, this does not mean we want to embrace a less ethical world. We cannot claim to be equal partners at the health care table when we still cling to outdated and implausible case-management habits. Differential diagnosis and critical thought has been slow in making a foundation for the chiropractic profession, which still relies on health models from the 1800s. We struggle to modernize ourselves, though we long ago accepted the modern world. We struggle with defining ourselves as a profession. We struggle with money, which risks compromises that can poison the chiropractic well for future generations.

To new graduates, I would urge you to be cautious on accepting every scam wind that blows through the chiropractic profession. If you want to be successful, above all else, be grounded in ethics, science and evidence-based care. The best way to make the most money is to make yourself the best doctor you can be. The rest will follow when the core is abundantly constructed. Practice gurus, bogus techniques and eternal treatment plans are also inventions of this modern world. But though we embrace shortcuts in our time-requirements, we need to also be wise enough to reject any shortcuts in our ethics. Ethics have never changed. Loving your patients more than yourself has never changed. And hopefully, they never will.

– Garth Aamodt D.C.

PCC-12/82

www.aamodtchiro.com

 

Everyone needs a mentor … or two

I think some students may not realize the importance of a mentor. While in school, of course we had our favorite teachers and clinicians that we connected with and sought their opinions. But for me, I never really had a specific mentor. I was content with the fact that after graduation I would have numerous doctors I could call for help.

When I moved back home, I received mixed responses from the other Chiropractors. Some were barely friendly, while others were glad to offer their ear if needed.

One doctor in particular was welcoming and, indeed, this was refreshing for me. I had no other option but to start my own practice; there were no doctors hiring associates and none willing to let me join them even as an exam doctor. (I live on an island and commuting wasn’t an option for me).

So I went for it. I had to. Luckily I became friends with another doctor and ended up working for him part time. As a new business owner and new doctor in a seasonal location, I had to find a part-time job. So I started working for him, simply running his office. This is hardly the ideal situation for a new Chiropractor, but I had to work somewhere, and I thought this was acceptable since I was still in a Chiropractor’s office.

Months later, this doctor has become my mentor, and I’ve realized that this relationship is invaluable for a new doctor and new business owner. Although I graduated with full confidence of my ability to diagnose and treat spinal complaints, I quickly realized that there was a huge gap in my education. Not that I blame Palmer at all, it’s just that much of it is learned by trial and error. Although I am glad that I started my own business right out of school, I highly recommend to whomever chooses to go this route to have a mentor. Right now I am still running my mentor’s office part-time, which is another invaluable experience. Even though I’ve worked in customer service before, working in a doctor’s office is completely different. I have a whole new respect for the person who runs the front desk.

Luckily, I also have my mentor’s team as a resource as well. Not only have they been in business for 20 years, but their insurance knowledge is vast. Even if we covered more on insurances in school, it probably would not be enough.

Much of what I’ve learned for insurance has been trial and error, so having another resource is essential. Although both the ACA and my state organization provide doctors with insurance resources, it’s not enough.

A mentor is an important resource, and they can be valuable for your practice growth. Not only am I able to discuss patient cases and get a second opinion if needed, I can easily access a successful business model, remove some of the stress of the insurance maze (that is often overwhelming) and improve my own personal and business skills. But perhaps most importantly, I have a network of people who want to see me be successful and are willing to help me get there. This alone is the most valuable of all.

Sincerely,

Kimberly Burke, D.C. (Florida Campus, Class 113, 2011)

Oak Bluffs, MA

www.islandspinecenter.com