E 180 House Call Chiropractic How & Why Jillaine St Michel DC

a doctors perspective e 180 house call chiropractic st michel 1
Jillaine St Michel, DC talks to Dr. Justin Trosclair, DC on A Doctor's Perspective Podcast

Learn the In’s and Out’s of house call chiropractic. Going to someone’s home or office has many questions and Jillaine St. Michel DC answers them. See if mobile chiro is right for you.

While working in a traditional brick and mortar higher volume practice, she quickly gained lots of experience but also learned some of the negatives of a traditional practice. This led her to pursue the mobile – house call – doctor comes to you – type of chiropractic practice.

What is a good niche for mobile chiropractic?

She noticed a niche in people who couldn’t keep asking off from work and those who hated the traffic and commute to the doctor’s office. As she crunched the numbers, she also realized that house call chiropractic could be profitable as well.

You can offer services like: pinch and release, myofascial tools for muscles, kineisology taping, of course the adjustment, laser, rehab, stretches and ergonomics

What kind of niche is a good idea to target for house call: individuals, corporate, small businesses or is anyone who actually wants the convenience of a mobile chiropractor good enough?

Liability for a Business Having a Chiro there

In a sue happy society, if you treat someone in a business, is that owner liable if the patient gets hurt? Can you just treat in a van or RV right off the premises? Can employees sign a waiver releasing the business of liability and consider it just a non-mandatory service that comes over once a month? (obviously she isn’t a lawyer and all these questions are not answered completely. Seek professional advice for all law related questions)

Although she does not use a camper, RV or van, what are some of the pros and cons that she has heard from being in the mobile chiro forum?

Does it make more sense to target under 5 employee companies, 100, 500, 1000+ employees etc?

How do we handle pets at a house call visit?

Considerations in Setting Fees

What are the considerations when picking a fee for service? Do you include travel time to and from, equipment, actual treatment and listen to hear the other things she mentioned?

Reasons to have your fees on the website.

Should you do paper or electronic notes? Any regulations with paper driving around town?

How do we determine what the travel fee should be? I’ve heard of flat rates and different prices based on mileage from a center point.

How do you schedule your day so you aren’t bouncing from the north and south end of town 5 times a day?

How automated can you get with scheduling, calls being answered, payments being made as well as automatic text or email reminders to schedule, appointment reminders and asking for reviews?

What is a typical treatment plan for a house call chiropractor patient?

Staying Safe in Other People's Homes

Dr. St. Michel is obviously a women and now a mom, so of course we discussed dual-working parents, how are the roles divided and the nuances that women doctors usually have to deal with more than their male counterparts.

Any corporate rates or discount rates for X amount of people or buy 5 get 1 visit free or a yearly fee?

What precautions can you take so that you as the treating doctor feel safe going into a stranger’s house as well as not being accused of inappropriate behavior?

Dr. Jillaine gives 2 examples of her way to make sure she was physically safe during early years as a mobile chiropractor.

House Call Marketing Ideas

She discusses several ways she was pounding the pavement to market herself that first year. Everything from 5k’s to networking groups and well, listen midway to hear some ideas you can implement.

We also talk about instagram check in, geotagging,reels for organic growth and hashtag strategies for local influence.

Major shot out to Billy Sticker and ChiroCandy Marketing. Learn more at www.chirocandymarketing.com/

Marriage Tip: open communication is a must and both partners need to be on board with the style of business you plan to have, sacrifices each are willing to make and the goals.

IG: mobile.chiropractic.wellness
www.mobilechiropracticandwellness.com

Show notes can be found at https://adoctorsperspective.net/180 here you can also find links to things mentioned and the full transcript.

a doctors perspective e 180 house call chiropractic st michel and trosclair 1
Full Transcript of the Interview (it will have grammatical errors and mistakes). Just Click to expand. Thanks audioburst!

00:00:06 – 00:05:11

Episode 180 House call chiropractic, how and why? I'm your host doctor Justin trust Claire and today we're doctor jeanine, saint Mitchell's perspective. Your joint award winning podcast host and bestselling author, doctor Justin Ross Clare, as we go behind the curtain and talk to doctors and experts about their specialty, marketing, and home life balance, let's hear a doctor's perspective. It's getting dangerously close to Halloween, so happy Halloween, do you still celebrated? Adult parties are at this point that you just bring your kids around. Let's have fun. Let's post some photos of either our costumes or our kid costumes on the Facebook page, Justin rose clear MCC. We can have some fun with it. Today on the show, we're going to talk about mobile chiropractic and house call chiropractic. They're the same thing. You can drive this somebody's house, you can convert a van or an RV, but before we jump in, the coloring books are now 5 languages, Chinese English, Spanish, French, and German, pick one up for your office, the kids can have something to do while the parents are getting treated. I mean, Christmas is coming up. Come on. Let's learn some animals and insects and all this cool stuff. All right, I don't ask this every time, but if you enjoyed the show, like what we're doing, go ahead, go to a doctor's perspective, dot net slash support. We got things like buy the host a cup of coffee to if you've learned some good things from marketing or just learn some practice management tips. You can support the show in other ways. Hire gifts, getting a T-shirt and other swag, picking up a book on Amazon. In a way, really appreciate the support that I do get appreciate the reviews, appreciate the comments. The good and the bad ones, you know, mostly the good ones, though. But we're going to cover a lot of stuff in this episode. Everything from how do you do it? Why would you do it? Marketing, the different types, like I mentioned a second ago, ways to stay safe, serves that you can be offering and a whole bunch more. All the links to the past series as well as the top downloads from each year can be found at a doctor's perspective dot net slash guide GUID, but let's get into it. Her show notes and transcript can be found at a doctor's perspective net slash one 8 zero, let's go hashtag behind the curtain. Live from Germany and Boise Idaho today on the show. We have a fantastic guest because they do something that I'm curious about, and it's kind of a unique thing even though in the past it was common, but it disappeared. It's called mobile chiropractic. You call it house call chiropractic, but we're gonna call her doctor jalan saint Michele. Saint Mitchell, you got it. You pulled it off. And the power of podcasting that is just gonna blend together. Perfect. This is why she probably goes by doctor Jay, probably a lot of times. You got it, yep. People can't even pronounce my last name. They don't even try, usually so I gave up. I'm like, is doctor Justin, that's fine. Yeah, that's perfect. Yeah. I always tell people, I don't care what you call me as long as you call me. Don't you call me? What's on everyone's mind? You're doing mobile chiropractic. Of all the options you could have available, what made you go that round? How much experience do you have at this point? And then from there, of course, I've got a bucket of questions that I can ask. Sure. So I'll just kind of give you my background I guess, 'cause it kind of leads me to this point that I'm at now, but so I graduated in 2015 from northwestern health sciences and I moved to Boise Idaho. Right away, my husband and I just kind of randomly made the decision. We didn't know anybody. We just thought it seemed like a cool place to live. And we were right. It's amazing here. But I took a position as an associate with another doctor in the area. And I was with him for almost two years. And so I got to see the kind of typical brick and mortar side of things, how that practice needs to be run. I got a lot of great experience and I learned a lot of what I didn't want to do as well as things that I do want to do. And so that really impacted my decision. I guess I was in what most people would consider like a high volume practice. I started to feel like as my schedule got busier, my time with patients became less and less. And my actual yeah, the hands on time. I missed that. I missed when I first started and I had nobody on the schedule. I spent 20 minutes with patients, right? But when you've got a patient in the room next door waiting for you, you no longer have that, that luxury. They're boss must have been not happy about that. What if we could get that down to like his goal for me with like two or three minutes? I think I got down to like 5 or 6 and it was like a happy compromise, I guess. But even 5 or 6 minutes for me felt really uncomfortable, it just didn't feel like enough. After about two years and kind of starting to feel a little bit burnt out, I was trying to decide what I could do on my own, that would be hopefully profitable, but also give me a little bit more freedom in practice, like how I wanted to practice.

00:05:11 – 00:10:04

And I knew in the back of my head listening to patients, either telling me they weren't able to make it to their appointments or griping about traffic. We have an infamous road eagle road here in town. It used to be an old highway, but now that's Boise has grown to the size that it has. It's like a main road and it is awful traffic is awful. So people talk about traffic and not being able to ask for time off of work. I started to kind of have this idea like maybe a House calls as an option. And so that's kind of where that was born in that I started that business at the beginning of 2017. Coming up on, yeah, four and a half, almost 5 years now. And it's fun. It's a very fun way to practice. So where to begin? Because there's so many to jump in like surfaces that you provide, would you say that it's comparable to what you can do at a regular office? I mean, do we really need interferential? So I'm primarily focused with hands on manual manual therapies, usually like pin and stretch techniques. Grafton ish, not officially trained, but soft tissue like mobilization techniques that kind of stuff. And then obviously hands on adjusting. But I the stuff that I bring to a house call is so minimal. I literally have a backpack, and that's got everything I use in it. So a little bit of rock taping. I've got like a hypervolt that I'll use and then really heavy on rehab. So I don't necessarily think that, you know, I think some of that stuff's great. I think muscle stem is wonderful, especially if you've got an office where you're working on somebody and somebody's in an extra meeting for you. Sometimes those therapies can be helpful, especially if you're a one man show, but I don't. Yeah, it's a nice, everybody likes it, but it's not necessary. Yeah, yeah. So I find I get the best results with just hands on care. And you have to cut a table everywheres or do they purchase a table? I have a portable table. It folds in half, it's in the back of my car. I drive a tiny little cast back vehicle, a Toyota CHR, it's great on gas mileage, it's around the city. Easy to park. And my table fits right in the back seat. So it's really a non issue. And it's unfortunately the maker was Tony tables. And I think a lot of students in chiropractic school buy those because they're super lightweight and portable. It's like 22 pounds or something. He no longer makes them unfortunately, but there's comparable tables on the market for sure. Sounds like a business opportunity for someone to purchase his patent and just get it on with it. Right, I know. I mean, when he went out, he sold his or decided to retire or whatever it was. I literally bought three tables. So I have gone back up just in case. Absolutely. Do you find that well, you know America you don't have a lot of stories, I guess. I'm thinking, you know, in Germany, we always get a boom on the 6th floor. Oh no, not again. But there's apartments, but maybe people living in an apartments aren't necessarily your clientele because of the cost? Yeah. I do have I have a very wide variety of patients, thought maybe this will get brought up at some point. Who's your ideal client? And I do not have one. I really don't. It's so varied. My ideal client is somebody who basically needs the convenient of a house call. And that's people. That's a niche all of it. Exactly, yeah. Yeah. So it's really across the board. I have some young people, you know, has been in wives that are living in apartments. And I mean, around Boise, there's not usually more than three stories. So I have gone up to third story, but I've got some offices that I go to as well and they usually have an elevator. So it's a non issue. But if you're in decent shape and the tables semi light, you can make it work. Yeah. Yeah. Yeah. Do you have to have special permission in business offices because a lot of those places are like, hey, now my eyelid. If you heard this employee on my time, how do you deal with that? So the nice thing about malpractice is it usually I mean, obviously check with your own carrier, but it usually covers you wherever you're at. So your malpractice is going to cover you anywhere in the state that you're licensed, whether that's a host call or a brick and mortar. As far as liability issues go, I like their liability of you. So I really targeted smaller businesses. I know some people like to do corporate care for really large. For instance, we have a micron center or campus here in town with thousands of employees. And I wouldn't, that's non area I'm interested in trying to jump through those hoops and all that red tape. I find individual business owners in the area, maybe I have some insurance agents. I've got real estate agents who have an office and they have anywhere from 5 to 15 employees. When you can get to somebody who owns that business and it's a smaller business than they don't have all of that work with or whatever. They're usually just so happy to have you there. It's been an on issue for me. But that said, I think it's a fair deal to have your own liability insurance that's going to cover you like an umbrella policy.

00:10:04 – 00:15:11

Yeah, for sure for sure. And it's not, but maybe a hundred or a 150 bucks. It's pretty interesting. For million. Cheap. It's cheap for the what you're getting. And really, obviously, malpractice is going to cover any harm that you might potentially do to a patient, but let's just say your table breaks and a patient falls over because of that, that would be a liability insurance issue for you break a vase when you come into someone's house or scratch up their floor or something, I don't know. Yeah, that would be important. Yeah, yeah, you want to be covered. Yeah. Do you tell people hey, put your dog in the room just in case? I probably should. I love dogs so much, though. I usually tell people to bring their dogs out. Unless they're like people know if they're not going to be well behaved and they're like, no, that's okay, I'll leave them, but if I can hear them, I'm like, can I need them, bring them out here at least for a second, so I probably not the best practice, but I think of my mom's dog and she likes to get all up in my business, whatever, you know, you're next to her, the honor, you know, so sometimes just like, could you move away just for a few minutes? Will I provoke this play? Yeah, and I know there are some high school docs. We actually have that in their paperwork, like, you know, when I show up, I require animals be locked in a different area or whatever. And I mean, people are the great thing with House goals as people are very laid back and if you need to be like, hey, the dog's kind of my way. People are understanding and yeah. Yeah. How much time are you spending with a patient being that you're at their house, they're paying usually a higher rate than normal. So is it still just you just get into your job and you get out hopefully less than 30 minutes or like what are you doing? Yeah, so whenever I talk to doctors who are interested in this, you obviously need to make sure that your rate that you're charging, like you need to visit to be worth your time. It's not only just the time that you're spending with the patient, but it's also the time getting to and from their house as well as any admin stuff on the back end of side. So I always tell people work backwards, right? Like, know what you need to make a year. And then figure out what that means per hour and how many patients you need to see. So I kind of I played with that number in my head a little bit. I knew that bare bones I wanted to spend no less than 15 minutes with a patient. Usually turns into closer to 20 from the time I walk in the house at the time I leave. But I have like a tiered system. So I have like a 15 minute option, which is most of my corporate visits where I'm seeing patients once a month at their office and I'm seeing 8 to ten patients. I have teen option. And then most of my health calls are actually 30 minutes. So I do have an hour option. I've got a handful of patients who schedule that on occasion. And that's super heavy on rehab focus. But most of the time I'm spending 30 minutes with patients. That seems like a fair amount because if you're going to be driving over there, there's a little bit of setup and set down and then let me show you some exercises while we're here. Okay, we had 8 minutes or ten minutes of muscle work with 5 minute adjustments or less and then like they'd like some rehab that you need to teach them. It kind of takes a little bit more time than 15 minutes. I would say most of the time. Yeah, and that's why I like if I can if I'm just in a spare room at somebody's office and I'm setting up the table and I can leave it there obviously. You don't have to set up and take down times. However, I do have that table breakdown time myself, I think I'm at like 18 seconds. Like it does not take me a ton of time to set up and break down. So that's the power of a nice portable table. But but yeah, I mean, you're collecting payment in that amount of time. You're doing your chit chat at the beginning, right? Sometimes if it's a new patient, you're like finding the best place to set up your table and what's going to be most convenient. And now I'm all electronics to know these filling out people work when I get there. But when I first started, people were oh, gosh. Taking time at the beginning. So yeah, I had to streamline that a little bit, but. Please have this filled out. I'm gonna email it to you. Yeah, and I've kind of gotten to the point too where if it's not filled out within two hours before your appointment, I email people. I'm like, I'm sorry. We're going to have to reschedule. I don't have the time to wait. I can sit here and watch you do it. Yeah, yeah. And, you know, people are good about that too. But yeah, I think 30 minutes is a fair amount of time to spend about 20 of that with actual hands on patient care. Yeah. Yeah. Do you charge travel fees then? I do not. I have everything lumped into my fee schedule. If anything is outside of 20 minutes from my home base, which is my home, I will charge an additional $25 travel fee. But I've kind of set myself up so that coincidentally we live right in the middle of the treasure valley. It's called we're in suburbia, but basically any patient that I see is within 20 minutes of my home eliminates that. Colleagues that you're a part of. I've heard it's like they might have a range. I don't know how much you know about other people's businesses, but there's like a radius of how far they go out so it could be ten bucks, 15 bucks, 20 bucks, extra, and so I charge 75, but there's another 15 on top. Yeah. Have you played with that? What have you heard from other people about that? Is it more complicated? I think that's helpful, especially if you're at all involved in the insurance room because you can charge what you believe insurance will reimburse, but also get paid for your travel fee.

00:15:11 – 00:20:01

So the patient would basically know that that is going to be their responsibility. Because an insurance is not going as far as I know, again, I'm not like this is not American. I don't know why you would do this and do insurance. That three that is wild. This is the whole point of me is to be a cash practice, too. Yeah. In my opinion, like, especially practicing this way, yeah, cash is the way to go. It just streamlines everything keeps it very efficient and easy. But there are people who are who are billing insurance in our area. There is a mobile nerve practitioner, and he has built a team. He's got like four other practitioners that work with him now. And they strictly do, I mean, of course, they have a cash rate, but they build everybody's insurance. People obviously, if you have insurance, you appreciate being able to use it. Yeah, for sure. But yeah. Do you find that electronic records are necessary for mobile? Could you just have a file system or just kind of just get too much to travel around with? You could. I think that comes down to security too. Gosh. I think requires you have two forms of, I don't even know what they call but you have to have two locks basically. So if you had a box, it would have to be locked again. Something like that with the paperwork. So it's a pain in the butt to get I mean, you know, you get done the day and you just want to be done. I don't want to come home and scan paperwork and lug it around with me. Secure, obviously you do run the risk of somebody broke into your car for some reason. That information would be readily available. So I choose to do everything electronically. It just iPads laptops. I have Microsoft surface. That's what I use. And I use the Jane app, which is super exclusive, like everything is so easy to use. And you can also do a lot of notes and stuff in between while I'm driving sometimes I'll dictate the subjective. And you can do that just talk to text on the app. So yeah, it makes it so much more easy. Yeah, for sure. And you just have to keep it separate. This is just your business computer, since you have patient notes and things like that. Well, I guess it saved on Jane. So really it doesn't matter. Yeah, it's classic. So, yeah, sure. Nice. Do you find that there's a benefit to having your fees on your website? I have there's a lot of back and forth on that. I think it eliminates a lot of phone calls and people asking me about my fees. And I feel like when people see it, they know up front, hey, this is for me or this isn't for me. And I've had a lot of people tell me that they appreciate me being upfront and honest about those fees and they know what to expect. There's no additional fees charged everything's just very straightforward. So I feel like the benefit is that, yeah, it allows me to screen potential, not potential not patients. Yeah, yeah, yeah. Yeah, yeah. Are you as automated as possible? Are you using text messages or are you trying to get people to just email you instead of call you online scheduling, just trying to be a kind of hands off as much as you can, so you're driving. You're not trying to always answer phones. Yeah. When you're with patients and all this. That's one area that I do need. I need to work on. I have automated text messages, which is also through the Jane app. So you decide how often they want to receive those. I think they get an email like 24 hours before and then they get a text two hours before the appointment, but you can choose how you want to set that up. And then I've just realized I had a patient who there is a portal. You have a portal through Jane as well. So I had a patient just this week canceled an appointment, but added herself to my wait list on a specific day, so I was able to just insert her where she so there are ways that I could be automating this more as far as being able to schedule completely on their own. I haven't I've gone back and forth with that just because I do try to schedule people in the same radius, try to cluster people together as closely as possible. So even though I don't have set days like Monday's not Boise or east Boise. North side. Yeah. I do know like when I'm scheduling somebody, let's say a month out, I try to put them with other people in their area. But I think there are ways that I could streamline that better and it would obviously be helpful. It's just it's that matter of taking the leap, right? It's uncomfortable so nobody wants to do it, but obviously I need to do it. And you've already alluded to the question I was having. How are you getting people to schedule? Mondays, I'm on the east side, two days I'm on the west side and I try to keep it that way. Do you see people more than once a week? Yeah, good questions. So the nature of this practice, I feel like lends itself to a pretty healthy patient base. So I don't actually get like I get a lot of people who almost see it as like a concierge service, like, hey, this is nice to feel, get some tension relief once a month type thing. And I just have repeat patients who even if it's just for 30 minutes of stress free relaxation time and a little bit of chronic pain management, that's what they utilize it for. I don't get a ton of acute flare up type stuff.

00:20:01 – 00:25:04

And if I do, I'm usually booked a week to two weeks out. It is hard for me to see somebody a couple of times a week. I if it's an existing patient, I will absolutely try my hardest to get to them twice a week if I need to. But my typical treatment plans for any patient are once a week for four weeks and then trying to wean them off to once a month. And if they decide they want to continue at once a month, then we maintain that schedule, but not everybody does. And that's fine. In the case that somebody does need some pretty acute consistent care. I think, you know, if they've been in a car accident or something like that, like I have a wide variety of doctors around the area that I gladly refer to and sometimes they become patients of theirs, which is fine. And sometimes they come back to me once they're past that acute episode. So. What's a busy day? I see a happy busy day for me is about 7 patients, 7 half hour appointments. That's a full day. Yeah, I mean, it's usually I start my day. I'm guilty of starting at like ten, but I have I can do that. That's kind of the point. Yeah, right. So tend to like 5 30 kind of at the latest. I have a lot of husband and wives that schedule together, which is really awesome. So two birds one stone. On days that I have an office of ten people that's usually all scheduled for the day is just that office. That's a good day. Yeah, but Anna on a typical typical week, I see 20 to 25 patients, I say, and I'm just right now I'm just working three days a week. Oh, yeah. Yep. All right. I had a, I don't know, yeah, we didn't talk about this earlier. I had a my first baby at the beginning of the year. And so I cut back to three days a week versus four and a half. So that was on my list. Yeah. Just trying to find classic man asking the woman. So how are you going to handle having a baby? Okay, well, we can go right into that. It works, the flexibility that this model offers you is probably unmatched. The thing is, like, if I'm not available, my patients just know I'm not available. They don't know I'm on vacation. They don't know I'm home with my baby on Wednesdays and Fridays. They just know that I can't schedule them on that day. So it affords you a lot of flexibility, which is really awesome and you create your schedule. I know there are some mobile I don't mean to be stereotypical. Male and females can be stay at home parents. But there are a lot of mobile moms who plan around their kids school schedule. So they know they drop off their child at 8 15. So they schedule patients from 9 till two 45 when they have to go pick up their kiddo again from school. So it totally affords you the flexibility. You can make this work for in your lifestyle, which is really awesome. If you're don't have children, you could do the 7 o'clock at night. You could do the 8 o'clock at night. Oh my God. If that's something that you desire. Yeah, there's a doctor, doctor Lucas marchand. Super Bowl South Dakota. He's like busy and successful because his availability is 7 days a week. Most of his business comes on Saturdays and Sundays and he's kind of drawn that crowd to him, and that's why he's as successful as he is is because he makes himself available. He needs to charge more, though. He does, yeah, he knows it. He knows it. We're all part of the group. Now he's like, he's stuck at that spot where he's like, I can't just double my rates. I gotta get more money. He is getting there. No, he is. And he's even said his own patients have told him. You need to charge him more like you more, yeah. So I think that's a struggle with chiropractors in general. We're nervous to ask for to bump up rates and ask for people to pay us what we're worth. I don't know why. We all have that hesitancy. I think we've been so frugal for so long that once you start asking, like, ah, this feels weird. What I pay for this? Yeah, I remember I jumped I had just a $5 increase in my rates last fall. And I remember just being so squeamish about telling people, at your next visit, it's going to be it's going to be 95 instead of 90s. Is that okay? And people are like, yeah, just get like you can charge me that now if we launch this swipe my card, you know? You're here just charge me. Yeah. I guess I guess I'll wait like I just said, I'll wait. Oh, never mind. Exactly. No, I'm not gonna settle you again. Do you ever feel like you need to add services or Emmy normal rates or whatever 95, but you want some cold laser. So I kind of have to charge an extra ten bucks. Do you want to do not want it? So now it's more. So the only thing that I charge extra for is I will charge extra for rock tape just because it's physically I have to purchase the product and then the product is gone. If it was your time, an extra 5 minutes on a trouble spot, I probably I don't charge for that. But if it's something tangible that I need to replace on a consistent basis, I will charge extra for that. So usually I'll do a first rock tape session or application for free. And then if somebody found it helpful, I will either sell them a rock tape and show them how to tape themselves or if it's an area they can't tape it out then I'll charge them like $10 at their next session.

00:25:04 – 00:30:05

But that's really the only thing. I mean, I do some like cupping and I do soft tissue mobilization with scraping tools or whatever. And I don't try to direct all of them. No, I always feel like it's cold lasers, rock tape. They have a lifespan. Yeah. And one's physical and one's a light, so you can't just use them forever. So you kind of have to factor that into. Yeah, absolutely. What you're doing is important. Do you ever do discount packages if Sally in the neighborhood invites people over and you have 5 people? Is there a discounted rate or corporate rates or anything like that? Like a chiro party? Yeah. Yeah. Always highly encouraging, obviously, as we all should be. I mean, if you're trying to grow your business, you want more patients, right? So I'm highly encouraging of especially husbands and wives to schedule together and the way that I incentivize that is you each get $10 off your treatment. That saves me travel. Even just for two, just for two, yeah. Wow. I wouldn't have to. I know that, but it's obviously appreciated and it does get people to want to schedule together. That little incentive is it saves me the travel time. I know there's a little in our House call forum group. There are some people who strongly agree with discounting services. And some people who advise you never to do that. So I think it has to be it's a personal decision, obviously, and you need to weigh the benefits versus is this worth it or not. And for me it is. And then for my corporate visits that are just the 15 minute, if there's a group of 6 or more that scheduled together, they each get $15 off at 15 minute rate. So it brings it down to basically the typical cash rate in the area. Yeah, who cares? Because then you got all your daily goals met in one time and it's been three hours, and I'm done. Yep. Or I don't have to be done. It could just be a really bang out day. Yeah, yeah, exactly. Or you're going to take a long to our break and work out and come back to it in a couple hours, so. Yeah. You ever do any memberships like buy 5 get one free or blah, blah, blah. When I first started, I thought I had this grand idea of selling packages like that. Like a punch card type thing by, of course. By 11 get one free I think is what I think I sold one package and I was like, never mind. People don't mind just paying per service or per visit. It's easier for me as far as like bookkeeping and stuff goes. And people aren't willing to pay the full price. I'm obviously fine with that. So no, that was something that I wanted to do. Maybe I didn't push hard enough. I shouldn't say push. Maybe I didn't bring that up off enough to even be. That's a whole year kind of depending on what they needed. So maybe a 6 visit might have been an easier. Yeah, yeah. You're probably gonna need 6 anyway. I might as well get one for you. Yeah. Save 10%, whatever. Yeah. But I have found that the type of patient that's willing to pay for a house call typically isn't so concerned with price. So I guess it's not the money for them. Yeah. Yeah. You ever feel unsafe? I mean, let's be honest, a guy can feel unsafe going somewheres absolutely. Double whammy. I mean, I think for myself, the only thing I would feel unsafe about is, oh, he touched me. Oh, this or that, and you're like, what? But you know what I mean? But I mean, sexual harassment, maybe not so much. Yeah. But sexual assault, hello. That could be something. That is a extremely valid question. And I think it's something that you need to if you're considering the house call business model. That's something that you need to wait for sure. Businesses like mine or I mean, you hear about female real estate agents, right? That's another issue. You always kind of have to have your guard up. So it's a real concern for sure. I take, you know, I do what I can to mitigate risk for sure when if I have a new patient. And that's the nice thing about having basically my business is pretty much all referral based now. So I know that if I have a trustworthy patient, likely they're referral is also going to be trustworthy. So I've gotten to the point where I do feel safe. Originally, when I first started, and I was just out marketing the heck out of myself and meeting all these new people that it was a real concern. And so how I chose to mitigate that was I would my husband has access to my accounts if absolutely necessary. He's never needed to log in, but I share my schedule with him, not the patient information, but I share this is the time that I'm going to be with this new patient. I've never met. This is when you can expect me to be to leave. And if you don't hear from me by this time, reach out to me, you know, like this is our mitigation plan, I guess. And then another tactic that I would use is when I would show up at the door and the patient would open the house. It would be on the phone with my husband and I would say, hey, you know, Brandon, I'm here for my one o'clock appointment with so and so with my new patient, whatever. I'll check in with you in an hour when we're finished. And so that way, the patient knew there was somebody waiting for me to check in. I'm not saying that that is 100% a guarantee that nothing could happen to you, but it lets them know like, hey, somebody knows where you're at who you're with and when to expect you to be finished with them.

00:30:05 – 00:35:03

And I think that is a level of accountability for anybody who might have ill intent. But thankfully, I've never had an issue. Yeah, up to this point. Good. Yeah. Yeah, that's great. You said you're referral based now, but what kind of marketing were you doing when you were just turning to start out? Oh my gosh, so much. I tell people like are like, how long did it take to fill up a schedule? Because 25 doesn't seem like a lot. But you've got to try to find 25 people who wants to do House calls. Yeah. And it's a very special clientele that wants that, right? That's going to feel comfortable with it. It's going to understand it. It's going to be a pay for it. So it took me, I would say a solid 6 to 9 months before consistency with my schedule where I got to a point where I was able to start paying myself and felt a little bit more comfortable. I marketed the heck out of myself for that first year for sure. I said no to a lot of really fun things so that someday hopefully I could say yes to a lot of really fun things. But I missed out on a lot of fun weekends. So it's a grind. It's definitely a grind but that's with any business. It doesn't matter brick and mortar or a smoothie shop. It's a grind. So I think it's important to let people know that. No business is just going to take off from the ground. But I spent a lot of time networking with local some local healthcare providers in the wellness realm as far as massage therapists, physical therapists, acupuncturists, and just letting them know what I was up to in what I was doing. I joined a networking group, like an official networking group that was probably the only thing that I actually invested money into with any of those networking groups like consistency is key. You have to be consistent with it. People know if you're there to just try to get some referrals like it needs to be reciprocal, and you need to be truly like devoting yourself to that process. And then I found a lot that for me, this was the best way I found a lot of local 5 K's small local 5 K's that probably weren't even having vendors and I would reach out to the race director whoever was in charge of organizing. And I would say, hey, I'd love to donate my services on Saturday morning to any of the participants. Do you mind if I come by and bring my chiropractic table and do some muscle work for people? And they were more than happy to let me come. So that was utilizing my time donating my time, but without having to pay an expensive fee to have a booth at an expo or something like that. So what would you do? Like, ruther my hamstrings? Yeah, so I mean, and the nice thing about those events is there's not thousands of people they're not these huge events put on that attract tons of vendors and tons of participants, but I got to spend a little bit more time with each individual. So maybe like ten or 15 minutes with ten people. And yeah, I'd ask them what usually bothers you or have them sit down on my table and I'd be like, oh, your traps are really tight. Do you mind if I work those out for you? You know, like, just that kind of stuff. And I think spending more one on one time with individuals because of the nature of those events, those led to I mean, I still have patients that I see once a month that I met four years ago and those little events. You know, and I might have only booked one or two patients at those events, but for me that has been successful because the return on that over four years has been well worth that two hour donation of my time. I think we get blessed sometimes and when we put the effort out there, sometimes, I don't know, it felt like when I was in practice in Colorado, it would come back some other way. I mean, I had a brick and mortar, but even just putting myself out there just seemed to get results in other areas where you're like, all right, well, that was kind of dry and now that's working, but it wasn't from what I did, but just the overall intention vibe or whatever you want to call it. Exactly. I'm totally like your vibrations, man. They affect the world and they come back to you, absolutely. 100%. Interesting, you say that. So we moved here not knowing anyone and then you're almost 7 years, I think in 6 years ago, my husband is a UND hockey fan who are from North Dakota originally. And he found a group of people here that were watching a UND game at some bar across town and we went just to try to meet people, right? And I met somebody there who added me on Facebook. Because we have joint connections to North Dakota or whatever, I haven't talked to him in years other than maybe an occasional like on Facebook or whatever. New patients this morning. Right? It is so random. I was like, okay, so like you're saying like, sometimes just those little interactions, those little touches that we have with people. They can pay off. It might not be next week. It might be 5 years from now, but yeah, that was pretty crazy. Once I lost Facebook, I don't know what happened, but I think I don't know. It got deleted. I don't do anything crazy, so I didn't know what happened and there wasn't I couldn't get it back. And I had like years of all these random Colorado people that you could have reached out to or they could have seen it on the algorithm or like when you pay for marketing, you can just target your people and you don't know who it's going to hit.

00:35:03 – 00:40:00

Sure. But man, that was the worst part. All these random business people that I met over like 6 years just gone. Oh no, it's funny you say that. And LinkedIn marketing is not the same as Facebook marketing. Have you tried Facebook or Google? I'm guilty. I don't do anything on LinkedIn. I just started. This is the first time I'm running ads ever. I started working with a local company and my goal for that is to try to hone in on just a couple areas. My treatment area or my zones of operation or whatever is pretty wide and I'd like to bring it kind of closer to my home base. So I'm running ads like you're saying to try to target this closer area to my home base and it's been like two months now. I'm just, yeah. We'll see what happens, I guess. Have you tried Billy Billy, Billy sticker? No, I'm going to write that down. Yeah, he did the chiro candy podcast. He's really good at it. I think money's not everything, but he, with the click funnels, he's won the $1 million reward. So he just worked with chiropractors. He's podcast was about chiropractic. And you know, they do videos and they have a whole system and how to make it work. Okay. And so I've been following this guy and he was on the podcast from the beginning to to see him grow to the level that he's grown, doing it ethical. Shout out to him 'cause there's so many people out there that don't even know anything about chiropractic. They just bought a program and pitched us and then whatever. But yeah. It seems this stuff works. If that one doesn't work, I would say don't give up on that. Maybe they just didn't do it well. Okay. What you're looking for. And so does this guy that you're talking about, does he actually teach you how to do it? Or does he have a team do it for you or help you with it? Partially, I think we want you to do certain videos. I need you to do the videos. Yeah. Then you send them to him, and then he'll create a certain type of landing page. Okay. And then they run the ads like how they target what they target, and then that gets put out there. And then they hit the video and then they hit another video and they retargeted. It's a whole system that you gotta do, but once you set it up and do your part, it runs on autopilot. And I don't think he charges a lot, which is nice. Okay. It's definitely an affordable rate that he charges. I will check him out. Thanks for that. That's awesome. Yeah, so we'll see how this goes. It's kind of just that first year was a grind, trying to acquire as many new patients as I could. And then thankfully, I mean, I think a lot of it comes down to be a good doctor, be good at what you do and people are going to send referrals your way, so. Yeah, of course, they have to like you. Everything we're talking about, you have to get patients better. Absolutely. Doc, I want to switch gears just a little bit. Some people actually get an RV, rip it up and convert it or like a trailer of some sort, so they do like trailer notch. What do you want to call it? A camper, mobile chiropractic, instead of going to somebody's house, it's actually out of a camper. So yeah, yeah. What do you think about that as a doable? Is it affordable? I mean, now you've got a 96,000. You could potentially have a $96,000 loan that you have to cover, which is way higher than what you're probably running on a month to month basis. Yeah. I think there's pros and cons obviously to both styles of practice. Obviously, my overhead is extremely low. The majority of it is paying myself. But as far as monthly bills go, very little, do I spend on that? But I'm also limited, right? There's only so many people that I can see as a house call Cairo, especially if I'm doing individual 30 minute visits. I'm capped per week. I think having a unit on wheels, whether it's like an I think it's like an astronaut van, something like that, like people. That's the craziest one to me 'cause I'm like, I'm gonna walk into a jiggly van. You know what I mean? That could fit a couch. I would much prefer the camper that got converted versus an ASTRO like that is so strange. You know, there are some people who have done some really cool stuff with those vans though with those conversion vans. They've decked them out pretty well. And it serves its purpose, right? All we really need is chiropractors as a table. But yeah, I mean, bare bones you need a table. And so if you can bring something to somebody where it avoids you, obviously, like you're avoiding any liability issues if you're not going into somebody's place of business, right? And you don't have the setup and the takedown, you can probably afford some additional modalities if you want. If you have ability to use electricity. And so I think there's benefits to you can see more people too like doctor Jeff Solomon. He's got a huge decked out RV and he's like the OG of mobile chiropractic. He's been doing this for years and years and years. He's in Florida and he's got a super decked out. But what does he do? You just drive to this neighborhood and the cul de sac and you just see one patient? He does more corporate stuff. So that's a great question. He does more corporate type stuff where he's I think he goes to like UPS and he will park outside of their grounds because that's just part of their agreement. See, that's a liability thing. Yeah, exactly, but he's eliminating that liability. Which is better for him. And then they just sign up in like 15 minute increments and come on out, get adjusted, and then they go back to work.

00:40:00 – 00:45:01

So he's still providing that convenience factor just in a different form. And he can see more people that way, because he's not individually stopping off at all these places. Definitely a longer road to get to, though. For sure. And I think a lot of people skirt host calls with that with that goal in mind. Like, hey, I'm going to save because I want to have a van or some people have a trailer that they pull behind a truck or a decked out huge sprinter van or whatever. I think that's a route that some people choose to go with House calls and House calls are the route to get there. And I know sometimes people are doing House calls because they're part time stay at home mom and they just want to see ten patients a week. Keep your license active, have a little bit of extra money. Money to pay off your student loans, maybe. And some people have bigger ambitions, I think there are doctors who have multiple chiropractors working as associates under them in our House call our mobile practice. So there's so much that you can do with it. It's pretty fun. Do you have your car, plastered with your logo on it? And then like an ice cream truck, you know? Carb? Crack dealer comments. I have chosen not to plaster my vehicle with anything. Really? I use my personal vehicles is it HIPAA? You know, everyone's so there's always somebody. Is it HIPAA compliant? The driveway? Yeah. I mean, if the person, so they still don't know which member of the household you're treating, right? They you could be there on a personal basis. I don't think that's really a hit by thing. I wouldn't think. It was always somebody whining about HIPAA. Yeah, I know. And you know anybody who's actually ever gotten in trouble for anything HIPAA related. I don't. I mean, what are we doing? You have to be like, blatantly throwing out people's paperwork at Walmart or something. I've never seen anyone get in trouble. I'm not advising that anyone not with hip is very serious everyone, okay? We're just we're just covering all the grounds on this podcast about driving to somebody's house. Everybody in Susan's neighborhood knows that. Vehicle. What's wrong with her? Oh, Karen. Karen had to get a car breading visit. Oh, I knew she was small on a park. I've loaned it for years. Yeah, I think that's an on issue. Perfect. Yeah, this is something I've always been curious about doing and I don't know if it's legal in every state or what your thoughts. I love the idea of like a membership where, yeah, you gotta pay for new patient exam and you gotta pay for an adjustment, but you know, for an extra one 25, a year. Now you're entitled to 10% or 15% discount on all your adjustments, 15% off vitamins and supplements. And in fact, I'll even cut down my travel fee 5 5 bucks and there's like the discount. And so it ends up taking a patient about a certain amount of visits before they utilize the membership. You know, get their money back from it. But it puts money and you know, everybody says that if you can get a subscription based whatever, it's the best way to make money. The food is delivered to your house every month. And you don't have to think about it anymore. So is there some way for us to do that? Sure. Does that have you ever explored that? Or heard about that? What's your thoughts? Yeah it is. Brick and mortar are for mobile. I think there is a way to do it. So the way that I've kind of played with the idea in the past, because I thought something similar, if somebody is going to keep their card on file with you and be part of your membership or gold premier member of your business or whatever you want to call it, they get instead of their house call being $95 at 85, but they agree to have their card charged at the first of every month. And then you're scheduling them on a monthly basis. Ideally, obviously. Whether they use it or not. Yeah. And so we know Jim's the reason they make money is on those recurring memberships and nobody's using, right? I don't know that I necessarily want to see that for patients. I worry about scheduling conflicts. If you have too many people trying to get in. And you're availability is only so much. It might work better if you had two doctors working together. Because the goal is memberships at that point. Yeah, yeah. And you have to see 400 people now. Right. Yeah, like then what do you do? Then you are working until ten p.m. and then you are as shady like that you might want to be packing when you go to somebody else. I run a room on Wednesdays, y'all can come to that. Right, I feel like that works better in a brick and mortar setting. But I think the way that you're talking, providing discounts on other services outside of, I think that's fair or offering a discount on if you're cash or you can offer whatever discounts you want. I think offering discounts for paying members on any subsequent treatment that they might schedule. I feel like it's doable. I think it's a good idea. You just gotta find out feed that you're happy with, but then at the same time, it's not going to take the patient 20 visits something ridiculous before they even see a benefit to it other than they like to take your vitamins or something like that. So you got to provide some kind of value to make them want to spend that extra money I would think. Yeah, for sure. So I'm going to think about, I think, yeah, I think there's something there.

00:45:01 – 00:50:00

One of the questions we always ask before we wrap up is almost forgot. You got a kid, you got a husband. How do you keep the love alive, so you don't end up divorced? Everybody gets this question. Yeah. No, it's a valid question, especially I think the answer I'm giving you now would be different than the answer I gave you last year, then the answer I gave you when I first started this business. I think it's constantly the answer should be constantly evolving because at different stages of your life, your relationship requires certain things. So, I mean, when I was grinding that first year, obviously, we depended on my husband a lot for his salary and having I think it all probably comes down to open communication. Making sure you're both on board if you are a partnership, like making sure your partners on board and they know what it's going to take for things to be steady for you, whether it's opening your own business or opening your own brick and mortar or your own house called practice understanding that stuff takes time. And you are going to have to say like I mentioned earlier, you're going to have to say no to a lot of stuff. So he very big blessing in my life, obviously, and he's my biggest supporter for sure and having him help through that tough time was absolutely crucial. I don't want to make it seem like it can't be done on your own because it absolutely can. But yeah, your partner needs to be on board. I think that's important in communicating about where you're at communicating business wise when we have this baby. We had to have a new conversation, like what is this going to look like for business for me now, right? Like I cut back to three days a week. And then I'm a mom. I mean, oh, it's a mom, but I'm the sole caregiver on Wednesdays and Fridays. So just open communication about what each of your expectations are what you're okay with sacrificing a little bit. And your goals like communicating about what do we want this to look like a year from now? For instance, I'm trying to get if we can find child care, which is really hard because I right now. If we can get Wednesdays at day care, I'm going to go back to four days a week just because I'm busy enough to do that. And I'm having to push patients back so far. So just communicating. I think that's the key thing, like communicating about what's working and what's not working, just being open and honest is going to save a lot of hardship. So yeah, that's my favorite cliche, but communication. And any books or podcasts or anything like that that you find as helpful for people? So not necessarily so I spend a lot of probably too much time on Instagram. And I don't mean necessarily just like mindlessly scrolling, but I think there's a lot of ways that we can utilize Instagram as an app to make us better providers. There's a lot of great accounts that you can follow that are putting out really great up to date information. I follow tons of physical therapists and chiropractors and medical doctors. You can gain really great information from social media. It doesn't just have to be like a fun tool or like a mind numbing tool, even though it does that as well. And there's so many ways to use it to connect and collaborate with other healthcare providers. And I think, you know, Instagram and Facebook kind of gets a bad rap sometimes because because there is some negativity associated with it, right? We're all addicted to our phones, and we use it too much, but I can not tell you how much I have grown business wise and communication wise by just putting myself out there on Instagram and sharing the funny side of business, the hard side of business, collaborating with other business owners and hopefully putting out some good content that's informative for people as well. I think you make it what you want to make it. So I get a lot of information from Instagram and maybe that makes me sound like a typical millennial, but I do. If you have a tactic, especially if you're in a B and I grew up in a networking, okay, let's do a picture, let's agree on this picture, everyone agrees yeah. All right, everybody tags. And so then now you get the exposure of all these local people once a week. You know, something like that. You can alternate or you share with the same picture, but you put your own twist to it and everybody's tagged and all those pictures. So there's ways to incorporate with locals. Like if I was on a local place like this, if I'm a burger joint, I'm checking in. Yeah. I'm hashtag. Cross referencing. Yeah, yeah. Local, I don't need to know about what's going on in Kentucky. But yeah, it's and Boise. But I believe it. And having, you know, like, some of my patients are they love using social media and having them post for me sometimes and share my stuff. That's huge, then referral marketing, right? They're referring you without actually referring an actual person. And so yeah, Instagram has been great for me. What's your handle? Mobile chiropractic dot wellness. So I recently discovered wheels within this last year. I mean, it just came out. But my following has grown by 200 people since I started posting reels. Oh, but Instagram and Facebook are down right now. I don't know if you knew that. Yes, I did. I was trying to get some information on you.

00:50:00 – 00:53:30

And I was like, what would your Facebook like a worldwide outage right now, so I'd love to add me later, but? It makes me giggle inside. It makes me so happy because. We're forcing it. So infallible. And your web page is mobile car project and wellness dot com. Yep. Correct? That's a ghilane. I really appreciate you being on the show, bringing so much valuable information. Thank you for having me. I had fun. I appreciate it. Another great interview has ended. While you're on your phone, click that review, but write up a nice review for me. 5 stars if you could, as everyone says in the industry, it'll help other people to find us when we have enough rankings, not to mention, I'll mention you and your review on an upcoming episode. If you're looking for one sheets, if you're looking for all the books that people have recommended, you can just go to a doctor's perspective .NET slash guide. And that's going to give you everything you need to know. The top episodes of 2017 and 2018, the podiatry series, dentist, acupuncture series, holiday 2017, financial series, how to write a review, how to support the show like buying a cup of coffee, getting swag, like t-shirts, the today's choices tomorrow's health book. That's the blueprints for better health, exercise, picking food correctly and financial. And then, of course, bundle packs, which can get you the no need or acupuncture book for the common conditions, including the electric acupuncture pin at a great deal. Page, has some of the products that I like. Affiliate style. So if you buy something from them, I get a piece of that. Just like on the show notes pages, if you buy a book from clicking that link, I get a small piece of that as well. So I really appreciate that. Things like screencast automatic, peer VPN, missing letter, J lab speakers, prolonged edge or hot grips. The trilingual coloring book is now 5 languages, English, Spanish, Chinese, German, and French. So pick one up for your own kids, your nieces and nephews and also for your office. So these kids have something to do. Again, that all income seen one link is a doctor's perspective dot net slash guide, GUI, DE. Once again, if you do need any coaching on how to improve your blood work, drop weight and the prolonged diet fast mimicking diet, 5 day plan, let me know as well as if you just need some coaching, whether it's health, whether it's marketing, whether you need some practice growth, et cetera, reach out, Facebook, Justin truss Claire, MCC. Of course, at a doctor's perspective net on the top right. You got all the social media icons that you can imagine. Click your favorite and reach out. Thank you so much for tuning in. Please, tell a friend, pass it along. You can go to .NET slash listen. It's just that easy. It'll open up right in your app. And don't forget, I appreciate you. Listen, critically think and integrate. See you on the mini sods. Hope you're enjoying those. I'm definitely having fun, summarizing these podcasts in less than ten minutes for you. You get the nuggets without having to waste your time. Have a great week. Come together to help you shine through. And give this. Perspective.

About the Author
Dr. Justin Trosclair, D.C., an expert in Chiropractic Care, has been focusing on back and neck pain relief for over 12 years and has delivered treatment to more than 6000 patients. With advanced training in treating disc derangement conditions, you can count on him to keep up to date with the latest research in physical medicine for spinal pain. He has 5 years of hospital experience in China, is currently working in Germany, and had a private practice in Colorado for 6 years. Dr. Trosclair hosts a doctor to doctor interview podcast called ‘A Doctor’s Perspective‘ with over 220 episodes. During his free time he wrote 3 books. Today’s Choices Tomorrow’s Health (rebooting health in 4 categories), a Do-It- Yourself acupressure book for 40 common conditions called Needle-less Acupuncture, and a step by step guide to look like a local for Chinese dinner culture called Chinese Business Dinner Culture. If you have kids, you may be interested in his 6 series tri-lingual animal coloring book series (english, spanish and chinese).