Learn the ins and outs of running a lean chiropractic practice with this free eBook!

You’ll learn:

  • About the benefits of all-in-one chiropractic practice management
  • How to avoid the common headaches of running a one-person practice
  • The secrets to making billing easy and efficient
  • Helpful insights on how to run a learn practice with low overhead
  • How cloud-based systems allow you to expand with greater ease for multi-location management
  • How new grads starting their own practices can get a step ahead of the competition and more!


Providing great care while making a living is the essential mission for any business in the healthcare field. While there could be other aspects to this goal, it is universal across the industry. Whether you are a chiropractor just getting started or a doctor with an established client base and multiple locations, the core factors of helping others and turning a profit don’t change. 

We can also realize that these are not mutually exclusive. Helping clients while maximizing profits is possible. It requires a specific mindset about working lean and looking for efficiencies, while keeping a laser-like focus on creating value for clients. In this ebook, we will unpack the concepts of working lean and creating value. We will also explore simple software solutions that can drive this work forward.

Finding Time to Get Started

Running a chiropractic practice is not easy, particularly when getting it off the ground. It takes time and energy, knowledge, and hard work. 

As a small chiropractic practice or one that is just getting started, finding this time is a challenge. Many factors can absorb your time, especially without support staff to assist. Insurance and billing require knowledge and timeliness. Scheduling of patient appointments can also eat up large parts of the day. The additional emails and phone calls for cancellations, rebooking, and follow-ups turn a few minutes of work into an hour or two. There is also the need to stay current on laws, regulations, and best practices, which is critical for anyone in the industry, regardless of experience level. Finally, while new clients are great for business, patient intake and processing of initial information can be the biggest burdens of all. All these tasks are essential to making the business run and eventually grow, but time spent doing these activities becomes time taken away from patient care. 

Depending on how the business runs, the chiropractor might be involved in some or all of the clerical duties. These are all necessary to operate the business successfully, so someone must do them or manage the software that does them. The initial temptation for the doctor might be to look to hire more staff to help with these tasks. While that is definitely a viable solution, there are other, leaner solutions to be found. By exploring cost-effective ways to approach these tasks, chiropractors can stop losing time that can be spent with individual clients, which in turn, helps them to add value to the patient.

Working Smarter, Not Harder, by Thinking Lean 

Just as a butcher trims off the fat to create a lean piece of meat, so can businesses trim unnecessary spending to create a lean and profitable business. On the surface, this seems like common sense: of course, we should work to not overspend or waste money. But lean practice management creates a systematic structure and model for ensuring that this happens. Born out of the manufacturing practices at Toyota in the 1980s, the concept has spread to all areas of business and industry, even into medical practices. 

Lean practice management is a model of continuous improvement and is rooted in the fundamental idea of respect for people. When people are in an environment that has already implemented lean practice management, it feels like the systems run like clockwork. This system has loyal customers who know that they are getting great value from the business and has engaged employees who understand how processes and automation can benefit everyone.

The five principles of lean practice management need to be understood at a basic level in order to see how lean management software can offer a solution for a leaner, more profitable business.

Identifying Value

The essence of any business model centers around creating value for the customer. Whether it is a product, a service, or an experience, the customer must feel they are “getting something out of” the experience to pay for it again and again. The chiropractic industry is no different: value must be offered to the client. 

The term “value” needs defining. That’s not to say that the term isn’t understood, but what value actually means for each client can differ and should be explored. Effective doctors have a process for finding this value with their individual clients. It is the first step to maximizing profits and retaining clients. 

To determine what value means to our patients, we need to seek their feedback. An effective strategy to do this is to ask clients about their wants, needs, and desires. They have stepped through your doors for a reason, and finding that reason is how value is built. Some chiropractors might use research and web analytics to explore what specific demographic groups might find more valuable when visiting a chiropractor. In the end, value comes down to, “What the customer is willing to pay for?” 

The answer to this question then becomes the hedgehog principle for the organization. Everyone from top to bottom should understand what value means and what it doesn’t mean. A high degree of clarity should result from this process; the decisions that are made in the next steps of the model all stem from this core idea. 

Mapping the System

Once we can identify the value, we can “backward map” to the activities that we perform every day. By using this as the center of our focus, we can create a matrix of our activities. On the left, we list things that add value and on the right, activities that don’t add value. Next, we organize these into “necessary” or “unnecessary” activities. Now we can clearly see what adds value. Next, we move to the necessary activities that might not add value. This could be things like regulatory compliance or systematic billing. These activities that are behind the scenes might indirectly impact our clients but don’t directly add value to their experience. Finally, we have the non-essential things that also don’t add value. At first, these might seem like low-hanging fruit, and some probably are. The more analysis that we do in this area, the more we can find multiple ways to approach waste and “cut the fat” from our processes. 

Add ValueDon’t Add Value

Creating Flow

The map is like digging a ditch for the river to flow. It’s what happens when the lean production system begins to move. It isn’t always perfect—in fact, it certainly won’t be at the start—but it does create momentum toward the goal of client satisfaction and added value. 

This is the point in the cycle that changes begin to create leaner practices, which save time and money. The owner’s job is to ensure that the flow of the steps runs smoothly and efficiently. This means that systems are created that allow for saved time on specific tasks, fewer mistakes, and empowerment to find other ways to save. This might mean that some multilayered activities are broken down into steps. Back-end office workers could create more direct workflows. Different employees could be cross-trained on multiple tasks to eliminate possible downtime and to help find time and cost savings across multiple levels of office tasks. These are just a few examples of how flow can look in a chiropractic office. The crux of the matter is the continued focus on becoming lean, which means focusing only on activities that add value for the client or that are completely necessary to perform.

Establishing Pull

Once things are flowing, we can look to create the “pull.” The concept of pull is similar to the ditch metaphor that we use for flow. But instead of the water naturally flowing at its own pace, there is now a pull to move it forward. 

In terms of the lean production system, this can refer to inventory and the feeling of momentum that products have as they leave the shelves, therefore “pulling” inventory in from other places. In the chiropractic industry, there isn’t an inventory, but there is a synergy that can create this same impact. 

The cross-training of staff creates this pull. Employees who understand value also understand that by finding ways to save time and money in their processes, they are helping the bottom line. For example, new ways could be found to reschedule patients, which saves time for both the organization and the client, thus adding value to both. 

But office staff needs to have the tools to make this happen. Even with a great idea for more efficient rescheduling, the right software must be present to do so. They might need certain printers, scanners, or supplies to become leaner in the end. By empowering the entire team with the right tools, the flow toward value has momentum that drives the process forward.

Looping Back 

Even once we have reached the end of the cycle, it is obviously not the end. Think of lean practice management in terms of a loop that is forever cycling around and around. We should return to the customer value and ensure that all our changes in practice and habits didn’t diminish value to the client. Through a constant cycle of refocusing on practices to become leaner, more efficiencies can be found. 

Information and data are necessary at this point to help guide decision making. It can be easy to feel like good progress is being made toward becoming leaner while maintaining customer satisfaction. But when being analytical, we want to work with hard numbers and not just feelings. Through the use of billing reports and client surveys, owners can monitor progress toward the ultimate goals of helping patients and maximizing profits. 

Committing to Lean

Now that the overarching concepts have been described, it is easy to see how the chiropractic industry can capitalize on lean practice management. Naysayers might claim that too many times, experts attempt to use business models in the health care setting, and they just don’t work. The market forces at play are too different, they say. In reality, becoming a leaner business applies in almost any setting and is even endorsed by the American Medical Association.

We know that maximizing value for our clients should be our primary concern. Many doctors believe that obtaining new clients is the path to profitability, but when thinking in terms of lean production management, this truly isn’t the case. Research shows us that maximizing value and therefore, profitability with our existing clients is a much better model for our business as we get it started. Creating growth through adding new patients is good, but it should not be the focus at the onset if long-term growth is the goal.

We come now to a decision point: lean into becoming leaner or stay the course with current structures. Moving forward with implementing lean practice management seems like the logical choice, but if you still aren’t sure, let’s explore how it might work in the chiropractic field.

Benefits Specific for the Chiropractic Industry 

Let’s consider a few areas of the practice that could benefit from lean management. When we think lean, we look at all aspects of what we do that could save time and money. From initial patient contact to the final bill sent, all tasks along the way can create better value for our clients. 

There are numerous tasks completed every day in the back office that keep each office running smoothly. To think in terms of mapping value, we should look at them in isolation to see what efficiencies we can find. First, consider the resources that are used with patient intake and initial scheduling. There are usually efficiencies that we can find. Accounts receivable is another area where clients can feel the value of a systemized process. With fewer touches of money changing hands or checks getting lost, value is increased. If a client needs to reschedule an appointment, there might be multiple steps to that. We gather data and information about our clients, so the handling and management of SOAP notes might have multiple phases. Finally, if the practice has expanded enough to have more than one branch location, there could be duplications of process between the buildings, even the physical transfer of paperwork at times. Each of these tasks in isolation is small and simple, but the minutes add up and become hours of unnecessary time. 

How does a practice turn these small, time-saving efforts into impact on profitability? There are two key areas. The first is more obvious: staffing. Hours or possibly even positions could be reduced if the organization can become lean enough. The second one is seeing an increase in the value that our clients are receiving. Decreased time for the doctor in the office allows for increased time in the patient room. Both concepts will require changes in habits and practice around the office, which is why we must consistently and systematically keep client value at the forefront of our thinking.

What are possible solutions to capitalize on to save time around the office? By putting in the work, you can automate and systemize some of these clerical practices that eat up time and add little value to your clients’ experience. One study estimates that six hours a week could be saved if repetitive tasks were supported with software. It might be tempting to try to do this “by hand,” so to speak. We could create spreadsheets or find standalone software that helps us perform one of these time-saving tasks (scheduling, for example). While this is tempting because the cost might be lower, it doesn’t make much financial or practical sense. 

The tool we need can be found in lean management software. The solutions are integrated and allow for becoming lean in multiple areas in a systematic manner. This software implementation can occur quickly if needed and can begin to add savings to the chiropractic business almost immediately.

It is easy to see where the time savings come from, but don’t forget the ultimate goal of client value. Through the implementation of lean production management in a chiropractic office, patients receive a higher level of chiropractic care, spend more time with the chiropractor, spend less time completing forms, and save time from being on hold waiting to schedule an appointment. It is a true win-win for all involved. 

Finally, as the practice experiences the growth that comes from delivering high-quality services to its clients, the right software can support expansion. Services must be cloud based and mobile to avoid location-specific paperwork issues. 

CHIROSPRING as a Practice Management Solution

Efficiencies can be found in many areas and in many ways, but as we have seen, practice management software is one of the quickest and most cost-efficient routes to take. Here are a few of the cost-saving advantages to initiating the use of an industry-specific software like CHIROSPRING.

The virtual front desk creates a systematic place for patient intake, initial scheduling, and appointment flow. Instead of wasting the patient’s time by completing a paper form in the office and then entering this data manually into a database, you can use CHIROSPRING to add value and save time for both the office staff and the client.

Chiropractors who don’t have an efficient electronic system for SOAP notes will find that implementing an LMS to do so saves huge amounts of time. The time that is freed up now can be spent on patient care, again increasing the value that the client feels.

Because the SOAP notes are digital and systematic, they can be scrubbed and dropped straight into billing. This automated process checks for errors or missing information, saving time when insurance claims are filed. Gone are the days of patients or office staff waiting on hold to troubleshoot simple errors with the insurance company. The software process is fast, easy, and audit-proof and even allows for templates to be edited and customized to meet the needs of the chiropractor. 

Billing and accounts receivable tend to absorb large amounts of time through the workday. Statement reconciliation can be highly efficient with software like CHIROSPRING. Through the use of an easy visual display and color-coded status updates, anyone in the office can know where an account stands at any time. 

By automating redundant processes, such as appointment reminders, reconciling remittances (with ERAs), simplifying SOAP notes, managing inventory, etc., doctors can run their practices with lower operating expenses and make more money through reduced office staff, fewer unpaid claims, and more patient visits.

Another bonus is the mobility of a software like CHIROSPRING. Because data is securely saved in the cloud, clients can schedule appointments at multiple locations without missing a beat. Doctors working in different offices on different days of the week can access records easily. Those office staff who were cross-trained in order to maximize efficiency and create flow can work at multiple locations too. 

Finally, we can return to our thinking about lean management and how we can map our actions back to the customer value. Because CHIROSPRING houses all the data in one system, analytics are easy to access. From customer surveys to billing reports, information that is needed to gauge value can be accessed from anywhere at any time. This data creates an opportunity to monitor success toward our ultimate goal of helping our clients while maximizing profits.

What Are You Waiting For?

Now that we have explored the burdens that can be created by antiquated systems and bloated payroll, we can see why Toyota has had enduring success by “going lean.” The philosophies of lean production management span all industries, even in the medical professions. Using the five guiding principles, we can find value for our clients, map the system, create flow, feel the pull of success, and backward-map to the mission we started with to ensure client value. We know how this can yield profits in the field of chiropractic medicine. Profits aren’t the only goal; passion for patient care and helping others is always at the forefront of our thinking and planning. Achieving both is possible and can be easily embraced with the help of lean management software, such as CHIROSPRING.

Now is the time to contact CHIROSPRING and begin the process of moving your practice forward in creating maximum value for each and every patient.

CHIROSPRING is an all-in-one practice management and EHR system built specifically for chiropractors to help them regain face-time with patients, spend less time on back-office tasks, maintain a limited staff, and save operational costs.To see how CHIROSPRING can help you simplify how you manage your practice, reach out to one of our specialists today!