A chiropractic home office is really just one aspect of the flexible working conditions craze that is sweeping the world; owing to the huge advances in technology many folk don't have to be at the office to get their work done. It's here to stay and, in fact, expand.
The chiropractor has, of course, to be in an office, but does it have to be in that downtown highrise? Working from your own house has many advantages, but there are also some difficulties. Greatest of these is a sense, in the mind of the patient, that this is unprofessional.
Management of the patient becomes more difficult; cancellations and missed appointments may increase.
For the young mother who wants to be able to slip home to check on her child, this is heaven. So too for the semiretired doctor who enjoys a cup of tea between patients, and lunch with his or her spouse.
Let's consider the negatives first. Above all else, it's virtually impossible to disguise the fact that the new clinic is, in fact, a converted bedroom or garage. In the mind of some, despite the fact that it's the same hands and head that will be treating the patient, often at a considerable discount, there is a lack of professionalism. It appears to them to be cheap and nasty; and perhaps it is.
Often there is no secretary; the doctor will be greeting patients who are arriving, answering the telephone, making the next appointment and collecting the payment. These critical distractions can be crucial. Many would rather pay more and have his or her full attention.
A distracted doctor may make mistakes. Extra time is vital and he must certainly plan to see fewer patients per hour. A secretary, even his wife, for a few hours per day may be the solution.
Many doctors are concerned that they will be badgered after hours and over the weekend. It was one my worries too. Oddly, it's rarely occurred that a patient with a long standing condition has bothered me over the after hours.
And to avoid becoming one of the 'take an aspirin and see me on Monday morning doctors', having a home practice makes it simple to see a new patient in severe pain. It takes ten minutes to shower and be dressed for the patient. It happened to me today, and the patient had every right to call. Previously, to see the patient downtown would have taken most of my Saturday afternoon.
If the doctor is conscious of these distractions, and makes a conscious effort to counter them, they can be overcome.
Let's now consider some of the positives of a chiropractic home office. Worldwide there is a move afoot to working from your own house. The reasons are certainly pertinent to the DC as well.
First, if the practice is geared towards families it makes sense to have the practice situated in the locale where the patients are to be found. A mother will be far less inclined to drive her infant suffering from colic to an inner city office where parking is likely a problem and she has to fight the traffic.
Secondly, the doctor him or herself can save themselves an hour or more in traveling time. Stepping from home directly into the clinic, or simply walking through an interleading door, fresh and unstressed from fighting rush hour traffic, he can give far better of himself. His energy levels are not depleted.
Likewise, at lunch time, or during a break between patients, the chiropractic home office is but one minute away from total relaxation. There's no need for fast foods and perhaps, if you're a greenie like me, a relaxing five minute walk in the garden will produce a bowlful of fresh salads.
Did you know that kale, seen at one o'clock on the lunch plate below, is extremely rich in vitamins A, C and K? The nutritional value of kale, raw or cooked, is finding its place once again on the dinner table; it's very easy to grow.
At the end of the day, one can tidy up a few ends, phone new patients to find out how they were after their first adjustment and be relaxing with a cup of tea in just five minutes.
If it's a busy practice, then a secretary is mandatory; he or she will certainly earn her keep. However for the semi-retired doctor who only wants to treat perhaps six to ten patients a day, and is happy to schedule patients every half an hour, he may decide that he can do the honours himself; and save himself one more salary cheque.
Rent, particular for the solo chiropractic practice, is obviously a huge expense. Add to that a couple utility bills, telephone and internet account and it's not inconceivable that a doctor might work half the week before he puts a penny in his own pocket.
The stress of not being able to make ends meet are obviously considerable; doctors fall by the wayside unable to meet their obligations. Could a chiropractic home office be part of the solution?
One sometimes has the feeling these that there are nearly as many chiropractors making money from colleagues as there are doctors earning the bread and butter from patients.
An exaggeration, of course, but into these borderline practices, are numerous sharks, persuading chiropractors that an average new patient should expect to be scheduled for forty or fifty, or even more consultations.
Personally, I've been to some excellent practice building seminars where the aim is to help keep patients through ethically acceptable procedures; the sharks are out to strip gullible patients in pain of their hard earned savings.
Tell me, doctor; if you injure your lower back, or wake up with a stiff neck, do you go to your colleague for fifty treatments? Of course not! So why are we advocating that for our patients.
You may need one less vehicle if you have a chiropractic home office; certainly you're going to put a lot less miles onto the odometer. Your savings in transport alone should give one cause to consider working from home.
There are considerable tax advantages from having a chiropractic home office. Some of them may infringe on that grey area between tax avoidance which is legal, and tax evasion which certainly isn't.
Could you claim the daily newspaper, a few magazines and a generous portion of your electricity and water as an expense? The house insurance and mortgage?
Of course, you will not longer be able to claim those traveling expenses which will now be close to zero.
For me, because electricity is so unreliable in the new South Africa, I have been able to claim a significant portion of the cost of building my own solar generator; you will have your own projects, some of which may be included in tax deductions.
by working from home, my own experience is that I see half the number of patients, and earn the same amount of money. I'm sorry I didn't do it years ago.
Professional code of ethics need to be considered in the chiropractic home office; with no secretary present who is can be called upon when the chiropractor needs to do a ticklish procedure?
Every chiropractor periodically has to work in and around the breast, the hip and groin or the coccyx; it's important to be able to invite a third person to be present with an anxious patient.
Many insurance companies now only pay for physical therapists to provide a chiropractic adjustment; that's in the face of powerful research proving that inclusion of DCs to perform their own technique would save them a good deal of money. One has to conclude that political medicine has gone off on another tack to contain our profession.
It's being successful with some doctors of chiropractic quitting. Others become involved in some dodgy practices, like demanding that patients sign up for a whole year of treatment in advance, in order to stay in business.
In recessionary times, the going is tough when the insurance won't pay.
Is the day approaching for a new Wilk versus the AMA and the insurance companies?
The chiropractic profession has tried hard to stay on the moral high ground; those who stoop to unscrupulous practices need to be exposed and disciplined if we are not to stoop to the low blows that medicine has often resorted to contain and eliminate us.
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