This week we have guest host, Kristen Brokaw on to interview Dr. Miles Bodzin about the business of functional medicine. Dr. Bodzin discusses what to do for your practice overwhelm. He shares what he struggled with as well as tips and tricks he has learned to improve patient retention. This episode goes into great detail on how creating business models and plans for your practice can help with patient retention and make running things smoother .

Highlights include:

  • How to create frictionless systems to increase patient retention
  • The four major components to improve patient follow through
  • How to level up your practice and how we can help
  • And so much more!

Resources mentioned in this episode:

Business of Functional Medicine: A Key to Overcoming Practice Overwhelm


James Maskell: Welcome to the Evolution of Medicine podcast, the place health professionals come to hear from innovators and agitators leading the charge. We cover the latest clinical breakthroughs in health technology, as well as practical tools to help you transform your practice and the health of your community. This podcast is brought to you by the Lifestyle Matrix Resource Center, who provide a range of options to help you deliver successful, effective, functional, and integrative medicine. To find out more and to get started, go to goevomed.com/lmrc. That’s goevomed.com/lmrc.

Kristen Brokaw: Well, hello Dr. Bodzin. I’m so glad to have you here. You are someone who is really focused on teaching other physicians how to gain patient retention because it’s something you struggled with in your practice. So, why don’t you tell us a little bit about your background and why this became so important to you.

Miles Bodzin: Well first, thanks for having me on the podcast. I really appreciate the time you’re taking to spend with me, and I am thrilled to share with the audience.

A little bit about my background. Like a lot of doctors, I practiced. I chose to become a chiropractor, a doctor of chiropractic because I wanted to serve humanity, serve people, help people, and I got into practice in the early ’90s. Like you just alluded to, it was a little bit of a struggle. I’ll share that struggle I think some of the doctors can relate with is that I’m sure most of the doctors I’m speaking with right now run a practice that is primarily private pay, where the patients are paying themself. In the early ’90s, when I first got started, there was this new thing in Southern California called HMOs and PPOs. It was all the new rage back then.

Of course, I tried to get involved with that. I wanted to participate with it, but being a young kid out of school, those panels were very difficult to get into back then and I could not get into it. So long story short, I had about 9 or 10 out of 10 patients who came to see me… Well, 9 out of 10 who came to see me who was part of an HMO or PPO that I was not part of. And they wanted that type of care, or they wanted to be able to utilize it and I couldn’t. It met a lot of frustration for me. It led to a place where I literally had to move back in with my parents and I couldn’t pay rent and all of that kind of stuff.

Not to dwell on that stuff, but I struggled. I know those of you listening right now, when I’ve gotten to know some of the doctors personally, you tend to let your guard down and you share a little bit of your own struggles. I know we’ve all been there. It was through that time of struggle that I put on a lot of study. I had a background in engineering prior to being a chiropractor. I put my engineering hat back on and I slowly but surely figured out what it really took to get people to say yes to care, pay for it themself, and more importantly, follow through and get great results with the care. That took a number of years to figure out, but I distilled finally down to a number of things. I now teach about it because there’s a lot of misconceptions out in the healthcare field in regards to what drives patient compliance and what drives outcomes as a result of patient compliance.

I think we could all agree that when patients don’t follow through, no matter what type of care we’re providing, they don’t get great results. And it serves us as healthcare providers to make sure we’re learning what we need to do in order to help patients follow through. That way they benefit from the care we’re ultimately providing. Especially in the functional medicine world, obviously we need patients to follow through. If they don’t, doesn’t matter what we tell them, doesn’t matter what we recommend, they don’t get great results. And if we truly want to get the best results for patients, we really need to learn what it takes to help people follow through.

That became a passion of mine. I’ve been doing this for about 20 years now teaching other doctors how to do it. In fact, I just got back from this weekend, teaching a whole group of … not doctors, but actually their staff, their teams on this subject matter, because quite frankly, it’s the teams that play a significant role in this. So, that’s a little bit of background on myself and what kind of led to where we are to this day now.

Kristen Brokaw: Exactly. I’m intrigued. So, you’ve got these systems, you figured this out. You had to painfully do it, but essentially what I’m hearing is you learned how to create loyal patients, right?

Miles Bodzin: Yeah. I mean, that’s exactly what we did. Nothing frustrated me more, and I bet a lot of doctors can relate to this, that you believe a patient understands what it is you’re sharing with them. They understand the need for care and lo and behold, even though you think they understand it, they still drop out. At the end of the day, we know people know they shouldn’t smoke, and they still smoke, and people know they should eat well and still don’t, and people know they should exercise and still don’t. I mean, knowledge is everywhere and in spite of the knowledge, people still don’t do the things they need to do.

When you brought up the term systems, just now, it wasn’t a system initially, but eventually we systematized what it took to have people follow through because I bought the lie that was taught to me. The lie I was told in school was that if I educated my patients well enough, they would follow me to the ends of the earth. And I spent an enormous amount of time, energy, and effort educating my patients like a lot of you listening right now. I’m sure you do. You spend time educating and teaching what they need to do. And low and behold, they still don’t follow through. I learned eventually there were actually four major components to people following through, to becoming loyal as you just described it. And that’s how to best describe it is that if a patient is loyal to you, there’s a number of things that’s necessary in order for that to happen.

I’ll give a quick definition of what I believe is a loyal patient. And the way I’ll describe it is by telling a quick story. When I was in practice, I interviewed patients on video, kind of like you’re interviewing me right now. I would interview patients and I would ask them questions. And one of the questions I would often ask them is why are you still coming here? You’ve been coming to me for years now. Why are you still here? And one of the patients specifically, I remember this story very clearly. She was a teacher. And she went on to say that there was all these benefits of coming here and all the conveniences of the way we did things and how she liked it. But the key message she ended up saying was is, “I ended up getting insurance that would cover me to go somewhere else, but I’d rather not do that. I’d rather stay here and pay for it myself.”

To me, that is the ultimate definition of a loyal person. They’re sticking with you, even though it costs them money out of their pocket, when it could have been paid for somewhere else. To me, that is the most raw definition of someone being loyal to you as a patient. And we identify there’s really four key areas of that, that drive drives that behavior ultimately. That’s what I ultimately in practice figured out and systematized, and now we teach other doctors how to do (it).

Kristen Brokaw: Okay. So, let’s talk about those things. I know a little bit. I’ve heard you speak before, and I know a little bit about what you’re going to share. But I want to ask before we get into that systems, how many doctors do you think have systems, even just systems in general, or even maybe even a business plan? They probably don’t and a lot of them, they’re so busy. They’re always so, so busy. So this is really important, isn’t it?

Miles Bodzin: It is absolutely important. To be blunt, everyone has a system. It’s just a question of whether it’s a good system or not. There’s a quote … I don’t have the quote memorized, but I’ll often say it in my talks when I have a slide up and I have it in front of me. But the quote basically says is, “You either have systems you designed or systems you tolerated.” The end of the day, we all have a system.

I’ll give you an example, perfect example. We know for example, that when it comes to collecting money from our patients, the way we collect our money significantly impacts whether a patient will be loyal to you or not. If you’re collecting one visit at a time and you have to stop at the desk every time they may come in and make a payment, versus you having an automated system that does the payments automated in the background, whether it’s a recurring payment or it’s one visit at a time, it’s still an automated process.

If you have a system, where there’s a lot of friction in the process, people are stopping and making a payment, you’re going to have lower retention versus when it’s automated. That one visit at a time, stopping at a desk where there’s a lot of friction, that’s a system. It’s not a good system, but it is a system. To improve upon that, we want to make our payments frictionless, which is one of the four areas of creating loyalty is the less friction in the payment processing, the more loyal a patient will be to the practice.

And I want to point this out, this has nothing to do with the clinical side of practice, this is strictly business side. If I interview a doctor and I hear how they’re collecting their fees, I can almost predict to… It’s very predictable how good the retention is with those patients based upon the way they collect their fees.

So a good system, a great system is one design with the idea that I want to remove friction in the payment process. That’s an example of applying a system. But to go back to your question, everybody has systems. It’s just a question of whether they’re good or whether they’re the ones that are just tolerated.

Kristen Brokaw: Got it. That’s actually said well. So, okay, let’s talk about the ways that you figured this out. So, starting even from the beginning, a patient comes in, you get a new patient, take us through that. I know one of them is forecasting of care, right? So why don’t you start there? So here I come in and to see you and you tell me what’s wrong and …

Miles Bodzin: Yep. so, when it comes to a patient coming in… I’ll paint a picture here. I want everybody to imagine what’s called a patient journey, which is basically a process of a patient going through the process of meeting you, contacting you, coming into the office, you doing your evaluation, the whole process of seeing a patient all the way through the point where they eventually become a loyal practice member. Think of it that way. We’ll refer to this as the loyal patient journey. It’s a process of seeing someone.

Every patient’s on a journey, whether they see one visit and that’s it, and they never see you again and that was their journey, or whether they become a lifetime practice patient of yours, where you’ve taken care of them for the last decade, it’s still a journey. The question is, are you consistently having a journey that you want the patients to have, or are you just whatever they happen to have, have?

In order to have that loyal patient journey, there are four key components that need to occur throughout the journey. We already mentioned when you just gave a prelude to called forecasting care. So, Kristen, if you were the new patient coming into a practice, one of the things that’s foremost that I do with you during those initial couple visits is to forecast your care, not just the care, but the financial responsibilities you have in the practice. We’ve identified that for a patient to be loyal to a practice, you must forecast it for them. It can’t be, “Let me get you started, let’s see how you do,” and figure it out along the way. That kind of communication will devastate retention with a practice member.

That patient does better by knowing where this is going even if you have to change it along the way. There’s no problem with it. Nobody says that you have to have a crystal ball and have to be perfect, but you want to be able to lay out to a person, “Hey, listen. For you to get the results that I anticipate, we’re going to need” … Whatever those results are in your practice, whatever you’re trying to accomplish, be upfront with people. “I believe it’s going to take a year and a half to accomplish those results. I’m going to see you every month or every two months or every three months. I’m going to need to do these consultations. I’m going to need to do this treatment on you.” Whatever it is, but they know upfront and it’s not, “Well, let’s get you started, I’ll re-evaluate next month and we’ll kind of take it from there.”

When you do that open-ended, non-committal type treatment plan, it’s a recipe for dropout. 100% of the time, it’s a recipe for dropout. That doesn’t necessarily mean you have to be 100% percent confident in what you’re recommending from the beginning. I know there are times you may not be fully confident that you know exactly what you’re going to be doing but do your best estimate. That’s my suggestion. You do your best estimate of what the patient should expect. And of course, as you do this more and more with patients, and as you get better practicing as a physician, that’s why they call it being in practice, practice makes perfect. Eventually, you get better and better and better and better on your recommendations over time with patients based upon the presentation or the clinical presentation of your patient.

I’ll often use an analogy and that is the analogy of the orthodontist. The orthodontist is usually pretty good about recommending care to a patient and recommending how long they anticipate it’s going to take. So, Kristen, if you are bringing in a 12-year-old daughter of yours to an orthodontist, the first orthodontist might say, “Well, let’s get your daughter started with care. I’m sure we’ll get great results. And we’ll just take it from there.” And that’s the whole recommendation to get started.

Then another orthodontist might say, “Well, Kristen, absolutely, your daughter could benefit from braces. I’ve been doing this for 20 years and I’ve taken care of literally thousands of kids. And based on what I see going on with your daughter, I’m confident we should be able to get her in and out of these braces in 36 months. You bring her every month, I’ll reevaluate her. I’ll make adjustments to her braces. As long as she’s making the progress that I know she should be making, you should be confident she’ll be done with these in 36 months. And for some reason, she’s not progressing as I anticipate, I’ll figure out why. I’ll make changes even if I have to refer somewhere else for another opinion, but I’ll make sure I communicate that to you. The program’s going to take 36 months. Talk to Sally only at the front desk. She’ll let you know what the cost is and pay per month, blah, blah, blah, blah, blah.”

The point being is that one orthodontist gave an open-ended treatment plan. The second one gave a full plan. That’s to show the difference between the two. And in every circumstance that second orthodontist is going to have much better follow through with their patients versus the one who’s just leaving it up to you to decide or guess how long this is going to take.

So, forecasting care is extraordinarily important when it comes to starting the patient out on the right foot. If you’re struggling in practice with patients following through, ask yourself the question, are you telling patients right up front what you anticipate the treatment plans going to involve from start to finish? And when I say finish, whatever you believe the end result’s supposed to be, whatever you’re trying to accomplish. And I know I’m talking to different types of physicians, so you might have different results you’re trying to accomplish, depending on the type of physician you are, but nonetheless, whatever that outcome is.

So, in my own personal practice as a chiropractor, I knew I had certain outcomes I was looking for. And those outcomes might take six months, eight months, a year. It was beyond symptomatic improvement. So, in your own practice, whatever it happens to be… If it’s functional medicine, you’re trying to restore hormonal balance, if that’s the case … Whatever you are doing, whatever that outcome you’re trying to accomplish, what is the timeframe and the treatment plan you’re expecting and communicate that completely right up front. I think that’s a really key component is the first of the four components when it comes to patient loyalty, if you want to think of it that way.

Kristen Brokaw: Absolutely. Yeah. I mean, even if it’s these are some of the labs we might be running, this is some costs… So just giving someone an idea. I could already like put myself in the shoes of that patient and you’re right. I feel way more confident knowing that we could change at any time based on evaluation, but that we have a game plan. And I think every patient just wants to know that there’s a game plan and that you know how to get me there.

Miles Bodzin: It’s funny you say that because we used to refer to this as a game plan. We actually used to call it, have a game plan. We later decided we want to make it easy for people to remember. You’ll notice the four things about to go through, they all start with the letter F, so it’s an easy way. And we found by communicating this way, the four Fs as I go through these, it’s just easy to remember them. So, we switch from game plan to actually calling it Forecasting Care because ultimately, we want to make it easy for the doctors to remember what we’re talking about. The first F is forecasting care.

The second one I’ll mention is, and I alluded to it already, and that is frictionless payments. So, if a patient is coming in, you want to make sure the payment processing that you do is frictionless.

What does that mean? It means it’s easy. It’s not send them a bill in the mail and wait for payment. It’s not bill their insurance and get paid later and then send them a statement to get paid later. It’s everything’s agreed to in advance so that if it’s going to be a treatment plan that involves… Maybe it’s a $4,000 treatment plan you’re putting them on, and you give them the option to pay it monthly over the course of six months or eight months or a year for the treatment plan period of time. Or if it is one visit at a time, you’ve put their card on file so that each time they come in, you just auto debit the card that they have on file so that they don’t have to stop and make a payment. The bottom line is you just want to make payment processing as easy as possible because the more friction in it, the lower the retention.

Going back to the story we were telling earlier where I said I had moved in with my parents and struggled, et cetera. The thing that took me from that struggle to have eventually having success in practice were these first two Fs. It was forecasting care and frictionless payments. These two things took me from struggle to really having a lot of success early on in practice or eventually early on in practice. And then we added the other things that we can go over here in just a moment.

Kristen Brokaw: So that is actually awesome. I have a physician I go to that I literally can just go, “Cool, peace out,” and I just leave, and it’s handled. I love that. I have another doctor I see that I do have to stop and give my credit card and then reschedule and all the things. So, I feel the difference between the two, but even if it’s a physician that takes insurance, and they do have to go through the … They have to submit it and all the things. Still having a credit card on file for maybe if the patient late cancels, or the cancellation fee or if there are supplement sales and it’s just frictionless there. So, there’s other things that you might want to have that. Everybody feels a little bit of pain when they have to pull that credit card out each time.

Miles Bodzin: There’s the magic right there. They feel a little pain. And I’ve even had, when I go back to those interviews I was referring to. I remember one of the patients saying that… I remember clear as a bell. She goes, “I used to go to another chiropractor. It was great and everything and it felt good, but that feeling good, I kind of lost it on the way out the door because I had to stop and do the whole payment thing. Not that there was any problem paying, I had no problem with it. But the good I was feeling was squashed by having to stop and make a payment. Whereas coming here, everything’s automated. I never have that. I never experienced that.” She was going on to say how much she enjoyed the fact that everything was automated, and she didn’t have to stop and pay.

So, there is that. There absolutely is that. It’s the same reason when you go to a restaurant that’s an expensive restaurant and they bring you your bill. There’s a reason they put candy on the bill. There’s a reason they give you some chocolate. It’s because they don’t want the last thing you did to be paying the bill. They want it to be you putting something sweet in your mouth. It creates that warm, great feeling. That’s why they do it. There’s a psychological reason putting candy on a bill. It’s not just from being nice. That’s the reason for it.

Kristen Brokaw: Interesting. I didn’t know that. This next F is actually one of my favorites because it’s something that I don’t know that anybody really does is where you’re giving them feedback and telling them how they’re doing.

Miles Bodzin: Yeah, there’s the third F.

Kristen Brokaw: So, let’s go into that.

Miles Bodzin: So, feedback is extraordinarily important. I know most doctors probably give patients feedback in some form. They’re going over lab results or x-ray findings or whatever it is. They’re giving the feedback on where they are. But the problem is patients don’t really understand it. It’s not intuitive to them. So we talk about giving feedback that’s intuitive, that automatically makes sense to the patient.

What we found works great is quite frankly, we do our clinical exams, just like in school, you have an exam. The only difference is we grade them. As a clinician we want to actually give the patient a letter grade, an A, a B, a C, a D, or an F. And the reason we do that is because it’s intuitive. You tell your patient, “Based on everything I did, here’s your lab findings, et cetera, et cetera. Based on everything, we’ve determined your health as a C minus or a D, and they just get it. And that’s what you want. At the end of the day, you want your patients to get it. If they don’t, you’ll lose them. And in fact, we know when patients don’t know how they’re progressing, they don’t know that they still need care and where they are in progress, you will lose them. That’s just a nature, unless they’re symptomatic.

We’re talking about beyond symptoms, which is a lot of our patients that we see. They get to a point where the symptoms are no longer the motivating factor for them to be coming and showing up. Like I’ve been seeing my functional medicine doctor for 10 years. There’s no symptoms that’s motivating me to show up. So, the feedback for most people is extraordinarily important so they know, “Hey, I’m making progress.” Or “I’m keeping my good grade.” Letter grades, I don’t have to explain what they are. Everybody knows what letter grades mean. So, when I take all my clinical findings and summarize it in a letter grade, it works extraordinarily well.

If Kristen, you were my patient, and when you first came in, we did everything, my workup, and we determined your health was a C minus or a D plus or whatever it was. And then a few months later I was able to communicate to you, “Hey, that C minus is now a C plus. Great job. Things are moving in the right direction.” And then a few months later that C plus is now a B. “Great job. Things are moving in the right direction.” A few months later that B is now an A minus. It becomes automatic for you to know you’re making progress.

It also is a great tool that if you were making progress and then you fell off the wagon for a little while, and then you came back into the practice, and then I evaluated you again and say, “Hey, last time I saw you last year, you were at a B plus. I know it’s been a little while since you’ve been in and you haven’t been really following things, you’re back down to a C minus.” You get it. There’s no question that the patient gets it. And that’s important because the failure for patients that know they’re making progress is a cause of patient dropout. It’s one of the reasons we’ll lose them.

Kristen Brokaw: It’s no different when I go to the dentist and they do the dental fitness program and they call out all the numbers, the 1, 3, 4, whatever numbers. And so, I’m always asking, “Well, am I getting better? Am I getting worse? Am I staying the same?” That’s really, really important. So, I’m always getting the feedback when I go to the dentist. And you’re getting maybe the labs and you’re seeing, okay, if I go to my functional medicine doctor, I’m doing fine here with my cardiovascular, but maybe my blood sugar is wherever it shouldn’t be. What you’re saying is you have a system that actually can summarize this all together and give someone a score?

Miles Bodzin: Absolutely. Yeah. We do have a system and I’ll go back as we go through these, I’ll go review each of the systems, how they play into each of these four Fs. Because you ask about the systems we offer … For those that aren’t aware, I haven’t mentioned already, but we have a company called Cash Practice. That’s the name of our company. We’re a software platform that doctors can then do these Four Fs. The four things that we’re talking about, these principles, we designed software. I designed software that allows you to do these things, that allows you to forecast care and build out an agreement for people to buy your services or to do frictionless payments or to do feedback called the wellness score. We’ll go back and review those.

The fourth F I’ll just quickly mention is pretty straightforward. I left it for last because well, most of us know this already. When it comes to our patients following through, they need to be educated. They do need some education, but quite frankly, it’s not the education they need. What they need really is frequent contact from us. That’s what we determined. It’s not so much that they understand what’s going on. It’s that they’re your top-of-mind awareness, quite frankly. That you’re sending them emails on a regular basis, that you’re sending them text messages possibly on a regular basis, or you’re sending them mailers, or they see you on Instagram or Facebook or whatever it is. But you are in their face. You’re part of their weekly life, or at least biweekly life that they’re seeing you on a regular basis. So, it’s not so much the content as it is t’s the awareness. It could be birthday cards. I mean, literally you want to make sure that you’re not out of sight out of mind is really what it comes down to.

So, we talk about this thing called drip education, which is you’re dripping your message on them on a regular basis, ongoing, not just when they first came in and then they don’t hear from you again for six months until they come back in again, per se. It’s on a regular basis. So that’s the fourth F, frequent contact.

So, to review the Four Fs, there was forecasting care, frictionless payments, feedback, and I’ll say feedback that’s intuitive to make it a little more clear, and then frequent contact. Those Four Fs are really the thing that need to occur throughout this patient journey. You’re doing them at the appropriate times throughout the entire journey, so that eventually it’ll lead to that patient ultimately becoming loyal to your practice.

We have systems, as we mentioned, just now that do these four things. We have a tool called the Care Plan Calculator, which is for forecasting care. We have a tool called the Auto Debit System, which is for frictionless payments. We have a tool called the Wellness Score, which is for the feedback. And we have a tool called the Drip Education System, which is for the frequent contact. So, we build these four systems that you use throughout the journey to apply these four principles. And ultimately it leads to extraordinarily high retention. I know not everybody listening right now are chiropractors. I know you’re all different types of doctors, but speaking from my own profession, I’ll just share with you that in the chiropractic world, it’s common for us to want to see patients frequently for an extended period of time. It’s pretty normal to do a treatment plan that might be four months, six months, eight months, a year, and to see a patient pretty frequently.

Well in the profession of chiropractic, to give you an idea, it’s average for most chiropractors to see a patient about 12 visits for their lifetime, which is not great. You’re not going to get great results with that. In my own personal practice, I retired 10 years ago from practice to dedicate myself full-time to what I’m doing now. And in that time period, when I, when I retired, my average patient had been with me over five years and over 300 office visits, which is an extraordinary high level of retention.

Now I know everybody listening right now that’s not the treatment model that you do in your practice, but I’m sharing that with you to emphasize the fact that patients followed through. That these four Fs when applied appropriately, it worked very effectively of helping patients follow through, which allowed me to deliver incredibly successful, incredibly great clinical results for our patients, as opposed to someone just getting temporary relief, which is not what I wanted. I wanted them to follow through and get the results we were trying to accomplish. So ultimately that’s the model that we were doing there.

Kristen Brokaw: Even a functional medicine doctor, let’s say a medical doctor that’s not a chiropractor, they will run labs on someone. They’ll maybe review it with them and then they’ll say, “I’ll see you back in three, maybe four, six months,” something like that. “We’ll go through all of this again, reevaluate.” But it’s that in-between time, I think that they could be having the frequent contact.

Miles Bodzin: Absolutely.

Kristen Brokaw: Even getting the birthday card saying, “Hey, we’re doing a group education on gut health and you would be perfect for that. Why don’t you come?” I mean, I can really see how, despite it … If you aren’t a chiropractor that isn’t your model, this still would apply all.

Miles Bodzin: In the functional medicine world, if I was in practice that way, and it was routine for me to do lab work every three months, let’s say. That was my practice. Every three months we’re going to run labs, whether it’s urine analysis or whether it’s blood work, I’m going to run those, meet with the patient, give feedback, monitor their care. And I knew that for me to get grades great results, it was going to take a year. Let’s say I knew that as a physician. Well, then I would write from the beginning say, “We’re going to see you. After this initial visit, we’re going to go ahead and schedule out the next three visits for the next year. So, three months from now, six months from, every four months.” Let’s just say every three months, whatever it may be. And I’m going to build out a care plan with the cost of all of that a year. I’m going to bill out the lab work, a budget towards supplementation, possibly if I’m doing nutraceuticals.

Whatever I’m doing, I’m going to build that into the care plan and have the patient enroll in that right from the beginning. So, when they’ve committed, they’ve already put money towards, okay, instead of having to do every three months, a big payment, maybe I say, “Okay, over the next year, I’m going to let them pay that monthly to me over the course of the year.” I’m not seeing it every month, but I’m getting paid from them in month two, month three. Then four shows up. They make a payment, but then they show up for their visit. And I do my labs and I do all my things and I can review things.

Then on month five that I’m not seeing them, but a payment runs and month six a payment runs and month seven … Follow what I’m saying? There’s payments running all year long that are going towards the entire package of the year of care. And that year is again, maybe it’s three or four visits, and it’s all the things you’re doing. To me, that model works much better. Plus, you’ve now committed your patient to that program. You know they’re following through. You know that they’ve committed at least for the year so that you’re going to have the opportunity to get great results with them. That’s really what we’re trying to do here.

To put in perspective, I often will ask doctors in a live audience. I’ll ask them, “If there was something I could teach you clinically to do … Forget about business, forget about money, forget about any of this stuff. Just clinically. If there was something I could teach you to do, and you would always get better results, you’d always get 10% better results, would you be interested in learning whatever that is?” And every hand goes up. Every doctor is, “Of course I’d want to learn that. I want to get the best results possible.”

So, my follow-up question to that is, “Wouldn’t you agree one of the reasons patients don’t get the best results is simply because they fail to follow through? And if you agree with me that they don’t get the best results, because they fail to follow through and at the same time you said you would do something to get better results that I could teach you, well, I’m here telling you. There are things you could be doing to help patients follow through and by doing so you will get better results. And one of those things is forecasting their entire treatment plan, right from the beginning and then committing them to that right from the beginning and then making the payments for them very easy throughout that year, monthly payments throughout the year, let’s say, or six months or whatever time period you’re committing them to. And I recommend you commit them to a time period that allows you to get to the point where you believe you’ll get the results you’re looking for.” That’s really what it kind of comes down to.

Kristen Brokaw: It seems no different than the example you gave earlier of the orthodontist. I mean, that’s exactly how my parents paid for my braces. And then when they slapped the headgear on, then they had to pay more money for it, but that was because they didn’t forecast it initially. But still, it’s like you could make adjustments. And I’m assuming if a patient did really, really well and maybe they didn’t need all of the things you had originally anticipated that obviously you can shift and credit them one. Right?

Miles Bodzin: The whole forecast day of care is an estimate, right? It’s your best estimate as a clinician. That’s our job as physicians. Our job is to forecast what we believe the patient will need. Now, granted, if you’re brand new doing what you do, you may not be great at forecasting. But after you’ve been in practice four, five, six, seven years, and you’ve been doing what you’ve been doing, I hope, you know what you should expect to happen. That’s my hope.

It’s like if a surgeon does surgery, we know they know what should be happening 12 hours after surgery, 24 hours after surgery. They know how you should be responding. At least we hope they know, right? At the end of the day, if you go to heart surgeon and he says, “Let’s get you to have surgery and let’s see how you do,” versus another heart surgeon, “Let’s do surgery. And I know after you’ve recovered after six hours, this is what you should be doing, after 12 hours, after 24 hours.” After two days, they know where you should be along the way. I have much more confidence in that surgeon versus the one who just says, “Well, let’s just see how it goes.”

You follow getting that? Communicating. I’m not saying their physician doesn’t know, but one takes the time to communicate it. That’s the point. You need to communicate it, so the patient’s aware of it.

Kristen Brokaw: Right. Just to wrap up, so I’m sure we have different, we have different tenures of physicians that are listening to this. You’ve got the person that says, “I have such patient loyalty. I don’t even accept new patients. I am full with my existing patients.” But I bet there’s still something that they could do even based on your Four Fs. Maybe it is the frictionless payments or maybe it is forecasting of care. Who knows? So, I guess, what would you say to that?

Miles Bodzin: What I would say is that there’s always room for improvement. There’s always room for improvement. Here’s what I can tell you. If you’re not doing frictionless payments … We see in most offices that implement frictionless payments using like our auto debit system, they typically save about 40 hours of payroll per month, from a business perspective. So, ask yourself in your practice, how much payroll are you wasting on the person collecting money? Because every time someone’s at the front desk collecting a payment, there’s time involved. And if you’re paying your staff on time, that’s a cost to you. There’s an actual overhead expense of the activity of collecting money. So, if you could reduce that overhead, of course it makes sense to do so. You want to streamline things. Not only that, it makes happier team members. It makes happier staff.

When I’m out in the public … Not in the general public, but in around physicians and clients of ours, the doctors always come up to us and are very grateful and very thankful for what we taught them to do. They’re happy, they’re growing, but staff literally come up and hug us and kiss us and like, “I cannot thank you enough for providing what you provide because you make my job as a front desk person or an assistant so much easier.” So even that office that’s busy, maybe you’re running around with your hair on fire. You know when you’re busy, busy, busy. Well, if we could streamline things and systematize them, then maybe you don’t have to run around with your hair on fire. Maybe you’re able to, not necessarily you want to see more people, but you just have more freedom in your time and more joy in your life.

Kristen Brokaw: Yeah, I feel like that’s probably what a lot of them are experiencing. I see a lot of offices where there’s a lot of hair on fire. Then if you would have someone listening to this, a new practitioner or even new to functional medicine, what would you say to that person?

Miles Bodzin: What I would say is start correct. Meaning there’s no reason you have to struggle for years like I did, and a lot of doctors do. If you’re starting out with this way, just start doing this stuff right from the beginning. And when I say that doesn’t mean you have to go reinvent the wheel. You don’t have to make this difficult. You could literally reach out to our company Cash Practice and work with us and apply using it. I mean, that’s the easiest. I don’t want to sound self-serving or biased like, “Just come work with us.” You could try these four Fs on your own. You could certainly try them. But the bottom line is, just do it right from the beginning.

Here’s what I could say also. I mentioned the stat of the 40 hours of payroll per month being saved on average when you do the auto-debit system. Another stat I’ll mention is this. Across the board when we look at our users of our systems, they routinely grow their revenue in their practice 24% a year annually year, after year, after year, after year. And I don’t mean just like one year or two years. I could showcase studies of 10 years of using the systems. And every year, 10 years they started off $50,000 their first year. Next year was $150,000, $250. And here it is 10 years later and they’re doing 2 million a year in revenue. Why? Because they keep adding practice members and services and things to their practice, but they’re not losing people. So, for that new person who needs to grow and ramp up, well, this is the way to do it.

And if you talk to your colleagues … I know you all go to conferences, and you talk with each other. If you’re honest with each other, a lot of you will share, it’s a struggle. “The business side of things aren’t the easiest for me. I’m a clinician, but the business side isn’t the easiest.”

Well, stop trying to figure it out yourself. We’ve figured it out very successfully. And I’m proud to say our doctors are very, very successful. They’re doing very, very well when they apply these things. So, if you are interested in being successful in the business side of things, both from a financial aspect as well as just having more joy in your life, more freedom in your time, I would highly recommend you reach out to us and at least get an opportunity to see what we do.

What does that look like? Well, if you visit our website cashpractice.com, you could visit the website. You can click on a little button there that says book a call. And what that’ll do is when you book that call, a representative for our company will schedule a time to meet with you and through a Zoom call or a web meeting, by using Zoom let’s say, they’ll demonstrate what the software does, answer your question, show how it’ll apply to your practice with no pressure. If you decide you want to work with us, great. If you decide not to, that’s your business as well. But we’re here to serve you.

Kristen Brokaw: Awesome. Well, thank you so much. And if you are interested in reaching out to Dr. Bodzin’s company, where would they go again? You said:

Miles Bodzin: Just simply go to cashpractice.com. If you wanted to email me directly, let’s say you wanted to say, “Hey, I would, I have a question for Dr. Bodzin,” you could email me at drbodzin D-R like doctor, and then my last name Bodzin, B-O-D-Z-I-N. drbodzin@cashpractice.com. Just simply say, “We listened to the podcast, and I had a quick question.” And I’d be happy to answer any questions for any of the physicians listening right now.

But like I said, if you just visit the website, cashpractice.com, there’s even a movie on the website if you want to watch, you can take a look at. There’s a fun movie to watch that’s an inspiring story of the call to serve in the healthcare field and illustrating some of the challenges that somebody might face and overcoming them. So, I encourage you to watch that. You’ll see the link on the website. It’s right there. It’s called The Calling Movie.

I know Kristen, you watched it, you had some nice things to say about it.

Kristen Brokaw: I did. Yes. It’s very cute. It’s very cute. And it’s eye opening. I mean, it’s a story of your struggle in figuring this all out. Yeah.

Miles Bodzin: Yeah. It was a lot of fun. It was a fun thing to do. And in fact, we shared it when we were teaching this last week in Michigan. Of course, we shared the movie with the staff. We don’t show it. We just told them about on the first day we were teaching and said, “You know, if you want to watch it in your hotel room tonight, watch it. And tomorrow when you come back in, we’d love to hear what you thought.” And a bunch of them watched it. And they came back in, they were similar thoughts. They all enjoyed it. They all loved it. They all felt inspired. And though that’s the intention, to inspire us to serve our patients. And that’s ultimately why we did the movie.

Kristen Brokaw: Awesome. Well, thank you very much.

Miles Bodzin: You’re very welcome.

James Maskell: Thanks for listening to the evolution of medicine podcast. Please share this with colleagues who need to hear it. Thanks so much to our sponsors, the Lifestyle Matrix Resource Center. This podcast is really possible because of them. Please visit goevomed.com/lmrc to find out more about their clinical tools like the group visit toolkit. That’s goevomed.com/lmrc. Thanks so much for listening and we’ll see you next time.

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