At 53 years old, I am hardly a newcomer to chiropractic practice.I was in practice at the age of 23 and have run high volume practices in the past.Having taken several years off to raise children and travel, I now missed the care of patients and wanted to get back into practice. I was asked by several people to keep a log for others to read so that they can learn from my experiences.
Let me first say that I still have much to learn myself.I also believe that I do not have all the answers. But I may just provide some insight into something that others may not have thought of.
As an opening to this blog, I have written a short story as a preview to the Blog.I have broken this preview into topic related sections. This short story will chronicle the pre-opening set up process. I suggest that you read that preview first before starting to follow this blog.After you read the preview, feel free to read this bog at your leisure.
Wow, things have been moving so fast now that I haven't had time to keep this blog us as much as I should. Well since we last talked the x-ray was installed and I am awaiting an inspection later today. If that goes OK we are ready!!! I still need film and envelopes but I will get them this week. I have announced an official June 1st opening. I already have some scheduled appointments that day and hope to add as many more as I can this week. I picked up used view boxes a week ago so we are good in that area.
I finished the darkroom a few days back making sure it was dark enough. The kitchen now also doubles as a darkroom but I had to come up with a way to seal off a window when I wanted it to be a darkroom without permanently sealing it off when I wanted the light from it when I use that room as a kitchen. I created an ingenious solution by buying a 30 inch hallow door and then cutting it to fit the window. I then added a molding on the inside of the window locks to hold the window in place. When I put the window in and lock it, it is dark! I can then remove it any time I want. The whole thing cost my less that $50 bucks.
I have selected a software program for the office. There were a lot of good ones so I went with one that has a monthly fee as opposed to spending a few grand up front. This one does not require a contract so if I'm unhappy I can switch later.
We painted the last few areas that need painting and the place looks ready. I have a few more little things to get done such as printing forms for the office using my computer. I have not used a printer as I design and print all forms myself.
There are a hundred little things I have done to save money. I believe this is important when you open a new office. In an upcoming entry I will review what I have done and list some the the thing that anyone can do to save money when opening. As for now, I have to get over to the office to meet the x-ray inspector.
I still have work to do on me. I need to continue to get my head into a practice mode. I have to hand out more cards and focus more in that area.
May 2, 2009 – Now the fun begins!
Probably one of the slowest portions of getting going was the waiting for the x-ray build out approval by the State of Georgia. Well yesterday I finally got the approval! This means that now I'm in a race to get the x-ray room build-out done and the x-ray installed. I'm hoping that this all will take just 2 weeks max so I can pick an official opening date. Even though I may get open for business earlier, looking at the calendar makes me think that Monday, June 1st would be a good "official" opening day.
I still have lots to do. I have not selected an office computer program yet, hung posters, moved one door, or a few other things I was waiting on. So now I am in a hurray to get these items done so I can begin. I need to meet with Life students from Dr Schiffman's Get The Big Idea club as they will be helping me with screenings. I also need to work on the bottom portion of the outdoor sign so I can place a grand opening announcement on it.
A week ago I receive another call from a woman wanting to become a patient. As I mentioned earlier, I have received a number of these calls over the past months. This time I could not say no. So I had her come in a start care last week. She was referred to me by another DC in Florida, and I figured innate did not want me to wait.
April 10, 2009 – Sign in place!
Yesterday was a work day at the clinic. One of the main things that we got done was to install the sign. There was a metal sign already present so I needed to put in new skins. As I previously mentioned I designed the skins myself and had them printed. I picked them up yesterday and went to the clinic to install them. Below is a picture of the sign. You can see more images at my clinic website at www.brailechiropractic.com.
April 8, 2009 – I'm a real Chiropractor!
I'm a real chiropractor, cause I got a spine! Today my mail order spine arrived so I feel more official! I did cut the red bulging disc off the lumbar area that they all seem to include. I just know every patient would say that their spine looks like that when I was trying to educate them on subluxations. I did get the less expensive model from www.shopanatomical.com. as that seems a good one for starting up. My business license arrived in the mail today to legally I'm ready.
I found and purchased 20 chairs for the waiting room and the adjusting rooms. I spent a few days looking around at office supplies and found only junk at a very expensive price. Now since I'm thinking volume, I wanted my waiting area to hold 12 chairs before I ad any for a doctor's report / lecture. All toll I can probably seat around 18 tight. Not as many as I'd like, but I'm planning on more that once a week lectures. The chairs I finally got I found online at www.bizchair.com. I looked over a bunch and decided on the church chair models in denim blue which you can see here. I like the fact that they hook together as that prevents them from sliding around on my hardwood floors and it allows more then 4 family members to sit in four chairs as that is how many I put in each adjusting room. (I have two adjusting rooms for now). I like the idea of a bench so these chairs act as both chairs and benches. And since they are church chairs, you know people can sit in these for at least an hour at a time.
I ordered my sign skins this week. I created them myself using a Illustrator program that I am familiar with. I sent them to a printer who will print them on vinyl and mount them on white Coroplast. Both skins are 40x77 inches. The total job was just under $400. I will pick them up and install them myself tomorrow. The sign at my clinic is an older metal sign that could be illuminated, but has never been permitted. So the owner of the property said to just get new skins and if the city says anything tell him.
Tomorrow is a work day at the clinic as I get a lot of set up done. We have a person coming to the clinic to show us a software program as well so we may make a decision on that.
March 28. 2009 – Furniture, Signs & Software
Headway is being made in the office furniture area. The day before yesterday my wife Evelyn and I spent a good portion of the day looking for office chairs and a front desk. Wow, were things more expensive than I expected. We went to about every major furniture store and saw that possible front desks were very expensive.
However, once again the power of prayer came through. (Check, "Still Having Doubts", for our first story on power of prayer). We had just left our third office supply store and while sitting in a parking lot my wife said a short little prayer asking God for some help in finding affordable office furniture, possibly from a place going out of business. Well, to the right of the parking lot was a Broyhill home furnishing store that was closing. Although Broyhill handles only home furniture, we decided to look inside. The showroom was almost empty as mot everything was sold. However, when I looked in the back of the store I noticed that the offices in the back contained L-shaped decks that were just what we were looking for. We asked a sales women's about these desks, and she asked the manager. He responded by saying, "Ah, how about a hundred apiece?" Our response was, "We'll take two!" and they also sold us the matching wood filing cabinets for $50 each. Not bad for a quick little prayer.
As far as a sign for outside. I am looking at two options. One is a more expensive monument sign according to code. I found a company that may be willing to offer a deal. The other option is to just re-skin the current non-coded sign with a new front. I can get this done for around $300 by creating it myself in my computer and sending it to a printing company. Since the sign is not according to code, (it has been there forever, but never permitted by the city), I plan to possibly use solar lights to avoid an electrical issue.
Office software is still a concern. I thought I had it worked out, but when looking at all the costs, I may have changed my mind. I want good software, but since this is a new practice, I do not want to spend way to much to get started. This is a decision we will have to make in the coming week.
This week I also created posters for my office. There are three posters that I must have. One is a subluxation poster. The classic poster here is the "Silent Killer" one that you can get from Sherman College bookstore. The other two are the subluxation degeneration poster and the sub-station scan poster. I use both of these in regular patient explanations. I've created these and you can see them here. Click on the thumbnail for a larger image.
Things I'm waiting on: I'm still waiting the city's official copy of the business license, so I can submit a copy for my Medicare number. I am waiting on the state's approval of my x-ray room design so I can start building out that room. (see below on x-ray room). And I'm also still waiting on Comcast to verify that my address is a business for phone and Internet installation. It seems they had that location listed as a home.
X-Ray Installation Notes
A few notes on my thoughts on x-ray. I believe you need an x-ray for a practice. Not only do I use it for my technique, but it helps with education as I use subluxation degeneration as a way of education the patient as to the time frame of their subluxations.
As I may have mentioned I purchased a used x-ray from a doctor who was closing a branch office. One quick look on Craig's List or Planet Chiropractic shows that there are really some great deals out there on used x-ray equipment. Last week I had the person I have chosen to install the x-ray come over and do a walk through so I could create plans to submit to the state. This was helpful as he gave me tips on what walls NOT to lead line. The less lead needed the more money I save. I have 9 sheets of lead sheet-rock that I purchased from another chiropractor who had extra from his x-ray installation. If I have left over, I'll sell them at my cost back to the installer, who will take them off the price of my installation and thus save me even more money.
Ideally, I want the x-ray room to double as my exam room. This is the only room that I will keep a door on as I do plan to gown people for examinations. My 2 adjusting room will have no doors, (semi open adjusting).
March 19, 2009 - Fast and Furious
We are moving along getting ready. I was able to get a business license from the city of Marietta in one day. This was a far cry from dealing with the City of Powder Springs in the former attempted location. I have more pictures posted that you can see on my clinic website at www.georgiachiropractic.com. To see the pictures just click on the “Click here for additional pictures” on the front page underneath the picture and address.
There is a lot to do. Below is a list of some of the things I need to do in the coming days.
Submit x-ray plans to State of Georgia for approval so that I can get started with installation. The State must first approve plans before I can install lead lining and do an install. After the install I need to call for an inspection before I can use the unit.
Create a sign skin for our front sign. I will be looking at getting a new sign as well to see of the property owner wants to upgrade, as the sign on site is usable but not according to code.
Purchase software for office. I am leaning toward the paperless system called Platinum. They just came out with a new deal for “new practitioners” (I guess I qualify again) that makes it very affordable. This system does everything from record keeping to billing and makes your office high tech and paperless. Usually this system is expensive and over my budget, but with the new deal it is worth starting with.
Submit for a Medicare number. I needed a business license number to be able to submit to Medicare.
Some outside clean up, minor landscaping, cleaning and some deck painting.
Meet with the “Get the Big Idea” students, as they will be helping with screenings and other events to help promote the opening.
Find and purchase office equipment. I need computers, chairs, and view box, posters, a plastic spine and a dozen other things that I will have to think of for the office.
Work on my “doctor’s report” / Lay lecture. This is important and I need to have a finished version ready to go. I will be using Powder Point as the visual and a large screen TV for presentation. I want to look upscale, but I want to do this on a budget! So I’ll be looking for deals!
Well that’s all for now. There’s a lot more so I have to get going. I’ll post more next week. BTW, I have not finished my bathroom that I posted about on March 2nd. I still need to grout and re-install the fixtures. Egats, I need to get busy!
March 10, 2009 - YES! New Location, New Beginning!
Today we signed a 3 year lease on a free standing building. This will be the future home of Braile Chiropractic. My wife and two daughters all came to the lease signing. Then we returned home to feed the horses and put an adjusting table into my truck. We went to the new clinic and immediately put up a temporary sign, and put an adjusting table into the building. It was important for me to have an adjusting table be the first thing that arrives at this location.
I spent the last couple of days calling the City of Marietta, and going over the lease. There is one possible image as to the sign, but this will not represent a problem. It seems the sign has never had a permit with Marietta. Since it is an older sign, it does not conform to code, and since there was not permit before, it cannot be grandfathered in. I do not see this as a problem, as I plan to either just re-face the sign as is, or erect a new and bigger one according to code.
There is virtually no build out needed in this facility. I plan on leaving the rooms as they are and maybe moving a door or two. The inside of this building is immaculate. New everything, including hardwood floors. The rent was reasonable ($1400 a month) for a 1200 square foot free standing building at this location. This area is much more upscale than the building I tried to rent in Powder Springs. This one is almost directly across the street from Marietta High School, so everyone knows the area.
Anyway, for those who would like to map out our new clinic, the address is 1150 Whitlock Ave, Marietta GA 30064. We are excited and ready to go. I’ll add more in a couple of days as we start going.
March 4, 2009 - Oooo This could be Good!
Yesterday and today my wife and I looked at a possible facility for our clinic. This one meets many of the requirements that I have set for a clinic, and has a few nice bonuses.
It is close to home.
It is a free standing building.
Free standing large sign in front.
It is on a very well traveled road but is easy to get into and out of.
It has parking and a large lot in case of overflow.
The building is a house that has already been converted to an office so I have very little work to do to get this open.
It is beautiful! Outside it looks really good. Inside it is simply stunning. New hardwood floors, new ceiling and paint, a fireplace, are just a few of the amenities. The place looks much more expensive than it is.
Over the coming days I will be reviewing a lease and checking with the City of Marietta to see if there are any hang-ups. If not I will sign the lease next week and get moving!
After having had my hopes dashed a bit over the past few months, I’m excited again! My wife Evelyn looked at it again with me today and she is on board 100%. As disappointed as we were with the first location not working out, this one is actually much better. Moral – God has a plan, but I sure do not always know what it is.
March 2, 2009 - Pulling my hair out.
Well that would be impossible with me, but I have been going a little stir crazy lately since I am in a practice mode and I do not have a practice. I found myself getting agitated, and frustrated that I have not found the “perfect location” for a new practice. Patience is important here as I do not want to rush into a location, into a long term commitment and decide later that it is not right for me or my family. I want my family to be involved so the location must be good and it has to “feel” right.
I will be looking at several more possible locations this week to see what might be possible. It’s not that there aren’t a lot of places for rent. There are plenty. But I am looking for that one place that fits my criteria, (see my location rules in my blog preview), and I should be able to just walk up to it and say, “this is it!”
Since I was in desperate need of a project, one day I was getting a little crazy so I started to tear out my main bathroom at my house. I pulled out the carpet, flooring, sinks & vanities, and the toilet. I will be putting down new tile, painting and basically redoing the bathroom. This is new ground for me as I have never done tile before. Oh well, better to be busy with projects around the house then to be driving everyone else in my house nuts!
February 13. 2009 - Still Looking
Well since we have pulled out of the previous location, my wife and I have spent some time driving around and looking for places for an office. The temptation here is to force the issue and take a spot that violates the basic principles I set forth for a new location. I want to keep my overhead as low as possible so I have passed on many empty new strip mall and shopping center possibilities. With the economy as it is there are a lot of rentals out there, but most are in partially vacant shopping centers. To me, most of these just don’t feel right. There have been a few possibilities, and we will continue to look into these and pray about it. Overall, this is a lesson for me in patience. Sometimes having patience is harder that getting patients.
Jan 28 2009 - It's behind me. Something better on the horizon.
Today was a day of finalizing. Over the last few days I moved out lead sheetrock, Christmas decorations, and cleaning supplies. Yesterday, I moved out the last item. This was also the first item I moved into the building when I was initially moving in. Yes, the first item in and the last out was an adjusting table. It was a little sad as I was excited about practicing at this location.
But in the midst of sadness is the knowledge that I have been "called" to be in practice again. The signs were unmistakable, (see my initial posting in the Preview). So it is time to just turn the corner and move on.
As a final step I sent the property owner and the realtor letters (with delivery confirmation) informing them that I have vacated the premise and I’d like my deposit and first month’s rent back.I’m not counting on getting anything, but I’d sure like to get some of that back.
I also sent the Mayor of Powder Springs a long 3 page venting letter explaining to her how disappointed I was in how the town treated me in the process.I felt that the town should have told me the first day I was there that the taxes were not paid and therefore they would not grant me a business license. Instead they waited over a month after I had spent money, including over $800 in fees to the City itself.I asked them for my money back that I paid them in fees, but you and I both know that getting a municipality to return money would take a miracle. But since I believe in miracles, I will not rule it out.
O well, enough for now, I’ll post more in a few days as I look for places for an office.
Jan 21 2009 - Oh Well - NEXT!
Sometimes you have to just step back and say, “In God’s time.” The location I was planning on opening in Powder Springs will not fly. In spite of all the reassurances, the owner of the property has not paid his taxes and it has been over a month now, so I will have to pull the plug and start looking elsewhere.
Yes, I’m a little bit down about this but on the flip side I’m excited. More than half of the fun of getting a new car is shopping for it. SO, now I get to look for a new location and “shop“ for a new location for my future clinic.
If you have ever seen the movie "Evan Almighty" there is a scene where Steve Carell, (Evan Baxter) is telling Morgan Freeman, (God) that building an Ark in not in his plans as he has a new house and a new job in Congress..." At this point Morgan Freeman (God) starts laughing, and Carell asks him, "why are you laughing?" To which Morgan Freeman (God) replies only by saying, "Your Plans." This is how I see it. I am trying to set plans, but as always, God is laughing at my plans as he always has better ones.
I'll continue posting more updates as I look a possible new locations.
Jan 16 2009
Well the wait and see continues for me. I spoke with the city and county. And, nope the taxes are not paid yet. I called the owner, he said he was out of town but said that he thought it was handled.The reasons that I keep hanging on are the following:
1. This location is really good
2. The rent is really cheap. At $750 per month this is worth waiting on.
The owner has not taken any money from me. If he wanted more money I would sense a scam here. But since the only money I paid was to the agent which she kept as her commission, he has not gotten a cent out of me. He also extended my free rent until November as I need to put in a parking lot. So he will not get any money out of me for months.
My patience is not limitless. I will bail on this property is something does not happen soon.I have been actively looking for another location but nothing has jumped out at me yet.
So for now, I wait, pray, and keep looking.
Jan 8 2009
If you read the preview you know that I have rented a building that was a house I plan on converting to an office. I am currently on hold as the owner has not paid his city and county taxes yet. So I am not going to spend thousands setting up if I might have to move. You cannot get a business license in my town (probably the same everywhere) if there are taxes owed on the property. The owner of the building I want to open in owes property taxes to the city, and county as well as there is a lien on the building from a contractor who did a A/C installation.He claims, as of yesterday that everything will be handled shortly. Since he is not taking any money from me, so I have no reason to think he is scamming me. So far I have paid him NOTHING! The deposit and first month’s rent went to the rental agent as her payment. So I’ve not paid him anything. He even extended my free time on the lease until November of 2009, (in exchange for me putting in a parking lot, which I will not do yet)!If he is trying to scam me, why would he give me all this free time and not ask for money?I am not spending any money on the place until I am sure that I will be there. So with nothing further to lose, I wait.I have paid the city of Powder Springs about $850 in fees so far. That will be a loss if I have to re-locate.
Introduction:
Today we signed a 3 year lease on a free standing building. This will be the future home of Braile Chiropractic. My wife and two daughters all came to the lease signing. Then we returned home to feed the horses and put an adjusting table into my truck. We went to the new clinic and immediately put up a temporary sign, and put an adjusting table into the building. It was important for me to have an adjusting table be the first thing that arrives at this location.
