The current COVID-19 pandemic around the world is scary to both the Spracklin Family and Spracklin Chiropractic, but the thing that scares me the most is the unknown.  Fear will drive a person crazy, but I have started to wrap my mind around the possibility of potentially having to close the office down for a week or two.  This is probably the last thing that I want to do at this point, but it may come to that in terms of public safety.

The issue that arises in my mind is the fact that no one truly knows how long this will go or how it will ultimately end.  If the state or federal government stepped in and said, close down for 10 days and after that point you can open back up for business and it would be business as usual, I would do that in a heartbeat. But no one can tell us that for sure.

I expected patient visits to decline over the course of the next couple of weeks, which they were down slightly last week, but it was still a fine week.  I’m not scared that the doors will close forever or that financial ruin will come upon the Spracklin family, the thing that scares me the most is the unknown.  Will this pandemic go for weeks, months or God forbid even years?

I’ve started to run into the situation of what to exactly tell people or what to do going forward.  We are doing our absolute best to follow the CDC guidelines of not allowing multiple people in the office at any given time, screening people over the phone before they come in, disinfecting A LOT more often and washing hands until they are almost raw/sore.  I’m not sure what else we can tell people at this point.

In order to keep everyone as safe and sane as possible, if you are ill, don’t come in; if you have traveled recently, please don’t come in; fever, stay home; cough that can’t be controlled, don’t come in. In order to avoid numerous people in the waiting room, we are going to implement using your car as a waiting room, allowing us to control the amount of people in the buildings and allowing us to disinfect thoroughly between every patient.

The interesting thing about living in central Nebraska is that it can be kind of isolated from the rest of the world and if you had to pick somewhere to live in a situation like this, middle America is probably about as good of a place to be as any.  Population is sparse and spread out, and social contact can be avoided if need be.  We have wonderful healthcare facilities all around us that are preparing for the “surge” of patients that is expected (cross our fingers that everything can get under control).

I’m going to close by saying that we are literally taking this a day at a time.  We genuinely don’t know what tomorrow is going to bring at this point.  The offices are going to be open for normal business hours, we will be performing numerous DOT Physicals, chiropractic appointments and possibly even some acupuncture.  With all this being said, please be cognizant of the people around you, wash your hands and if this pandemic can teach us anything about society as a whole, please use some empathy and kindness in your days, it can go along way for people at this time.

As always, I truly do appreciate all of our patients during this difficult time, it has been a major stressor for me as I am very much a planner and routine based person.  The ups and downs of the past couple of weeks have been absolutely crazy, but we will all get through this, hopefully better than before.

Online reviews, whether you like them or not, are a major source of advertisement on the internet for small businesses.  One bad review can drive the business owner crazy but how much can you actually do about it?  I would like to think that my reviews on Facebook and Google are pretty good, but the two that drive me crazy are the 2 three star reviews from people that live in other parts of the country that I have never treated.

You want to know what to do in this situation, in my opinion, nothing.  You better hope that you can get more reviews that out-number those and average them out.  If you are good enough at what you do for a living and have a good enough rapport then you should have no trouble getting a boat load of five star reviews on any page that you operate.

The rule of thumb when it comes to working with the public, you cannot please everyone.  You will have bad days, people that come in and out of your office will have bad days.  Those days can reflect in one click of a mouse and can potentially affect your business but unfortunately that is the world that we live in.  I sometimes feel that by responding to negative reviews you are just baiting an argument and that is the last thing you are going to want on the internet is you looking petty trying to defend yourself and your business.

While I cannot control the reviews that get posted, I will tell you that none of them are from family members or friends that are looking to boost my online profile.  I have been known to snoop around on Facebook, when I start looking at reviews for other offices and you click on the links to see that the persons mom, dad, wife or chiropractic school classmates are leaving the majority of the reviews, it looks a little fishy to me.

Bad reviews are not always a terrible thing for you either, I have always been told that learning experiences are around every corner.  If everyone in your life just pats you on the back every day and told you how good of a job you do, while that may seem great on a daily basis, are you ever actually learning your flaws or trying to improve on things.  While no one like criticism, including myself, if you are going to own your own business and work with the public, thick skin should be developed in a hurry or your feelings are going to get hurt A LOT.

With all this being said, try to learn from your reviews and receiving genuine reviews are far superior than getting your mom and dad to leave you a five star review.  While your parents may love you, it looks funny when all of your reviews come from people with your last name.  The public is a weird dynamic to work with, you will not please everyone and patients will not be happy with you all the time, the only thing that you can do is show up every day and work to gain trust and respect.

In ending, if you have ever thought about leaving a review feel free, good or bad.  Small businesses rely on these reviews in order to boost our online presence and I would be grateful for the feedback that is left on my page.

P.S. I hope this request does not backfire on me spectacularly!!!

Growing up I was the son of a teacher, I thought that I always wanted to be a math or science teacher.  As soon as the idea came out of my mouth I can remember I mom saying, “no you don’t.” Then I thought I wanted to be a medical doctor, through high school and about a semester into undergrad, that was the thought process.  I had a sit down conversation with a classmate at the time and we talked about what we wanted in life. It was at that time, that I started to think about other fields that would allow me to work/help people yet still have a standard and quality of life that I could be proud of and practice for years to come.

That is when I went a shadowed a chiropractor and came to the conclusion that this was for me, I would be able to run my own business, help numerous people on a daily basis and not be married to a cell phone to be on call with a clinic or hospital.

Every once in a while I get the random thought in my head, “why didn’t I try to go to medical school or law school, I think I would really like those professions?” Then my wife and family are right there to bring me back down to reality, “you have no idea how good you have it and you don’t have to answer to anyone but yourself. It’s truly the best of both worlds.”

I have a new found respect for people that own their own business.  I never really realized how much of a risk you need to take in order to make everything portray that a smooth operation is happening.  When I started out, I did everything myself and it was okay, I managed but it can be very stressful to make sure everything is done in a timely manner. When we bought the practice in Minden, I had always come from the school of thought that buying a practice did not make much sense, but my mind was changed when Dr. Wakefield came calling, when the numbers make sense, they make sense.  Year after year of solid numbers don’t lie.

Do I have regrets in my life, sure, everyone does but the last couple of weeks Kristina and I have been reflecting on how far we have come in a short amount of time. Big decisions require diligence and caution but at a young age we have made some decisions that we genuinely do not regret in the least.

The past couple of weeks have been busy around the office and I have to tell myself to embrace it, keep letting it grow and enjoy the journey. When you analyze the numbers from when we first started to where we are now it is night and day and I hope in a couple of years that the numbers today will be night and day.

So, do I have regrets in my life, sure but not many.  I have absolutely no qualms about becoming a chiropractor.  Yes, we may be an outcast in the healthcare fields but I’m okay with that because I can see first-hand how many people come in and out of the office on a daily basis and that we are making an impact on their lives.  We may not be the final answer for some people but we can be a good first step for those that we cannot ultimately help to the fullest.

I’ll end in saying if you would have asked me when I was 16 years old that I would be a chiropractor living in central Nebraska with a beautiful bride, nice home and an ornery 18 month old, I would have told you that you are crazy.  But sometimes the dream that you have when you’re younger are not necessarily the dreams that make you happiest.

I’m going to address a few questions that I get all the time and reply to them with as much honesty as I can in this post:

Have you ever considered adding more services to the practice?

Decompression, Laser and even drug testing get asked about.  The reason that I try to keep things as simple as I can is that when you add a new therapy to the office you have to justify the cost.  If I were to purchase a decompression table or a laser for the offices, I would then have to use it on the current patient base.  This would be an added cost to the patient, as the equipment is not going to pay for itself just sitting the back room.  Your average visit would jump roughly $20 a visit and most people don’t need the therapy.  I feel that whether I meant to or not you would start to use the new techniques on everyone whether it would be needed or not just to try to cover the equipment cost.

If you would have asked me this when I graduated, I would have thought you were crazy.  I always thought that the more services you have to offer, the bigger and busier your practice would be.  I have found over the years that keeping things really simple, adjustments and a few therapies that cover roughly 90-95% of the patients that come in the door will suffice just fine.  Keeping your fee schedule fair and don’t overdue the therapies will get the same if not more efficient results than if multiple therapies are performed every visit.

Scrubs and tennis shoes; must be nice to get to wear that to work every day.

Why yes it is, but I actually just switched to wearing them in the past year.  I used to wear dress pants and nice shoes every day, which I really did enjoy wearing but the fact that I am constantly bending and twisting myself into awkward positions and I was ripping the back end of the dress pants faster than I could buy them.  So I made the decisions to wear something with much more flexibility and cost effectiveness.  So yes, I do wear scrub pants and tennis shoes to work, not out of fashion but out of comfort and practicality.  On the plus side, it allows me to buys some pretty cool tennis shoes.

Have you ever considered hiring an associate?

Yes and no, is the answer to that question.  The answer always comes back to a pretty definitive no….I don’t like to be the boss of people.  Yes, I have two secretaries, but as they would tell you they are pretty much engrained in the woodwork in Minden.  They know exactly what to do and have been working in the chiropractic profession for about as long as I have been alive, no I’m not exaggerating that.  I have no intention to micro manage them and I am very fortunate to have them.  If I were to ever bring someone else into the practice, they would need to think and work like me.  A grinder and a self motivator, not just there to collect a pay check.  I have put way to much sweat equity and money into building the practice into what it is at this point to have someone come in and for them to care as much as I do.  That’s not to say that the person won’t care and maybe my mind will change as the years go but right now I have no desire to bring anyone else into the practice.

In ending, if I add a therapy I am doing it because there is enough demand and it is a cost effective choice in treating numerous conditions.  I will never bring in another therapy as another revenue generator, there are too many gimmicks out there but tried and true chiropractic works for the majority of people that are going to be coming in to the offices.  An associate is probably not coming in the near future, but if there is someone out there that can try and convince me otherwise my email is always open.  Lastly, scrubs and tennis shoes are really comfortable to wear every day

The old adage of “if you love what you do for a living, you will never work a day in your life.” I’m starting to really believe that this is a true statement and something that people should try to attain.

As some people reading this may or may not know; I worked for a clinic before I started my own practice. I chalk this experience up to a learning experience. I had a certain vision of how I wanted to practice when I got out of school and this practice is what I thought I wanted. Turns out, it was the exact opposite of what I wanted. Kristina and I made a decision about six months in, that it was time to come to some hard truths. If I kept practicing with how I was going, I would have been out of the profession in a few years. I was miserable. We consulted a few attorneys’ and decided to make a run at it.

I will never forget talking to my mother-in-law and her saying, “if you fail, you can always just start all over again.” So that was kind of my motto for the first couple years in practice on my own. The money can get tight but ultimately I was happy running my own office and I was able to sleep soundly at night. I told myself that I was going to run a low pressure practice that treated musculoskeletal problems and concentrated on adjusting people and doing some modalities/therapies. I love my patients but most don’t want to be in the office for more than 20-25 minutes, tops.

Along the way, I found a niche, which has more or less taken off for me. I’m a firm believer that everyone that is starting a practice should have some sort of niche that they enjoy and can mix the day up a little bit. I do DOT physicals, it’s a service that is required for people that have a CDL and it can build on itself. I do a quality physical at a reasonable price and local companies and drivers have figured out that it can be convenient to schedule with our office.

Over the course of building a practice, you will make questionable decisions, but overall over the past 7 years, Kristina and I have made some life altering decisions that have played to our benefit. We paid off student loans, as a young chiropractor you should seriously consider doing this, it’s worth it (follow the link to see what interest you can qualify for: http://refer.credible.com/tHX6Tp. Buying a practice was another big decision, while not for everyone; this allowed us to grow exponentially and started us on a path towards building a practice and life that we can be proud of.

The year that I worked in a practice that was not my own, I vowed to myself that whatever course I was going to take, I was going to be able to sleep well at night. I wasn’t going to have lengthy, expensive treatment plans that may or may not get the patient better. You can justify this argument either way, but when I go to bed at night, the fear of an insurance audit or a malpractice suit are not real high on my thought list because I treat the patients that I’m capable of treating with the necessary care and refer out the others that I’m not comfortable with. I’m truthful to a fault, if you want to know my opinion; you’re going to get it, if you ask. I’m not very good at sugar coating things.

While some days can be tedious and boring at the offices, the majority are highly rewarding with genuine conversation, interactions and treatment of people that come through the door. Personal satisfaction is a huge morale booster. I set out to build a practice that my family and I can be proud of. I feel that we are accomplishing this and will continue to strive for this standard. My secretaries are comfortable collecting payment from people because they do not feel that we are taking advantage of people and I’m not embarrassed to go out into the community and tell people what I do for a living.

The moral of this story, set out on a path that you trust and believe in. Stick with it, give it time and you will reap the rewards. Yes, there is risk involved but just be proud of what you do and know that sometimes doing the right thing with not necessarily make you the most money.

The longer I have been in practice, the more I find myself falling into a level of practice that makes me focus on conditions that I feel comfortable treating and knowing that I will get the desired results that both myself and the patients expect. The problem with practicing in Central Nebraska, you are going to see all sorts of conditions. I have classmates that have a very narrow practice area, but they live in large, diverse metropolitan areas with plenty of population. Someone may come in with shoulder pain, I do an examination; I make the determination that this problem is something that I am not going to be able to help with. Not that I can’t help resolve some of the pain associated with a rotator cuff tear, but most patients are going to want to get an orthopedic consultation for optimum treatment and advise.

Just last week, I had an older female present to the office. She walked in with a walker and could hardly put any pressure on her left hip. She had never been to a chiropractor. I did what exam I could, but it was ultimately decided that she was going to need a set of x-rays and possibly seek care outside of out office.

There are some things that come into the office; that I have no business trying to treat. This is the premise of getting comfortable in your own skin. I’m figuring out what I’m good at and I stick with those specific things.

My business is one of the passions in my life and I have always said that I don’t have a lot of vices in my life. I enjoy what I do for a living, I really do, I play quite a bit of golf when the weather is nice and I have always collected and enjoyed vintage baseball cards. When I take a day off, odds are it is related to one of these topics or family commitments; I don’t take R&R days as I find my job to be fairly therapeutic for me.

My mind wonders quite a bit during the day but it is generally about these topics and my family.
When a patient comes into the office and I can’t help, I ponder it. I lose sleep over it. I wonder about it. Could I have done anything different to help the pain, increase function for the person or to improve their quality of life.

I have been performing insurance reviews for the past 6 years, do I like doing these, they’re okay, but it allows me to stay up to date with the current insurance guidelines and what is specifically allowed by insurance companies. Staying up to date on the guidelines is wonderful but it does help fund my golf habit and it doesn’t really affect my evening time with my family.

I also obsess on the business and finances of both my life and business. I recently paid off my student loans after a couple years of sacrifice, but it’s crazy how much of a stress relief it can be when you have one major chip taken off of your shoulder. Seriously, if you are a young chiropractor and want to feel like you are starting to get ahead, get your student loans paid off and feel the burden get lifted off, it’s a wonderful thing.

As I started with this article, I am what I am and I would like to think that the people in my life have come to realize this because I’m starting to recognize it every day. I like to treat headaches, most type of back pain and I love doing DOT Physicals. I follow the guidelines when I work, I stay in my lane and don’t venture to far away from that. Most people that come in enjoy the fact that I don’t sugar coat things and I’m going to make the process as simple as I can.

Not a lot of people read these articles, but it’s almost therapeutic for me, in the sense that it allows me to put some of the random thoughts that run through my mind on paper. Golf, baseball cards, family and chiropractic can pretty much sum up my life, so if you have any interest, I’d love to talk about any of them.

Lastly, if you have student loans, seriously consider refinancing as rates continue to be pretty low: http://refer.credible.com/tHX6Tp

Recently, I have been fielding a lot of questions about surgical interventions, stem cell therapies, lasers and different types of muscle testing. It always kind of puts me into an awkward situation, as I don’t do any of these therapies. If you come into the office, I’m going to give you a straight forward answer when it comes to these therapies but for the most part I don’t know enough about the options to give you a valid answer.

Stem cells are currently not FDA approved for most any treatments. While there are numerous outlets, including chiropractors that claim to cure just about anything under the sun with stem cells. Shop with caution, knowing that none of these claims have actually been approved for the “said” use. For the most part, if your insurance does not cover the procedure, odds are it has not been deemed useful enough for wide spread use.

Another therapies that I don’t really know much about is muscle testing. Patients will come into the offices and indicate that so-and-so made me hold a bottle of supplements and my arm was held out and I tested strong for this supplement, he now wants me to take a few supplements. I have never taken any courses on applied kinesiology or muscle testing when it comes to supplements. I’m not necessarily against this practice, but if you ask me, I’m going to tell you that I don’t know enough about the practice to make an informed comment.

I’m not opposed to laser, I’ve actually considered getting one for the offices, but I don’t find that I can justify the price and charge patients for its use when it is not a covered service with your insurance. I think it can actually be a very useful therapy but I personally think that a patient wants to “feel” what is happening when it comes to therapy. Most people will not feel anything with a laser. When the time is up, you don’t really feel anything happening and then I have to charge you cash for the therapy.

Lastly, I’m not anti-surgery either. Sometimes surgery may be the only option for pain relief. But just remember, all doctors have their specialty and knowledge. The old saying of surgeons do surgery is not necessarily true today as insurance companies will normally force some sort of conservative care for chronic musculoskeletal cases. If you present to the office with any number of red flags and a referral is necessary, then that may be the decision that is coming. I actually kick myself sometimes as I feel that I may fold my cards sooner rather than later.

With all of this being said, I am starting to get to a point in practice that if a case presents with signs and symptoms that I don’t feel comfortable with, I have no problem sending you on your way with hardly any treatment from our office. I like to treat headaches, low back pain and most musculoskeletal complaints. I don’t deal a lot with internal disorders as some chiropractors do and I don’t deal with babies that I am not familiar with. Rest assured, that if you are being treated at either office I am perfectly comfortable treating your condition.

The headline on this post is going to be a little miss leading but I like it, so I’m sticking with it. Time can be a very strange thing. It is a finite thing, there is only so much of it in a day. The past couple of weeks I have tried to make a conscious effort to utilize the time in the day to be the most productive that it can be.

I’ve had my hands full the last couple of weeks, with things that are changing around the house, keeping up with a seven month old and running the day to day aspects of the practice. Trying to balance this on a daily basis can be daunting, but I’m starting to learn that you can only control so much of it. My mindset recently has been tackle the things that you can at moment and the rest can wait.

The reason that this topic even arose in my mind; a patient asked me earlier this week, why is it when she calls the office we try to give her very specific times. There are a few good reasons that this happens: it makes the office flow well, as we are giving times that work best for the office and will limit the wait time for the patient. The last thing that we want as an office is for someone to come into the office and have to wait 20 minutes in order to be seen.

There is a caveat to this, we appreciate and like walk-ins, in fact the majority of the Kearney office is walk in type visits. This seems to appease a lot of people as they are able to come in when it is convenient for them, but there is an unwritten understanding that if you are going to walk in there might be a little longer wait time.

We value your time in the practice and we will do everything in our power to limit wait times and to make scheduling as easy and convenient as possible. If you call and the time that you desire is not available, we will offer times that work best for the practice, for the common courtesy of you and your time. You are more than welcome to walk into either office and we will work you into the schedule but this will be done without sacrificing patient care of the others in the office.

Before I wrap up this post, I would like to just say that if you are wanting in for a DOT physical, we do appreciate them be scheduled due to the paperwork and extra steps that need to be taken in order to perform the exam in a timely manner. You are more than willing to take a chance but it makes our lives a little easier to know this ahead of time.

So just remember next time you call into the office and request an appointment, we aren’t just randomly giving times, giving a time preference can help us direct you to the proper timing and if those don’t work for you or your schedule walking in is always an option and you will get the same level of care but there might be a little longer of a wait on certain days.

Treatment plans have always been somewhat of a mystery to me since I started practice. I have always prided myself on the creed of not having a long term commitment or significant “treatment plan” before you seek treatment. Your first visit in either office will include an exam, an explanation as to what is going on (in my opinion), followed by treatment that is agreed upon. There is no sales pitch to convince you that you, as the patient, are going to need months of treatment.

Treatment is made on a case by case basis, with proven techniques that have been used for years. If you need ultrasound to calm down a flared SI or facet joint or electric stim to relieve muscle spasms in the middle back, then that is what we are going to do.

I was listening to a speaker a couple of weeks ago and everyone in the crowd indicated that they do not require long term commitments to be patient in their given offices, as the Q & A section came about, one of the audience members asked how different a rapport can be built when you are treating a patient 15-20 times. I got to thinking, is this what is considered when a chiropractor thinks of no long term commitment. If that is the case, I think I need to reevaluate what I consider long term treatment plan.

The longer I go into practice the more I have come to realize that every patient is different and everyone responds a little differently to care. So for someone to walk into an office, they do an initial intake, x-rays and tell you to come back tomorrow so that they can discuss your findings and go over the “treatment plan” is crazy to me. Odds are if you are presenting to the office, you want relief or answers quick. Most conditions, unless red flags are present on the intake, that present to the office do not warrant x-rays unless progress is not being made. I know that people will argue this view point but this is genuinely I how feel.

As stated earlier, I have started to reevaluate my stance on no long term commitments because I am realizing that my definition is vastly different. As oppose to saying no long term commitments, I think I am going to start using, we treat until you get better or you don’t and then we refer you on. Some patients may need more care than others and some may be able to come in for a visit or two and feel that they have received as much benefit as they can get from our office.

I am perfectly okay with this stance, as I feel that patients that want to follow through with care and seek the best possible health decisions will follow up with the recommendation on a case-by-case basis. If a patient feels that they are receiving benefit from the care in your office they will gladly come back for follow up care. If a patient misses an appointment, we don’t usually call to reschedule because if you are in enough pain and you value our care then you will call to get back in.

I know that I am in the minority with my stance, but I do genuinely feel that I give the patient the best possible care that they are willing to commit too without a pressure sales pitch that may or may not cost you hundreds if not thousands of dollars. The comfort level of the patient is a big deal for me, as I want them to see value in my care and to come back if other issues are to arise without a big surprise of months of care that most people do not see necessary.

Care should be given on a case-by-case basis and not a cookie cutter basis that may result in a several month long treatment plan that is going to cost you thousands of dollars. So now I am going to live by the adage of: We treat until you don’t need it or feel that you are not receiving “value” from our care.

At the office we strive to be perfect, solve every problem that walks in the door and help everyone. If your insurance is not processing things correctly or work won’t let you off for enough time to get in for treatment we try to accommodate everyone. I try to be the perfect doctor, pleasing everyone and having something to contribute to the wellness of every patient that presents.

As most people know, the perfect office does not exist, we cannot solve every problem and we cannot help every person that comes in. That does not stop us from striving for this. Treatment does not always go according to plan, set-backs will be had but ultimately we feel that we can either guide you on a path to feeling better or at least point you in a direction that success can be obtained or better suited for that individual patient.

Marty and Carol can only do so much with insurance, sometimes we need the patient to take control and contact insurance on their own behalf. They can only try to solve the problems that are within their control and that seems to be a reoccurring theme of Spracklin Chiropractic, we try to control what we can and help guide people in the right direction on the things that we cannot.

The perfect office would be able to cure every ailment, solve every problem and everyone that walks in the office would be happy and satisfied. Trust me, we strive for that in the offices, but sometimes people find other care that fits them better. They may not mesh with me personally and that is okay. Maybe the hours that we offer don’t fit into your lifestyle (which I don’t know if that is possible because I feel that I live at the offices) but none-the-less there is someone out there that would like to be treated at 5 in the morning or 8 at night.

In the perfect setting we would have every therapy known to man, whether it be lasers, stem cell injections, diagnostic equipment or unlimited electrotherapies. Time and money does not allow this for our offices. I have the therapies that I feel benefit the patients that walk in the door, if I purchase a piece of equipment, patient use would have to justify the cost. Sometimes as a business owner, it does not make sense to have all the therapies under the sun.

With all of this being said, I strive to be the perfect doctor with a perfect staff that can please everyone. We offer numerous services and therapies in both offices, are accommodating to peoples’ schedules and accept nearly every insurance in the area that would be carried by local people. CDL physicals are scheduled 5 days a week at all office hours, not just slotted times that work best for our scheduling.

We may strive to be a perfect practice but as I have alluded to finding a setting that fits everyone’s needs or finding a doctor that can solve every problem is far from easy. This is not a simple problem to solve, nor will it probably ever be solved. We will continue to strive to be a more perfect setting where you or family and friends can feel comfortable seeking help for your healthcare needs.

As the year turns over, a few hours will change in order to accommodate my life but we will continue to offer the best care that we are capable of without leading you down a never ending treatment road that does not benefit you or me in the long run.

We look forward to growing and building a better practice and future in 2019.