Editor’s Note: Today, Dr Greg Iacono shares his thoughts on why it’s beneficial to have a cash practice and develop cash services.

As a full-cash practitioner for over 12 years, I can tell you in my opinion that a cash practice is the way to go in Chiropractic. The positive aspects of a cash system far outweigh anything negative (unless you are running a PI practice of course) and the reduction in stress alone is enough to convince most DCs to switch.

Basically, with a cash practice there are no headaches or stress due to waiting for payment, refusal of payment, or complete non-payment of your bills. None. With a cash practice your patients pay up front (if that’s legal in your state) or pay every time they visit, saving you and your staff a ton of paperwork. You also know exactly what is coming into the practice at any given time, which is helpful; for many reasons.

Now, this article is not about how to change your practice to a cash-only practice but simply why it’s a good idea. If you’re looking for the actual steps to change and the legal ramifications to changing your practice to cash-only, you’ll need to do additional research. That being said, there are plenty of websites, books and gurus out there that will give ideas and tools for making the switch.

However, you’re looking to change to a part cash / part insurance practice, there are plenty of things you can do accomplish this goal and lots of options.

When looking for more ways to expand your practice or additional chiropractic cash services, the best services are ones that don’t use a lot of your time. You need to focus on seeing and adjusting patients, consequently, any new cash services should focus on treatments that can be performed by your staff.

One such service is massage, either relaxation or deep tissue. Patients love massage and it’s normally an easy upsell, especially if you have a good massage therapist that your patients like. Keep in mind that you don’t have to actually hire your therapist but can sign them on as an independent contractor, which will save you a lot of tax money and paperwork hassles. In fact you can and should do this for any therapy that you use in your practice unless it’s something only a DC can provide.* (Please read the editor’s note below.)

300x250 md-attorney referral I really like massage the best because it only involves a small investment. One room and an upfront cost of less than $1000.00 in most cases. In fact, if you have a massage therapist who has their own equipment you can cut that investment cost by two thirds.

Some chiropractors have gone as far as including aesthetics as part of their practice. Others specialize in nutrition counseling and vitamin supplements.

The most important factors for whatever extra services or modalities you decide to provide, are the investment cost and the ability of that service to either be performed automatically or by a staff member. Also it needs to be something that isn’t time intensive and is relatively affordable to the average patient.

So, to reiterate; I believe that cash is the best way to run a Chiropractic practice, and any extra cash services that you provide should be services that others can perform, don’t need a big investment and are affordable to your patient base. If you can find something that covers these bases (and there are many out there) you’ll be well on your way to a substantial cash income for your practice.

* In the past, we’ve been advised that in many cases it is illegal to categorize a massage therapist as a contractor if they have regularly sheduled office hours and follow office guidelines in any way. To determine the correct strategy for your own practice, please check out this article from the IRS  and consult your attorney or accountant.



About the Author

Dr. Greg Iacono

Dr. Greg Iacono graduated from Life College in 1996 and immediately opened his 1st clinic in Savannah, GA. However fate (and a large airplane) took him to Belgium, where he practiced for 9 years and was the first Chiropractor ever to advertise in the country. Only 2 years after returning to the States, Dr. Greg was again called to another country, and for almost 4 years saw patients in Peru. He is one of only a handful of Chiropractors who can explain Chiropractic in 3 different languages. That, plus $9.00, will buy him a large double latte at Starbucks.

4 Responses to Chiropractors – Reclaim Your Profits With Cash Services
  1. I have been doing a cash practice for the past 2 years and wasn’t sure if I could survive without insurance, but to my surprise I have been doing all right. With more restrictions of insurance companies it is less stress.

    • Couldn’t agree more! Many of the obstacles we are facing in our profession have unfortunately been created by ourselves.Thanks for the reminder of how important it is to make sure patients understand what we are doing to them, but even more importantly, what we are doing FOR them!

  2. I also graduated from Life in 1996. I appreciate you article. I accept insurance at this time, but with copays what they are I am practically a cash practice anyway. Thanks for the insite. Mike

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