But Dahan cautioned that an integrated practice is not for everyone. "We set a foundational premise: you must be well-anchored in chiropractic philosophy, because if you are not, as soon as you bring in an MD it will become a medical clinic," he said.

Mark Sanna, president and CEO, Breakthrough Coaching, Vernon, N.J., suggested that practitioners should "embrace a diversified business model by delivering sought-after wellness services. The major question facing chiropractors as we confront the uncertainty of health care reform is: Where does chiropractic fit into the substantial market being created by the baby boomer generation? As the baby boomers exert their market forces on the health care delivery system and the chiropractic profession confronts the pressures of health care reform, one choice becomes obvious. That choice is to adopt a business model based upon delivering wellness services along with the traditional chiropractic services of examination and adjustment."

Steps to Take Right Now to Win in 2011

Whether you want to remain as a traditional solo practitioner or want to expand your services with other health professionals, our experts believe there are several items that should be at the top of your "to-do" list for 2011.

Make time to build: "The single most effective habit you can develop to successfully manage your practice, after hiring a professional coach, is to establish regularly scheduled practice building hours," Sanna said. "While almost every doctor I speak to has established regular hours for patient care, very few have established similar hours for practice building." 

Practice potential: Sanna also pointed out that 2011 will mark a moment in time when electronic health records (EHRs) move to center stage for the profession.

"You have probably heard about EHRs and the $44,000 incentive. The first wave of certified EHRs will hit the chiropractic marketplace the first quarter of 2011," he said. "There is a considerable amount of income on the table for your practice and this is magnified if you are a multi-provider practice, as the $44,000 in EHR incentive payments are per provider.

"However, you must achieve 'meaningful use' of a certified EHR program for 90 consecutive days starting in 2011 in order to qualify for the full $44K," he said.

Sanna emphasized this will require you to make your EHR program decision by mid-year to allow adequate time for training and implementation.

"Did you know that you could be receiving a bonus payment of 2 percent of your Medicare Part B billings by adding a few simple coding and documentation steps to your current office procedure?" he added. "You deserve every dollar the government has agreed to pay you for the excellent care you provide. Make this the year that you begin Physician Quality and Reporting Initiative (PQRI) reporting on your Medicare patients and start receiving an additional 2 percent reimbursement on your allowable Medicare services.

"In fact, with the passage of the new Health Care Reform Act, physicians who don't comply with reporting these simple Medicare quality measures by 2015 will actually have their Medicare reimbursement decreased."

Insurance panels matter: With Obamacare poised to begin taking effect (barring congressional intervention), Dr. Peter G. Fernandez strongly suggested that doctors "get into as many insurance panels as possible."

"The president's new health plan will result in 95 percent to 98 percent of the American people being covered by health insurance. If you're on their insurance panels - you'll get paid. If you're not - you won't be. You had better be payable," said Fernandez, whose DrFernandez.com consulting firm is located in Seminole, Fla.

On the expense side of your ledger, Fernandez offered this practical advice: "In 2011, reduced insurance reimbursements will result in less patient income. If your overhead remains high, and your patient income is low, your practice will be out of balance. If this happens, your practice overhead [will need] to be adjusted."

The power of marketing: While marketing alone is unlikely to create a sustainable, growing practice, Fernandez emphasized that it still must be a substantial part of your 2011 strategy.

"When your marketplace changes, you need to change to adapt to the changes," he said. "Make 2011, the year you network and market yourself like mad. You'll need more new patients per year to make up for the insurance companies' smaller patient reimbursements. The more people who know about your practice, the more patients you'll attract."

And "marketing" isn't simply a question of advertising and making the rounds of the local service groups in your community, Maule (Integrity Management) pointed out. It also should include giving back to the community.

"Look at your own community and its particular needs, and then donate time and service," he said. "When I see a doctor giving of themselves for something other than themselves, that is the doctor I want."