Chiropractic Practice Management: How To Rescue Your Case Average

Chiropractic Practice Management: How To Rescue Your Case Average

*The following is an actual transcript for Chiropractic Practice Management: How To Rescue Your Case Average. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.*

Chiropractic Practice Management: How To Rescue Your Case Average

Hello everybody, and welcome to Thrive In Five. I’m Dr. Dennis Perman, and I’ll be your chiropractic coach for today. Two weeks ago, I spoke about the power of a strong case average. Case average is a statistic that most doctors don’t pay that much attention to, because in order to get it, you have to do a little bit of math to figure it out, but it’s worth it.

Your case average is the amount of money you make on a typical case, and the way you discover it is by multiplying your OVA, that would be the amount of money that you make per visit, times your PVA, the amount of average visits you see a typical patient. So your case average is found by multiplying your PVA by your OVA, and it tells you a measure of how the practice benefits from having that patient there. This is an important way to compute your profitability and set your goals.

Last time we talked about the power of a strong case average. Today we’re going to talk about how to rescue your case average if it needs it. We’re going to talk about the practice of a Dr. Cody, let’s have the first slide, who sees 15 new patients a month in a five day work week, sees 85 visits a week, and collects $13,000. This doctor, Dr. Cody, wants to grow 50%, and he’s highly motivated to do so.

Let’s take a look at what he might be able to do in order to accomplish that. Well, currently at five days a week and 85 visits a week, he’s seeing 17 patients a day, or 340 visits a month. On 15 new patients divided into 340, that tells us that the average patient stays 22.7 office visits, and at 13,000 over the 340 office visits, that tells us that Dr. Cody is collecting $38 a visit. This means that Dr. Cody’s case average is 22.7 times 38, PVA times OVA, or $867.

The total annual income on 15 new patients a month, or 180 new patients a year, is $156,000. Dr. Cody wants to grow 50% plus. Let’s see how we can do that. He can increase his new patient flow from 15 to 22, that would do it, or he can increase his PVA by 12, from 23 to 35, that would do it, or he can increase his OVA from 38 to 57, $19, and that would do it. The problem is those are all pretty heavy lifts. In order to take your PVA from 23 to 35, that’s a pretty heavy lift. In order to take your OVA from 38 to 57, that’s a pretty heavy lift. And in fact, if he’s at 15 new patients, trying to get seven more, it could be a lot of work. So how can we use these numbers to figure out an easier and better way to get there?

Well, the way to do it is to use both PVA growth and OVA growth. This way we only have to take the PVA from 23 to 30, we only have to take the OVA from 38 to 43, and that will increase the case average from about 900 to about 1,300. Now how could Dr. Cody do this? Well, you can increase your PVA by improving your Report of Findings and your recommendations, you can improve your patient education, or you can improve your re-examining report.

You can increase your OVA $5 by simply raising your fee $5, or by improving your collections ratio, or by building some backend systems that raise the OVA $5. This way, instead of forcing the gears on having to take any one of these parameters and forcing it to a much higher level, we can grow each of these modestly, and it dramatically changes the case average. It rescues the case average. This is going to grow the doctor’s practice from $13,000 a month, $156,000 a year, to $19,500 a month, a growth of 78,000 to $234,000 a year, just by improving the ROF and the patient education, or just by raising the fee $5, or improving the collections ratio.

It’s really important to understand that these numbers don’t just drop out of the sky. You can use the Practice Growth Calculator to be able to figure out what your numbers are, and by doing so, that sets you in motion to be able to figure out where are the glitches in your practice? What is it that you have to change or improve in your practice to grow 20, 30, 40, 50% or more?

Go to the Practice Growth Calculator. The link is at the bottom of the screen here, that’s, and you’ll be able to get access to the Practice Growth Calculator, and don’t just do it once. Set a variety of goals and figure out what it takes in order for you to get there. Then, really important, create your one-on-one consultation with Dr. Bob and myself, and get the depth of understanding that you need, not only to repair a faulty case average, but to establish just a better practice in all terms of measurement.

We’re planning our first major live event in a year and a half in Tampa. We did have a seminar in Orlando in May, and it was so successful, it was a sellout. We know that we’re going to be able to do a fantastic job entertaining you, educating you and empowering you at SuperConference 2021 in Tampa on October 21st, 22nd and 23rd. We have awesome guest speakers. They’ll tell you about neurology, they’ll tell you about case management, they’ll tell you about social media utilization, they’ll tell you about using better coding to be able to establish a better relationship with third party payers, you’ll learn about risk management.

This is a very thorough program, and it’s designed to make sure that you get everything you need in order to unmask your practice to take the only logical next step to massive practice growth. SuperConference 2021 is going to give you the rules of the game that only the most successful practices know, so please go to That’s, and join us because you’re going to get an incredible education, you’re going to get inspired, and you’re going to get to hang out with some of the finest doctors in the profession, who are doing everything that you need to do in order to create the practice of your dreams.

We’re looking forward to seeing you there. It’s my pleasure to serve you on Thrive In Five. I’m Dr. Dennis Perman for the Masters Circle Global, signing off for today.


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