Bigger is not always better
by Freelance Writer Beverly Knight
Conventional wisdom tends toward the “bigger is better” philosophy, but for Josh Pulver, D.C., the opposite has proved true. When he graduated from Sherman in 2004 and returned to his home state of Michigan, he opened Pulver Family Chiropractic in a 2,200-square-foot existing office. As soon as the lease was up on the office space, he moved to a 1,400-square-foot space. Then in June of 2011, he downsized yet again to a 600-square-foot office in Petoskey, Michigan.
He likens the magnitude of the transition to that of someone moving from a 2,000-square-foot house to a 1,000-square-foot apartment. It takes some organizing and eliminating to make the move work smoothly.
“A move is always going to take longer than you think,” Pulver remarks, adding that the first time he moved, he allowed himself six weeks to get everything ready. “But this time the deadline I set for myself was shorter and proved to be difficult to meet. I totally underestimated how long it would take to get everything ready.”
Still, he was determined to re-open on his July 6 deadline, even if he hadn’t yet put the final polish on the carpentry and painting in the new space. The one thing he learned, he says, is that “just because you’re moving into a smaller space doesn’t mean it will take you less time to get it ready.”
Pulver had an advantage that many young chiropractors do not. He never considered a career other than chiropractic, learning early from his father, Brian (also a Sherman graduate), the value of chiropractic care. “I was born into chiropractic. It was ingrained into our psyches,” Pulver says of what seemed to him a common sense approach to health care. “I learned that chiropractic was what you sought if you wanted to be healthy. If we were happy and doing well, we went across the street and got adjusted. If we were run down, we got adjusted. If I was getting ready to pitch a Little League game, I got adjusted. If I needed to run a mile, I got adjusted.”
And that lesson was not only conveyed to him, but to his brother Levi who also graduated from Sherman, and to his younger brother who is currently enrolled at Parker in Texas. His father is now retired from practice, but Levi has an office in southern Michigan, only four hours away.
Now Josh and his wife, Robyn, who is the office manager, have learned the value of contracting their work space. Instead of two examining rooms, Pulver put both tables in one. He also decided to eliminate two things that had consumed much of his time and space: processing insurance claims and in-office x-rays.
Making the office a cash-only operation was the key to other changes necessary to make the smaller office work efficiently. “The cash practice makes everything easier,” Pulver says of the decision he made based on the fact that more than half of his patients didn’t have insurance and others couldn’t meet their large deductibles. After analyzing his office procedures, he says, “It was clear that we were structuring everything based on a minority of our practice.”
“When I got rid of the x-ray machines, I got rid of 300 square feet of space requirements,” Pulver says of his decision to refer his patients to a nearby radiology facility when x-rays are warranted. “I not only saved space, but I also made the office more efficient.”
And, he’s found, with a radiology center less than a mile away, his patients can walk in, get an x-ray and have it posted to his server by the time they can get back to his office. “If a patient is concerned, before I lay my hands on him, I send him down the street and get the visual confirmation,” Pulver says. “Not only am I saving space and making my office procedure more efficient, but someone else is paying the expense of owning and operating the equipment.”
The solution, he says, to making the smaller space work is careful planning. He worked over the floor plan before he made any decisions about how to utilize the new space. That planning has paid dividends in time saved. “Because everything is in one room now, I’m able to see people more efficiently. So when I get congested with walk-ins, it works much better than it did in the bigger office,” Pulver says, noting that surprisingly, he sees the same number of patients in the smaller space that he did in his larger one. “Now the office is much easier to navigate and the flow of traffic is better.”
And he can now focus on his goal for the future. The father of a toddler wants to become certified in chiropractic pediatrics. “There is a need for more pediatric chiropractors as many more people are embracing the wellness lifestyle,” Pulver says, remembering his own early introduction to chiropractic. “I believe that chiropractic can have an even greater impact on a young child than on a fully grown adult.”
As he grows his practice and seeks further certification, there is one thing he plans to keep in mind: “You don’t need as much space as you think you need.”