How’s your back end?

back-end marketingI hope all of you have had a chance to read the excellent article by Dr. Erich Breitenmoser in the August issue of The Chiropractic Journal. He gives important tips for increasing practice revenue and, at the same time, providing added benefits for patients.

He rightfully reminds us that we work hard to gain our patients’ trust and can expect them to ask about a variety of health and wellness services and products. The temptation is always to give them the least expensive options, but this isn’t always the best course of action.

“When asked, you should recommend what’s best for the patient, no matter the cost,” Dr. Breitenmoser advises. “There’s nothing wrong with recommending certain products, as long as you believe in them and know the company is a trusted name.”

These products can range from nutritional supplements, weight loss products, topical over-the-counter analgesics, and natural foods to orthopedic supplies, mattresses, pillows, backpacks, sports equipment, home gym and exercise equipment, or even ergonomic chairs!

You could, of course, refer them to the local pharmacy for their vitamins or the nearest Wal-Mart for the rest, but it could be helpful to patients if you would recommend or even sell high-quality items to them from your office.

In addition to helping your patients, this is also an ethical and low-cost way to increase your own revenue. As Erich notes: “Back-end marketing is extremely important for long-term practice growth and for the overall success of a sales and marketing venture… Back-end marketing is a very inexpensive form of marketing because the largest expense relating to marketing (new patient acquisition) has already been incurred or absorbed.” (Erich lists four specific reasons why you need back-end strategies, so be sure to read his complete article.)

The addition of multiple streams of income has become all but essential in most private practices today, and I’m not talking only about chiropractors. According to an article on the medical site, Physicians’ Practice: “As reimbursements fall and costs continue to climb, private practitioners across the country are adding an impressive selection of new products and services to their line-up — a direct attempt to diversify and enhance revenue streams. Some sell pharmaceuticals and prosthetic devices. Others offer physical therapy and smoking cessation clinics, along with inhouse elective procedures such as vasectomies, Botox injections, and laser hair removal.”

Thank goodness we don’t have to resort to doing that! But if we don’t help our patients find the health and wellness products that will help complement chiropractic care, they may end up at their MD’s office asking advice. So, take the initiative and give some thought to which products or services your patients would benefit from and consider implementing back-end marketing programs to provide those items.

As Erich succinctly puts it: “To be successful in chiropractic marketing in the long run, you MUST become adept at back-end marketing in your office.”

Air traffic


Have you seen this satellite image on YouTube? It’s a greatly speeded up look at air traffic around the globe over a 24-hour period. Each yellow dot is an airplane in the sky making its way from one point to the next, loaded with passengers and cargo.

It looks very much how I envision the nervous system, with nerve impulses traveling from point to point within the body, carrying their own “cargo” of messages and instructions.

There are busy times and slow times, but the nerve centers never completely go dark.

Can you image the work air traffic controllers have in keeping all this coordinated and running smoothly? They redirect those yellow dots to reduce the risk of accidents.

To me, chiropractors and other wellness professionals who deal in the neurological functioning of the human body are like air traffic controllers. We don’t create the energy but we help it flow as it should and prevent “accidents” that occur when the energy flow is disrupted. Also, like air traffic controllers, we can’t always prevent accidents — pilot/patient “error” is still a factor.

At the risk of belaboring this analogy, there’s another thing we have common with air traffic controllers: we can suffer a great deal of stress because of our “calling.” We worry about our patients, income, profession, and families. We work long hours and battle insurance companies as well as those who favor a medical monopoly over health care. We even, at times, have to deal with bickering within our own professions and organizations.

But our work is so important that we can’t afford to allow ourselves to succumb to stress. We have to take time to care for ourselves, to rest and recharge our mental, physical, emotional and spiritual batteries.

If you’re feeling like an air traffic controller trying to juggle all the planes in that video, you need to back off and take time for yourself. If you don’t, you’re going to “crash.” Which will be more disruptive to your practice and your life: a few days off to relax, or a month off to recover?

One size does NOT fit all!

Doc writing on clipboardThe July 20 issue of Annals of Internal Medicine included a report on a study showing that most medical doctors perform “cookie cutter” medicine and don’t provide patients individualized care based on their specific needs.

The study, by the University of Illinois at Chicago and the VA Center for Management of Complex Chronic Care, was the largest ever to be conducted using actors presenting as patients in doctors’ offices.

“Physicians did quite well at following guidelines or standard approaches to care, but not so well at figuring out when those approaches were inappropriate because of a particular patient’s situation or life context,” said Dr. Saul Weiner, associate professor of medicine and pediatrics at UIC and staff physician at the Jesse Brown VA Medical Center, lead author.

Weiner said physicians need to understand why a patient is failing, for instance, to control their asthma, rather than just increase the dose of the drugs they prescribe. Specific issues — such as the lack of health insurance, the need for less costly treatment, or difficulty understanding or following instructions — must be recognized when making clinical decisions. Inattention to such issues leads to what are called “contextual errors” in patient care.

The study used actors trained to simulate real patients in 400 visits to a wide range of physician practices in Chicago and Milwaukee, including several VA sites. At each clinic, identities were created along with medical records and insurance information for the actor-patients. The doctors had all agreed to participate in the study but were not told which patients were actors.

Unlike real patients, the actors, or “unannounced standardized patients,” consistently adhered to a script, enabling researchers to make comparisons of physicians’ performance across the visits, said co-author Alan Schwartz, a methodologist and UIC associate professor of clinical decision-making.

Four case scenarios, each representing a common outpatient condition, were developed. Each case had four variants — uncomplicated, biomedically complex, contextually complex, or both biomedically and contextually complex.

The actors followed scripts that contained hints or “red flags” of significant issues which, if confirmed, would need to be addressed to avoid error. The actors always started with the same two red flags, but were randomly assigned to respond differently based on the variant.

For example, in a case involving a 42-year-old man concerned about worsening asthma, the actor mentioned both a biomedical red flag (coughing at night) and a contextual red flag (losing his job) that suggested acid reflux and loss of health insurance, respectively, as a key part of the problem.

The study looked at whether the physician picked up on the red flags and implemented an appropriate care plan for each of the case variants.

Not many did. For those patients where individualized care required modifying the “customary treatment,” only 22% of the doctors provided error-free care during a contextually complicated encounter, 28% during a biomedically complicated encounter.

When both contextually and biomedically complications were present, only 9% of the doctors made error-free medical decisions.

Even when no “complications” were present and doctors didn’t have to modify “customary practice,” only 73% provided error-free care.

“To date, measures of doctors’ performance have focused on situations where knowledge of the individual patient is ignored,” said Weiner. “Under those conditions, physicians did fairly well. But as soon as care required more than following an algorithm — finding out what’s really going on with a patient and acting on that information — only a minority of physicians got cases right.”

Interestingly, it didn’t even matter if the doctor spent time with the patient — they still got it wrong. “We expected that if physicians had more time with patients, they would be more likely to individualize care,” Weiner said. “But what we found was that among those visits where physicians did a great job identifying contextual issues and addressing them, they did not on average spend any more time with patients than the physicians who didn’t recognize contextual issues. That was surprising.”

The study found that physicians were more likely to respond to the biomedical rather than contextual red flags even when both were equally important to planning appropriate care. “We believe that reflects the way in which physicians are educated,” said Weiner. “The lesson here is that there has to be a dramatic change in the way we train physicians.”

The lesson we, as non-medical wellness providers, have to learn is that — unlike the allopathic paradigm — one size does NOT fit all. While it’s important to be aware of clinical guidelines and customary practice, we can’t so slavishly follow the guidelines that we overlook patients’ individual needs. Every person who enters our office is unique and we have to approach each encounter as a distinctive opportunity to provide care tailored made for that individual.

Back to school marketing

BackpacksIt’s only July, but the stores are already beginning to stock fall clothes and Halloween candy. That’s your cue to begin educating parents about “back to school” health issues, which chiropractic can address.

The drug industry is already beginning its back-to-school vaccine push, and once more chiropractors and other wellness professionals will be leading the campaign against mandatory vaccinations. You can help by learning the facts about vaccines (a good place to start is the National Vaccine Information Center and sharing that information with patients as well as community members (they have a number of excellent downloadable flyers).

Become aware of the exemptions allowed in your state for school children and protest the forced vaccination of children against their parents’ wishes. Many states are inserting “philosophical exemptions” that permit children to skip vaccines if their families have strong but not religious opposition to the drugs.

It’s also the time of year drug companies pump up their advertising for cold and flu medicines (every season is cold season to them!). In response, distribute information on the studies done on chiropractic and immune function (see the WCA position paper and the lengthy list of references supporting the claim that chiropractic can boost immune strength). Place a big poster with this quote in your waiting room:

“People who receive regular chiropractic adjustments have immune system competency that is 200% greater than those who don’t.” — Dr. Ron Pero, New York Preventative Medicine Institute and Environmental Health at NYU.

Chiropractors need to start a campaign to remind parents that health comes from INSIDE the body — not inside a bottle of pills.

And, of course, there’s the problem of backpacks, which seem to grow each year. I’ve seen kids wearing backpacks that would bring a longshoreman to his knees. The strain they put on back muscles, and the damage they can do to posture definitely involves the chiropractic profession.

CJ Mertz, DC, president of Full Potential Leadership, warned about this problem years ago: “The weight of their packs and the one-sidedness has led to an epidemic of adolescent back problems. The time has come for chiropractic to take the leadership position and save these children from a lifetime of suffering.”

There are a number of excellent resources online for information about backpack safety (such as Backpack Safety America and Posture Pro) where you can download research data. You might want to consider stocking some good backpacks to sell to your patients for their kids. Not only will you increase your revenue, but you’ll be going the extra mile to help protect the children’s health.

And don’t forget to use your local newspaper to spread the word about your efforts. Sending in an article, letter to the editor or press release helps educate the public AND position your office as a true “back to school” health resource. (search Google news for press releases by other chiropractic offices to give you some hints on how and what to write).

The kids may be going back to school soon, but we have to get back to work if we’re to help them get through the months ahead!

“Performance” isn’t only for athletes

In his book, “Chiropractic Revealed: One on One with the Great Masters of a Misunderstood Profession,” editor David K. Scheiner, DC, interviewed a number of well known chiropractic leaders and one of the questions he asked them was, “How do chiropractic and performance relate?”

Performance isn't just for athletesThis is an important question because chiropractic isn’t just about getting sick people well. It goes far beyond the traditional ideas of health and actually has a powerful impact on the personal total well-being: physical, mental and emotional — all the elements that go into “performance.”

Parker College President Fabrizio Mancini gave the near-perfect answer when he stated: “One of the things that appeals to me about our profession is that it deals with function, which is a very similar word to performance. The reason why so many high executives, celebrities, and sports people use chiropractic is because they recognize that they do perform better. For the last 20 years, I always get adjusted before I give a speech. I never know in advance what I’m going to say and I believe I perform better when I’m adjusted. I get adjusted once or twice a week because of my travel experience and physical activities.”

It’s easy to sell “performance” to athletes because, in the chiropractic context, we tend to associate the word with some kind of physical feat. There’s even some research to support the benefits of chiropractic for athletes, such as the study published last year in the Journal of Chiropractic Medicine. Researchers studied 43 golfers and those who received chiropractic care hit their balls farther. In another study, 50 athletes were tested and the group that received chiropractic adjustments showed significant improvement in all 11 tests used to measure athletic ability, including agility, balance, kinesthetic perception, power, and reaction time. A study in the Feb. 2006 issue of the Journal of Manipulative and Physiological Therapy showed a significant improvement in quadriceps muscle strength in subjects receiving chiropractic care (good news for those athletes needing to lift large objects like opposing players).

Okay, so none of these studies are going to win the Nobel prize in medicine, but they confirm what we’ve seen in chiropractic offices for more than a century — chiropractic is great for both professional and weekend athletes.

But, as Dr. Mancini pointed out, athletes aren’t the only ones who “perform.” Executives have to hit a homerun at board meetings; mothers need to make a slam dunk every time the kids call for help; taxi drivers have to have the quick reflexes and stamina of an Indy 500 driver; computer operators require the concentration of a gymnast (and knowing how they hunch over their computers, most of them probably pull more muscles than a linebacker). Even giving a speech, as Dr. Mancini notes, is a performance that can be enhanced by chiropractic.

We can’t put a sign on our door saying we help improve public speaking skills, but in our patient and public education information we can make sure we explain that chiropractic does far beyond what we normally think of as “therapy” or “medicine” (despite the titles of our research journals). Nobody needs to be sick or in pain or exhibit a list of symptoms to be relieved. Healthy, active people who want to perform better in all aspects of their lives can benefit from chiropractic. You just have to make sure they know it!

Marketing doesn’t have to be pricey

Inexpensive marketingAs a general rule of thumb, you should be spending about 9-10% of your expected yearly gross revenue on marketing and advertising a new private health care practice. If you need a big spurt of growth, make that 10% of your current annual gross income, 7-8% for moderate growth, and 5-6% to maintain your existing patient base.

Those percentages get eaten up very quickly, given the cost of the almost obligatory (though of questionable value) Yellow Page ads; print or broadcast media ads; promotional and marketing material including flyers, mailings, brochures, etc.; and the marketing of open houses, health fair booths, and other activities and events.

That helps explain why many wellness professionals turn to the internet. Look at some of the press releases posted by chiropractic offices online at 1888 Press Release and PR.com. They announce almost everything — changes in staff health, health lectures, new equipment or services, notable events, etc.

Press releases can (and probably should) be posted on press release distribution websites, but to take full advantage of free publicity, they should also be sent to newspapers in your area — along with high-quality photos showing your office in action or a professional portrait shot of the person highlighted in the release.

While press releases should be a primary part of your marketing campaign, you don’t want to submit material that sounds like an advertisement.

Examples:

“The Acme Chiropractic Clinic will hold a public educational forum this Sunday on how a balanced diet and chiropractic care affect your immune system and may help prevent colds and flu this season.” Here we have true press release material. It serves the purpose of publicizing your practice and offers a needed service as well.

Then there’s this: “Say well with Acme! This Sunday, the doctors at Acme Chiropractic Clinic will tell you all you need to know about how coming to us can boost your immune system — and keep you from getting colds and flu this season.” This belongs in an advertising section. An internet site where you pay to have your press release posted might accept it, but most print publication editors will reject it as being too promotional for editorial copy.

Also, be careful how you word your press release so it doesn’t violate any of your state’s regulations. Thankfully, chiropractors have fewer limitations on advertising than medical doctors do, but press releases could be classified as “marketing and advertising” by state boards, and be subject to the same restrictions.

You can write your own press releases if you have the time and talent. Still, it might be best to engage the services of a professional marketing company that can coordinate the releases as part of your overall message. If you decide to go that direction, be sure to choose one that’s thoroughly familiar with your particular health care approach. A company that really doesn’t understand what you do will obviously have difficulty trying to explaining it to the public.

For more information on writing press releases, see PRWeb and WikiHow.

In these hard times

Hard times a matter of perspectiveI don’t think I’ve talked to a single practitioner lately who hasn’t complained about the bad economy, the “hard times” or the financial crisis (in their practice, the country and/or the world). Patients aren’t coming in, revenues are down, they can’t afford the rent, they’re facing ruin.

In the past, I would’ve joined them in a good moan, lamenting my own financial losses and piling my worries on top of theirs.

Not any longer. I’m more and more convinced that this type of poverty talk is self-perpetuating. Call it the power of concentrated thinking, the law of attraction or whatever you want, the more we focus on lack and scarcity, the more we experience them.

The opposite is true as well. When we choose to think about abundance and success, we draw that to us.

There are many explanations for why this happens, and it may be as simple as the fact that our words and thoughts program our subconscious, which (even though we may not be aware of it) determines our actions. If we’re convinced that times are tough and our business is declining, we’ll most likely make decisions or take actions consistent with that belief. We’ll sabotage our own efforts without even realizing it.

Scientists have determined that the subconscious mind is 30,000 times more powerful than the conscious mind. The conscious mind works at slow speed, processes information at a mere 40 bits per second. Operating at 40 million bits/sec., the subconscious is a rocket booster in comparison.

Motivational guru Tony Robbins says that “All personal changes must take place at the subconscious level.” I extend that to professional changes as well. If we want success and wealth, we have to drill it down to our subconscious level that we can reach those goals. We have to replace our negative self-talk with positive reprogramming.

Personally, I couldn’t just jump from “woe is me, the economy’s rotten” to “I’m a magnet for money” in one leap. I had to take it a small step at a time. When I looked at things realistically, I had to acknowledge that many practitioners are hurting financially right now. But there are also doctors whose practices and businesses are actually growing and becoming more prosperous every day. The fact they’re doing it proves it can be done. So, it was logical to think that I could do it, too. One step closer to positive thinking.

Also, while it’s true that many patients are putting off needed care because they, too, are infected by the rampant poverty consciousness, despite the “recession” these same people are spending more on things like consumer electronics (up 12% this year over last year), chocolate (Hershey Co. profits in the first three months of 2009 surged 20%), wine (U.S. sales of California wines up 2% in 2009), and even gifts for their pets (an 11% increase according to an Animalfair.com readership study).

Whether they spend their money on health care or rhinestone-studded doggie collars is a matter of priority, not limitation. And if they’re not making health and wellness a priority, we share in the blame because we’re not educating them as well as we could.

Two steps closer to positive thinking.

Once I convinced my conscious mind of these two facts, I had to work on getting them embedded in my subconscious. That took repetition and vigilance. I constantly caught myself replaying the old tapes about the “hard times” we were in. Each time, I mentally “erased” that thought and replaced it with one of abundance and prosperity.

As my subconscious mind gradually accepted the new “reality,” my actions began aligning with that reality and I made decisions based on optimism rather than fear. It’s still a work in progress, but I’m seeing the results already.

Ask yourself whether you’re deriving any benefit from talking about how you can’t afford things, aren’t doing well, and are having a tough time in this bad economy. If you’re not, what would it cost you to try a more positive outlook for a while?

Ever think of making house calls?

The recent economy has forced many health and wellness practitioners, including chiropractors, to re-evaluate the way they offer and charge for their services. We’re having to become much more innovative in order to continue providing care to our patients and still pay our bills. One of the more interesting ideas being tried by some doctors is the return of the house call.

Doctor making house call

'Country Doctor Ernest Ceriani Making House Call on Foot in Small Town.' Photo by W. Eugene Smith / Life Magazine Archives.

Up until the 1950s or so, many (if not most) medical doctors made house calls in addition to seeing patients in their offices. That was before they felt they needed $2 million in equipment before they could write a prescription for antibiotics. When medical went high-tech, the little black bag wasn’t sufficient, so house calls went out of fashion. According to a report in the Clinics of Geriatric Medicine, house calls accounted for 40% of physician encounters in 1930, 10% by 1950, and less than 1% in 1980.

The really interesting thing is, in recent years that figure’s been creeping back up and now hovers around 5%. Apparently, many MDs are seeing the wisdom of seeing their patients at home. Some even do it full time in order to rid themselves of their high-rent offices, expensive equipment, and costly staff. Others offer house calls in addition to office hours in order to provide services for elderly, bedridden or housebound patients, or even busy parents who can’t get to the doctor’s office.

Chiropractors appear to be even more willing to try this creative approach to patient care. One DC used his blog to explain to patients that that he was going to start making house calls. He totaled the time it takes for a patient to have a regular in-office appointment and, with the preparation, driving, and waiting, it came to about an hour just to see the doctor for 5-10 minutes. “There are tools that I will not be able to take with me,” he explained to patients, “but as a chiropractor and a massage therapist all I really need is my hands. I have my portable table …

so, if you need a chiropractor or massage therapist, but don’t like the hassle of driving to an office and waiting to be seen, give me a call. Or if you know someone who is housebound due to pain. I will also be working with hospitals to treat people in urgent care centers and emergency rooms. I hope to be able to bring chiropractic to those who want it more conveniently or who can’t get to me.

Others are trying a variation on house calls and setting up mobile offices, complete with tables, selected equipment, and other supplies. In New Jersey, for instance, Demetrios Kydonieus, DC, drives around the area in his “Wellness Wagon.” Daren Bethia, DC, offers services “to make receiving chiropractic care convenient to the sick and shut in, the busy small business owner, the stay at home mom who is busy with the kids, those with limited transportation or anybody who needs immediate treatment, but can’t make it to our office.” He offers both chiropractic and personal training sessions to people in and around Charlotte, NC.

Obviously, mobile offices and making house calls isn’t for everyone and it’s too early to tell if they’re successful alternatives to traditional offices. Still, these are definitely interesting ideas that we’ll be seeing more of in the future. I invite anybody who’s tried either of them to let me know of their experiences.

Is the profit motive wrong?

By Terry A. Rondberg, DC

American dollar bill in white porcelain mortar and pestleThere’s an aura about wellness providers, some indescribable sense that they’re morally and ethically superior to medical doctors. Frankly, I agree! But I think sometimes we take that image of altruism too far when we shy away from having (or admitting to have) a profit motive in our practice.

Jasson Urbach, speaking of South Africa’s enormously popular Vitality program, noted: “Innovative wellness programmes, such as Vitality, that are driven, not by altruism, but by the profit motive, are an important method of tackling the increasing burden of chronic disease across the globe.”

There’s nothing wrong with making a good income by helping people reach new heights of health and wellness, and it’s time we stopped thinking of profit as something that sullies our image. If you want to be totally altruistic, open up a free clinic and give your services away for free. If you’re independently wealthy or have a spouse to support you and your family, that might be an option. Otherwise, we have to charge for what we provide.

The problem isn’t with profit. It’s with making patient and client health care decisions BASED only (or even primarily) on profit.

Should a doctor of chiropractic recommend weekly visits only because he or she wants to buy a new car and needs the extra income, that’s WRONG. It’s exactly the same as surgeons performing unnecessary procedures just to pad their checkbook.

But if those weekly visits are honestly going to help the patient, then it’s the RIGHT recommendation, regardless of how much or how little the doctor charges for those visits.

The same goes for other products and services provided in your office. Do you REALLY believe in the efficacy of the vitamin supplements you’re selling, or are you doing it just for the money they bring in? Have you personally tested the pillows and mattresses you’re recommending or are you selling them because you get a nice fat commission?

If you can honestly say that you recommend and/or sell ONLY those services and products you feel are beneficial, then why be ashamed to make a profit on them? Can your patients get the same thing for free elsewhere?

Making money from health care has gotten a bad rap thanks to the obscene profits being made by drug makers and some medical providers. Yet, when you really examine the issues, the fact that they make profits isn’t the real problem. It’s the fact that they put profits before the welfare of the public. They make billions of dollars selling overpriced and dangerous pills that don’t cure anything, performing unnecessary surgical procedures, and recommending and administering useless (and even harmful) vaccines.

Do you really think you’re in the same category because you charge a fee for your services, or give patients the opportunity to purchase helpful products in your office? How many of your patients work eight hours a day for free?

You have two choices:

1) Embrace the profit motive and build a high-volume, successful and prosperous practice that can provide wellness care to THOUSANDS of people.

2) Go broke, close your doors, and be unable to help anyone.

By choosing a wellness practice, you’ve already proven that you aren’t in it solely for the money (a successful drug sales rep can easily make more money than a doctor of chiropractic, acupuncturist, or other non-medical health care provider!). So, hold your head up high and make your practice a super success!

7 ways to green up your office

By Terry A. Rondberg, DC

Being Green - By Terry A. Rondberg, DCMost practitioners interested in the health of the human body are also interested in the health of the planet. The trend toward “green offices” is a natural direction for all wellness providers and it’s really not as difficult or expensive as you might think.

I’m not talking about putting solar panels on your roof or wind power turbines in your parking lot. But we can all accomplish a lot just by looking around the office and seeing what items are “so 20th century” as the kids say.

Here are 7 top ways to green up your office:

1) Switch office supplies. Everything today is available in a “green” version: recycled paper, mercury-free rechargeable batteries, re-manufactured ink cartridges, biodegradable and non-toxic cleaning supplies, even office furniture made from eco-friendly and recycled wood products. They may cost a little more, but that’s a small price to pay for living in harmony with your principles.

2) Watch your lunchroom. You’re not still using Styrofoam cups at your water cooler, are you?  Is your staff lunchroom stocked with plastic plates and cutlery? Why not switch to corn-based products that are easily recyclable and biodegradable? Reusable items are best, but if you’re going to use disposable products, make sure they’re not only MADE of recycled materials, but that they can be recycled (and provide a recycling bin).

3) Provide a “green” kids’ area. If you cater to children in your office, set up a small “kids’ corner” with safe, educational toys (preferably made from organic or recycled material). My favorite source is Hazelnut Kids, but the Internet is filled with small companies specializing in this type of product.

4) Go paperless (or almost). When computers were first equipped with hard drives, experts predicted we’d all have paperless offices within a few years. It didn’t happen and I doubt if it ever will, but we can reduce the amount of paper we use and toss every day. Print hard copies only if needed, and reuse the other side of the sheet when appropriate (be careful about privacy issues, though). Naturally, use recycled paper made from a high percentage of post-consumer recycled content.

5) Switch to LED bulbs. I do NOT think fluorescent bulbs (CFL or otherwise) are a good idea. They will ultimately add tons of dangerous mercury to our landfills. If you’re going to switch to a more energy efficient bulb, invest in LED bulbs or wait for the next generation of bulbs, like electroluminescent lighting technology.

6) Clean “green.” Make sure your cleaning service uses environmentally friendly cleaning products. Toxic chemicals like chlorine bleach are not only bad for the earth but can leave caustic residue on surfaces in your office — not an ideal “wellness” environment. In 1989, the EPA estimated that the fumes produced by common household cleaners were three times more likely to cause cancer than other air pollutants. Another study (American Journal of Respiratory and Critical Care Medicine, 2007) found that 15% of all asthma cases were actually caused by exposure to cleaning products. Get rid of them!

7) Eat “green.” You can’t tell your staff members what they can or can’t eat for lunch or during their breaks, but try to encourage them to make healthy choices, not only in the food they consume but in the packaging it comes in. And instead of putting a jar of sugar-laden candy on your counter, try an all-natural, healthy treat.