observations from our travels in the world of chiropractic

Random header image... Refresh for more!

Tent Poster – Wim Hoff

“We have healing power inside us.  But we block it because we feel we need to take pills and become dependent upon outside forces…

We have an inner doctor.”

~Wim Hoff





For a printable copy of this tent poster click link: Wim Hoff

June 23, 2017   No Comments

Patient Education: A Simple and Fun Method

Patient education is definitely a clinical function.  But… it is also good marketing.

And note that your entire office IS the marketing department and each team member has a marketing role.

To help everyone on your team better participate in patient education, use this simple and fun method:

Get a whiteboard and place it where patients can see it.  Assign someone to write something on it each day so that your patients, or you, can comment on it.

For example, you could write:

  • What does this mean?

“Pain is the last to show
… and the first to go.”

This will be a cue for the doctor or a team member to talk to your patients – and can also provoke your patients to talk to you.

Here are some other examples:

  • “What does a chiropractic ADJUSTMENT do?”
  • “How is pain like an iceberg to your health?”
  •  What does A.D.I.O. mean?

At your morning team meetings, or weekly meetings, go over each subject so everyone has a better idea on how to educate patients on the topic.
For active PM&A members, go here for a more complete list:  PMAmembers.com

June 20, 2017   No Comments

New ABN Form Effective 06.21.2017

New ABN Form and Implementation Instructions

Frequently asked questions and answers for the ABN form

New ABN English 2017(PDF) – Form CMS-R-131 goes into effect June 21, 2017. You may begin using the new one now(April 2017), but on and after June 21 per CMS, you may not use your current ABN.

New ABN 2017 (DOC) Form CMS-R-131 goes into effect June 21, 2017. You may begin using the new one now(April 2017), but on and after June 21 per CMS, you may not use your current ABN.

New ABN_Spanish 2017(PDF)-Spanish Version Form CMS-R-131 goes into effect June 21, 2017. You may begin using the new one now(April 2017), but on and after June 21 per CMS, you may not use your current ABN

ABN-Use(Doc) How and when to use the Advanced Beneficiary Notice for Medicaid Services

Script-for-ABN-form(DOC)– Script for explaining the form to the patient

Final Revised ABN-2012- Advanced Beneficiary Notice for Medicare Services – expires June 21, 2017.

June 20, 2017   No Comments

Has Your Office Been Target by Medicare for an Audit?

Ms. Lisa Barnett with Petty, Michel and Associates specializes in preventing Medicare Audits. She has helped those who have already been targeted find a fast and safe way out of trouble.

You are not alone…. Things do Happen…..
You are busy and possibly you have overlooked a certain requirement. Your computer has gone through updates and you have not kept up. Or possibly your documentation is simply inadequate in the eyes of medicare or the government.

Whether you are faced with a prepay audit or a post payment audit. I can help !

With 10 years of experience in the chiropractic industry and with documentation; and a chiropractic advocate for 30 years I care and I want to help.

Call today for your complimentary phone consultation and record review. 920-334-4561

June 9, 2017   No Comments

The 3 Key Ingredients to Motivating Your Chiropractic Team

Most of your staff are not engaged in the success of your office.  Most of them JUST DON’T CARE. 

At least that is according to a 2015 Gallup report that interviewed over 80,000 working adults.

The report showed that there are twice as many “actively disengaged” workers in the workplace as there are “engaged” workers who like their jobs.   The percentage of U.S. workers in 2015 considered engaged in their jobs averaged 32%. The majority (51%) of employees were “not engaged,” while another 17% were “actively disengaged.” (“Actively disengaged” means that they are actively sabotaging their work.)

But let’s say your office is different, which I am sure it is.  You are motivated enough to read this article and I am sure that is reflected by your team as well. But all the same, take a look with me at the level of motivation of your office.

How was your last team meeting?  Were you there? Was everyone sitting on the edge of their seat and contributing new ideas and plans on how to reach new goals in the office? Or, were most everyone pretty silent?

Sure, your employees smile and look busy when you are around, and often work hard and they do care.  But really, how much?

What would your office be like if the motivation, creativity, and level of pro-activity was always very high at “10,” or even ranged from 7-10?  If they felt that it was “their” business, where they took responsibility for the quality and quantity of outcomes, and regularly worked to improve the business – and themselves?

I have been reviewing the subject of motivation for some time, from my own experience over the years and from what social scientists have reported.

I have incorporated certain principles into a new system of business management that are specifically designed to unleash everyone’s innate motivation – including business owners like you!

Motivation is the foundational in a chiropractic office, or dental office, acupuncture – even with therapists and other service firms. It is a bedrock for any healthy practice and business.

Here is one very useful principle specifically about motivation and how you can use it to generate more engagement – and productivity — with your team.

3 Goals System of Business Management: Principle #5

Self-Determination and Motivation

Everyone wants their own sandbox to play in.

You do. This is one of the reasons you went to school – and why you started your business.

We all want to have something that we can call our own where we can create and demonstrate our competence. What we get in return is feedback that we can do something good, that we have power, that we can make something beneficial happen, that we can … make a positive difference.   If only to ourselves, we can say: “Look what I did. I did this. This is my creation.”

You can see it in children, for example, when they bring you their colored scribbles on crumpled pieces of paper to proudly show you their great work of art.  This is their sandbox.

Of course, we all work for money. But we also have deeper motivations that if tapped into and nurtured, can be very powerful.  By harnessing these motivations, and then linking them with others who have a shared goal, we can create a dynamic team driven business that is very profitable.

This has been explored by social scientists who have studied what has come to be called Self-Determinism Theory.  I have also seen it in action. Essentially, it states that we all have innate drives and inherent needs that motivate us to be more self-determined rather than determined, or controlled by, outside forces.

External motivation, like the fear of being fired, can only motivate us so far. Threats, criticisms, negative reinforcement may produce short term action, but in the end, they demotivate, or worse.

The level of employee motivation has a tremendous influence over the success of your business. 

An unmotivated staff, one that only becomes engaged to the level of “I will perform just good enough so that I don’t get fired or criticized,” will weigh the office down.

Self-Determinism Theory (STD) has three components, all of which easily apply to your business. These are:

  • Autonomy
  • Competence
  • Relatedness.

And by the way, while reading this, consider how this also applies to you as well!


You do not want your treatment plans second-guessed by a clerk in an insurance company. Neither does your front desk want you breathing down their necks about where all the patients or practice members are, or why they used the blue pen.  You should train and educate your team, but then get out of their way and let them succeed or fail.

Think of helping a child ride a bicycle. Sure, they will need your help for a while. A push now and then. Perhaps some training wheels. But you will have to let them fall down a few times and allow them to get the courage to get back on the bike and succeed. You can continue coaching them to improve, but you must let them go.

Even if you see employees appearing idle, or having brief personal discussion with another employee, back off. Tolerate minor errors. Give your team some rein.  Come back around later to coach them and train them to improve. Mostly educate them on the mission of the office and of their roles, and get them to understand what outcomes they are supposed to be producing. Once they see that the statistics measure their performance, they will be more self-directed and want to do all they can to win the game!

We all want to be free to create our own enterprises, even if we work for someone else. As long as what we do is in line with the purpose or mission of the business and our role, there should be no problem.  This helps us demonstrate our competence, which is the next element of Self-Determined Theory.


Doing a good job, all by itself, is its own reward. It pushes away self-doubts and shows us, and others, how good we really are. It is positive reinforcement.

And the better we can do a good job, the better the results will be, which demonstrates to us just how awesome we truly are!  Plus, as we increase our skills, we also will find that our duties are easier to perform.

Your team wants to improve their skills. Help them do so.

Sign them up for seminars, webinars, give them monthly reading assignments, and give them a coach or three of them.  But this has to be done in conjunction with your supervision. You will need to guide them through the training so that they see how it applies to their roles and the business as a whole. Quiz them on what they are learning and have them give presentations to the team on what they are learning.  The old maxim applies: “to teach is to learn twice.”

And where possible, make sure they earn certificates and can wear pins or insignia that testify to their competence. This goes along with Game Theory – people win at one level and then want to go to the next level. They want their “badges.”

Business owners throw staff into their jobs and expect them to produce with little or no training. Without exception, the offices I have seen that provide more training and coaching for their team — do better.  Companies spend an enormous amount on employee training. $161 Billion in the U.S. last year (trainingindustry.com). And, it pays off.

One study showed a comparison between car companies and how many hours they trained their new employees: Japan spends an average of 364, Europe averages 178, and the United States – 21 (Pfeffer –The Human Connection).

And you can guess which country has cars with the best frequency of repair record.

Children want to be super heroes and wear their capes.

Don’t we all!


This is the feeling of being connected – and there are two aspects to this.

Family. First, “relatedness” is the feeling of not being left out of the “loop” and of being included. Staff meetings help with this as does the general work environment. This is the sense that we are in this venture, job, and profession together. That we are part of a family.

Keep your team involved with your decision making. Give them some of the issues you are dealing with and encourage their input. They are stakeholders – it is their office too!

Greater Purpose. The other aspect of relatedness is that people generally want to be associated with a greater purpose. The more that each member can connect to the greater purpose of the group and make it their own, the more motivated they will be. Taking it a step further, if employees have higher goals of their own that coincide with the organization’s and they are allowed to pursue them within the organization, there would be no reason for employees to work anywhere else.

Train your team, let them own and creatively improve their own areas – and help to do the same for the entire office. Nurture camaraderie and a spirit of family – and always remind them – and yourself — why we are doing what we are doing.

Do this, and not only will your business be more successful, but you too will be more motivated and have more fun in the bargain.

#   #   #

Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. Ryan, R. M. & Deci, E. L. (2017) and Why We Do What We Do: Understanding Self-Motivation Paperback – August 1, 1996
© Edward W. Petty,    From the upcoming book: “Three Goals:  A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.”  By Edward Petty, due to be published sometime before the Singularity. © May, 2017

May 8, 2017   No Comments

Medicare Audit Emergency Response Number

Medicare Audit Emergency Response Number:     



The Medicare Audit Preparation(MAP) is available to chiropractors nationwide. This is an emergency response program and on-site appointments are scheduled based on availability. Do NOT send records without calling us first.

The MAP program covers up to three full days (24 hours) in your office, plus 90 day off-site follow up as needed. The cost is $4,995 prepaid*. PM&A management clients can receive a 20% discount if they are active and current members.

Call for terms and conditions for this service. 920.334.4561

*Travel expenses may apply


April 12, 2017   No Comments

Tent Poster – Aaron Swartz

“What is the most important thing you could be working on in the world right now?…And if you’re not working on that, why aren’t you?”

~Aaron Swartz

For a printable copy of this tent poster go here: LINK

April 11, 2017   No Comments

Our Shallow World – and What Your Chiropractic (Acupuncture, Dental, Medical) Patients Really Want

We live in a shallow and superficial culture. It is fast talking, faster messaging, with abbreviated emotions and texts.

No one seems to really care, or takes the time to care.

Communication has become digitized and synthesized. We forward messages from some people we know, and from many we don’t, to people we know, and to many we don’t. We are addicted to our smart phones and “phub” each other. (Phub: The practice of ignoring one’s companion or companions in order to pay attention to one’s phone or other mobile device. Google.)

We buy things from “clouds” that seem to know what we want, as if they had been eavesdropping on all our personal affairs.

The Age of Artificial Intelligence that cares more for us than people who “friend” us is growing faster and faster.

Yet, somehow, shallow works. It is practical. It is fast and efficient. When I ask you “how are you?” I really don’t have the time to hear about how your kids did at their Christmas play, or how you like your new socks. I have my own deadlines and have to go.

We are caught up in minimal viable encounters. They are functional, but they provide the only the minimum amount of care. Any less, and there wouldn’t be any service at all. They are “duct tape” solutions.

This is our life now. The fast, the short, the immediate.

For all its practical aspects, this is the first goal in any business exchange. We must provide the outcomes and services that are initially wanted by our patients. This is a “drive through” consumer culture that moves quickly for things that are wanted. In return, business is trained to provide the minimum quickly, efficiently, and yet is still valuable.

But just because our society is shallow, does not mean that your patient is.

This may be the culture in which they have adapted, but privately, your new patient might not have been satisfied with the services they have been receiving from others. And as the expert and professional, you know that it is likely that they have been short-changed on their care.

No doubt, your patient wants relief – now. But if you want to know the truth, they probably want more than just a quick-fix.

Your patient is looking for someone who genuinely cares. They are hoping to find someone who listens, empathizes, and someone they can trust to help them get what they really want.

What do they really want?

Ask them:

What is most important to you about your health?

Then, find out why.

This is a broad and open ended question. It takes the both of you through the quick-fix drive-through to get to, finally, what they really want.

If I have a painful tooth, I would see a dentist to at least treat it enough so that it wasn’t causing me discomfort. But if the dentist asked me what I really considered important about my dental health, I might say that I would like cavity free teeth that never caused me pain. I would like all my teeth and gums to be healthy and look good until I am at least 105.

The dentist would then repeat back to me what I said that was most important about my dental health so that we could agree that this was my goal — something I wanted. With this disclosed and agreed upon, we could now dig into my history and perform the exam to see what was going on that was causing the symptoms.

Once all this was done, he would explain to me not only what was causing my pain, but what I needed to do, in the long term to get my mouth 100%, which we already agreed upon I wanted.

I definitely don’t want or need a hard sell for something I am not sure I need.

But if you find out what I really want and let me know that you can deliver, you won’t have to sell me. I am already motivated.

Confrontational Anxiety

Confrontational anxiety is that stress you, and your patient, can feel when discussing the length and expense of your recommended treatment plan. But it melts away and evaporates if you work towards what the patient really wants.

There are many different approaches designed to help get the patient to agree to a more complete treatment plan, including scripted words or phrases for the doctor and staff to say. Ultimately, the patient must trust you. They will have to understand what is causing the symptoms, what it will take to get better, and the benefits to be had. In the end, you will want to work out your own procedure. (Give us a call, we can help!)

Realize that your new and prospective patient is just barely trusting you, as it is. They would like to trust you more. They hope for more than just a “pop and pray” (“…and hope that they pay”) treatment and adjustment from you. What they usually offer you, or present to you as a new patient, is a symptom that may have deeper causes. Their condition is probably not new. They likely have had it, or some aspect of it, for some time. Only when it becomes more acute do they come to see you.

The analogy of the iceberg is useful.

Your patient wants relief, but also wants everything in life that the pain hampered or prevented. This might include less recurring episodes of pain, the ability to resume their hobbies and sports, improved performance in life activities, stronger immune function, better balance, increased knowledge to improve their health, more happiness, better weight management, and more energy. You can and should make a list of at least 10 benefits that come from a patient completing their treatment plan.

I buy a new car not to just have a better ride, but to feel that I have a better life. I pay for a cleaning service because I want a cleaner house, but deep down, I really do so because I want a happier wife.

Patients are too often short-changed because of a culture that is fast and shallow. You don’t have to be – and you can give your patients complete and thorough care. This is what they want – once they understand their condition and what you can provide. And, once they trust you.

Be interested in your patient and go deep to find out about their health, their history, and what they really want. Then, educate them on how the both of you, working together, can best help them get what they really want — and what you want and can deliver.

Ed Petty© Edward W. Petty, From the upcoming book: “Three Goals: A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.” By Edward Petty, due to be published sometime before the singularity. © 2017



March 15, 2017   No Comments

Tent Poster – Change – Rosa Parks

“To bring about change, you must not be afraid to take the first step. We will fail when we fail to try.”

~Rosa Parks

For a printable copy of this tent poster click: 2017-03-rosa parks

March 15, 2017   No Comments

Tent Poster – Be Kind ~ Bible:Ephesians 4:32

Be kind to one another, tenderhearted, forgiving one another…. 

~Bible Ephesians 4:32

For a printable download of this tent poster click {HERE}

March 2, 2017   No Comments