Do You Have a New Patient Log in Your Chiropractic or Healthcare Practice?

two women sitting at a desk discussing new patientsLaying the foundation for an enduring patient relationship

FIRST IMPRESSIONS COUNT!

I had advised a chiropractic office we had been working with for over a year to implement a new patient onboarding checklist. For one reason or another, this procedure just couldn’t be applied.

The chiropractic doctor wisely took our Goal Driven Practice MBA program with his practice manager last fall. They completed the program in December, and since then, I have been keeping track of their results. In almost all aspects, including key performance indicators, the practice has improved: collections, visits, new patients, and harmony!

The office seems to have come alive calmly and professionally.

While the practice has improved for many reasons, it has also put in place, finally, a new patient onboarding checklist I have been encouraging them to use. (I think I am happier about this than I am about all the other wonderful outcomes they are achieving!)

THE CHIROPRACTIC NEW PATIENT LOG

There are many reasons to improve the quality of the first 3-5 days of your patient’s care. Some studies prove it, but you don’t need studies (see references below.) You have your own experiences that verify the importance of first impressions. Any time you go to a new restaurant or retail business, how you feel about your visit will determine how quickly you return – if you ever do.

You know this, and so does your staff. But, like with any set of procedures, they will erode! I call this Procedural Atrophy. I cover this in my book, The Goal Driven Business (Page 159).

Procedural atrophy starts without notice. It’s not deliberate, but little actions start dropping out here and there. You substitute rote and automatic responses that replace thoughtful and lively communication. After a while, you wonder why your patient retention is low (patient visits per new patient).

A strong solution is to create a New Patient Log. (Email me, and I will send you a sample.) The first column has the patient’s name. Subsequent columns are for specific actions to take on each NP over the first 1-6 days.

The front desk can keep the log up to date. The doctors review it at the weekly meeting or even at the morning meetings. This is a form of case management to ensure all new patients (and returning patients) are receiving the care they need. I recommend the log be kept on a hard copy sheet, even on a clipboard. Digital is OK, as long as it is kept up to date and reviewed regularly in a group.

Here are some items that can be put on the New Patient Log:

Check and date when each of the following are done.

  1. Provide a warm welcome.
  2. Report of Findings.
  3. Treatment plan.
  4. Patient financial consultation and orientation.
  5. Multiple appointment card.
  6. Scheduled to Progress Exam. (Or longer)
  7. Take home reference pack: written report of findings, family care coupon, a treat!
  8. First adjustment call.
  9. If referred by patient, who the patient was. (This is so you can thank the patient with a card or gift.)
  10. Additional testing. (E.G., on Day 5 orthotics scan)
  11. Scheduled for patient orientation class. (Remember those!)
  12. Follow-up education emails.

Of course, ensuring these actions are done is just the first step. The next step is to see that they are done skillfully and with a friendly and engaged attitude. Rehearsing the steps on the New Patient Log every two or three months can help keep the onboarding system in tune and groovy!

Keep it fun — and help your patients achieve their goals,

Ed

Email me for a sample New Patient Log ed @ pmaworks.com

Cool References:

A study by Abrahamsson et al. (2017) found that patients who received clear information and education about their treatment plan had higher levels of adherence and satisfaction with their care. https://doi.org/10.1046/j.1471-6712.2002.00083.x

Deyo et al. (2018) demonstrated that patients who received follow-up communication after their initial appointment were more likely to adhere to their treatment plan and report better outcomes. https://doi.org/10.2522/ptj.2015.95.2.e1

A systematic review by Ganguli et al. (2016) highlighted the importance of addressing patients’ concerns and questions in improving treatment plan adherence and overall patient satisfaction. https://doi.org/10.1377/hlthaff.2017.1130

Spikmans et al. (2003) found that patients who received take-home materials and regular communication from their healthcare provider had higher levels of treatment plan adherence compared to those who did not. https://doi.org/10.1046/j.1365-277X.2003.00435.x

Consequences of poor onboarding practices:

A study by DiMatteo (2004) found that patients who did not receive adequate education or support from their healthcare provider had lower levels of treatment plan adherence, leading to poorer health outcomes. https://doi.org/10.1097/01.mlr.0000114908.90348.f9

Lacy et al. (2004) reported that patients who experienced poor communication or a lack of warmth from their healthcare provider were more likely to miss appointments and not follow through with their care. https://doi.org/10.1370/afm.123

A review by Martin et al. (2005) concluded that patients who did not feel engaged or supported by their healthcare provider had higher rates of treatment plan non-adherence and were more likely to seek care elsewhere. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1661624/

Schectman et al. (2005) found that patients who did not receive clear information about the costs and financial options associated with their treatment plan were more likely to delay or forgo necessary care. https://doi.org/10.1007/s11606-008-0747-1

—————————————————-

If your practice building efforts aren’t taking you to your goals,
there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

the goal driven business by edward petty

 

 

The Goal Driven Business
By Edward Petty

order now button

Ask Lisa: Payer Notes Request: Now What Do I Do?

stack of medicare insurance paperwork

With the increase in notes requested from third party payers, more recently Medicare secondary plans, it is good time to review the process once you receive a request.

First, do not ignore the notes request. You can call the payer acknowledging receipt of their request, or simply print or export the SOAP notes from your practice management program and send them to the payer. It is also highly recommended to include the initial patient intake form, or New Episode patient form, exam form(s), and care plan schedule including treatment goals which can simply be specific ADL functions pre-injury.

I also recommend looking to see what the most current Onset date is in your patient profile. Many recurring notes requests are due to the onset date going back two years and more. If this is the case, the patient is due for a re-exam and more than likely a new set of diagnosis codes, and you can include this information in your response to the payer.

If you need a review on what exactly to include in a SOAP note, click on this link HERE to access the checklist that complies with Medicare documentation requirements.

I use this checklist when I conduct onsite documentation reviews.

Questions? Need help with a documentation audit? Ask Lisa – I can help!

920-334-4561

lisa@pmaworks.com

Bravery in Your Chiropractic Office

bravery but funny goal drivenBravery is one of the themes of our practice manager training program.

Brave, Not Perfect is the title of an excellent book by Reshma Saujani, and also from her TED talk with the same title. She states that our culture influences girls to be perfect while boys can be wilder, take risks, and make more mistakes. She encourages women to be braver.

I think this can apply to us all.

Practice Manager Success Story

But this newsletter is about a success story. A story of bravery and integrity. It is also to boast about one of our managers who recently graduated from our Goal Driven Practice MBA program for chiropractic and healthcare offices and demonstrated these values.

As the practice manager, she also does the billing in this office. The chiropractic doctor had treated a patient who had suffered a motor vehicle accident. She submitted the bill to a 3rd party, reducing the what was owed slightly as the doctor agreed to discount some of the services.

The 3rd party company came back and said they could only pay 70% of the bill.

This was the manager’s response:

“Good morning,

“Thank you for letting us know.

“We provided 100% of the care that our patient needed; therefore, we require 100% payment of our services we provided. The original discounted offer of $X,XXX is no longer valid.

“We have decided to pursue the full amount plus interest, along with any court/attorney fees if we haven’t received payment in the full amount of $Y,YYY by March 7th.”

“Thank you,

[Signature]

“Manager of Chiropractic Health Clinic”

She received the full amount before March 7th.

Be Brave — with Integrity and Humor

Be nice, be fair, but first, be brave.

This can apply to scheduling patients at the front desk. It applies to reporting on the patient’s condition and treatment plan options. It applies to promotions and advertising. It can apply to training and coaching for you and your team.

It takes courage to become a doctor, to start a business, and even to work as a professional in an independent healthcare clinic. It takes even more to succeed at doing so.

But hey, it can be fun. And it helps to have some humor.

Our manager made a copy of the correspondence with the claims company with a copy of the check. She gave it as a surprise to her clinic director, who sent me a text with the image of what she gave him. On the copy of the email, she included a handwritten quote from the classic comedy movie Princess Bride:

“NEVER GO AGAINST A SICILIAN WHEN DEATH IS ON THE LINE.”

Stay Brave and Goal Driven — and Have Fun.

Ed

P.S. Our next management and leadership training program begins this summer. We have been retooling it and upgrading it. Only 7 students will be accepted. If you are interested, please get on the Wait List, and I will contact you soon with more information. Click here for Wait List for our next Practice MBA

—————————————————-

If your practice building efforts aren’t taking you to your goals,

there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business book for CEO and Office Managers by Edward W Petty.

The Goal Driven Business, By Edward Petty

Goal driven order now button

Have You Mapped Your Patient’s Health Journey?

woman mapping out patient flow for chiropractic office

Improving Your Chiropractic Patient’s Experience

Advertising has peaked. We are awash in ads coming at us from every possible source. We are hit with anywhere from 4000 to 10,000 ads per day.* With AI and ultra-sophisticated forms of targeting, it’s almost totalitarian.

The new marketing is customer service or Service Marketing.

Advertising has its place, of course, if it is to the right market, with the right message, and the right offer. But with all ads, the low-hanging fruit gets picked quickly, and new ones are needed.

There are other avenues of marketing your chiropractic services, but the importance of world-class service and outcomes is more vital than ever.

You’ve seen the stats:

  • 40% of customers began purchasing from a competitive brand because of its reputation for good customer service.
  • 55% are willing to recommend a company due to outstanding service, more so than price.
  • 85% would pay up to 25 percent more to ensure a superior customer service experience.*

Nothing is radically new about these numbers, but it helps to see them again.

And Service Marketing is not really new. But I believe it is and will be the dominant feature that distinguishes you from comparable providers. This is because content marketing has flooded the market. Therefore, call it service marketing or relationship marketing, turning each of your patients into raving fans who become salespeople for you is an intelligent marketing strategy.

But you must deliver the WOW!

CUSTOMER AND PATIENT JOURNEY MAPPING

Customer Journey Mapping is a relatively new term that has been hatched over the last 10 or 15 years in marketing. While the term is new, the concept is not.

Customer Journey Mapping is a procedure used to visualize and analyze customers’ end-to-end experience as they interact with, in this case, your practice.

It is essentially a flow chart.

It starts with a prospective patient’s first call to make an appointment. What do they see when they drive up to your office, walk through the door, and are greeted? It involves mapping out every encounter and even the likely emotion your patient experiences through Day 1, Day 2, Day 12, and so on.

And how far do you take your patient? Is it 8 visits and done? Do you take them through Acute Care, Corrective and Strengthening, to Supportive and Wellness? Do you have a map for your patients and do they know it? What are the milestones along the way? Are your patients excited about reaching them?

IMPROVING YOUR CHIROPRACTIC AND HEALTHCARE SERVICE

One of the exercises I covered in my book The Goal Driven Business, which has always been useful, is a complete Day 1 and Day 2 walk-through. It is rehearsing your flow chart or patient map.

Everyone watches while someone acts as a patient. I have often done this and acted as a patient. I will notice things that everyone has taken for granted — the old poster from 1989 still on the wall with the Muppets, a dead plant in the corner, a dead smile on the front desk, no explanation when I am dumped off on a therapy unit. Staff start noticing things as well. Redundancies show up, so do poor handoffs between the front desk and the doctor or from the doctor to patient accounts.

Zeroing in on how the phone is answered, an exam is done, or a report of findings is presented, you can find many small improvements that make a big difference on how your patients experience your office.

(Want me to set this up for you? Schedule a time and give me a call.)

Creating your patient’s experience is your most important marketing activity. Mapping it and practicing will help you create raving fans — that will generate even more fans.

Keep improving,

Ed

*The average American encounters around 6,000 to 10,000 ads or brand exposures per day. Source: “MIT Technology Review” article by Michael Schrage (Aug 7, 2017)

*Customer service stats. X: The Experience When Business Meets Design, by Brian Solis

—————————————————-

If your practice building efforts aren’t taking you to your goals,

there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business book for CEO and Office Managers by Edward W Petty.

The Goal Driven Business, By Edward Petty

Goal driven order now button

Ask Lisa: What exactly goes into valuing a chiropractic practice?

Why in the world would one want to get their chiropractic practice appraised?

I’m glad you asked!

Having your practice appraised is an investment in both you and your practice’s future. Even if you are not ready to sell your practice, having your practice appraised is important and sometimes required to fulfill legal obligations, for example in divorce, bankruptcy; estate settlements; and buy-ins or buy-outs. You may simply want financial peace of mind from having a valuation done.

What exactly goes into valuing a practice? Several components are used to create a comprehensive valuation and report. These components over a certain time period, say three years of data, include:

  • Gross income
  • Net income
  • What type of insurance and/or payment is accepted (e.g., PPO, HMO, Medicare, and Medicaid insurance participation)
  • Total number of active patients
  • Number of new patients a month
  • Techniques specializing in, and therapies utilized
  • Patient and area demographics
  • Accounts Receivables and Collections
  • Market trends
  • The practice’s goodwill

We do practice appraisals! Want to learn more?

Just Ask Lisa, 920-334-4561, lisa@pmaworks.com

=================

Lastly for today, *AN URGENT MESSAGE* I was not planning on including the below information regarding the recent AND significant cybersecurity attack to UHC Change Healthcare, but since this is significant and since the cyberattack may have impacted you or your practice, it is worth including an update. Below is a nice summary from Dr. Chris Anderson from Chiropractic Society of Wisconsin. The most recent full HHS article follows.

Summary of HHS article

  • Cyberattack Impact on Change Healthcare: Change Healthcare, a unit of UnitedHealth Group, experienced a cyberattack in late February, affecting healthcare operations nationwide.
  • HHS Coordination Efforts: The U.S. Department of Health and Human Services (HHS) prioritizes coordinating efforts to mitigate disruptions in healthcare services. It is in constant communication with UnitedHealth Group leadership, state partners, and external stakeholders to understand the impact and ensure an effective response.
  • Immediate Steps by CMS: The Centers for Medicare & Medicaid Services (CMS) is taking immediate steps to assist providers in serving patients. This includes providing flexibilities such as expediting electronic data interchange enrollment, relaxing prior authorization requirements, and encouraging advance funding to affected providers.
  • Encouragement for Other Payers: CMS urges other payers, including state Medicaid and CHIP agencies, to waive or expedite solutions for claims processing, and to consider offering advance funding to providers.
  • Accelerated Payments and Paper Claims: Providers facing cash flow issues due to system outages can request accelerated payments from Medicare Administrative Contractors (MACs) and submit paper claims if necessary.
  • Cybersecurity Resiliency: The incident underscores the need to strengthen cybersecurity across the healthcare sector. HHS released a concept paper outlining a cybersecurity strategy focusing on resilience, accountability, and coordination within the healthcare ecosystem.
  • Continued Communication and Collaboration: HHS pledges to maintain communication with the healthcare sector, monitor response efforts, and work with industry stakeholders to address cybersecurity gaps. It emphasizes the importance of heightened cybersecurity measures for all stakeholders in the healthcare ecosystem.

Full article: https://www.hhs.gov/about/news/2024/03/05/hhs-statement-regarding-the-cyberattack-on-change-healthcare.html

================

We have received questions from you regarding how to send claims in that won’t go. Consider pushing your claims to paper and either mailing or faxing them to the payer if you are not able to send them electronically, until a resolution is completed.

Please reach out to Lisa or Dave if you have follow-up questions.

Why You Should Keep Smiling in Your Chiropractic and Healthcare Office

receptionist at chiropractic office working with a customer

More Chiropractic Jokes Please!

In the late 80s, when I took my son to his first adjustment, I noticed bold but innocent cards on the doctor’s front desk counter.

They said, simply, KEEP SMILING.

Over the years, I have often seen this card at chiropractic events and offices – almost as a chiropractic tagline: KEEP SMILING!

I would love to know the history of this phrase, and if anyone knows, please come over to the Blog and explain it, or hit reply with the info and I’ll share it with your permission.

I have seen it on a chiropractor’s envelope from the 20’s, so I know it goes back a while.

SMILING MAKES YOU HAPPIER AND HEALTHIER

Getting those smiles out will improve your mood and improve your health.

IT’S SCIENCE.

Something the chiropractors of the 1920s and before knew.

“When you smile, your brain releases tiny molecules called neuropeptides to help fight off stress. Then other neurotransmitters like dopamine, serotonin and endorphins come into play too. The endorphins act as a mild pain reliever, whereas the serotonin is an antidepressant. One study even suggests that smiling can help us recover faster from stress and reduce our heart rate.”*

Try right now — SMILE!

See! It works.

OK then, DON’T SMILE. Gotcha. It works. :- )

Smile, laugh, and the whole world smiles with you. Frown, and you frown alone.

SMILING IMPROVES PRACTICE PERFORMANCE

But smiling can also improve your practice.

A happier office will have better performance.

“Smiling can have a positive impact on our performance at work. Research has shown that when we smile, we experience a boost in mood and a reduction in stress levels. This can lead to increased productivity and better performance on tasks.”*

2 METHODS TO SMILE MORE IN YOUR CHIROPRACTIC HEALTHCARE OFFICE

Old School Trick: Front Desk Mirror

Place a mirror facing towards the staff on the front desk. It should be so that it can be seen by whomever is working at the desk and answering the phones.

Place a caption on the bottom of the mirror. Something like: SHOW YOUR TEETH!

People can tell if you are smiling when they talk with you on the phone.

Morning Meeting Jokes

For your morning case management meetings, one person is assigned to tell a joke. The next day, it is someone else’s turn to tell a joke. Each team member must tell a joke.

Yes, the jokes are usually dumb, and it can be embarrassing. But it is also can be funny!

And besides, there is B.J. Palmer’s Rule Number 9:

“Don’t take yourself too damn seriously.”

So, that’s it.

Don’t be so serious!

Smile more, and you’ll find more things to smile about.

To help get you started, I found some chiropractic jokes and put a few of them below. More are on our Blog. (Also added an acupuncturist and dental joke.)

Have a funny day!

😊

Ed

Some bad jokes!

I never believed that chiropractors could solve my back problems.

2 weeks later, I stand corrected.

Did you hear about the chiropractor who got in trouble with the IRS?

It was for back taxes.

What do you call two chiropractors who’ve got each other’s backs?

Vertebros.

My chiropractor and I got into a terrible fight in the middle of my neck treatment.

Now I have to spend the rest of my life looking over my shoulder.

What’s the difference between a chiropractor and a proctologist?

You go to one if you need your finger cracked and the other if you need your crack fingered.

I went to the acupuncturist the other day.

When I got home my voodoo doll was dead

Be kind to your dentist.

He has fillings too.

My chiropractor is serious as hell.

But he still cracks me up.

“But Quasimodo, what makes you think you need to see a chiropractor?”

“Oh, it’s just a hunch…”

I go to the chiropractor because my wife told me to.

At least I assume that’s what she meant when she said, “Prove to me you have a spine.”

I had to quit going to the chiropractor …

I felt he was always trying to manipulate me.

Does anyone remember the joke I made about the Chiropractor?

It was about a weak back.

Went to see my chiropractor for the first time in a long time.

First thing he said when I walked into his office was “Glad to see your back!”

How many chiropractors does it take to change a light bulb?

Only one, but it takes 24 visits.

Good friends are like chiropractors.

They have your back and set you straight.

Don’t ever let a chiropractor tell you a joke.

It’ll hit your funny bone.

One thing I have learnt this year is to never trust acupuncturists

They’ll stab you in the back the first chance they get.

My dentist mocked me today, saying that even though he’s much older than me, he has healthier teeth.

I said it must be because he has the better dentist.

References:

*Grin and Bear It! Smiling Facilitates Stress Recovery-  https://www.psychologicalscience.org/news/releases/smiling-facilitates-stress-recovery.html

*Smiling: The Surprising Benefits You Never Knew About – https://psychologily.com/benefits-of-smiling/

*New Study Suggests Smiling Influences How You See the World-https://www.psychologytoday.com/us/blog/the-right-mindset/202008/new-study-suggests-smiling-influences-how-you-see-the-world

*The Health Benefits of Smiling-https://intermountainhealthcare.org/blogs/the-real-health-benefits-of-smiling-and-laughing

—————————————————-

If your practice building efforts aren’t taking you to your goals,

there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business book for CEO and Office Managers by Edward W Petty.

The Goal Driven Business, By Edward Petty

Goal driven order now button

The Flywheel Theory of Practice Marketing For Chiropractic Practice Marketing and Health Businesses

kids on merry-go-round

More marketing for less effort in your chiropractic practice

There is good marketing, better marketing, and best marketing.

There is only one kind of bad practice marketing.

That is … NO marketing.

Unfortunately, “no marketing” is too common. The typical scenario in many chiropractic and health offices is this: “Numbers are down. Let’s do some marketing.” After a great effort and expense is made, the numbers go up. Then what happens?

Everyone becomes so busy that there is no time for marketing, and marketing gets tossed aside like an old pair of worn socks.

This contributes to the Practice Roller Coaster. First, there is some marketing. Then there isn’t. Then there is, then there isn’t. Up and down.

Good marketing requires regular attention and action. Like making a cake or cooking a steak, you must pay attention and make adjustments. You can’t turn on the oven, then turn it off to watch your cable program, then turn on the oven again.

THE MERRY-GO-ROUND FLYWHEEL

Remember those merry-go-rounds on playgrounds? Everyone would get on, and one person would push. With the same amount of force applied consistently, the wheel’s speed would increase. Just using an even push, the wheel moved faster and faster until kids started screaming and falling off. Great fun!

What would have happened if the person pushed the wheel a few times and then let it stop? Then pushed it and got it going again. And then let it stop.

All the momentum that accumulated would disappear. Then, getting it going again would require more force. What a waste of energy! And how exhausting to start it up again!

Of course, once it is moving, it doesn’t take much to keep it going or even get it to move faster just by steadily applying force.

Effective chiropractic and practice marketing is just the same. The merry-go-round is like a flywheel. A flywheel is a “mechanical device designed to store angular kinetic energy in a rotating mass.” (Wikipedia) It is used in various engines and has several uses, but primarily, it keeps the momentum, or the energy, going.

Jim Collins refers to the Flywheel effect in his book, Good to Great. “Each turn of the flywheel builds upon work done earlier, compounding your investment of effort.”

HOW TO KEEP YOUR MARKETING FLYWHEEL GOING IN YOUR PRACTICE

  1. Make a list. With your team, make a list of key marketing activities that you have done that have worked. Keep it simple.
  2. Marketing assistant. Then, assign someone to keep track of these activities. They assume the role of marketing assistant. 1-2 hours per week. They essentially are project managers who ensure all marketing actions occur.
  3. Keep to a schedule. The time allotted to do the marketing must be maintained and not get hijacked by “urgencies.” The temptation will be there. Whatever time is scheduled, don’t allow this position to collapse into other departments.
  4. Monthly review and push. Every month, you can assess what actions seem to be working. Don’t be too eager to discontinue a procedure — some marketing takes time. Gradually, you can add more activities that are working. Keep pushing the flywheel!

We plan on offering a course on the Marketing Manager System for your marketing assistant later this year to help you achieve your practice goals.

GOOD TO GREAT – IN CHIROPRACTIC AND OTHER HEALTH PRACTICES

From Jim Collins: “Good to great comes about by a cumulative process—step by step, action by action, decision by decision, turn by turn of the flywheel—that adds up to sustained and spectacular results.”

Keeping the momentum going,

Ed

(c) 2024 Edward Petty

—————————————————-

If your practice building efforts aren’t taking you to your goals,

there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business book for CEO and Office Managers by Edward W Petty.

The Goal Driven Business, By Edward Petty

Goal driven order now button

How Responsible is Your Chiropractic Healthcare Office?

take responsibility for what you care for

Responsibility Scale – Ownership or Spectator?

A few years ago, I was teaching an exercise program to a group of underprivileged kids ranging from 8 to 13 years old.

The program was part of a larger volunteer program run out of an old, dilapidated church. The kids came from a very rough environment. Keeping them focused in class was challenging, and getting them to participate was even harder.

I would start the class by going over a virtue. This might include kindness, cleanliness, honesty, or discipline. When I asked the group questions, no one would usually answer.

Except for this one time.

I asked the children what the word “responsibility” meant. In the back row – I had them all standing in rows – one scruffy-looking boy, about 10, immediately raised his hand and said: “Ownership.”

“Ownership.” I was stunned. Not only did someone answer, and quickly, but what a perfect definition!

RESPONSIBILITY IS OWNERSHIP

Responsibility is taking ownership. It is saying “I caused that.” “That is mine.” It could also be saying, “I didn’t cause that.”

It is not deferring to excuses or outside forces. Sure, there are many things outside your zone of control for which you cannot take responsibility. But your job and the group you work with are within your limits. If the office is not doing well, don’t blame it on your childhood, Spring Break, or Taylor Swift.

As an employer, you should encourage your team to take responsibility. Their job, or department, is their sandbox, too. Encourage them to offer suggestions for the entire practice as well – and listen to them.

And on the other hand, all employees are stakeholders. They aren’t working for a large and well-funded corporation or government agency. How they perform each day determines how the entire office will perform.

And something else: a friend of mine says: “Everyone is on commission, but most just don’t know it.”

CHIROPRACTIC HEALTHCARE PRACTICE OWNERSHIP

We discussed the concept of responsibility and ownership in our Chiropractic Healthcare Practice MBA program by reviewing Jacko Willink’s book, Extreme Ownership.

Some managers played it for their team meetings. I recommend you do it as well. (The link is below.)

No doubt, we all take responsibility and ownership for our work. We are professionals. Sometimes, however, our determination can slip. When you notice yourself complaining about things, know that you are slipping! Complaining IS a form of responsibility, but just a very low form.

A scale of responsibility might look something like this:

SCALE OF RESPONSIBILITY

Extreme Ownership
Ownership
Spectator
Complainer
Blamer
Apathetic

Here is a quote from Jocko Willink, and I recommend watching a clip from his TED talk with your team.

“Implementing Extreme Ownership requires checking your ego and operating with a high degree of humility. Admitting mistakes, taking ownership, and developing a plan to overcome challenges are integral to any successful team.”

― Jocko Willink, Extreme Ownership: How U.S. Navy SEALs Lead and Win

Stay Goal Driven,

Ed

TED Talk. Jacko Willink. Extreme Ownership. ( 13 Minutes)

—————————————————-

If your practice building efforts aren’t taking you to your goals,

there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business book for CEO and Office Managers by Edward W Petty.

The Goal Driven Business, By Edward Petty

Goal driven order now button

Goal Driven Time Management Skills

chiropractic or small business time management skills calendar

You may delay, but time will not.
Benjamin Franklin

Time is your most precious resource.

How you use it makes all the difference in your progress toward your practice goals.

I still remember my father remarking on my 5th-grade report card. On the back of the card was a space for comments from the teacher. The comment was something about: “Edward would do better if he did less daydreaming.”

This “comment” has haunted me all my life. I daydream. I admit it. Sometimes, this is good – I learn something new. But the challenge is not wasting the time I need to complete projects.

Goal Driven time management procedures allow us to get more done during our day’s working hours. And even though we all are familiar with the principles and techniques of time management, it helps to review them occasionally.

Here are a few techniques I have learned from others that help me. Maybe they can help you too.

GOAL DRIVEN TIME MANAGEMENT PROCEDURES IN YOUR
CHIROPRACTIC HEALTHCARE PRACTICE

Breaks. Don’t feel guilty. We all need to take breaks — a short one every couple hours or so, longer ones every day, longer ones even still every week, and so on. Breaks are a physiological and mental requirement discussed in an insightful book called The Power of Full Engagement by Jim Loehr. Just schedule your breaks.

Scheduling blocks. As a chiropractor and health care provider, you naturally block off time periods to see patients. You can use the same concept for team meetings, individual conferences, and “paperwork.”

Goal Driven. Each time block should have a goal. The work you must do and the procedures you use should all focus on the desired outcomes.

No interruptions. As harsh as this may sound, unless there are emergencies, don’t allow yourself to be distracted during the block of time dedicated to doing your work. Schedule a brief period during the day to return to the unplanned issues.

Cluster booking. Schedule blocks of time for similar activities close together. The general idea is to keep you doing what you are doing until you are done. For example, seeing 3 patients and then waiting for 10 minutes before seeing 3 more slows you down and takes you out of the Flow. The idea of Flow is not new but recently refreshed by Mihaly Csikszentmihalyi in his book, FLOW. Flow is a mental experience when you are so lost in your work that nothing else matters – you are in the Zone. It is when you are “Lost in Service.”

Cluster booking can also be applied to other services: specific therapies or rehab, a Thursday morning for seniors, or a Mom’s Saturday morning with kids. Once you are in the Flow, you become more productive.

Prioritize: Take care of the Important and Urgent tasks as you must, of course. But do not neglect the Important but Not Urgent projects. This comes from Stephen Covey’s book, The 7 Habits of Highly Successful People, and Eisenhower before him. Covey notes that the more time spent on Important but Not Urgent projects, the less time needed for urgent matters.

Sort out the tasks – The 4 D’s. As you review your inbox or new tasks that come up, sort them along these guidelines:

  • Do them now.
  • Delegate them.
  • Delay them.
  • Dump them.

Many of these points, and others, are covered in my book, The Goal Driven Business. We also worked these over in our Practice MBA program.

Yes, I still daydream. I recommend it. But now, I just schedule it!

Seize your future,

Ed

—————————————————-

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business building methodology

The Goal Driven Business,  By Edward Petty

goal driven business buy now button

How to Add Extra Services to Your Chiropractic Healthcare Practice

two men discussing chiropractic therapy equipment

Avoiding Hidden Expenses in Scaling Your Practice

Do you want to improve your income and the quality and quantity of your services?

One strategy is to add a therapy machine — or another one — to your practice. You could also bring on another provider. This could add more services per visit and more visits per week, improving your income and the outcomes you get with patients.

Makes sense, right?

In theory, yes. In real life, not so much.

Properly implemented, more services from machines or providers can improve the quality and quantity of outcomes and improve the bottom line. However, the implementation must be done correctly. And often, it is not.

I have seen chiropractic clinics with the largest room in the office filled with therapy equipment that was rarely used. I have had heated discussions with doctors who would buy more equipment when they were not using what they had just purchased. And if the equipment is used, often there is insufficient staff or resources elsewhere: no one running the front desk department, marketing is sporadic, and patient treatment and financial plans are rarely or poorly done.

This gets even worse when hiring associate doctors. You have heard the stories, so I won’t elaborate. Group practices can work well, and we recommend them. In fact, I don’t know of one chiropractic management company with more combined experience working with associates than we have. Multiple-doctor clinics are one of our specialties. But they have to be done correctly, and they rarely are.

Let’s look at three principles to help you implement additional services correctly.

1. FOCUS AND IMPROVE YOUR CORE SERVICES

More therapy and more providers will not take the place of quality and well-organized services.

By expanding your services, you can dilute your unique selling proposition!

Starbucks did this back in 2006. They kept introducing new products, which devalued their primary brand. The baristas had difficulty keeping up with all the new products. They had to become fast-moving technicians rather than friendly conversationalists with the customers. Their statistics decreased until they simplified their services and focused on their core values and services. *

Before you add machines and providers, focus on your core services and improve those, which will also enhance your bottom line.

2. SIMPLICITY

More services can add more complexity. Richard Koch is one of the researchers I quoted in my book, Goal Driven Business. He says: “Because business is wasteful, and because complexity and waste feed on each other, a simple business will always be better than a complex business.”

A therapy unit, for example, even if it is “unattended,” requires supervision by the staff and you. And who will do it if it requires someone to apply the therapy? You can see the extra expense once you work out the details and the math.

Complexity can hide overhead. So, when adding more services, beware of adding complexity and keep the services as simple as possible.

3. LARGE BUT SIMPLE CHIROPRACTIC HEALTHCARE BUSINESS

A larger business provides more services and can generate more income. While Richard Koch recommends simplicity, he also supports growth:

“Because scale is normally valuable, for any given level of complexity, it is better to have a larger business. The large and simple business is the best.”*

Add more services to your practice, but keep these three points in mind:

  1. Improve what you have. First, focus on and improve your skills and those of your team. Invest in your team and yourself. This will enhance your bottom line and your services. Your goals are expertise and mastery.
  2. Keep it simple. Always work towards simplifying your procedures and your patient’s experience.
  3. Scale. Add services and scale your business. But first, plan it out ahead of time, examine the extra time, effort, and costs involved, and manage it well. (You can have us help!)

Keep expanding — but keep improving first. And keep it simple.

Ed

References

*https://hbswk.hbs.edu/item/starbucks-lessons-for-premium-brands

* The 80/20 Principle (Richard Koch)

—————————————————-

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business building methodology

The Goal Driven Business,  By Edward Petty

goal driven business buy now button

Ask Lisa – Introduction

Lisa Barnett practice appraisals credentialing and

Lisa J. Barnett

HI!

I’m Lisa with Petty, Michel and Associates.

I’ve been with this wonderful company for nine years and have worked in the chiropractic profession for 17 years.

Do you need help with:

• credentialing new providers and/or your tax ID?
• debugging complex insurance issues?
• documentation/insurance audits?
• practice appraisal?

Would you like these projects completed without you or your team spending time doing it on your own?

Let me do it for you!

Contact me. Because some practice issues shouldn’t wait.

lisa@pmaworks.com

920-334-4561

Find out more about me here

== == ==

“I Give PMA Two Thumbs Up!
Lisa was incredibly helpful and created huge value and peace of mind when she came face to face to my clinic and looked over everything. There are core competencies when it comes to dealing with Medicare and Petty Michel and Associates knows the process and what Medicare will be looking for if you get a notes request or an audit request.

PMA proved to be a huge value and I am thrilled they were able to help my clinic become compliant, which makes seeing Medicare and Medicaid patients more enjoyable and less worrisome. I give PMA two thumbs up.

Matt Kingston D.C.
Madison Chiropractic Solutions

Optimizing Chiropractic Front Desk Procedures for Patient Retention

patient reception in chiropractic office

What kind of check-in and check-out procedures do you have?

How you do these procedures can make an enormous difference in your patient retention, referrals and office visits.

Your health care front desk needs to schedule patients and collect their payments, but when should they do this – when the patient checks in — or leaves?

If your chiropractic practice is insurance-centric, the front desk can become an extension of the insurance department. When this is the case, collections and scheduling are often done first.

I have seen this occur in many offices.

I recently visited a practice office where patient retention had been declining. I noticed that the patients came in, stopped off at the front desk, made payments, and were confirmed for the next appointment. Then, they waited to see the doctor. After their adjustment and treatment, they often zoomed out of the office, headed to their next destination with an occasional “bye” from the front desk.

I thought there were several weaknesses to this approach, but I wanted to see what other successful practices were doing. We asked other practice managers how they handled their check-ins and check-outs.

Chiropractic Manager Surveys

One manager from an established 2-doctor chiropractic office said:

“We have a check-in/check-out system but scheduling and payments are done together at check-out. This works better for our office flow. The patient walks in, heads right on back and grabs a table for their appt, unless they have an exam or something similar that we need to take them into a different room. Then when they check out, they schedule their next appt, or several future appts at once, and we collect payment if they owe anything.”

Another manager of an office with multiple doctors said they preferred to collect patients’ payments and update their scheduling when the patient checked out.

  1. You give them the feel that their care is more important than the money.
  2. The last thing they hear when they leave the office is ” we’ll see you on such and such a day at such and such a time”! “And by the way bring your kids in.”
  3. What happens if their services are more or less than what you collected for??? Now you have to alter their charges.
  4. If you have pre-scheduled them and they need additional or less services you are now going to have to change the scheduling.
  5. #3-4 causes confusion and messy records.”

I think this only makes sense. Let’s zoom in:

The check-in. The front desk needs to be welcoming to your patients who endured challenges just to make it into your office that day. This is a win for everyone, and the initial greeting acknowledges the patient’s effort to make it in. Then, any and every barrier should be removed to get the patient back to see their doctor and provider on time.

The check-out. Here are a few vital transactions that can take place:

  • Validating the benefit of their recent adjustment and treatment. “So glad you made it in today for your care. Every visit helps and builds on the last one.”
  • Confirm their schedule, or schedule them for the next month, or longer.
  • Go over any payments that might be needed.
  • Quality control. Should the patient mention any doubts or concerns, the front desk can either direct the patient to the doctor for a fast consultation, or to Patient Accounts, if there is a finance concern, or note it to be addressed on their next visit.
  • Marketing. Encourage the patient to schedule an appointment for a family member or friend to come in for a no-charge consult or an upcoming event, such as a new patient lecture or special promotion.

Every office is different and you should always customize procedures to best suit your situation.

But, the following applies in all cases:

  • Your patients are your guests. You invited them.
  • Treat them as you would a friend visiting your home — with a warm welcome and then, when they leave, a thank you for coming and a sincere wish to see them again soon.

Keeping the goals in mind,

Ed

—————————————————-

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business building methodology

The Goal Driven Business,  By Edward Petty

goal driven business buy now button

 

Build a Better Chiropractic and Healthcare Practice by Serving Kids

How and Why to Develop Your Chiropractic and Healthcare Pediatric Practice

Anyone who does anything to help a child in his life is a hero! – Fred Rogers

Last week I talked about the importance of caring for our children’s health.

Not only is it needed like never before, but the evidence is clear: chiropractic helps kids. For example, one study in 2019 of 2001 mothers showed that 82% reported definite improvement of their infants, and 95% reported feeling that the care was
cost-effective. *

The evidence is out there, and even more, so is the personal testimony of so many grateful parents.

But in addition, promoting better health for children in a chiropractic or independent healthcare practice can create positive effects on generating new patients and retaining existing ones.

Regardless of the demographics or niche of your practice, including care for kids can enhance your practice and attract new patients.

Here are some suggestions on how and why to do so:

1. Family-centered care. Emphasizing pediatric care creates a family-friendly image for your practice. Parents are more likely to choose a healthcare provider who can address the health needs of their entire family, including children.

2. Community engagement. Engaging with the local community through educational workshops, seminars, or events focused on children’s health can position your practice as a community leader. This involvement helps raise awareness about your services and can attract families seeking comprehensive healthcare.

3. Word of mouth referrals. Happy and satisfied parents are likely to recommend your practice to other families. Positive word-of-mouth referrals from parents who appreciate your focus on children’s health can improve new patient acquisition.

4. Specialized services for children. Offering specialized services or programs tailored for children’s health needs can set your practice apart. This could include services for issues such as:

o Posture

o Sports injuries

o Musculoskeletal development

o And other concerns, such as earaches, bedwetting and issues from toddler tumbles!

5. Educational Content. Share educational content on your website, social media, or through newsletters that focus on children’s health and wellness. Most people just don’t know how effective chiropractic can be for children. By providing valuable information, testimonials, and case studies, you position your practice as an authoritative source and can attract parents seeking reliable healthcare information for their children.

6. Collaborate with schools, daycares, and mother’s groups. Partnering with local schools, daycares, or community organizations to provide health screenings, workshops, or informational sessions for parents can create valuable connections and increase visibility in the community.

You might consider tying a kid’s promotion with a monthly observe or holiday. Each promotion could include a posture check or a free screening. For example:

  • February 7th is National Girls and Women in Sports Day. Provide a special screening for girls in sports, or a workshop from a local athletic coach and yourself.
  • March 17 is St Patrick’s Day. This is a great time to have a Leprechaun Appreciation Day. Bring the kids in for a screening and provide contests.
  • April is Foot Health Month. For those of you that provide orthotics, you can have a foot scan.
  • May. May is National Correct Posture Month. Offer posture screenings for the entire family.

There are many possibilities, and these are just a few. Work with your team and have your marketing assistant put together a plan for this spring.

And if you don’t have a marketing assistant or manager, you should! Please contact me and I can give you some ideas on how to develop this essential position.

Carpe Deum,

Ed

References:

*Maternal Report of Outcomes of Chiropractic Care for Infants: https://www.sciencedirect.com/science/article/abs/pii/S0161475418301453

Pediatric and Prenatal Chiropractic Research
https://icpa4kids.com/research/

https://nationaltoday.com/national-girls-and-women-sports-day/

Let’s Hear It For Chiropractic and Kid’s!

Petty Michel and Goal Driven Donation to Wisconsin Chiropractic for Kids How to support the health of our children

“History will judge us by the difference we make in the everyday lives of children.” Nelson Mandela*

Here in Wisconsin, the Chiropractic Society of Wisconsin, the primary chiropractic association, is sponsoring a Kid’s Day next week, which we are supporting.

Also, I am supporting it with donations from the sales of my book. Please consider contributing directly to the C.S.W. or buying my book (or 20 of them!).

If you look into it, how we treat our kids in the 2020s is probably worse than in decades past. The Styrofoam-like food, the toxins such as Glyphosate and Phthalates in our breakfast cereal, the nano plastics now in our blood, the sugar and seed oil, the escalation of Pharma drugs and shots, the social media, the list goes on and on.

Just look at the stats for health care in America, those that you can find. They are abysmal and getting worse. (I have links to some listed below.)

There are plenty of sources to learn about how we treat our kids, but as you can imagine, they are hard to find on regular internet searches. It’s a little like trying to find the truth about cigarettes or asbestos in the 1950s — you almost have to search out whistleblowers to find out what is truly going on. An e-book that was published in 2018 called The Sickest Generation, by Children’s Health Defense, is a good place to start. (Link below)

People in your community aren’t going to hear too much about this from the media or most corporate-paid doctors – though more independent physicians seem to be speaking out. This is why your work is so vital.

As a side note, promoting health care for kids can build your practice. Helping children get healthier is a great marketing and practice-building strategy.

But first and foremost, the primary reason to see kids is to help them stay healthy.

Chiropractic care can help young children with the bumps and tumbles they take as they grow. Young athletes especially benefit from adjustments. Other independent and naturally oriented health providers, such as those practicing acupuncture and Traditional Chinese Medicine, and functional and integrative medical providers can also be of great help.

But beyond chiropractic adjustments, education and support for a healthy chiropractic lifestyle is fundamental. Educate the parents and help the kids.

Consider contributing to the C.S.W. Kids Day program.

Also, consider encouraging your state association to develop a kids’ program, and if they already have one, please contribute to that.

Ed Petty

 

Link to Chiropractic Society of Wisconsin: https://www.chiropracticsocietywi.org/chirokids-day

Link to The Sickest Generation published by Children’s Health Defense, https://childrenshealthdefense.org/ebook-sign-up/ebook-sign-up-the-sickest-generation/

More links to references:

From The Sickest Generation

American children have never been sicker. Over half (54%) are suffering from one or more chronic illnesses.

The “4-A” disorders—autism, attention deficit hyperactivity disorder, asthma and allergies—have experienced meteoric growth, affecting children’s quality of life and con­tributing to premature mortality.

U.S. children are far more likely to die before their first birthday than infants in other wealthy countries and life expectancy is falling, driven largely by rising death rates in adolescents and younger adults. Suicide is the second leading cause of death in teens, half of whom are reported to have at least one mental, emotional or behavioral disorder.

The proportion of public school children using special education services is skyrocketing, with estimates ranging from 13% to 25% of school populations.

Mystifyingly, there is almost no outcry in medical, public health or government circles to find answers and solutions.

 

A Million-Dollar Chiropractic Healthcare Practice — and More in 24

 

When in doubt, paddle out!

We have been refining our Goal Driven System of practice development.

After our management training program completed with outstanding practice managers, it is clear to me that most offices can achieve 6 figures in income.

But why aim for a million dollar (or more) chiropractic practice? Good question!

Because you can. Because it is a challenge that you are worthy of.

Because, in the pursuit of this goal, you and your team will demonstrate your competence. And competence is an internal goal and a need we all want to demonstrate.

Behavioral Science in Practice Management

I cover the concept of Self-Determination Theory in my book, the Goal Driven Business. Much research has been done on what drives us and motivates us to achieve our goals. According to work done by Edward Deci and others, there are three motives we all have:

  • Autonomy (Independence and self-governing.)
  • Competence (Skill and effectiveness at getting something done.)
  • Relatedness (Being part of something bigger.)

These internal needs motivate us more than our motivations to receive external rewards or avoid punishments. Despite conventional “management” practices, external “incentives” only work in the short term. In fact, the promise of extra money and bonuses, like threats, can be detrimental to performance.

There is a right way to provide bonuses — we cover this on our Goal Driven Programs.

Competence in your Chiropractic Team

I want to focus on competence, though autonomy and relatedness are as powerful.

Here is a quote from one of Deci’s books:

“Decades ago, the personality psychologist Robert White wrote a compelling paper about “The Concept of Competence” in which he argued that people yearn so strongly to feel competent or effective in dealing with their environment that competence could be thought of as a fundamental human need.

“People, impelled by the need to feel competent, might engage in various activities simply to expand their own sense of accomplishment. “* (My emphasis.)

What does this mean?

We all want to demonstrate what we can do and even test the limits to see if we can do more. Look at children and the explorations and exploits they attempt. Think of your own crazy youth and all the dumb dares you accepted!

But we become domesticated as we enter adulthood. We censor our drives, curb our enthusiasms, and our purposes ebb.

But the intrinsic drive is still there – an ember that can be stoked.

Getting Stoked

Like the surfers say, the feeling of being stoked is exhilaration and joy. The feeling is worth the effort and losses.

Demonstrating your competence results in the Stoke. But you can’t demonstrate your competence or feel the Stoke if you don’t set big goals and then go for them. You enter a challenge, a contest that pits you and your team against the obstacles to your goals.

Paddling out to catch a wave, a surfer exerts tremendous effort. As they struggle to get out, they need to go through wave after wave crashing in on them until they are finally out far enough to wait to catch the right wave. Waiting, and then finally finding one that no one else is trying for, paddling hard to catch it, and often failing. And sometimes getting caught “inside,” with waves crashing down on them, pushing them into the depths or scraping on the coral reef.

But making that one ride as you smoothly glide over the ocean is a feeling that can last a lifetime.

Any adventurous activity is not for the money. It is to satisfy an internal need—the Stoke.

Improving Competence in Your Chiropractic Practice

Achieving big goals requires big motivation, and improving competence is one way to do so. Here are 6 approaches to improve your competence and that of your team to help you hit your super big goals this year:

  1. Be a coach. Schedule in-office training, seminars, webinars, courses, advanced training, and books for yourself and your team
  2. Feedback and support. Regular Coaching Reviews.
  3. Recognize the wins. Acknowledge and celebrate employees’ achievements and contributions. Including your own!
  4. Challenging goals. Set up tasks and projects that challenge you and your team. Let your team take ownership. Keep it fun.
  5. Go for a million (or 5 million) dollar practice.
  6. Get a coach. Suit up, commit, and be a player.

Remember, you are more than a doctor, provider, and support professional. You are also an entrepreneur and part of an entrepreneurial group.

You are an adventurer!

So set big goals and get out there. Go for the Stoke!

Ed

References:

Why We Do What We Do, Edward L Deci, Gagné, M., & Deci, E. L. (2005). Self-determination theory and work motivation. Journal of Organizational behavior, 26(4), 331-362.

 

2024 – A Good Year to Be Braver in Healthcare, Chiropractic, Business, and Life

2024 – A Good Year to Be Braver in Healthcare, Chiropractic, Business, and Life

GoalDriven.com in 2024 for chiropractic healthcareGood Morning Lake Michigan! Jan 2, 2024

How to Be Braver

This is going to be a good year to be brave.

There are a couple of reasons:

First, there is — and will be — a lot happening in the world and the US. Whew! We got the wars, the elections, the economy, and the behind-the-scenes agitation sowing distrust and division. I don’t need to enumerate. But bravery will help us all.

Second though, it’s a great time to go for it and reach your goals. And why not?

Isn’t that what bravery is? Sticking to your goals, regardless.

Isn’t bravery about caring – caring about where you want to go — and why?

It’s the straight arrow commitment to our destinations — what we want for ourselves and those we care about.

There are many distractions thrown in our way and overcoming them is courageous. But really, it is just sticking to it.

We have our own odd fears, ideas, and biases that can preoccupy us and dampen our cheerful vigor. And there are the odd fears, ideas, and biases of people close to us that can slow us down. And these are kept in constant agitation by the reporting of the factual tragedies and horrors that go on daily. Good news doesn’t sell newspapers. Scandals, sensationalism, and fear-inducing headlines sell.

Our attention, and your patient’s, is manipulated. Look at this, but don’t look over here. Watch out for that person, politician, or virus, be careful, and shelter in place.

But we are not made for shelters. We are explorers and entrepreneurs. We are innovators and dreamers.

As an entrepreneur or working in an independent business, you get hit more than people who work as employees of corporate-controlled businesses. You ‘ll need to be braver than others.

But of course, you are.

Over the last couple of weeks, I had the chance to read through parts of two books. One, by Walter Issacson, on Elon Musk. Great author, he also wrote a biography on Steve Jobs, which I loved. Musk’s grandfather was a chiropractor in Canada, by the way, and his entire family were adventurers. Another book I gave to my granddaughters, and we reviewed in our MBA program, by Reshna Sanjani, called Brave, Not Perfect.

These books and the people in them reminded me that bravery, while not easy, is simply sticking to our goals.

I was also reminded that it’s very difficult to make it on your own.

It matters who you associate with. Loners do not achieve goals. We make our progress with the help of other people.

Don’t let the environment comprise your connection to truth, compassion, and your goals.

Be braver. Help others reach their goals, and don’t be too shy or proud to reach out for assistance.

We’re here – and want to help you achieve your goals. (Contact us about our new programs fore this year!)

It’s 2024. Let’s go!!

Ed Petty, Edward Petty, GoalDriven.com, chiropractic

Ed Petty — Let’s Go!

Goals for the Present

Goals for the Present

Goals are about the future.

But sometimes, they are about the present – and respecting the past.

December is one of those times. There’s a distinct vibration that moves in this time of year, subtle waves of friendliness that sparkle like Christmas tree lights. Almost an instinct — whether connected to a Sunday service before the 25th, a Jolly Old Saint Nick, the candles of Hanukkah, or the winter solstice, we feel a sense of fellowship during this time of year.

With the traditions of other cultures over the millennia, people have gathered with a Spirit of compassion and celebration. People even take time to pause in war.

One example was the Christmas Truce of 1914 during World War I, when soldiers from opposing trenches laid down their weapons and initiated an unofficial ceasefire. The truce began on Christmas Eve and continued into Christmas Day, with soldiers exchanging seasonal greetings, singing carols, and even venturing into no man’s land to fraternize with the enemy. Troops from both sides shared food, tobacco, and souvenirs and engaged in impromptu soccer games.

I think this speaks to our fundamental nature, that we are supportive and kind when unprovoked by the agitations of those who might profit from our conflicts.

As a practice and business goal for your chiropractic and healthcare office, I suggest that this week and next, focus on the present and appreciate the many accomplishments of the past year. Consider your blessings – your patients, profession, teammates, and family.

The Future Can Wait

For now, take time for some gratitude and have a cup of kindness and good cheer.

And play some Christmas jazz. Man!

Below is a link to some mellow Christmas Jazz – 4-hour playlist. Christmas Jazz: https://www.youtube.com/watch?v=Dbgx5ChU3ZM

Carpe Diem,

Ed

Are You Looking at All Your Statistics?

As one year ends and another gets ready to launch, I look back at our clients’ numbers and see that, for the most part, everyone’s numbers went up.

And these are not new offices. Their increases were not because of a snazzy ad campaign or a motivational seminar. Their numbers increased because of their hard work, courage, sacrifices, and love. I am sure the same is true with you and your practice as well: because of the wonderful improvements your patients experience, as a byproduct, your numbers for this year also went up.

But maybe not. Maybe not this year.

Maybe your practice numbers did not go up?

Well, you may not be accounting for all of your positive outcomes. For example:

** Our goal with one office was not to increase their numbers, but just to keep them from going down the drain. The successful outcome was no bankruptcy! Positive numbers did not go up, but negative cash flow numbers did not occur.

** One business owner I worked with, whose numbers had gone up for a few years, but had recently dipped, was able to take a vacation for the first time ever. In fact, because of additional providers, was able to leave for a few weeks. Practice numbers did not go up, but vacation and personal statistics did!

** One practice owner saw her numbers go down. She had her third child and would have gone down further had it not been for the work we did on bringing on another provider who she deftly managed. Family numbers went up!

We do manage by the numbers as these are objective and because so much conventional management is done through emotion, bias, new but dumb ideas, or other weird standards.

But not all accomplishments show up on the standard practice scoreboard. You would need a different set of statistics and a different scoreboard for family, personal, and organizational outcomes.

• Maybe you spent time training in a new clinical technique.
• Maybe your staff spent extra time training and becoming more proficient.
• Maybe you were able to see more of your child’s activities.
• Perhaps you and your spouse finally went on that vacation.

Business building can be understood by the Law of the Farm (Also Law of the Harvest). As Steven Covey says:

“The only thing that endures over time is the ‘Law of the Farm.’ You must prepare the ground, plant the seed, cultivate, and water if you expect to reap the harvest.”

I like this analogy because it shows that so much is involved in producing what finally ends up in your grocery store.

Yes, you reap what you sow. But the sowing itself is an accomplishment that needs to be recognized and acknowledged. If you keep building and nurturing all aspects of your business, including your skills, your people, and your procedures, both in and out of the office, and stay aligned with your mission, your production numbers will improve.

You might take some time this month to look at all the gains you have made that might not show up on the bottom line.

Celebrate ALL your positive improvements in 2023, and prepare for a prosperous 2024.

Stay Goal Driven,

Ed

NGS Medicare Fees for 2024 Chiropractic Services CMT

CMS has now released the 2024 fee schedules for each State*. Note that these often change between the time they are published and the time they go into effect.

According to CMS, the 2024 Part B deductible will increase $14, to $240 as of Jan 1, 2024.

NGS Medicare has released the Medicare Physician Fee Schedule (the 2024 CHIROPRACTIC FEES SCHEDULE) for codes 98940, 98941, and 98942 for Par and Non-Par Part B providers (not Facilities) for dates of service Jan 1, 2024 forward.

Fees for Wisconsin are:

medicare NSG fees 2024

*States include: CT, IL, ME, MA, MI, NH, NY, RI, VT, WI