Internet Marketing and Social Media: Myths and Realities. What’s Working and What Isn’t

** Thursday, May 17, 12:30 Central 45 minutes

Special Guest: Dr. Jamie Phillips

Some of the topics include:

Facebook -  Myths and Realities. How to make it work – and not!
Your Website  — What you can do to improve your website NOW!
Internet  – How you can generate more new patients from the Internet without paying anything.

You and your marketing team are invited to attend this Internet marketing Webinar at no charge.

**Why Internet Marketing? Because it works – if done right.

** Why NO CHARGE? We are offering this webinar at no charge to our newsletter subscribers and friends and colleagues of our clients because many offices get so close to effective marketing but still miss it by a mile. Enuf already!

** Special Guest. Dr. Jamie Phillips. Dr. Jamie sets up web sites for chiropractors across the country and gets them ranking high on search engines. See has been helping our clients increase their Internet presence and generate more new and returning patients for a couple of years.

If you can’t attend, sign up anyway you will have access to the recorded webinar for the next week. Active PM/A members will have full access on PMA members site.

Hope you are having a great month.

Best regards,

Ed

****TO REGISTER for these webinars as an active PM/A client or guest, please go here: LINK    

For health and marketing purposes, a screening is a step by step process of first discovering if a person might have a problem or condition that may need further looking in to.  If there any indication of a possible spinal related problem or condition, the screening is there to also help the person become more aware of their health condition  so that they want to do something about it.

It can be done at any type of a venue, from a health fair to a casual meeting.

It is a sequence of actions that that ultimately ends in the “screenee” making an appointment to come in for no risk introductory service, such as further testing or a workshop.

The example below, taken from our PM&A webinar on screenings from 2012, shows the steps taken during a screening. It is important that each step is taken sufficiently in order for an appointment to be made.

Screening Steps

The actual screening itself is a process of enlightening a person so that they see that they might have a spinal related condition, if indicated, and if so, realize how it might affect them. Also, if left untreated, what the long term affects might be.

They are now ready to be encouraged that they really should do something to address the problem, no matter what!  Offering them an introductory service as a no risk beginning solution now helps them “solve” their ethical dilemma of just what should they do about their condition. This could be a service at your office, or with another provider at another location. Your professional integrity should always be maintained.

There are three general types of “screenees”: roughly 80% or so are not ready to get help with any health conditions, 15% or so are almost ready, and about 5% are ready to do something. Your target is to work with the 5% that are ready. You may be able to influence some of the 15% that are almost ready, depending on your skill in screening. And with your professional and friendly presence, in the long term, you can also influence some of the 80% that are not and may never be ready to see you, but do have families and friends that they are now more likely to support seeing you because of their good experience with you at the screening.

Below are 6 simple steps that can be remembered and used. It is also a good idea to practice these to improve your skill and to train new Screening Technicians.

For more information, please watch or listen to the Fundamentals of Effective Screening Procedures on our PMA Members site from April 19, 2012.

The Art of the “Screen”

1. Find Out More – about the condition.
2. Find Out the Affects – of the condition.
3. Look at the Future – of the condition.
4. Do something  — about the condition.
5. Offer a something to do – about the condition
6. Appointment for something to do – for the condition.

More
Affects
Future

Do
Offer
Appointment

*Screenings are always the responsibility of the doctor and conducted in accordance with local statutes and professional standards.

Click to download a tent poster for your office (in pdf format): Come Alive Thurman

Do you work hard but you just don’t get as far as you should?  The reason may be that you are running into unseen bottlenecks that are choking off your production and suffocating your growth.

Here is an example: One doctor we worked with a few years back had a small office of about 1000 square feet. He was seeing about 140 visits week but wanted to see more. He felt the problem was not enough promotions generating more new patients.

We visited his office and noticed that he already had a decent amount of marketing underway and he was getting external new patients. While his marketing could have been more effective, it wasn’t that bad.

We noticed that the reception area was tiny and mentioned this to the doctor and suggested he move to a larger office. He had his mind made up.  He did not want to get a larger office because he had heard of doctors seeing 300 O.V.’s per week in 1000 square feet with very low overhead and he wanted to do the same.

So we set up a special focus group and personally interviewed his patients. The primary complaint was that the reception area was too small. The patients interviewed said that during peak hours there was no room for them to sit. They said that they felt that he must be too busy and therefore they would not come in to see him because he was full, and that they referred their friends to other offices.

Well, with this information, the doctor finally decided to move into a new office with a larger reception room.  Shortly thereafter, his office visits shot up to an average of 225 per week.

There are a number of lessons to learn from this story. One being not having a fixed opinion of how things should be based upon hearsay, or what may work for one doctor may not work for you. But the biggest lesson has to do with capacity. And, there are many examples of capacity restraints that we often uncover in our consulting and coaching work over the years.

Bottlenecks can occur at the front desk, in the therapy area, and in the insurance department. They can occur with the patient flow, with paperwork or in doctor time.

The theory of capacity management, as expounded by Eli Goldratt and explained in his books, including the best selling The Goal, discusses the theory of capacity constraints as applied to a manufacturing environment.  The same principle applies to a health care facility.

According to Goldratt:“Capacity is the available time for production.” A bottleneck is:  “what happens if capacity is less than demand placed on resource.”

SOME CHIROPRACTIC EXAMPLES:

• Peak Periods. Between the 4-6 pm slot, where there is extra traffic, additional staff or increased capacity is not always provided. If staff feel that patients are waiting too long, or that they are not able to handle all the traffic, they may unconsciously hope the phone does not ring or another patient walks in. In turn, should someone new call or walk in, the quality of service may be poor.
• Paperwork.  Older forms may not meet the current needs, be redundant or even hard to read.
• Poor scheduling of patients: (not cluster booked, not booking for NP or paperwork)
• Doctors waiting for therapy patients. (No therapy staff or therapy after adjustment)
• Front Desk doing insurance and scheduling at each visit (no multiple appointment plan or Prepayment plan)
• Not enough exam rooms
• Clutter in front desk/insurance area
• Quitting time. After a long day, all staff and doctors are looking forward to leaving and really don’t want extra patients to call or come in.
• Backlogs. Undone reports from two summers ago, partially completed projects, cluttered desks or office space, all discourage an increase in production. You only have so much mental capacity, and if it gets frittered away on projects that are not completed, you will have “too many irons in the fire” to add any more
• Doctor talking too much. “Table talk” should be about chiropractic, the patient’s need for care, their progress, and referrals.  Now and then, a few questions about the patient’s personal life to demonstrate your genuine interest is good. Aside from that, there is no need to justify your services with lots of talking. Keep it moving.
• “Difficult people”. Some staff, or patients, will seem to drain you of your energy, or consume too much of your time trying to keep them happy. This can “clog” up your day.
• Doctor too busy doing administrative tasks and micro managing. This distracts him from the work that he needs to do.
• Doctor’s mind “filled up” with lots of experience and no longer curious or interested in practice.

SIX CATEGORIES OF CAPACITY IN A CHIROPRACTIC OFFICE:   We can break practice capacity constraints into 6 categories.

1. Physical. (For example, not enough rooms, rooms too small, or just too cluttered.)Doctor. (For example, doctor doing billing, answering phones, and micro managing. )
2. Procedural. (E.G. making 4 copies of each EOB rather than making an electronic back up)
3. Equipment. (For example, using hand feed copier rather than an automatic feeder.)
4. Personnel. (Not enough staff, poorly trained staff, barely competent staff preventing you from hiring superior staff, and negative staff, etc.)
5. Doctor. (For example, doctor doing billing, answering phones,  micro managing, head “filled” with “krap!” )

REMOVING PRACTICE CONSTRAINTS

Here are some steps to take to remove bottlenecks.

First, start by determining what is the maximum number of patients that could be seen by the doctor if all he or she did was adjust or treat them.  What is the doctor’s capacity in terms of visits? E.G. 250 visits per week – if all she did was adjust, do SOAPs, exams, and report of findings, with 6 New Patients and 5 returning or re-injured patients.

Then, look at what eats up the doctor’s time.  Then, consider the flow of patients, of paper, and anything that slows it down or gets in its way. Consider patients waiting, paperwork waiting, and any times of the day or days during the week where there is a slowdown or backlog.  Honestly check each category below.

Once you do this, have a staff meeting, explain the concept, and get responses from the staff.

1. Doctor’s time: What does he do other than adjust patients? Can it be delegated? Can scheduling be improved so that the doctor never waits? Does she have any redundant tasks that can be made into a routine template?
2. Procedures: Are there redundancies? Is something being done that could be done faster?
3. Personnel: More training needed, more staff needed, better attitudes needed?
4. Physical space: Do you need more space? Could things be arranged differently for greater efficiency?
5. Equipment: Could a new piece of equipment speed things up? Does anything need fixing?

Once you have done this, give yourself 30 days to fix the biggest capacity constraint. Then, reassess. If the constraint is fixed and the flow is improved in that one area, it may have migrated to another area.

For example, a doctor was doing all of the x-rays which took extra time and she was also waiting for patients because they were not “cluster” booked. Solution: staff did all the x-ray work and the doctor just came in, checked, and “pushed the button.” The front desk booked the patients tightly so that the doctor did not have gaps in her schedule. Visits increased by 40 per week, from 160 to 200 for the week because now there was more “room.”

However, now that this was fixed, the bottle neck may “migrated” to another part of the office.  Now, the insurance department can’t keep up with the extra work and a backlog starts to build up in this area.   If this does not get fixed, then the insurance department’s traffic will slow down,  like a traffic jam,  and the office visits will eventually go back down to 160 per week.

When your business is not expanding like you feel it should, you may have bottlenecks or hidden logjams choking and stunting your growth. Fixing these and opening up the flow, even at extra cost, will usually greatly increase production and income and be worth it.

If it doesn’t get fixed soon, give us a call.

Sometime

(copyright Petty Michel & Associates 8/27, 2007. Revised 2012. CHMS, Inc.)

A few months ago a chiropractic office manager called me

Her primary role had been that of Billing and Collections Coordinator, but she was also the office manager part time.  I had worked with the office for a few months and knew the doctor and Dorothy (not necessarily her real name.) I had gone over the role of the Office Manager with her and the doctor. They both felt that they understood the situation and would let me know if they ever needed any help. I was pretty certain they didn’t know what their roles were, or how to execute them, but their minds were made up.

Months went by and then late one Monday morning I got a call from Dorothy. She told me she had been fired. I asked her why? (Knowing her and the doctor, I had a pretty good idea.)  She told me that the number of new patients had been dropping for some months and that the doctor was not happy about this.

She said that she couldn’t believe it. “He fired me for that? I am not even in charge of new patients?” She was upset and went on about how new patients weren’t her responsibility.

What do you think?  Was she right? Or, was the doctor right?

Let’s look at this: the doctor is ultimately in charge of marketing. As the Chief Executive Officer for the business, marketing is a key component of his or her job. But since he is also so busy as a doctor, he needs to delegate most of the marketing activities. But to whom?

1. First, to all of the staff. It is each team member’s responsibility to “sell health.”
2. Then, a staff member could help coordinate all the marketing activities as a Marketing Coordinator or Marketing Manager.
3. You might also delegate different marketing activities to different staff: someone for external events and screenings, someone for the internet, etc.

But behind it all, is the Office Manager’s role to make sure everything is running smoothly.

Actually, no one should have been fired. Instead, they all should have been trained on marketing and especially on MARKETING MANAGEMENT.

This is one of the reasons for our monthly webinars.  We just completed a very informative webinar on the key duties of the office manager (now posted on our members site) which can help clarify the role of the office manager.

The purpose of business is to create a customer, patient, and practice member. I didn’t say that. Peter Drucker did. You should know about Peter Drucker as he is the granddaddy of all management consultants.

“Because it is the purpose to create a customer, any business enterprise has two – and only two – basic functions: marketing and innovation. These are the entrepreneurial functions. Marketing is the distinguishing, the unique function of the business.”  Peter Drucker

Doctor, you are busy.  Your #1 focus should be on quality patient care. But as the CEO of your business, you HAVE to drive the marketing. To do this effectively,  you can and should delegate the marketing activities to others. The office manager is responsible for making sure all office activities are being done effectively, and this of course, includes marketing.

Whatever your office mission states, it has to include the concept of marketing.  It is your job, and everyone’s job, to tell the chiropractic story – and to communicate the value of your services in such a way and often enough that thousands of people come in to get better.

Don’t get fired. Get fired up!

But as your practice grew, your role of “Everything Else” also got busier. This was a distraction from your role of doctor, so you delegated front desk, billing and therapy duties. You still kept the role of “Everything Else.”

As your practice continued to grow with more staff – your role of “Everything Else” expanded geometrically.  This concerned you.

You didn’t think about it much because you enjoyed being a doctor and loved your patients, but when you were very busy, you made more money. You could take a vacation with your family, put money aside for your kid’s education, and pay off debts.  Sometimes, you could see yourself producing even more, helping more people, and being even more prosperous.

These dreams didn’t last long. Your role of “Everything Else” became more demanding.  There were more “everything else’s” crying for attention.  There was too much to do and soon you saw your patient volume dropping. Patients were dropping out of care and new patients became scarce. You had lost control.

Other doctors who were experiencing lowered income blamed insurance companies. Or the economy. Or the modern culture.  All you knew was that it wasn’t fun anymore and there was just too much work to do. Work that wasn’t chiropractic.

The fact is, you were never too sure of this role of “Everything Else” and never really liked it all that much. You didn’t have any training in it like you did as a doctor.  And when all of the “everything else’s” starting coming at you, you felt like things were getting beyond your command.

You experienced some staff turnover and now with patient volume down, you didn’t need as many staff. Gradually there was less to do in your role of “Everything Else.”

This cycle may have occurred to you a few times: numbers up, then more stress, then back down. A roller coaster.

  MONTHLY OFFICE VISITS And here is where you may be now.

If you were to add up the amount of revenue you could have made had you stayed at your highest level, or been able to go even higher were it not for your role of “Everything Else”, you might be surprised how much this “Everything Else” role cost you. Hundreds of thousands of dollars.

= = = = = =  =

If this is your story so far, don’t go away. The last chapter hasn’t been written. In fact, your next one might be completely different. Here is an introduction to it:

You read about the chiropractic Executive Freedom Package and started it.

You discover that the “Everything Else” role is really the role of the business executive. It is the role of the CEO.

You realize that all major businesses have an executive and that there are certain skills and tools as a CEO to be learned. These skills have to do with leadership, management, and marketing.

So you learn these skills and get coached on them.  In time, you get better and better at applying them.

You find a staff member and give her the role of office manager. You get her continuously trained and give her lots of your less important CEO duties. As she gets better, you give her more.

You get someone to help you coordinate all the marketing. You give him continuous training.

You have staff meetings and get the team on board with managing the office.

All the “everything elses” are organized into systematized procedures and delegated to your team.

Numbers go up. Your team continues to improve. They are happy about this as they are sharing in the management of the office and its success. Now that all the “everything elses” are packaged up into nice neat systems, you have time to focus more on patient care, future planning,  personal studies, and other pursuits.

You are now a better leader, better manager, and a better marketer, and your business continues to grow. Your team is happier, more people are getting served, and you make more money.

If someone had only told you about the role “Everything Else” and what it really was all about years ago you would have avoided losing so much money and wasted time.

On the other hand, now that you know what the secret is, you are on your way out of the rut you have been in and on your way to greater freedom.

You can learn more about the “Everything Else” role and how to create the business structure that puts you in command with our new chiropractic business Freedom Package here.

The Lorax is a Dr. Seuss children’s book that was made into a movie in 2012. (more info: Wiki)

We have said this over and over, but you have the opportunity to make and improve your own brand.  And the way you principally do this is through an active and continuous conversation that you have with each of your patients, vendors, staff, and local businesses.

You start your conversation usually on your patient’s first visit. Then you continue it on the second and on successive visits thereafter. Also through newsletters.  Also while doing a community event, letters, or even while shopping: “Hi Bob. How did your wife do at the 5K run?”

The conversation has to be two way.  You have to listen as well as communicate.  Facebook fits right into this, but you have to post more than what you copy and paste  from the American Chiropractic Association or from Mercola. Pictures of babies, puppies, recipes from a patient with photos, and anything you feel genuinely passionate about.  Anything endearing: “Aw, look at the cute baby.” Even a bulletin board with local stories of your patients let’s others know that you are paying attention.

Your brand is based upon how you converse with your select community, your own tribe.

Here is a great quote from Seth Godin’s book, Small is the New Big.

“Markets engage in conversations, but marketing often doesn’t. The reality is that most brands are actually monologues, not dialogues.  A conversation might create a better, more robust, more useful brand but, alas, most organizations can’t handle that truth. So they do their best to do it the old way.

Big brands are dying. Little brands are doing great.”

• For guests (not active PM/A members), you may register for all  of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

• For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK

TEAM PERFORMANCE

How well does your staff perform their duties?

Studies show that there are 3 primary methods to improve performance:

• Deliberate Practice
• Expert Coaching
• Family and social support.

Natural talent is a factor, but is never enough by itself and is often overrated.

So, how well does each member of your team perform?  Are they experts? Are they ready to teach their own seminars?

And how about your how team? How well do all of you work as a team? Will they go to the Super Bowl or World Series this year?

Your office responds to training like any athletic team or musical group. If the scoreboard shows that the numbers aren’t where they should be, then individual performance or team performance is a likely reason why.

What is the fast and economical solution? Training. Coaching.  This is something you and your office manager, and each team member can learn.

Team training is not done by just one person; it is done by the team. One member helps the other member, and back and forth until both improve.

Our webinar this week covers just this topic.

 10 Tips on How to Be An Effective Team Trainer

Tools and Tips for Fast Team Training That Pay Off

Thursday, March 8^th, 12:30 CT

Don’t miss it. Excellent for Clinic Owners (CEO’s) and Office Managers.

 ===============

 COMMUNITY SERVICES: External Marketing

We all live in caves.

We live in a cave house. Then we get into our cave car and drive to our cave office and stay in our cave rooms.

Meanwhile, there is a whole world out there with thousands of people that need your care, but don’t know it.  And the main thing you have to do is to just … SHOW UP and do something.

What’s so hard about that?

You all have done screenings and you all have done some kind of external events: workshops, school presentations, visiting medical offices. The hard part is not the presentation. The most difficult (and it is not difficult) is getting these events scheduled.

Ideally, you should have your community services calendar scheduled with a few external events of one kind or another every month.

This is the subject of our next marketing webinar.

 Scheduling Effective External Events and Generating External Referrals

Learn how to schedule effective events in this short webinar.

Thursday, March 15^th, 12:30 Central Time.

How to Register

For guests, you may register for all  of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK