What Is Your Full Capacity in Your Chiropractic and Service Business?

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chiropractor adjusting a full capacity waiting roomWhy Running Below It Costs You More Than You Think

The idea of full capacity is so simple that it is easily overlooked.

WHAT IS FULL CAPACITY AND WHY IS IT IMPORTANT?

Full capacity is when you are serving as many people as possible, given the available space, equipment, and staff. In other words, what is the maximum number of people you can see in a day – comfortably – given full support?

This number will vary, of course, depending on how you practice.

Full capacity is a vital goal for financial survival. You are already paying full price for your space, equipment, and team. With lower production, your overhead rises and your profits decline. Overhead actually jumps. If you’re running at 50% of full capacity, you’re not paying “half the overhead” — you’re paying close to the same rent, staff wages, and equipment costs as if you were at 100%. That’s why practices at half capacity often feel like they’re working just as hard, if not harder, for a fraction of the profit.

WHAT GETS IN THE WAY OF FULL CAPACITY IN YOUR CHIROPRACTIC AND SERVICE BUSINESS

Let’s say you have a busy month. See lots of patients. Your front desk is busy scheduling and keeping the appointment book full.

One afternoon, during a momentary lull, you notice the front desk staff has a few moments, so you give them some insurance work to do. A week later, the chiropractic insurance department does the same.

The following month, everything seems the same… the front desk is busy.

But visits are down.

What happened? Can you guess?

Any system or flow pattern will accumulate unnecessary additions – extra checks, additional actions, or routings that start to slow the flow.

This gradual shift and increase in systems is called “Process Creep.”

PREVENTING PROCESS CREEP

Step back from your practice and ask the engineering question: given my space, staff, and equipment, how many visits can we see each week? What is our full capacity?

For practical purposes, use Visits as your metric.

That number is your Full Capacity Goal. Once you know that, you work backward: what’s standing between where you are now and that number?

You need to look for the capacity barriers in the way – and remove them! These are different types of bottlenecks. I discussed this in earlier articles and in my book, The Goal Driven Business*. Some barriers are in the systems, while others can be in the people.

It could be patient notes, patient scheduling, or even too many services available. Not enough new patients, interestingly, often goes back to a mindset.

Complexity occurs naturally — so you have to work to simplify the flow and eliminate unnecessary steps. This gives you more time to engage with your patient – your customer.

But it all starts with:

  • Determining your Full Capacity Goal – the real ceiling, not a guess
  • Removing the barriers standing between you and it

Contact me if you want to explore what might be holding you back from reaching your full potential!

And stay Goal Driven,

Ed

Email

*References

Ask Lisa: Practice Roadmaps to Help Your Bottom Line.

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chiropractic roadmap business plan

Ever get the innate sense something is missing in bridging gaps you may be experiencing in your practice? As a result, you may tend to keep guessing and overthinking processes. Understandable from both a clinical perspective, and in today’s reimbursement landscape. Documenting and mapping out a business plan/practice roadmap can help calm the chatter.

According to Investopedia, “A business plan is a document that defines in detail a company’s objectives and how it plans to achieve its goals. A business plan lays out a written road map for the business from marketing, financial, and operational standpoints.”

A business plan can help You navigate and evaluate the revenue cycle categories, which by the way are our specialties:

1.) Credentialing: The better HMO/PPO payer networks you participate in based on your geographic location and patient insurance type, the better the value of your practice.

2.) Practice Appraisals are a great foundation to your overall plan to see what your practice is worth at the time the appraisal is done.

3.) Network participation assessments: Have you recently ran reports on each payer group in your practice management software to see if you are getting reimbursed per contract? Where are any shortfalls you may want to voluntarily opt out of participating in? You’ll want to make sure you opt out of a network voluntarily, and intelligently – getting kicked out of a network involuntarily can bite you in the ass later on if you or your successor want to be in the network and continue filing insurance for patients. A common question on credentialing and re-credentialing requests is if you have ever been terminated involuntarily from a payer group or government program.

4.) Accounts Receivables: Where are your payer and patient receivables month to month? Is it increasing? Decreasing? According to Healthcare Financial Management Association (1), your ideal A/R percentages should fall here:

0–30 Days: ≥ 80% of your total A/R should fall into this category.

Over 90 Days: Less than 10% to 15% of your total outstanding A/R should be in this bucket.

Over 120 Days: Should ideally be kept under 15%. Accounts older than 180 days are often written off as bad debt.

If your financial policies are strong, you should have very little outstanding cash accounts over 90 days. Auto claims with attorneys and commercial secondaries should be about the only claims out in these categories.

5.)Meeting state and federal compliance requirements. Have you had a compliance assessment completed?

We can, have, and do help offices in each of these areas. Just Ask…

Lisa

Happy 250th Birthday, America!

Reference:  hfma.org- 7 KIPS Providers Should be Tracking

Still Independent After All These Years – Chiropractors and Other Doctors that Put Health Freedom First

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declaration of independence and American flag in celebration of the 250th birthday of America for chiropractic offices.

What you and the Founders have in common

This is the U.S.A.’s 250 year anniversary.

That is a Big Deal.

If you read the Declaration of Independence, it reads almost like a poem.

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the pursuit of Happiness.

56 delegates from 13 colonies got together in 1776 in a sweltering building in Philadelphia. Reports indicate there was a lot of bickering and that the delegates were pretty much a bunch of radical nonconformists.

But they all agreed upon certain things:

  1. The tyranny and abuse the colonialists experienced from those who ruled over them. (England)
  2. The opening line above – “that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.”

In certain respects, I have to compare those men back then with the chiropractors and other independent health professionals of today.

For example, among the delegates were:

  • Franklin — Printer, inventor, self-made. Deeply irreverent. Did not fit any mold.
  • Jefferson — Brilliant, contradictory, restless thinker. Not a crowd-pleaser.
  • Adams — Cranky, blunt, famously difficult. Cared nothing for being liked.*
  • Tom Paine was there too. He wasn’t even a delegate. From what I can tell, he crashed the party and was loud, outspoken, angry, and uncompromising! **

I am featuring these men because, honestly, they remind me of you and the many doctors and business owners we have worked with over the last nearly 40 years!

All different, but all shared common GOALS – Liberty.

I can’t help but see the connection between what these brave men fought for and what the brave men and women continue to fight for today in chiropractic and independent, integrative health care professions.

We’ve been rooting for you since we started, and will continue to do so.

Have a great 4th and celebrate our nation’s independence — and while you are at it, the independence of your profession and business as well!

Keep to your goals!

Ed, David, Linda, Lisa, Phyllis and Barbara

* Founding Brothers by Joseph Ellis .** Wikipedia

Your Front Desk – Practice Driver or Practice Denier?

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front desk comparison in the chiropractic officeI walked into two businesses recently.

I needed some printing done so I visited a local printing business. It was near a local college. As I walked in, I noticed that the front desk was covered with a see-through plexiglass, from the ceiling to the counter. There was a small opening just above the counter. The woman behind it looked up, begrudgingly, as if I was interrupting her. I asked her some questions and soon decided NOT to work with the company.

But here’s the weird part…

It was a printing company that made signs. So, it had its own sign, a colored banner actually, up at the top of the plexiglass on the Front Desk. It read: WE ARE ALL VACCINATED.

Now, I don’t keep up with all the new trends, like the latest songs, clothing styles, and what is popular nowadays. So, I am asking, is this the new COOL?

Then, the next office I visited was a chiropractor’s. So, I walk up to the front desk. Well, not all the way. In front of the front desk was high table, belly-height. I guess this ensures that I just don’t get too close to the person who is on the other side of the desk.

So, from a distance of 4 to 5 feet, the woman at the front desk looks up from what she was doing and with a concerned and cautious look, asks how she could help me. I attempted a conversation, but she was not interested. I said that I have known the doctor for many years and wanted to drop something off for her. She was still not interested in me or the promotional material I was leaving for the doctor.

== == ==

What the heck?

What is wrong with people nowadays?

No… “Howdy partner, what brings you into town?” “You from these parts?”

Is everyone scared or angry?

So, this takes to me to the point of this newsletter… your Front Desk.

== == ==

Why do you have a Front Desk?

What is its Best Purpose?

→The purpose of your front desk is to fill up your appointment book.

→The ideal outcome of the Front Desk is a fully scheduled – and kept – day.

How does the Full Desk fill the book? You name it:

  • Being friendly and conversational is a good start.
  • Not being frightened of germs or cooties from cheerful older guys
  • Converting phone call inquiries to appointments
  • Generating referrals from existing patients’ families, friends, employer, and clubs/associations. (This can be a significant source of new patients.)
  • Retaining existing patients.
  • Getting involved in community events that generate more new patients.

Basically, the front desk should own patient volume – and be rewarded for it. They should be a “Demon on Control,” and “Aggressively Friendly.”

Keep it simple.

Do not burden the Front Desk with insurance or other admin duties. That clogs up the flow. (This is too typical and tempting, so guard against it.) And don’t frighten your Front Desk staff about the dangers of germs or other people!

Keep it simple and focused to fill up that appointment page/sheet/screen.

And remember – “There’s always room for 1 more!”

Stay Goal Driven,

Ed

Scale Your Chiropractic and Healthcare Practice?

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chiropractic practice growth graph

 And what does this really mean – to scale?

I’ve been seeing ads all over social media blasting away about “scaling” your practice – chiropractic, dental, any service business.

But what does it mean?

The online Webster’s dictionary does not have a definition for it as it is used in business.

It’s really a math term.

Scaling is keeping the basic proportions of an object the same but just increasing its size by multiplication. “Growing,” as opposed to scaling, is just adding things. For example, you may add more new patients, but you also add to your expenses.

More for Less

Scaling is getting more for less.

When we launched our multiple clinic centers here in Wisconsin in the 90s, we did add locations, doctors, and front desk staff.

But, we were careful not add the same number of billers, managers, or marketers. We developed systems to keep our growth limited in most areas while increasing production.

Scaling is driven internally. Scaling is improving what you have – your people and your systems.

So how do you scale?

You improve your people and systems each month.

And improvement is done through coaching.

The Best Coaches

Vince Lombardi, former Green Bay Packers coach, is credited with focusing on fundamentals in training camp, and is reported to have said:

Practice does not make perfect. Only perfect practice makes perfect.

And what did Dr. Clarence Gonstead say – while he was adjusting 300-400 visits or more a day?

I need more new patients?

No! He said:

Practice. Practice. Practice. Never stop.*

If coaching improves what you already have, and this produces scaling, what gets in the way of coaching and practicing?

The Biggest Barrier to Scaling Your Chiropractic and Service Practice

Your biggest barrier to scaling is not new patients. It’s that you don’t have enough time to practice and improve your business.

That is the hidden reality with nearly all competent and decently run practices. The clinic director does not have enough time to work ON the business.

Michael Gerber’s The E-Myth is practically required reading in chiropractic. Every doctor nods at his advice to work ON the business, not just IN it. And then goes back to adjusting.

Why? Because something is missing.

A manager and a management system that supports improvement.

The research by Gallup reveals:

“Gallup finds that the quality of managers and team leaders is the single biggest factor in your organization’s long-term success.” *

The manager takes care of business operations so that the doctor can:

1) focus on improving patients, and then,

2) focus on improving the business.

Most practice/office managers I have worked with are willing and capable, but not quite sure about what to do or how far to go. Good management is a skill, just like doctoring.

If you have a manager, encourage them to read our Tuesday Goal Driver newsletters. Coach them so they improve!

And stay tuned for more information about our practice MBA this fall. You can also sign up for our Practice MBA Waitlist where we will offer special info on practice management.

Fall 2026 Practice MBA Waitlist

== == ==

Scaling is generating more production with the same or less resources.

The key to scaling is improving your systems and people.

And the key to improvement… is a competent and motivated manager.

Keep Driving,

Ed

References

*It’s The Manager, Clifton/Harter

*Clarence Gonstead, Wikipedia

Communication: The Real Practice Builder in Your Chiropractic and Service Business

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chiropractor understanding patient

Seek to Understand First

Last week we reviewed the Japanese concept of Ichi-go Ichi-e – “One Time, One Meeting.”

The lesson was simple: Be present. Be interested.

But why is that so important?

Because communication creates relationships. And relationships create practices.

But you think you already know this, right? Well, yes and no.

Intellectually, perhaps you do. But in real life… a practice is busy, and life is full. So, communication often devolves into a text or is abbreviated.

Authentic human communication takes time — time that busy people don’t always make.

Communication with Your Chiropractic Patients

Doctors rightfully focus on adjusting and treating patients. Staff members believe their primary job is scheduling, collections, insurance, or even marketing.

The Clinic Director is looking at the bottom line.

But underneath it all — is communication.

Communication is the operating system that allows all the other “applications” in your practice to function.

Every patient who walks through your door is asking a question:

“Do you understand me?”

Not necessarily with words. But they are asking it, nonetheless.

Patients want competent care. They also want to be heard, understood, and valued.

When patients feel understood, trust grows. Trust is the foundation of every successful relationship.

And when trust grows, recommendations are accepted more readily, appointments are kept, referrals occur naturally, and relationships strengthen.

Communication Within the Chiropractic and Service Team

The same principle applies inside the practice.

Your practice is composed of people. Staff, chiropractic associate doctors, and providers often wonder why things are managed the way they are, why something was changed, or… whether their work is any good or appreciated.

Over the years, I have seen staff members leave practices not because of pay, benefits, hours, or workload.

They left because they didn’t feel understood. Their questions went unheard, and their accomplishments went unrecognized.

And people don’t always get up and just leave a relationship. They usually leave mentally first – months ahead of time.

I bet right now, you can think of how this applies to you and your situation.

This applies to any team. It applies to family and family members as well.

And it certainly applies to your patients.

__ __ __

Communication is more than talking. It is more than giving instructions. It is more than conducting meetings.

Communication requires being there — with attention and genuine interest. Then it needs understanding the other person’s point of view well enough that they know you understand.

It also requires time, but it is time well invested.

When the quality and quantity of communication in your practice improves, the practice numbers will go up!!!

As Stephen Covey says, in his 7 Habits of Highly Effective People, Habit #5 is:

Seek First to Understand, Then to Be Understood

Stay present. Stay interested. Listen to understand.

The results may surprise you.

People stay, and are happy and productive, where they feel understood.

Patients.

Staff.

Providers.

Family.

Keep driving – what you are doing is important!

Ed

P.S We work this concept strongly on our Practice MBA course this fall – with tough but fun exercises!

And remember,

A practice is a network of relationships – created and sustained through communication and service.

What’s Happening with Fulcrum/Chiropractic Care?

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Note: This article pertains mainly to offices in the Midwest, but you may find the information interesting if you live outside of the Midwest.

As you may have heard, Fulcrum/Chiropractic Care (a Minnesota-based, nonprofit physical medicine benefit management organization) will be ceasing contract operations effective August 31, 2026.

For those of you participating with Fulcrum, please watch your emails from Fulcrum and/or each payer group for further details and timelines. Whole Health Inc. will be taking over most of the below payer groups, and have advised some offices, via email, that they will be in contact.

We strongly recommend you ask Whole Health for a contract to review, along with a Fee Schedule.

Below is a sampling of what we know to date. Please refer to the FAQ included here Fulcrum Health Inc.  for a full list of the payer groups impacted.

  • Aetna/Allina
    • Termination date with Fulcrum: 07/31/2026
    • Contract through MultiPlan to stay in network (non-Minnesota), and SecureCare (Minnesota offices)
  • Aspirus:
    • Termination date with Fulcrum: 07/31/2026
    • Aspirus is working on a transition plan; no further details at this time
  • BPA
    • Termination date with Fulcrum: 5/31/2026
    • Claims for dates of service on or before 5/31/26 must be submitted to Fulcrum no later than end-of-day 7/17/26.
    • No further details available at this time.
  • Cigna
    • Cigna will contract their chiropractic network through First Health.
  • Quartz
    • Termination date with Fulcrum: 6/30/2026
    • Quartz will handle services in-house and will contract with provider groups only. They are focusing their outreach based on member utilization, geographic coverage & network needs. Provider groups that haven’t submitted claims within 12 months may not be contacted. If chosen, Quartz will send a group contract via Docu-sign and should have been received by 6/1/26.
  • The Alliance
    • Termination date with Fulcrum: 8/31/2026
    • The Alliance is actively finalizing the contract and coordinating transition details with the new provider network partner. Once completed, their new provider network will reach out with next steps.
  •  Zelis
    • Termination date with Fulcrum: 6/30/2026
    • No further details available at this time; however, if you are credentialed and contracted directly with Zelis, you should not be impacted by this change.
  • WPS
    • Termination date with Fulcrum: 7/31/2026
    • Fulcrum is sharing provider credentialing files with WPS. WPS may contact providers or providers may reach out to WPS at Provider Contracting.
    • WPS informed me that the administration of their chiropractic network will transition to Chiropractic Management Services. To remain participating, providers will need to reach out to  CMS Services LLC.
    • WPS indicated their termination date with Fulcrum is 7/1/2026 (different than Fulcrum’s termination notice indicating termination on 7/31/26).

Additional Questions? We can help! And we will find an answer for you.

A big Thank you to Wisconsin’s Robyn Tozer for her work in helping to get initial updates – Thanks, Robyn!

Lisa

Ichi-go Ichi-e in Your Chiropractic and Service Business

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ichi-go ichi-e

For better case acceptance and retention in your chiropractic and service business
–be present and be interested.

________________________________________

We live in a fast and shallow world.

We spend more time in front of screens than we do with people. Conversations are reduced to texts.

In the office, scripts are learned, smiles are trained, and interest is manufactured.

Everyone does their best, but staff and doctors are often rushed. And our culture has become used to a kind of electronic operating system that insulates us from one another.

But in the end, we are people, not systems. We are social beings.

Your patients want to be seen. They want to be heard and understood. They want an honest relationship.

Remember that:

A practice is a network of relationships – created and sustained through communication and service.

A relationship is created through communication. The requirements for communication include attention and interest.

Be Present

Years ago, I spent some time in Japan. While I was there, I attended a traditional Japanese Tea Ceremony with a few others. On the wall was a plaque, like the one at the top of this article.

It translates to “One time, One meeting.”

The idea is that, at this moment, this moment is its own. It will never happen again. Therefore, respect this moment, this time, with this person.

Just be here. Don’t think about what to say next. Respect this time.

Be Interested

Every person who walks through your door has lived an entire life you know nothing about. Each has a hobby, a loss, a dream, a funny story. It is always there.

People, your chiropractic and service business patients are interesting. You can always find something interesting about another person. And when you show interest – genuine interest, the other person feels it immediately.

They can also sense if it is fake!

When practicing “scripts”, or what to say and when to say it, rehearse being present with your patient. Practice being interested in them.

Real interest is never faked.

In every successful practice and healthcare business I have visited over the last nearly 40 years, these two qualities were naturally demonstrated by the doctors and staff.

And when it was present, there was a lightness and happiness that pervaded the practice – and it showed up in the numbers!

Practice MBA

This September, we will go deep into this subject and practice these points in our next Practice MBA program. We are putting the program details together now. Stay tuned for more info coming, and if you really want the inside scoop, you can sign up for our Waitlist below.

And thank YOU for being a subscriber and reader. Please forward to a colleague or friend if you want.

We are interested in you, so feel free to contact us anytime.

Stay present, stay interested, and

Keep drivin’ to your goals,

Ed

Do You Have ADHD — Most Chiropractic Entrepreneurs Show the Signs

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If you own a chiropractic practice, or any other type of service business you likely have some degree of ADHD.

How do I know this? Experience!

We have worked with business owners, and especially chiropractors, for 40 years. You all have the American entrepreneurial spirit our ancestors had — go West, homestead, start a business, make a claim!

WHAT IS ADHD?

ADHD — Attention Deficit Hyperactivity Disorder — is officially defined as a condition characterized by persistent patterns of inattention, hyperactivity, and impulsivity that interfere with daily functioning.

That’s the clinical version. But I wouldn’t call it a “disorder.” In fact, for many entrepreneurs, it might be closer to a gift.

Research consistently finds ADHD traits at significantly higher rates among entrepreneurs than in the general population.* Here are a few you may recognize:

  • You can see the big picture, but become impatient with the details.
  • You get excited about starting things, but follow-through is weak — “shiny” new programs and equipment draw your attention, while maintaining systems and procedures drift away.
  • You struggle with time management and organization.
  • You get bored easily, especially with tasks that require prolonged mental effort.

ADHD and the Chiropractic and Healthcare Entrepreneur

On the plus side, these same characteristics often help a business owner:

  • High risk tolerance lets you bet on yourself and act before all the information is in.
  • Creativity — I have been genuinely impressed by the sometimes genius-level solutions of many chiropractors.
  • High energy and urgency create a driven intensity that people find both exhausting and magnetic.
  • Comfort with chaos makes the startup environment feel natural rather than threatening.

But these same traits can stall the growth of a practice:

  • Starting things is easy — finishing them is hard.
  • Detail and administration are not strong suits.
  • Structure, routine, and repetition are exactly what the ADHD brain resists — yet consistency is what a growing business requires.
  • Impulsivity and changing directions can confuse and demoralize staff who need steadiness from leadership.
  • The practice remains dependent on the owner’s daily presence and energy.

Whether you have an ADHD brain or not, you are still an entrepreneur, and some of these traits just come with the job.

I am sure this is why Michael Gerber wrote The E-Myth, and it is why I wrote The Goal Driven Business. There are plenty of other books and researched solutions to this business dilemma.

IF THESE AE THE SOLUTIONS, WHO WILL IMPLEMENT THEM?

The big question is — who is going to implement the solutions? The entrepreneur?

Doubt it.

THE ENTREPRENEURIAL BRAIN — AND WHY IT NEEDS A MANAGER

Gallup put it plainly in It’s the Manager — the quality of managers and team leaders is the single biggest factor in an organization’s long-term success.

Many of the traits associated with ADHD are noble and admirable, and I applaud the courage it takes to build something.

But passion without structure stalls. And structure — is management — putting systems in place, keeping them in place, and steadily improving them.

The most honest advice I can give you is this: get a trained manager — someone whose brain complements yours — who loves the structure you resist and maintains what you build.

This September, I’m opening a small cohort of 20 managers and their entrepreneur doctors for our next Practice MBA Program – our 4th.

If that interests you, stay tuned. We will be putting up a Waitlist next week with more information.

Ed

* Research on ADHD traits among entrepreneurs has been documented extensively, including studies by Johan Wiklund et al., published in the Journal of Business Venturing. Wiklund et al., Entrepreneurship Theory and Practice, 2025. Estimated 29% of entrepreneurs meet ADHD criteria versus 4-5% of the general adult population.

Get Off the Internet and Into Your Chiropractic Neighborhood This Summer

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While Everyone Else Is Going Viral – Go Local

Community health screenings remain one of the most effective marketing tactics for you.

They can deliver genuine human connections that cut through digital noise and advertising.

We are saturated with social media “content.” And increasingly, it is AI-generated content. Fake.

But you are not fake! You and your team are real and alive.

Trust is a big factor in healthcare, probably the biggest. As I pointed out in an earlier newsletter, trust in MDs has crashed. And trust is built far more effectively in person than through a smart phone.

By being involved in a community event, you demonstrate that you are a member of the community, just like those who walk by your booth.

Also, people who attend these events are usually more motivated than social media scrollers. They are more apt to schedule for further services at your office.

We’ve been doing health screenings with and for chiropractic offices since the 80’s — believe it or not. But the fact is, they still work!

Now, there is some tech on how to make the screening or information booth work for you. So, there is that. You can’t just go sit in a chair and wait for people to come to you.

List of What Makes a Chiropractic Healthcare Screening Work

Here is a fast list of the key duties:

  1. Venues and Admin. Finding suitable screening locations takes work and is vital. Then, there is the admin – registering for the event, bringing the forms, equipment if you use any, extra personnel, and handouts.
  2. Setting up. The setup is simple. They are centered around the two roles described below.
  3. Two Roles. There are also 2 roles at the booth.
    1. The Greeter. Think of the Front Desk. Friendly. Controlling! 😉 They fill the booth.
    2. Then the doctor or the Screening Tech. I still have my name tag, “Ed – Screening Tech!” The doctor checks the subjective and then can use an objective tool, such as a posture analyzer, a mirror, or other equipment. Primarily, the consultation is the determining factor. Screening equipment can help attract people to your booth or even validate what comes up during the consultation.
  4. Scheduled for further testing. If indicated, the doctor or screening tech encourages the screenee to come for more thorough testing.

Those are the basics and they work. A well-run screening can generate 5 or more new patients in an afternoon.

Bonus: The Reunion Effect

And besides generating new patients, these events always reactivate former patients!

Doctor or staff member: “Hey Frank, haven’t seen you for a while!” (Frank, looking sheepish) “Yea, I need to come in. Been busy.” (Greeter schedules Frank.)

Also, you can generate new community alliances for future screenings, talks, and mutual referral relationships.

Your people. They are looking for someone — let them find you.

Stay Goal Driven,

Ed

What Gets Measured Gets Done in a Chiropractic Business, or Any Business

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chiropractic statistics scoreboard

Goal Driven and Team Managed

Sometimes you can’t see the forest for the trees.

Sometimes you think things are worse than they are.

But then again, sometimes you think things are going better than they are. And then,

BANG! Poop hits the fan!

What is the best way to determine how your business is doing?

Your Chiropractic Healthcare Scoreboard

Your numbers are the best indicator of your performance. They are your scoreboard. They are your Google Maps, dashboard, and your altimeter as you take your business off the runway and up towards your goals.

In our consulting work, we too often see major management changes driven by a minor error, hearsay, or emotion. This can have devastating long-term results.

On the other hand, improvements that show up on the stats can be ignored if no one is watching them.

One chiropractic office we worked with continued to see an increase in new patients referred from a local gym. But amidst the busyness of the daily patient care, they hadn’t noticed. Since we closely monitored their numbers, I saw this increase in new patients from a local business on their New Patient Tracker. After discussing this with the doctor and manager, they finally took action to strengthen this valuable relationship.

Having a scoreboard can help your team be more engaged in the business. A great example is keeping a line graph of the percentage of kept appointments. This helps the front desk team manage themselves by objectively showing how they are doing in keeping patients on track.

You can miss the good things — as well as the coming crash. Numbers help you predict what needs fixing before things get ugly and what needs reinforcement to keep the good times going.

Ultimately, statistics tell you if you are moving toward your goals — or away from them.

Unfortunately, most offices do not consistently keep track of their numbers in such a way as to easily review them or their trends.

As a result, business owners do not get the information they need to manage their businesses properly. Software can spit out reports that can help, but they are not enough. And usually only partly used, if at all.

Tips for Using Your Scoreboard

  • Key numbers. Monitor week-to-date and month-to-date numbers, especially new patients, visits, charges, and collections.
  • Line charts. We use monthly line graphs plotted over 1-2 years. This is the visual that clearly and simply shows the truth – are you headed up or down? This is the first thing I look at when checking any performance indicator.

line graph of chiropractic statistics

  • Percentages. Use percentages, such as visits per new patient, to gauge how long your patients stay with you.
  • This year to last year. You should be able to compare this year-to-date with last year-to-date.
  • New patients. Track the sources of your new patients as well as the types of new patients.
  • Weekly reports. Have someone in your office give you a daily, or at least a weekly and monthly, statistical report.
  • Individual providers. If you have multiple providers, they should have a complete package of their performance indicators so they can better manage their performance.

I can’t recommend a more valuable management tool for managing your business profitably.

Your analytics scoreboard will help you—and your team—navigate toward your goals.

Stay Goal Driven,

Ed

Ask Lisa: What the Heck is HETS? And Other Helpful Resources

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SPECIAL ANNOUNCEMENT RELATING TO THIS MONTH’S ARTICLE

KMC University is hosting a live “Answer Call” to help you take action now on the CMS HETS update.

Keep More Cash: Don’t Let the CMS HETS Update Disrupt Your Revenue
Presented by: Rebecca Scott, CPC, CPCO, CPB, CPPM
Date: TODAY! May 7, 2026
Time: 1:00 PM – 2:00 PM (MT)
For more information read their newsletter

Download the Free Template NOW
Insurance Benefits Verification Form(docx)

If you have received communications from Medicare regarding HIPAA Eligibility Transaction System (HETS) requirements, keep reading for information that will be helpful as you navigate if this applies to you.

First don’t panic if you received communication instructing you to register … HETS is only a beneficiary eligibility tool that will sync within your Clearinghouse or EHR Program, and may apply to you only if both of these scenarios exist in your office:

  1. Insurance Verifications are part of your practice operations. (Verifying is a key component to your revenue cycle and keeping you in the know for your patient financial consultations.)
  2. You normally use your clearinghouse or EHR Program as your insurance and Medicare benefits verification tool.

If you do not pay extra for and do not have the benefits eligibility verification service with your clearinghouse or EHR Program, HETS is not applicable to your office.

You may be now asking… What are the best third-party payer verification tools? Here’s a current breakdown for you:

Medicare Verification: Connex is CMS Medicare’s Portal to use to verify eligibility and benefits, and claims. If you do not have a Connex account you have two options:

  1. Apply for an account Here
  2. Add this service to your Clearinghouse contract for an extra fee. If you go this route, you will need to follow the HETS policy and procedure. Learn more here: HETS

Medicaid Verifications: Each state has its own Medicaid Portal/website for checking eligibility in advance of treating your patient. Use your favorite search engine to search for your state’s Medicaid online Portal website. Keep in mind each website may have a different default browser that works better; for example, Google Chrome may sync better with the site vs. MS Edge.

Major Commercial Payers:

  • UHC/Optum/AARP: Verify here UHC Optum or call the Provider Line on the patient insurance card. Make sure to get the representative’s name and a call reference number if you need to follow up on a claim once the remittance comes back.
  • UMR: Verify here UMR or call Provider Line on the patient insurance card. Make sure to get the representative’s name and a call reference number if you need to follow up on a claim.

Use Availity Portal for patient benefits and eligibility: Availity

Currently for these payers:

  • Aetna
  • BCBS Plans, most states
  • Humana
  • CIGNA
  • Well Care for Medicare/Medicaid

Implementing and maintaining patient benefits verification will help you plan ahead for your financial consultations which is an important part of managing your revenue cycle and generating income.

Follow-Up Questions? Just Ask…

Lisa
920-334-4561

Please share this newsletter with your colleagues so they may
benefit from this information too!

Playing to Win in Chiropractic and Healthcare

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Bill Walsh, Head Coach of the 49ers, conferring with Joe Montana

Bill Walsh, Head Coach of the 49ers, conferring with Joe Montana.

Practice Management as a Sport in Your Chiropractic and Healthcare Business

I enjoy sports.

Well, enjoy isn’t quite right… Enjoy is too passive. I don’t think you can just “enjoy” sports.

It is an activity you play to win.

That summarizes it. You embark on a pursuit where you want to achieve something — but you may not. You may lose! So, you have a goal – to win. And not to lose.

But I think the keyword is…”PLAY.”

I will come back to this.

All Kinds of Sports

Many of you have kids or grandkids involved in some kind of sport — baseball, track, chess, even online games. Maybe you play yourself.

I recently bought a book for my grandson who pitches. It’s called Ninety Percent Mental by Bob Tewksbury, a former Major League pitcher. Reading it, I realized his tips apply just as well to running a practice — because where you work has all the elements of a sport:

  • A scoreboard
  • Plays and routines
  • Teammates and coaches
  • A playbook
  • A time limit
  • Goals and obstacles to overcome

Tips on Winning in Your Chiropractic Healthcare Practice

Tewksbury talks about two things that stuck with me:

The “Little Man” — the inner voice that tries to derail your performance with negative thoughts. Learn to recognize it and silence it.

Pre-game Routines — controlled breathing, visualizing success, positive affirmations. These help players stay calm and focused when it counts.

Here are two of my own:

1. Stay focused on your Goals. This means both the big ones — your purpose, your why — and the practical ones, like what you want to achieve by the end of the week. Visualize them. Commit to them.

But then…play!

2. The importance of Play.

A sport is an activity you play to win. The keyword is PLAY. Not fight, not stress —but play.

When work becomes too serious, mistakes multiply and stress fills the room. In a chiropractic practice, patients feel that. Trust me — I’ve seen it work both ways. A too-serious office, and numbers go down. A focused but playful office, and numbers go up.

Bill Walsh

When I lived in San Francisco, I was a huge 49ers fan. Before Super Bowl XVI in 1982, coach Bill Walsh arrived at the team hotel in Detroit a day early — and paid a bellhop $20 to borrow his uniform.

When the team bus arrived, Walsh — in full bellhop attire — tried to grab Joe Montana’s luggage (Montana was the starting quarterback). Montana, not recognizing him, brushed off the “silver-haired bellhop” and told him to get lost. When the team finally recognized their coach, the place erupted in laughter.

The relaxed 49ers went on to win their first Super Bowl, beating the Bengals 26-21.

Regardless of your role — doctor, owner, front desk, or bellhop — be goal driven.

But playfully.

Ed

This weeks cool tune is from the Playing for Change series: The Weight, with Ringo Starr and Robbie Robertson.

By the way, Joe Montana said this about chiropractic: “Chiropractic care works for me. I’ve been seeing a chiropractor and he’s really been helping me out a lot. Chiropractic’s been a big part of my game.”

Is the Sun the New COVID?

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Dr. Peter McCullough, MD and Ed Petty at CSW VaxCON convention

A look at who’s behind the curtain

Friday morning, I had my annual skin cancer check-up with a dermatologist.

She entered the room hastily and, with forced friendliness, asked me how I was doing while she looked at some papers. Then, she abruptly looked at me, face-to-face, and asked me if I had been using “protection.”

I was so shocked, taken off guard, trying to process what she was talking about. I might even have been a little frightened… as if I were a teenage boy on the prowl, and the school counselor were admonishing me to use “protection.”

She looked me over. Aside from my “mature spots,” my skin was fine. As she was doing so, she cautioned me about the sun and “sun damage” — and talked about little else for the nine minutes she was in the room.

She handed me a prescription for a chemotherapy lotion – but didn’t really explain, and was out the door.

I wear a hat and shirt when I am on the water, and it is early in the summer. I understand her point generally, but she was so adamant and abrupt that it was very odd, if not alarming.

I left the clinic and headed to a seminar to hear several prominent M.D.s, including an attorney, discuss their experiences with big Pharma and COVID.

As I drove to the seminar, I wondered… was the SUN going to be the new COVID?

A Look at the Stats in Dermatology

After the seminar, I did some digging. Take a look at these stats:

  • Dermatology — Dermatology is growing at nearly twice the rate of other medical specialties. The reason is simple: private equity has taken over. Outside investors see this as a money-making opportunity. (Source: JAMA Dermatology, Health Affairs)
  • Big Pharma – Merck. Merck’s skin cancer drug Keytruda is prescribed by dermatologists. This is from their own financial filings:

Yearly Keytruda Sales

2015 $566 million
2018 $7.2 billion
2021 $17.0 billion
2023 $25.0 billion
2024 $29.5 billion

A 52-fold increase in nine years.

  • Overdiagnosis — Melanoma diagnoses have risen sixfold over 40 years. Death rates over that same period? Essentially unchanged. What does this mean?

It could be argued that treatments have kept death rates down despite an aging population. OK. But independent researchers make a stronger case: they are overwhelmingly finding and treating tumors that would never have harmed anyone.*

A 2024 study in BMJ Evidence-Based Medicine estimated that 49.7% of melanomas in white men and 64.6% in white women were overdiagnosed in 2018 alone.

  • And a special note about …. Merck. I can’t leave this out, just to show you who is behind the curtain: Merck made Vioxx — the arthritis drug pulled from the market in 2004 after it emerged they had known for years it increased heart attack risk by 400%. An FDA official testified that the delayed recall caused up to 55,000 premature deaths. Merck settled for $4.85 billion.

This is the same company now generating $29.5 billion a year from a skin cancer drug.

The Opportunity in Front of You

Trust in medical doctors has collapsed — from 71.5% in 2020 to just 40.1% in 2024. (See my earlier newsletter.) Patients are not just dissatisfied. They are actively looking for something different.

That would be YOU!

Even the medical doctors are jumping ship.

The M.D.’s whom I listened to and briefly talked with this last weekend described how practical remedies to COVID were suppressed, and how they saw patients unnecessarily suffer and die. They touched upon how, as highly regarded long-term proven doctors, they were vilified, fired, and slandered for their work using safe but “unapproved” procedures. (I have links to their books below. Read them! Fascinating.)

So they started or joined their own new associations.

And I had to chuckle… Here were these exceptional M.D.’s, talking to chiropractors about being marginalized for helping patients outside of institutionally approved protocols. You guys know about that more than anyone!

Also had to smile at the fact that they were all referencing various supplements of one kind or another! (Royal Lee of Standard Process, 1895-1967, may have predicted this!)

So, let me end on this:

The door is wide open for you to grow your practice and business.

You are the good guys!

The patients are already looking for you. Make sure they can find you.

And as a plug, after 40 years in the biz, from Dr. Jim Sigafoose to Dr. Peter McCullough, I know the TOP 3 or 4 key factors that will help you take advantage of this situation. I will be writing about them in the future.

You can contact me for advance notice at any time.

Stay Goal Driven,

Ed

P.S. Kudos and thank you to the Chiropractic Society of Wisconsin for hosting these inspirational doctors.

Dr. Peter McCullough, MD and Ed Petty at CSW VaxCON convention

Dr. Peter A. McCullough and I

Links to their books on Amazon

* BMJ Evidence-Based Medicine (2024) — Adamson AS, Naik G, Jones MA, Bell KJ. “Ecological study estimating melanoma overdiagnosis in the USA using the lifetime risk method.” BMJ Evidence-Based Medicine. Published January 19, 2024. doi:10.1136/bmjebm-2023-112460

• JAMA Dermatology (2022) — Kerr KF, et al. “Dermatopathologists’ perceptions of melanoma overdiagnosis and their own diagnostic behavior.” JAMA Dermatology. Published April 20, 2022

2 Powerful Drivers of Your Chiropractic and Healthcare Practice

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looking to the futureLooking to the Future

In 10 years, where will your chiropractic and healthcare practice be? And why?

Two vital elements that drive your practice may seem so obvious that they are overlooked—or taken for granted.

There is ample evidence in management studies that attests to better business performance if you and your team fully engage these two factors. I discuss both in my book The Goal Driven Business.

They may seem theoretical, but they are, in fact, hardcore leadership and management tools that can improve the quantity and quality of your services — now!

PRACTICE DRIVER #1: YOUR PURPOSE

This is the overriding reason you are in practice.

In his book, It is Not What You Sell, It’s What You Stand For, Roy Spence, Jr says

“Purpose is a reason for being that goes beyond making money — and it almost always results in making more money than you ever thought possible.” — Roy Spence.

Christine Arena, in her book, The High Purpose Company, which I also refer to in my book, found a similar result. She studied 75 major companies with strong social and environmental responsibility and concluded that “purpose” is not a feel-good add-on — it is a core driver of profitability and performance.

PRACTICE DRIVER #2: YOUR LONG-TERM BUSINESS GOAL

This is where you want to take the practice and where you and your team want to be in 10 years.

Jim Collins calls this a BHAG, a Big Hairy Audacious Goal. For example, in 10 years, your practice will be so popular that it will require 3 (or more) doctors, and most patients will be returning for wellness. Or, in 10 years, 50% of all mothers in the area will be bringing their kids in for a checkup by at least their first year. Or all the local sports teams will request your services.

There are plenty of examples of these two success drivers in business and in sports teams.

But these elements also find their parallel in physics. When everyone (or everything) is moving in the same direction for the same reason — a “flow” state is achieved.

You may have felt it before.

But it doesn’t usually last. Staff change, you change, computer software needs to be updated, backlog found in insurance, and so on. Issues crop up.

By providing consistent leadership every month, you can find new ways to personally stay engaged with the purpose of the chiropractic or healthcare practice — and help your team do the same.

So:

  1. What is the greater purpose of your practice? What is its why?
  2. What will your practice look like in 10 years, and what will it have achieved?

Keep working on these, and you and your team will forever be—

— Goal Driven.

Ed Petty

P.S. This Friday and Saturday, at a resort here in Wisconsin, the Chiropractic Society of Wisconsin, in conjunction with the Illinois Prairie State Chiropractic Association, is sponsoring 2 days of the most amazing line-up of speakers I have seen in recent times. The event is called VAXCON!

Make it if you can. (I will see you there!) Here is a link to the CSW page for more info and registration: VAXCON LINK

And here is a line-up of the speakers (more info can be found linked to their names).

Each one of these individuals has had an extraordinary journey. Listen to their stories, and you will be amazed at what they have gone through and accomplished.

 

Be Dangerous – In Chiropractic and Healthcare, Standup for Your Patients

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standing with integrity and purpose

Integrity and Purpose are the Keys to Your Growth in
Your Chiropractic and Healthcare Practice

We live in a world where what we perceive can be manipulated.

Advertising, public relations, and sophisticated behavior modification strategies are powerful tools. They can generate consensus, approval, and demand for a product, service, or idea.

A status quo is generated and supported this way.

For example, when I was a kid, everyone smoked cigarettes. Everywhere. It was heavily pushed and advertised — with M.D.’s no less. And by the Federal Government! (I still remember some of the slogans…! “Winston tastes good like a cigarette should.”)

For years, research continued to show that cigarettes were very unhealthy, but this threatened those who profited from their sales.

If you challenged the manufactured consensus and the messaging, you were attacked, like this man was…

Dr. Jeffrey Wigand was a Vice President of Research and Development at Brown & Williamson – tobacco company. In the mid-1990s, he exposed that industry giants were intentionally engineering cigarettes to be more addictive. They responded with a powerful negative P.R. campaign, compiling a 500-page dossier of smears to brand him a liar and using anonymous death threats to silence his testimony.

Cigarettes finally moved to the sidelines, but those same companies (Philip Morris and R.J. Reynolds) moved into the cheap (addictive and harmful) food business—buying up corporations such as Kraft and Nabisco.

There is a money-making complex of industries in which one hand greases the other, a matrix that includes captured lawmakers and professional organizations. Their interests are money and control to keep the money coming. And they have powerful tools to keep this game going.

Many of us are not always familiar with the details, and your patients may be naïve about the attacks launched and sustained through direct and indirect campaigns by these industries.

But to whatever degree you are aware of it, you are on the battlefield – as a player or a piece.

And if you speak up and speak out, if you stand up for your purpose — you can be attacked.

That’s what happened to these doctors:

Peter McCullough, M.D., a renowned cardiologist and professor, was an academic pillar until he advocated early, repurposed treatments for COVID-19. His protocols threatened the pharma-only mandate, so the establishment unleashed a negative P.R. campaign, branding him a “misinformation spreader.” They stripped his journal editor roles, forced him out of his university health system, and revoked his board certifications.

Pierre Kory, M.D., a leading critical care specialist, promoted protocols similar to McCullough’s early protocols. He was attacked for disseminating “dangerous misinformation,” and faced platform censorship, suppressed Senate testimony, and lost hospital affiliations. The American Board of Internal Medicine later revoked his certifications.

Simone Gold, M.D., J.D., an emergency physician and founder of America’s Frontline Doctors, spoke against mandated protocols. The establishment painted her as “unhinged,” deplatformed her group, fired her, and she was arrested and sentenced to prison after January 6.

Eric Nepute, D.C., a vocal chiropractor, got the full-on attack. He dared to suggest that patients focus on immune-supporting nutrients like Vitamin D, Zinc, and Quercetin. The federal government responded by suing him for a theoretical penalty of half a trillion dollars—an absurd effort to bankrupt him and terrify any other practitioner from prioritizing natural health over the pharmaceutical mandate. (I’d say he has bragging rights!)

== == ==

For decades, the chiropractic profession has been the target of this exact same machinery.

When you have a product, service, or clinical truth that threatens a vested interest, you will be fought. So, you are encouraged to hide out. Stay safe. Be agreeable and… tame.

But when you hide, compromise, or try to be “accepted” by a corrupt medical establishment, you are indistinguishable from the thousands of other providers they already control.

They win.

But when you are “dangerous” — when you stand firmly for the truth that the body is designed to heal, not to be a lifetime customer of the pharmaceutical treadmill, you become a beacon.

You are then no longer just a piece on their game board.

Patients today are not looking for more of the same. They are looking for a doctor who stands for real health.

Being dangerous is your greatest marketing asset. It builds a level of trust that no institution can break.

The patients who are waking up to this reality will seek you out because you are a target. They will trust you because you refused to compromise.

Oh, Dr. Nepute — he is even more dangerous now. He operates 30 clinics!

Stand for the truth and help more people be healthy. That is how you build a business.

Don’t be a piece… be a player.

Be Dangerous…

…and Goal Driven,

Ed

P.S. Doctors McCullough, Kory, and Simone – and others – will be speaking at the Wisconsin Society of Chiropractic Society of Wisconsin’s VAXCON, April 24-25 at the Dells, WI. See you there! Link.

*References

On Dr. Jeffrey Wigand & The Tobacco Industry: 

·  On the “Tobacco-to-Food” Strategy: 

·  On the Doctors (McCullough, Kory, Gold): 

·  On Dr. Eric Nepute:

Maybe You Are Focusing On the Wrong Thing in Your Chiropractic Healthcare Practice

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chiropractors looking at chiropractic x-rays

Your best marketing tool may surprise you

I was asked to help an office a few years back with their marketing. It was a three-doctor office.

Did we work on discount ads, promotions, talks, and social media? No! I am all for these approaches, but I wanted to look at something else first.

== == ==

Marketing begins with what you are putting into the market — your product or your service outcome.

In this practice’s case, it was a “person who was healthier, relieved of pain, and had a great experience.” A person who had a “Wow!” experience.

THAT is what we worked on. We role-played, reviewed Days 1 and 2, and discussed different cases with the senior doctor. We trained on techniques and reviewed clinical procedures.

The focus was on the doctor’s services.

There was nothing really wrong with the quality of their service — they had been in business for many years. But after a while, I figured it would help to “sharpen the saw.”

Yes, we also worked with the staff and ran some promotions, but the primary effort was to refocus the doctors’ attention on their skills, training, and patient care.

And their numbers went up!

== == ==

I have seen this go both ways more than once.

Another example is a long-time client who has been using a new chiropractic technique for the last couple of years. He has told me how he finds this technique very effective and that he is getting the best results ever. His office has grown and stayed steady.

On the other hand, I see doctors too often become focused on scripts, office policies, or promotions. While these need to be addressed, they are not the purpose of the practice.

That is why I always stress the importance of getting one of your team members trained as a manager — even part-time. This allows you to delegate much of your management and marketing work so you can focus on providing superior service and generating extraordinary results.

If you focus on the quality of your care and get great results — if you get “Wow!”s from patients who exclaim about not only their outcome but the care they receive from you and your team — your numbers WILL go up.

== == ==

Take a few minutes to think about this. It is easy to get caught up in statistics and the latest management “operating system.” Fine — that is part of running a business.

But first and foremost, review the quality of your completed cases — not just “visits.” Then improve them.

== == ==
The Goal Driven System for Your Chiropractic, Healthcare, and Service Business

Our Goal Driven System includes a manager who supports the team, the doctors, and the patients — and the marketing! We cover this in our book, The Goal Driven Business, which you can grab on Amazon.

You don’t need a manager if you are at 50% capacity or less. But once you start hitting 60% or more, or have multiple doctors and providers, you should have someone to help with marketing and team support. It is not a bossy type of role, but someone who can pick up the odds and ends so you to keep your attention on patient results.

In the meantime, your best marketing is constantly improving the delivery of service to your patients.

That is your #1 goal.

Keep the “End in Mind,” as Dr. Stephen Covey said!

Ed

P.S. We are rolling out our new and updated Practice MBA program for practice managers and clinic directors this fall — stay tuned!

Ask Lisa: The Hybrid Bus is Here! Are you Ready to Board?

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ask lisa sitting on a physio ball reading chiro economics magazine billing and collectionsWhile at my desk on my physio ball, I was reading Chiropractic Economics annual Salary and Expense Surveys and took a deep dive into the Billing & Collections (B&C) category. I was jarred by a pattern over the past five years which makes me continue to fear that we are falling behind. The surveys in B&C category are a wake-up call that proves we can no longer ignore the impact of decreasing third-party reimbursements.

Below are the survey results countrywide in the chiropractic office B&C category and Average Reimbursement Percentages over five years. It is noteworthy that billings/charges increased each year with the exception of one year’s slight decrease. Here’s what the survey reveals from billed charges/reimbursement ratios:

2021 – 65% Reimbursement
2022 – 69% Reimbursement
2023 – 74% Reimbursement
2024 – 71% Reimbursement
2025 – 62% Reimbursement

So, what can you do to increase/improve income in your practice? Here are some tips:

  • Improve your practice’s patient care plans to ensure patients stick with their plan. Have you offered a visual picture of the patient’s report of findings, for example, and is your confidence in your adjustment where you want it to be when discussing your clinical findings? Are you making the best use of your therapies in your care plans?
  • Offer care plan packages to create a hybrid reimbursement practice or close the gap between your insurance model and patient self-pay model. It’s okay that you want to continue billing patient’s insurance as a courtesy to your customer base. Know your obligations when doing so regarding treatment plan standards, documentation/medical records standards, billing standards, obligations to respond to payer requests, and credentialing & compliance standards.
  • Offer valued products for retail such as ergonomic/rehab equipment like foam rollers, cervical rollers/pumps, resistance bands, and pillows. Other items include massagers, nutritional supplements, fitness trackers, orthotics, and your own branded merchandise such as water bottles or ice packs. Keep in mind the anti kickback laws. You’ll want to ensure these products are for sale and not giveaways to induce referrals. Please consult a healthcare attorney if in doubt.
  • And finally, you’ll obviously want to keep your collections by having a solid compliance program in place to avoid potential payback penalties for not having a solid program in place.

Need guidance on developing your hybrid practice and navigating the reimbursement landscape? We can help! Just ask…Lisa

Source: Chiropractic Economics Online Magazine, www.chiroeco.com

Lisa
lisa@pmaworks.com

Trust in Physicians and Hospitals Crashing – An Opportunity for Chiropractic and Independent Doctors

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chiropractic assistant welcoming a family of patients. Your Opportunity is Now

A landmark JAMA Network Open 50 state study (2024) found trust in physicians and hospitals plummeted from 71.5% in 2020 to 40.1% in 2024—a 31 point drop across every age and income group.*

Gallup confirms the free fall: confidence in the CDC and FDA is at record lows, and only 18% of Americans now view the pharmaceutical industry positively.*

I am sure this doesn’t surprise you – or anyone in chiropractic or natural health—and even many in mainstream medicine. Despite marketing, lobbying, and billions in PR, Big Pharma isn’t fooling everyone anymore.

I just read an article by researcher James Lyons Weiler, PhD who cites the same data and adds:

“A 2023/2024 global analysis of 2,500+ patient organizations showed pharma’s reputation falling from COVID era highs, with U.S. patient groups rating the industry ‘Excellent/Good’ dropping from 65% to 57%.”

He also mentions Dr. Eric Berg, who has 14.5 million YouTube subscribers. An AI driven review of 102,000 comments across 152 videos on his channel revealed something bigger than diet tips. Viewers share personal stories of reversing illness through nutrition while expressing fury toward mainstream medicine, pharma influence, and decades of failed dietary dogma.

Oh…did I mention that Dr. Berg is a D.C.! (How many subscribers do you have? Lol)

Weiler cautions that YouTube comments aren’t a representative sample—but the passion matches national surveys: not mild skepticism, but documented anger. (“A society of healthy people is a big threat to the pharmaceutical industry.” — 4,229 likes.)*

You’ve heard the same from your patients—and from MDs, nurses, and whistleblowers who’ve paid the price for honesty. The industry is captured. Even AI built on “medical consensus” logic tends to reinforce circular reasoning, never asking who funds the evidence base sustaining the trillion dollar medical machine.*

HOW TO LEVERAGE THE GREAT MEDICAL DISTRUST

This presents a heightened opportunity for you to step out and be the provider your community can trust.

As chiropractic and natural healthcare professionals, you’ve always stood outside the medical matrix and big pharma oligarchy. In marketing terms, that’s positioning: you are positioned in the marketplace as providing natural, honest wellness for the whole family.

We applied these principles when we built our 25 office Wisconsin network—and it worked. Our constant theme:

“Pain Relief and Better Health, Naturally.”

(Contact me if you want details on how we positioned ourselves as trusted neighbors in our communities.)

And the fact is, natural health providers are growing in popularity.

Data from 2024-2025 state boards and public review platforms show chiropractic care continuing to rise — patient satisfaction averaging 4.8 out of 5 stars (roughly 98 % positive feedback). Google search interest for “chiropractor near me” still 30 percent above pre pandemic levels.*

And a Gallup–Palmer survey trends confirm that more than six in ten Americans now view chiropractors favorably—the opposite trajectory of hospitals and drug companies. In short, while institutional medicine loses trust, chiropractic earns it.*

There are similar uptrends with naturopaths and independent MD’s.

And by the way, you won’t find this in most AI ‘fact checks.’ Their results will sound neutral because they’re trained to protect the same institutions that lost our trust.

Today, with physician trust down 31 points, millions are actively searching for professionals who will simply tell the truth.

And when hospitals, drug ads, and agencies lose credibility, the public doesn’t abandon health—they go looking for it elsewhere.

Let them find you!

ACTION STEPS

  1. Educate openly.
  2. Highlight independence.
  3. Emphasize natural health.
  4. Increase face to face contact.
  5. Use social proof — testimonials, not slick ads.
  6. Collaborate with fellow independents.
  7. Train empathy, not scripts.

In this climate, trust is your strongest marketing asset.

Ed Petty
Petty, Michel & Associates
Your trusted partner in practice development since 1988.

*JAMA Network Open (2024); Gallup Poll (2023); U.S. Senate HSGAC Hearing (2020); AAPS Archive; Virginia Pilot; Maine Board Order 2022 25; Gallup–Palmer College of Chiropractic (2022); CDC NHIS 2017 2022; Iowa & Florida Board Reports (2023–24); Google Trends 2019 2025; Healthgrades/Zocdoc Review Data (2024); James Lyons Weiler PhD, Popular Rationalism (Substack).

For a less biased AI experience, try Alter.systems.

Do You Need an Attitude Adjustment? Does Your Chiropractic and Healthcare Practice Need an Adjustment?

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Marketing always begins with the right attitude

Your chiropractic practice starts with marketing. But marketing starts with attitude.

# # # # # #

A FEW YEARS BACK, a long-time client called and asked if I’d visit his office to help two new associates grow their caseloads.

I took the two young chiropractors out to lunch. Both were eager and not shy about their goals — large practices, and confident they’d match their boss’s caseload within a year. When I asked why their numbers were still low, they blamed the owner’s lack of advertising and suggested the office needed a better brochure.

I told them marketing comes down to a caring attitude about people and having an interested attitude in how they were doing. They nodded enthusiastically. “Absolutely!”

Then I said, “Look around this restaurant and pick out someone. Imagine a possible issue they may have that you could help with.” Both associates avoided looking at anyone and changed the subject back to themselves.

I asked each for a business card. Neither had one.

Having predicted this in advance, I’d taken several cards from the office before lunch and placed two in front of each of them. Then I said, “I’d like you to get up, find someone at the bar, introduce yourself, and hand them your card. If possible, make an appointment.”

They looked at me as if they’d seen a ghost. They slumped in their chairs. Neither would do it. I suggested they try the cashier, the waitress, or the manager. Their fear turned to dismissiveness, as if the exercise were beneath them.

We went back to the office, discussed the situation with the owner, and over the following weeks, the two associates decided to leave and start their own practice.

Was I being too demanding? No. They could have introduced themselves to the manager, mentioned they were new in town, and made a natural connection. Instead, they were hiding out, unproductive, and mildly complaining.

It was a matter of attitude—and they failed the drill.

IN ANOTHER INSTANCE, I visited a new doctor whose office was in an upscale strip mall. He told me that he felt stuck. He was confident in his skills but couldn’t figure out how to generate clients. He wore cowboy boots and looked a little rough around the edges, but he was friendly and seemed to have a great service attitude.

I went over some basics of handing out cards and suggested he meet five new people in the strip mall over lunch. I offered to come along.

He gazed at me for a moment — processing, I suppose — then popped up and said he didn’t need my help and would be back soon. No more than fifteen minutes passed before he walked back in with a man and woman, deep in conversation. He led them to his office. When I returned from lunch, they were just leaving.

Beaming, he said he’d only spoken to three people, but the last two were so interested that he brought them in—and they’d signed on as new patients. He said the whole thing was fun and planned to do more of it.

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There are many approaches to effective marketing. But all of them start with the right attitudes.

How’s yours? How about your team’s?

I think we all need an attitude nudge or adjustment now and then. (Coaches can help!)

The good news is that your attitude is something you can control. It is all yours. When needed, check and adjust those attitudes, and help more people.

Cowboy boots are optional.

—Ed
PS. Contact me anytime if you want or need an attitude adjustment. 😊

I have observed 8 key attitudes for effective marketing. Download NOW: Successful Marketing Attitudes- 2026

(This story is a condensed version from my book, The Goal Driven Business. You can find many more stories from in the field consulting for over 30 years.)