About Edward Petty

Consultant with Petty, Michel & Associates, Author of Marketing Manager System, the Goal Driven Business www.GoalDriven.com. Father and grandfather, husband, student, active in athletics, and in health and environmental causes.

The Real Reason For Low New Patients

Why Two Chiropractic Doctors Couldn’t Grow Their Practice

A few years back, a long-time client of ours gave me a call and said that he had hired two new doctors.  He asked if I would visit his office and see if I could help them grow their caseloads.

I told him that I was happy to pay him a visit.  A month later, I was touring his office and interviewing his team.  I then went out to lunch with the two new associate doctors.

I got to know them and asked them questions.  They were not shy about their goals. They told me that they wanted a “high volume” practice.  They boasted that they felt that it would not be difficult to see as many visits per month as the senior doctor by the end of the year.

They went on about philosophy, BJ Palmer’s “Green” Books, clean food and wellness. Both were young and looked fit and seemed eager.

They said that they wanted marketing help. They talked about how they had been working on social media, but felt that the owner doctor wasn’t supporting them enough by buying advertising.  It wasn’t blatant, but they seemed to be blaming him.  I acknowledged this and said that was something we could look into.

I knew that their practice statistics were very low. I told them that marketing comes down to caring about people – caring enough to talk to them, and caring enough to be honest about how you can help them.

They nodded like zealots. “Absolutely!”

I then said:

OK, look around this restaurant and describe a possible health issue with some of the customers. Just pick one and do a very preliminary screening based upon the way they are sitting or walking.”

This didn’t go as well as I had thought it would. Both doctors, I discovered, didn’t look at the fellow customers in the restaurant.  So, I prodded and finally got one of them to mumble a possible health issue with someone who was walking out.

I then asked each for their business card. Neither had one on them.  I paused to give them a look: “What?”

I had taken a couple of their cards each before lunch and placed two of them in front of each doctor.

Then I said:

“I liked what you both said about wanting a large practice and wanting to help more people. I would like to help you. So, to start, I would like you to get up from this table and find someone in the restaurant, introduce yourself, and hand out your card. If possible, make an appointment for them to come see you.”

They both looked at me as if they saw a ghost.  Gripped by fear, they both slumped down in their chairs. Neither would do it.

Seeing this, I suggested they talk to the cashier or waitress, or the manager.  Now the fear turned to a dismissive attitude, as if this exercise was beneath their dignity.

We ended lunch and went back to the office. We met with the owner doctor and discussed the situation. Over the following weeks the two doctors agreed that the relationship wasn’t working out and decided to leave on good terms to start their own office.

— — —

You don’t have to be a hyper-extroverted charming salesperson to be an effective marketer. In fact, this may act against you. The largest office I have ever worked with was seeing over 2,000 visits per week.  And the owner was serious and gruff, and talked like an angry fishing boat captain.

Marketing starts with a burning desire. It begins with an almost obsessive drive and purpose to help others by getting them into your office.  Marketing then depends on your belief and confidence in your skills and service. And it hinges entirely on how much you really care and empathize with each patient or prospective patient. And then, there is the effort you put in. You gotta do the work, and this means sometimes long hours, long weeks, and long months.

And as the C.E.O of your business, it also means getting the rest of your team to feel the same.

Again:

  1. Desire. Drive
  2. Confidence and belief.
  3. Compassion and empathy.
  4. Effort. Work. Sweat!

There are thousands of different methods to market your services. These may include “social media,” big goals, and “philosophy.” They may include newsletters, workshops, or back to school promotions. But in the end, marketing is communication, whether done electronically, through print, in groups, or one on one.  It is always and especially – one on one. In time, you will find what works best for you.

But no number of manuals, books, or coaching will do a damn thing for you if you don’t have the desire, the belief, the empathy or put in the work.

Patient Education: A Simple and Fun Method for Chiropractic Offices

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

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

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

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

For example, you could write:

  • What does this mean?

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

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

Here are some other examples:

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

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

The 3 Key Ingredients to Motivating Your Chiropractic Team

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

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

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

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

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

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

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

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

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

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

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

3 Goals System of Business Management: Principle #5

Self-Determination and Motivation

Everyone wants their own sandbox to play in.

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

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

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

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

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

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

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

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

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

  • Autonomy
  • Competence
  • Relatedness.

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

Autonomy

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

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

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

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

Competence

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

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

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

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

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

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

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

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

Children want to be super heroes and wear their capes.

Don’t we all!

Relatedness.

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

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

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

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

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

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

#   #   #

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What do they really want?

Ask them:

What is most important to you about your health?

Then, find out why.

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

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

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

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

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

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

Confrontational Anxiety

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

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

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

The analogy of the iceberg is useful.

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

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

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

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

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

 

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Chiropractic Spring Marketing

chiropractic marketing with petty michel
(Free sample marketing planner below.)

Practice marketing may not be entirely what you think it is.

 

If you are having challenges with your “marketing,” or you just want to generate more new patients, you need to consider something.

There are many good and great marketing activities you can do. (You can go to our website under “Free Resources” and find buckets of marketing. And, for those of you who are active members, there are mountains of even more marketing programs for you on our Member’s site.)

There are many paid programs you can purchase that explain different methods of generating more new patients. You have seen them, perhaps purchased them: DVD’s on dinner talks, workshops on how to present to businesses, Facebook and print advertising programs, and automated newsletters and Facebook posts.

These all can be useful in generating new patients, but the results often fall short from what the few successful doctors who promote the programs claim. This is usually because there were two major components missing in the marketing.

When doctors return from marketing programs, I like to ask them what they thought of the material.

“Yes, I liked it. It was good info. Learned a lot.”

“Great.” I say. “So, who is going do it?”

“Well, Susan can do it.”

“Oh really, when? She has a backlog in insurance and is working overtime trying to work with your sketchy notes as it is.”

“Hmm, well, we’ll hire someone.”

“Great. Who is going to train them? You?”

Not trying to be a jerk, but part of any good consultant’s job is to provoke analysis!

Besides the marketing event or procedure, there are two other critical elements to practice marketing that have to be included for the promotion to work. These are not always taken into account.

This was the basis of the Marketing Manager System I wrote and published some 17 years ago.

Most companies, as Simon Sinek talks about in his TED talk*, boast about what they do, or how they do it. It is all about them. Look at us!

But the better companies talk about WHY they do what they do, and they do it for YOU. They do it for your kids, grand kids, community, and the betterment of the world.

This is practice marketing. It is personal. You tell people why the heck you do what you do — and you say all this with genuine care and confidence – in your own VOICE. You do this in your newsletter, in your talks and in your ads. The best marketers do this – often naturally.

  1. So, the first missing component that must be included with your marketing is motivation. Marketing must have a mission and it has to be embraced by everyone on your team.
  2. The second missing component is organization. The events and procedures must be assigned to different people with enough time for implementation.

Complete practice marketing then, has three major components:

  1. Motivation. Why. Make sure you and your team WANT more new patients. Get that accomplished first. That may take a while. An office staff and doctor who are backlogged with their paper work, already working full time and more, who also may have a few inter-office unexpressed grievances, confusions, or doubts about your service or you… no matter how many programs you sign up for, nothing will work.
  2. Organize. Then, work out who will be doing what. Spread the marketing around to everyone and put someone in charge just to coordinate.
  3. Marketing Procedures and Events. With the above 2 components in place, you are now more likely to “rock” your marketing efforts more successfully.

Increase the WHY, increase the CAPACITY, then yes, please — lots of marketing activities.

Let the party begin!!

Ed Petty

Spring Marketing Planner- (DOC) Sample Marketing Planner for Spring

*TED Talk link: www.pmaworks.com/observations/2011/02/10/leadership-in-chiropractic-the-golden-circle/

Chiropractic Patient Reactivation Program and Sample Postcard

We recommend offering a special promotion to patients who have not been active for 6 months or more.

The links below will take you to a couple of articles describing procedures that can be used to encourage less active patients to come in to see you.

The Reactivation Program has a number of sample letters and a sample postcard and the Reactivation Card is a sample post card that can also be customized for your email newsletter.

Sample Reactivation Postcard – Sample postcard layout and instructions on how to customize your postcard.  Information can also be used for email notification.

Reactivation Program An article on the importance of regular reactivation program.

Best Wishes for your New Year!

How To Make Your Chiropractic and Natural Health Lending Library Work

lending-library

A natural health lending library is a very practical marketing tool – if used.

A lending library is a collection of books, DVD’s, and other information that you can loan your patients. It is part of an ongoing patient education program. The better your patients understand what you do and why you do it, the more likely they will be to stick to a long-term care program and to refer their family and friends for services.  Patient education, compared to other marketing activities, is not that expensive.  It has a good ROI!

Download a list of suggestions here for your chiropractic or natural health care library.  [Ideas for your Lending Library]  Please give us your suggestions as well.

This all is logical, right?  We all know this.

So…why is it rarely done? Most of the offices that I have seen with lending libraries have them on the bottom shelf in some corner of their office filled with books from a garage sale and old VHS video cassettes.

Everyone knows patient education is important. Like the Spinal Care Class, or new patient education class, everyone knows this is good for the patient and helps the office grow. Right?

Funny story… I attended a small get-together of chiropractors one evening here in Southeast Wisconsin. The presentation was given by the lead doctor of a multiple doctor office. Great doctor, nice practice. He had been in practice for years and looked weathered and ready for retirement. The talk was how to give an effective Spinal Care Class for new patients. The presentation was full of practical content. The only thing… the doctor wasn’t that cheerful about his presentation.

After he finished, and as he left the front of the room looking down at the floor, he muttered, as if passing on a confidential apology to another spy… “But we don’t do the classes anymore.”

So, no need to fool ourselves here. It might be just easier to buy some nice posters and be done with it.

Ah, but there is a trick to making your lending library work… and patient education in general work!

The lending library is primarily for YOU — and each member of your professional team.

We have been looking at it all wrong.  The lending library is a reflection of YOU!

If YOU study, and if your support team studies and learns, you all will be so enthusiastic about the information that you will insist that your patients learn this information as well.

Be curious and ask yourself some questions. For example:

  • Chiropractic adjustments have been shown to significantly lower blood pressure. Do your patients know this? How does it work?
  • Why do some intervertebral discs degenerate and others (in the same spine) do not?
  • Do your patients understand the myth of cholesterol, heart disease, and how statin drugs may be causing some of the symptoms they are coming in to see you for?
  • How is the adaptive immune response affected [during “cold and flu season”] by the adjustment?
  • Is the average time for a whiplash patient to achieve maximum improvement 7 months 1 week? If so, why? If not, what is it?
  • Nonsteroidal anti-inflammatory drugs for rheumatoid and/or osteoarthritis conservatively cause 16,500 Americans to bleed to death each year. Do your patients know this? Do their families?
  • Glutamate and aspartame can cause chronic pain sensitization, and removing them from the diet for 4 consecutive months can eliminate all chronic pain symptoms. Do your patients know this? Do their spouses? *

Read a book, watch a video, question authority, ask questions — seek the truth. Get excited about learning new things about your profession.

DON’T GET BORED. If you are bored, quit and go home!

Otherwise, be grateful for the opportunities we all have to learn and expand our knowledge and understanding of the services we provide and the world in which we provide them.

Be curious.

Ultimately, you sell yourself before you sell your services. How can you sell a care class or an extended treatment plan if you are not truly excited about them?

Learning new aspects of chiropractic, health care, wellness, sickness, the sickness industry, how your patients are being manipulated and exploited… all this should agitate you one way or another.

For example, I watch Vaxxed – the movie — and then listened to Dr. Andrew Wakefield and Brandy Vaughn (former Merck employee) talk on YouTube about the movie and how they are now being covertly and overtly intimidated to shut up.  If this pharmaceutical company is trying to help members of your community get healthier, why are they now attempting to squash dissent and in such a sinister and yet powerful way? I can’t help but wonder: just how powerful are they at manipulating public opinion? How are they influencing my community and my family?

If you look further into the effects of pharmaceuticals, from Vioxx to statins to MMR and vaccines, and explore some of these questions, you can’t help but feel compelled to educate your patients on how to keep their children healthy and free from a toxic environment.vioxx

Some of the most successful offices I have seen have spent untold sums on going to seminars (and on coaches!). The verysuccessful can be reckless with book buying and webinar watching and seminar attending.

Continuing education isn’t just for re-licensing seminars. How dull!

If you are not impatiently curious about different aspects of your profession – its science, its philosophy, what it is up against in the market place, you are becoming part of the problem.

Stay curious. Question authority. Study.

Do this:

Assignment #1. You. Order a book – or video- from Barnes and Noble, your local books store, or Amazon. Read most of it on a weekend or weeknight evening rather than watching TV.  Present what you learned at the next staff meeting and put the book in your Library.

Assignment #2. Your Team. Have your staff read a few chapters from a book, or watch a video from your lending library and then give a presentation about it at a staff meeting. Everyone learns and the staff member learns twice! Give bonuses for outside study.

Just like we work on our patients, just like we work on our business, we must work ON our roles as professionals and we do this by studying.

Then, no doubt, you and your team will be dragging your patients over to the lending library to check out the latest editions to your collection.

And your patients will know that they came to the right place. They may think you are all a little nerdy, maybe even fanatical about better health, but they will know that you sincerely care about them and their wellbeing, not just in collecting some money for some fast or rushed service.

Assignment #3. Stay curious and learn – and provoke others to do the same.

Sincerely,

Ed

See our attached list of sample books and videos for your Lending Library Ideas for Your Lending Library

Please give us your suggestions for informative books or videos!

*Questions taken from Dan Murphy’s web site.www.danmurphydc.com

 

Using the Power of Simplicity to Develop Your Practice

“The way we’re running the company, the product design, the advertising– it all comes down to this: let’s make it simple, really simple.”     Steve Jobs  (Walter Isaacson) 1.

If you could simplify your business even more than it is, you would make more money and have less stress.

There is a direct relationship between simplicity and productivity, and an inverse relationship between complexity and productivity.

The most successful businesses have capitalized on this fact. This was one of Apple computer’s unique selling propositions – to focus on the simple and eliminate what wasn’t essential.

From its inception, the Apple Macintosh computer was designed with simplicity in mind.  Other companies have focused on simplicity: McDonalds order via drive-through, Ikea with its simple design, and Amazon with one-click ordering.

Simplicity Pays

Siegal-Gale is an international marketing firm that has studied simplicity in business and has been able to profile and rank businesses according to their simplicity. They call this the Global Brand Simplicity Index and have found that those companies that rank the highest, also outperform companies that rank as more complex. Their report states (2):

  • 214% – How much a portfolio of the world’s simplest brands has beaten the average global stock index since 2009
  • 69% – The percentage of consumers who are more likely to recommend a brand because it provides simpler experiences and communications
  • 63% – The percentage of consumers willing to pay more for simpler experiences

What Does This Mean for Your Practice?

You want to simplify the experience your chiropractic (or other) patient has in your office. From the first phone call, first appointment, examination, report of findings, patient finances, and scheduling, discover ways to simplify your procedures.

Your intake forms may be redundant or complicated, there may be too many rote statements or “scripts” for your staff to say to patients, or there can be extra pathways that your patients have to travel, like so many rabbit trails, where they can get confused and the flow slows down.  Staff, or doctors, may have too many decisions to make at each visit.

For example – what extra therapy should the patient receive? Not knowing, I have heard support staff simply ask the patient what therapy they wanted today, as if they were ordering a latte.  And as we know, there are definitely too many codes and documentation rules to follow for the doctor. Going total cash is one solution, but intelligent software, dictation, and scribes are other solutions.

Many, if not a majority of the more profitable offices that I have worked with over the years practiced what could be called “straight” chiropractic.  The straight practice (no additional modalities) works well, when it does, because its procedures and flow are simple. It is usually more profitable because extra overhead hides in the complicated.

Focus: Eliminate All but The Essential

Steve Jobs again: “People think focus means saying yes to the thing you’ve got to focus on. But that’s not what it means at all. It means saying no to the hundred other good ideas that there are. You have to pick carefully. I’m actually as proud of the things we haven’t done as the things I have done. Innovation is saying no to 1,000 things.”— Steve Jobs, WWDC 199(3)

I am not advocating no supplements, no exercise physiology, no electrical therapy. But to be honest, how much of this gets used in your office? I know offices — right now, and have known hundreds more, that have equipment lying around unused or bottles of vitamins collecting dust on overlooked shelves.

444378-simplicity

You have to embrace first only those unique outcomes that you can deliver. Work backwards and add only the most critical steps. “Begin with the end in mind”, as Stephen Covey observed in high producers.

For the Chiropractor – Adjust

For a chiropractor, this means adjust. (For other professions: what is your core function?) One of the first doctors I worked with when I moved to Wisconsin in 1988 worked closely with Clarence Gonstead. His license plate read: I ADJUST. He had a full practice, chuckled a lot, and seemed to make a nice living.

Start with this first, and then add additional services carefully – if you want.

Educate – In and Out Of The Office

Secondly, educate. Educate your patients, your team, and your community.  But your education has to be simple.  Your message has to be concise. One doctor we have worked with over the years has a waiting list practice, with nonstop patient, and even some MD, referrals.   He doesn’t do a 4-day report of findings and he doesn’t do a 2-day report of findings on new or reactivated patients.

He just very intently adjusts and talks about the adjustment and what he is adjusting.  From there, he then also gets into other health topics such as toxins (vaccinations), nutrition and weight, and exercise.

This is a good model: start with your core service and move out from there. For chiropractic education, you can use simple metaphors like “pinched nerve,” “garden hose,” “rusty gate hinge”, and how the body fighting toxins creates heat (inflammation), etc.

And keep educating your patients with care classes, lending library, table talk, movie nights, special speakers, case histories, and testimonials.

And do this first and continually with your support team.  This is not done enough!

One method to discover what to simplify is to regularly practice your procedures. For example, do a rehearsal of what happens when a new patient comes into your office on their first day, 2nd day, 3rd day, etc. You will flush out confusions, redundancies, and extra motions that complicate the patient experience.

Outside of your office, the same applies. Educate your community on what you do.  What is your simple selling proposition that people want?

For example, someone asks you “what do you do?”: “Well…

we help to improve your health, we relieve your pain,

and we increase your game – naturally!

No drugs, no surgery, and we guarantee you have fun in the bargain.”

How’s that? A simple and a desirable unique selling proposition (USP). (You can use this in all your marketing communications – no charge!)

Make it Fun – and Have Fun

Lastly, there is fun. You can and should have fun doing this. And so should your patients and support crew.

Patients will mostly remember how they feel after leaving your office.  Was it a pleasant, enjoyable experience? Was it fun?

Practice life can often bring about a kind of serious hue over the office. Administrative errors, missed appointments, a dissatisfied patient, a staff member out for the day, too many bills – all of this can create an extra layer of anxiety or seriousness in the office.

Fight this by being grateful for all the wonderful outcomes of your patients.  Work on having a “the gratitude attitude.”

And as you simplify your processes, you will find that everyone’s attention becomes freer to enjoy helping each other — to help the patients.

Simple is more fun and profitable.

So here is a question for you: Which comes first, the fun or the smile?

Well, you can kick things off right now… right now with a smile.  Actually, smiling is simpler and requires less muscles than frowning.

Frowning is complex, so start right now by smiling.

Try it.

See? Already your business and life is simpler and better – and funner.

-Ed

MAGNET003

(To help you keep things simple, you can order two magnets of the above image for your office, courtesy of PM&A while quantities last. Click here to order.  We will mail them to you at no charge.)

For a printable copy of this article click [The Power of Simplicity]

Chiropractic & Practice Marketing Ideas for Fall 2016

Autumn pumpkin background

(Download a PDF of this article)

3 Echelons of Practice Marketing: Motivation, Management, Procedures

Most attention is usually put on marketing procedures. That is fine but when marketing fails, it is usually because the procedures just didn’t get done, or only half done. And this is because no one was put in charge of them and given the time to execute them. Pretty obvious, but easily overlooked. This was the essential theme of the Marketing Manager System I published in 2000. It is out of print now but much of the info is on our PM&A Member’s site.

And underneath it all is motivation. Who really wants to do the marketing? You may get excited from a seminar or about an event you have planned. But motivation can dissipate quickly and too often we are not active enough in keeping ourselves and our teams passionate and determined about providing more and better service.

So all three levels or echelons of marketing need to be in place. What follows is a brief list to help you set up effective marketing activities for the next 4 months.

 

QUALITY SERVICE AND CARE COMES FIRST
It goes without saying but it needs to be said – from an executive point of view, quality care and service comes first. Ultimately, an office that gives “WOW” service and produces extra-ordinary outcomes generates enough word of mouth to create a waiting list practice. Think of Clarence Gonstead.

MOTIVATION
Plan weekly motivational talks at your team meetings and major motivational activities each month. These can be discussing case successes, watching Doctored, or doing a free clinic for the underprivileged. Keep the saw sharpened. Keep reminded of WHY you all are doing what you are doing and your greater purposes. This is the fire that drives the engine of your practice.

MARKETING MANAGEMENT
Someone to Coordinate
Delegate someone to be the marketing coordinator. You could have someone for just internal and someone for external events. These roles are only a few hours per week as coordination jobs. The actual work is delegated as separate duties so that everyone on your team has a role in marketing. Your entire office is the marketing department but it helps to have duties assigned just like you do for the front desk or billing dept.

So Many Procedures, Which Should You Pick?
Select the marketing activities that have worked for you in the past and add a few at a time. Pilot each and see what works better for you. Marketing is all about testing. Find out what works and then put it in a system. Keep it simple. Get your marketing systematized and departmentalized and delegated.

Time to Plan
Part of marketing management is setting aside time to plan and coordinate upcoming events. At least monthly, schedule time aside to review past promotions and plan new marketing for the next few months.

Calendar
Make sure you have a large calendar to post all of your upcoming promotions.

MARKETING PROCEDURES
COMMUNICATION CHANNELS
All your marketing does no good unless it is communicated. Marketing IS communication, so keep the communication going – in and out of the office. Make sure each month you promote via team members, “table talk”, e-newsletters, posters, Facebook, etc.

Recurring Procedures
The most important marketing activities are your usual, recurring procedures that you do on a daily and weekly basis. Many of these are already embedded in your routine procedures. Because they are done routinely, the usual and everyday procedures can be overlooked or not given the importance needed. For example, just answering the phone can make a big difference. Don’t let the routine become the mundane. Practice new ways to have fun with your recurring procedures.

Community Services
This is what I call the free or discounted services you provide in your community. Health screenings, workshops, networking events, setting up alliances with dentists, for example, or just conspicuously showing up at the Lions Club breakfast. I would delegate this to one person and give them 4-6 hours per week to schedule events and to help coordinate who attends these events. There is a good deal of administration in this role. I have seen events scheduled a year in advance that generated new patients and referrals from alliances that come in years after they were initially set up because the relationship was well maintained.

  • External Workshops and “Lunch and Learns.” Schedule external classes for January and February now. Business “Wellness Programs” or lunch and learns at the local YMCA or Senior center. Include massage to make it even more attractive.
  • Local Health Fairs. Contact all the locations you have held events in the past year and schedule events for the New Year.
  • Contact local businesses for health fairs in the New Year and get them scheduled.

Internal Workshops.
Internally, you can also schedule special classes over the next 4 months, including “Natural Approaches to Flu Prevention”, “New Healthy Ways to Lose Weight and Get Fit This Winter,” etc.

Google Reviewsgoogle-review
If you get 4-5 star reviews on Google, you will get new patients. This is proven. It is true. Assign it to someone and do it. Now. It may take a few months, but if you do it, they will come.

Patient Education: Table Talk and the New Patient Care Class
In my opinion, educating your patients is more important than adjusting or treating them. Not all patients are easy to educate, but all can be gradually persuaded to understand the value of your services: what they do, how they work, and why they are important. Educated patients refer more. They stay with you longer. They are more enjoyable to care for. And, most importantly they are healthier. Table talk is an excellent practice with each patient. But your new patient care class is a proven winner. It just takes your intention to do it. Two times per month. Do with the fervor of a Sunday sermon or with the frankness of a fireside chat with old friends. It will boost your practice and you. And… how much does it cost? That’s right… nothing.

Care to Share
There are many ways to do this program but I like it because it encourages your patients to help you get the word out about their successes so that others do not have to suffer as long as they did. It gets them to help their community. It taps into their greater purposes and gives them an opportunity to help others. Set up a monthly drawing and give away a modest prize or two. Enter the drawing by submitting a Google review, by bringing someone into the office for a no charge consultation, or by getting a workshop set up in their place of employment. Run the program monthly or every other month.

Special Promotions
These are the big events that can be fun and energizing which you hold in your office every couple of months or so. I list some ideas below.

OCTOBER
October is National Chiropractic Health Month. (The International Chiropractic Association and the American Chiropractic Association once recognized October as Spinal Health Month, but now it is simply called Chiropractic Health Month.) This can give you a reason to do many different promotions. For example:

  • A banner in your office for patients to bring in family members for a free “Check-up.”
  • Reactivation Month – send postcards to all inactive patients who have not been in for at least one year or more for free spinal checkup: “Chiropractic Check-up Time.” Use an image of an alarm clock.
  • The ACA has other suggestions on its site. (http://www.acatoday.org)

Child Health Day
Under a Joint Resolution of Congress, the President of the United States has proclaimed National Child Health Day every year since 1928. It was originally celebrated on May Day, May 1, each year until 1960, when the date was moved to the first Monday in October. Use this as a great opportunity to have a Kid’s Day. (Google it. Many differen sites offer suggestins.)

National School Lunch Week
National School Lunch Week takes place on the second Sunday in October (http://www.nea.org/tools/lessons/48412.htm ) You could have a workshop on fast and nutritious meals for kids targeting parents and moms.

Awareness Weeks
If workshops aren’t your thing, then set aside one week to focus on a particular condition, such as headaches and call it “Headache Awareness Week”, or “Pinched Nerve Awareness Week”, “Neuropathy Awareness Week”, etc. Schedule one a month where possible for the next 5 months as part of your Community Education Program. Detail procedure with posters in your Marketing Manager System Toolkit and on your PMA Members site under: “Community Education.” Offer free consultation, screening, and information regarding the condition.

Crazee Dayz
Select a day and make it special for your patients. Only one day a week is necessary otherwise it’s not special. It can be once per month or every week. Serve extra treats. You can have the staff dress out of uniform coordinated to the day. This can add some extra fun to the office and help with retention and long term referrals.

  • Muffin Mondays – Serve up a selection of health bran, blueberry, or gluten free muffins.
  • Two for Tuesday – Bring a friend for a complimentary spinal exam and offer the patient a free adjustment. “Two Fer Tuesday.”
  • Whacky Wednesdays – gag gifts for patients, “adjust-a-mints”, etc. (http://www.bannermints.com/)
  • Thirsty Thursdays — Organic apple juice served in plastic wine glasses with a sliced green apple on the rim. NA margaritas.
  • Fruity Fridays – Bowl of local fruit.

Chiropractic Opportunity Week (“The doctor is having a COW.”) (patient referrals and advertising new patients) Free consultation, exam, and x-ray if needed.

Hair Dresser/Beauty Salons/Spas

  • Offer a workshop on “How to Stay Fit While You Clip.”
  • Free massages (and screenings) for customers

Kids and Halloween Party
With Casper as inspiration, a kid’s Halloween party with a friendly ghost theme has the right mix of tricks and treats. Invite the young ghouls to come dressed up, but you can also have them make ghastly masks as part of the fun. Other ideas include spooky decorations, scary snacks and a friendly ghost hunt.

NOVEMBER
Thanksgiving Turkey Drawing Poster

  • Refer a friend and enter the drawing for a free turkey
  • Special for Organic Turkeys – announce in your newsletter
  • Make arrangements now with your local supplier

Thank a Veteran Day
Veterans Day – November 11. It is no secret that the physical and mental health support veterans receive is inadequate. This good time to set up a promotion honoring those who served. Special promotions including free or discounted services or donations to local Veterans organization. (More info: http://en.wikipedia.org/wiki/Veterans_Day )

Donation Drives (patient referrals, advertising new patients)
Holiday time always brings an increased demand for helping those less fortunate. Within your office set up a collection area for any of the following programs and promote it in your newsletter.

  • Coats for Kids
  • Food for Families
  • Toys for Tots
  • Blood Drive
  • $25 in exchange for first day services.
  • Also, you can support drives at local church or gyms. EG “Free first day services for every donation a member of YMCA makes to the homeless fund.”

Deer Widows Week
During hunting season or first week of December offer complimentary massage for your patients who refer in a new patient

Girl’s Night Out
This is a shopping/gift exchange that can take place in your office. Have patients who have little businesses set up booths in your office and stipulate that they have to bring guests. Supply some refreshments and promote as great way to “Shop Local” for Christmas presents. Enlist the help of massage therapist, local spas and direct marketing consultants. You can provide free screenings.

DECEMBER
Holiday Coupons – Gifts Certificates (patient referrals)

  • Good for Massage, consultation, exam, x-ray
  • Denominations: Free, $25, $25 or food donation to charity.

Poinsettia Give Away
Give away free poinsettias, one per family. Include in the cards a gift certificate for family members or friends. (See Member’s site for gift card)

Saturday with Santa

  • Set up Santa in your reception room corner
  • Treats for the kids
  • Pictures with Santa
  • Free spinal check with Doc

Appreciation to External Referral Sources
Deliver a fruit basket or other present personally during December with a card of thanks and mention how you are looking forward to another year working together. This would go to any location where you had an external community services type of event, such as a screening or workshop. Include: “Looking forward to working with you next year.”

Health Never Takes a Holiday
Post a sign in your office in December that “Health Never Takes a Holiday” and review and re-schedule patients through December to January.

Giving Tree/Angel Tree
The Giving Tree/Angel Tree Project is a great way to bring community awareness to your office. It is a simple project that gets your patients be involved to help others where they might not otherwise have the opportunity to do so.

JANUARY AND FEBRUARY
Winter Workshops and Movie Nights – Internal
These, of course, can be done anytime of the year. Whether it is how to make organic soup for the week, or a talk on vaccinations with an MD, winter has been a good time for internal events. Weight loss, fitness, and food have seemed to be popular. These should be planned by December or even November. Ideally, plan your workshops with a guest speaker such as a holistic MD, biological dentist, midwife, etc.

We have a great deal of information on our PMA member’s site for those of you who are active clients, much of it compiled from the Marketing Manager System I published quite a few years ago. There you can find readymade posters and detailed information on how to do many of these projects.

Yes, I know some of the posters are old but we are not in the graphic arts business and neither are you. But they are on Word files and can be easily changed. A simple graphic and title is all you need with the specifics in bullet points. Depending on the level of your program, we can also put together simple posters to help promote your particular project.

If you are not active with PM&A, you can still find a great deal of info on our web site at www.pmaworks.com/observations.

With shared intentions to get more people healthier and smarter about their health!

Ed Petty
September, 2016

Thank You Linda Skiles for 15 Years of Dedicated, Caring, and Purposeful Service to Petty Michel and Chiropractic Offices Everywhere

Linda Skiles

Linda Skiles

15 years!

 

Actually, seems much longer as our relationship goes back to the great and honorable Dr. Gaylord Culp of Lake Geneva. And what a grand privilege that was – he was a master Chiropractor.

And then I bumped into you again as the office manager at the renown Wheelock Clinic in Burlington. WI. A dynamic multiple-doctor office that is still going strong.

You certainly had good experiences with solid chiropractic with these doctors and at these offices so there was no doubt in my mind as to your credentials.  You were Chiropractic Assistant of the Year here in Wisconsin too… back a few years it was!

A person can have credentials and training but these are minor compared to the exceptional and outstanding qualities of character that you have demonstrated.  It is too rare to find people who have the personal ethics and courage and selflessness to continue to provide support services through thick and thin, day and night, when needed, as needed, year after year.

In a quiet corner of the world your industriousness has been unflagging…and directly and indirectly because of you and your work, hundreds if not thousands of people are living better lives through better chiropractic offices.

You are always ready to provide us consultants, our clients, and our company with fast service any time.

We don’t say this enough, but your continued support has made a difference to all of us and so many others. But here it is, on your 15th Anniversary:

Thank You Linda. We love you.

🙂

Vaxxed – The Movie and Questioning Authority

I just watched Vaxxed, a new movie about the relationship between vaccinations and autism, the CDC (a federal agency, the Center for Disease Control and Protection), and Big Pharma. It has limited showing across the U.S. and is currently playing in Milwaukee until today (June 30th). (Downer Theater)

Most of the film quotes M.D.’s and PH.D’s, except for a few stories by the parents of vaccine injured kids. Some of the clips show M.D.’s over time as they discover a link for themselves.

A key element in the film centers around an admission of the key research scientist, Dr. William Thompson who, after working for the CDC, claims that he is now a whistleblower. He says that data was manipulated and evidence was destroyed to cover-up a direct link between certain vaccination protocols and autism. “I have a boss who is asking me to lie… The higher ups wanted to do certain things and I went along with it…” [paraphrased]

After the movie I did a fast Google and found: “Autism rates soar, now affects 1 in 68 children…” from USA Today, 2014.   It occurs 4-5 times more in boys than in girls, according to Wikipedia. In 1995 it was 1 in 500, and back in 1975 it was 1 in 5000. (autismspeaks.org)

Vaccine rates have also soared – 49 doses of 14 vaccines before age 6. CDC schedule. 2 With both numbers soaring, there is at least a correlation.

But my attention is on the money. It is no secret how many Big Pharma lobbyists work in Washington (about 2 to 1 for every member of Congress) – or how profitable the pharmaceutical industry is, or how much they spend to influence government, doctors, and the public.

And it is also not an odd coincidence that the head of the CDC when Dr. Thompson was doing research on vaccinations, Julie Gerberding, gets hired by Merck. She was put in charge of Merck’s vaccine division. Big surprise!  Merck had or has 12 vaccines on the market, including Gardasil – a vaccine India is suing Merck for in the deaths of girls. It is hard to tell how much she is making, but one report shows that she just cashed in Merck stock for over 2 million dollars.

You may remember Merck, the company that produced Vioxx that killed 38,000 Americans, maybe more. Merck finally pulled the drug in the early 2000’s. And there were cover-ups and whistleblowers back then too. Dr. David Graham who worked in the FDA, (Food and Drug Administration) testified that “Nearly 60,000 people may have died.”  After his testimony, Graham was publicly criticized by the FDA. He later sought help from a whistleblower protection organization. It is dangerous to be a whistleblower or to go against powerful interests!

But you don’t need to be a whistleblower to connect the dots. From cigarettes to finally aspartame, people are gradually seeing that what is popular is not always what is healthy or in their best interest.

Yet, with enough money, consent can be manufactured through Big Data and Big Marketing. It can do it subtly and in a thousand different ways.  Public Relations is a science and is becoming more sophisticated every day and unless you do your homework and have an open mind, and QUESTION AUTHORITY and CONVENTION,  you may be like someone who supported invading Iraq because Sadam Hussien caused 9/11. ( Even two years after 9/11: “Nearly seven in 10 Americans believe it is likely that ousted Iraqi leader Saddam Hussein was personally involved in the Sept. 11 attacks…” USA today, 9/6/2003)

So, yes,  I recommend the movie Vaxxed and draw your own conclusion, but more importantly and always… question authority.

“You don’t need a weatherman –  To know which way the wind blows.”  Bob Dylan

Your Perennial Waiting List Chiropractic Practice: Like Daffodils, Your Patients Keep Coming Back

petty michel and associates on creating a full office

Daffodils from Linda’s back yard in Wisconsin, 2016

Spring is finally with us and the flowers and trees are beginning to bloom up here in the northern Midwest.

What is amazing to me is that I start seeing flowers pop up where I must have planted them, or someone did, a few years past. Pop, pop… a daffodil here and tulip there, some lilies and Astors and I don’t know what! Who planted these?

Growing, developing, and sustaining a chiropractic practice corresponds in many ways to the laws of nature or the laws of a farm. What makes these plants bloom are many things – the warmer weather, some biological clock, water, of course, and sunlight. Maybe some organic fertilizer now and then.

They also have something else. Something that has allowed them to weather the snow and the cold and the storms so that they are here now… waving to us in the still cool of early spring.

A few years ago I wrote an article about roots and patient retention. I know… seems like an odd comparison, but it’s not really. The thing with roots is that they are not seen and not always appreciated. I made the analogy of having a good root system in your practice – which would be the loyalty your patients have with you. I discussed methods to create and improve this relationship in the article, Chiropractic Root System

I just reviewed the article and realized that I omitted a key component in creating great patient loyalty, patient retention, and patient referrals. It is actually pretty obvious and something I see in the offices I visit.

But first, let me include here some survey information from the 2010 Customer Experience Impact Report (CEI) for North America by Rightnow Technologies* that will help make my point.(My underlines and bolds.)

“WORD OF MOUTH IS MIGHTIER THAN THE SWORD
Consumers aren’t only demonstrating their power with their wallets, but they are influencing those around them as well. Whether a consumer has a positive or negative experience, their friends, family, colleagues and networks are sure to hear about it and what they are saying carries weight.

Customer service is the most influential thing a company can do to increase customer advocacy.

55% (up from 53% in 2009) of consumers recommend a company because of its customer service, compared to products at 49% and price at 42%.

But those who have issues are also voicing their opinions and it can have a severe impact on a company’s reputation and ultimately bottom line.

Imagine the result of 66% of a company’s frustrated customers on a mission to discourage others from buying from that company. Consumers aren’t just complaining when something goes wrong, they are determined to have their presence felt by the company at fault:

  • 79% of consumers that had a negative experience with a company told others about it
  • 97% used word of mouth as their preferred method to share their experience

WHAT MAKES A GREAT EXPERIENCE?
Consumer expectations continue to rise, but their requests are reasonable and within reach. Put simply, consumers want easily accessible, accurate information to make well informed buying decisions. And they want to be respected, treated well, and have their issues resolved in a timely fashion.

Of those who decided to stop doing business with an organization,

  • 73% was a reaction to rude staff
  • 51% reacted to unknowledgeable staff
  • 55% were because of issues that weren’t resolved in a timely manner.”

Finally, it all comes down to this:

“WHEN YOU HAVE A BAD EXPERIENCE, YOU DON’T GO BACK.
This has been a mainstay result from the Customer Experience Impact Report (CEI). The fifth annual report cited that 82% of consumers have stopped doing business with a company as a result of a negative experience.”

So, it is not “time” or “money” as the primary reason patients drop out of care. Simply put – their experience was not AWEsome enough!

This is why Google Reviews or any legitimate review has such a strong impact on referrals. It is Word of Mouth marketing.

But how do you create it? Is there some fancy form or new procedure? A Dx code perhaps? Well, there are forms and procedures, but these are 20th on the list. The first 19 have to do with excellent communication and service. Communication that is genuine and caring.

In the article about increasing patient retention and the root system, I do give a few ideas on how to improve your service and, in turn, retention and referrals. But… so apparent to me now, I left something out!

Time and time again, where I see an office struggling to get new patients… I also notice a low morale office.

The low morale may not be obvious. In fact, studies show that the majority of employees (70%) are really not engaged in their work, but simply go through the motions.** This is so common that blasé, disinterested employees or time crunched, rote professionals seem to be the cultural norm.

But I routinely interview staff and work with office managers and hear THEIR side of the story, at least part of it.

If a team member is disgruntled, disaffected, discouraged, or in any way “dis”, the quality of service they provide to the patient will be affected. Let’s put it another way: if your team is anything BUT happy and cheerful and truly looking forward to their day with YOU and the patients, you have a problem.

There are many studies that show the cause and effect of employee morale and customer service. But I have personally observed it many times myself.

The offices with the HIGHEST patient retention and most patient referrals are the ones where the support team and doctor, or doctors, have a great relationship with each other. In fact, aside from the now and then stress points, you could say that they truly like and admire each other and respect each other’s good work.

Adding to this, these offices also have dedicated a continuous effort for training and education. Webinars, seminars, internal trainings, coaching (Hi there!), and books – one of the most overlooked training tool.

Now, what hampers all this is the stress of running a business. Doctors like to “doctor.” Chiropractic, or whatever good care you provide, does not fail. Doctors can always improve, and should, but it is usually the support organization that finally jams up on itself like railroad cars banging into each other, or even jackknifing.

As many of you know, I am working on a practice CEO training program. After a certain point of practice growth, it becomes difficult to continue to grow the business as a doctor. There is just too much to do. This is why you now need to learn and implement some fast flow procedures as a CEO, procedures which are very different from a doctor.

The CEO is a leader. John Maxwell*** lists five levels of leadership. At the first level people will follow you because they have to. At the second level they follow you because they actually like you! You have a relationship with them. At the third level they see that you get real results for the organization. Fourth… you are helping them become leaders! The last level is many orders of magnitude above the others… they follow you because of what you represent. Think of Martin Luther King, Gandhi, etc.

Practical Steps to Take to Improve Morale, Customer Service, Patient Retention and Referrals:

  1. Improve your communication with your team. That’s it. If it is good enough for your patients and for your family and friends, it is also good enough for your team members. As the doctor, of course, you are very busy. You are here for the patients and we are here for you.  But… as the CEO, you are here for us. Please listen to us, help us get better at helping you and the patient. Schedule time to do this each month with your veteran team members. A few minutes in the office, or even a lunch now and then.  It will pay off! And besides, it is only the decent thing to do.
  2. Plan events or projects to improve everyone’s competence. Schedule the team for training and coaching (Hi, again!) …or have them propose learning activities. Help them become leaders. Help them become expert. Lots of study and training and coaching.

As this happens, a lighthearted sense of pride and confidence will grow in your office. Synergy will improve. Staff will be engaged with the patients more and the patients themselves will also become part of the synergy.

Your practice will become well-nourished and strong, like perennial plants and trees that flower each spring.

Your patients will keep coming back.

#   #   #

Learn to look after your staff first — and the rest will follow.Customer service can make or break a business. If you treat your staff well, they will be happy. Happy staff are proud staff, and proud staff deliver excellent customer service, which drives business success.  – Sir Richard Branson (Virgin Companies)

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Chiropractic Root System and Patient Retention

  *Rightnow Technologies. Download the report here. http://media.stellaservice.com/public/pdf/Customer_Experience_Impact_North_America.pdf

**http://www.gallup.com/poll/181289/majority-employees-not-engaged-despite-gains-2014.aspx

*** John Maxwell, The 5 Levels of Leadership

Extreme Chiropractic Practice DevelopMENT! California Jam®, 2016

Go Cal Jam

I am standing on a beach by the partially ice-covered Lake Michigan, sometimes referred to as part of  the “Third Coast.”   It is a good day!

Once a year I send out a promotion for the wildest and most unique chiropractic seminar I have seen in 30 years.

“Out-of-the-box” is a cliché that doesn’t really do Cal Jam justice.  Like extreme sports, Cal Jam pushes the boundaries of what is customary and conventional.

But isn’t that chiropractic?  Isn’t that you?

Chiropractic is unique (and wild) because it has purpose and soul.

Purpose and Soul, plus plenty of… Rock and Roll.

At Cal Jam!

Hope to see you there!

Date: March 18-20, 2016

Link to site: California Jam: www.CaliforniaJam.com

Your Most Important Set of Chiropractic Office Procedures

An Introduction to the Practice Development Process of Continuous Improvement

A key difference between a successful and profitable chiropractic business and a roller coaster type practice can be traced back to procedures and systems.

Many practice problems occur because procedures are not established, consistently followed, and regularly improved.   This has been the secret to franchising. Starbucks may offer new products and services now and then, but for the most part, they follow their checklists and manuals of successful procedures.  The local New Age coffee shop down on the corner with the unemployed guitar player usually lasts for about a year before the owner’s savings and inspiration dry up, along with the last cup of coffee.

chiropractic practice playbook

Of all the categories of systems in your office, what would you say would be the most important?

☐Patient Accounts (Billing/Collections) Systems
☐Marketing Systems
☐Front Desk Systems
☐Therapy and Clinical Support Systems
☐ Doctor Systems
☐ Business Systems (Payroll, Financial Planning, Taxes,)
☐ Leadership
☐Office, Practice Management Systems

My guess is that you usually keep most billing procedures in place as… obviously, you need to be paid.  And, you will usually keep most front desk procedures in place. These deal with patients and patients are obviously in the office, or not. And you, of course, follow your clinical procedures.

Your marketing procedures come and go, at least they do in most offices. They are just not consistent. This is why I put together the Marketing Manager System in 2000. The biggest error in most offices with their marketing is that it simply isn’t done consistently.

But the most important category of systems is not so obvious. These are the management procedures and systems.  Why are these most important? Because they keep all the other procedures in place and are continually being improved upon.

Why do you think CEO’s are paid so much money? Because they are in charge of the management of a business and are able to increase its bottom line by the millions.  They have procedures that they follow and insist that others do as well. These procedures all add up to systems.

Over the years, Petty Michel and Associates has been very successful at increasing the revenues of practices. One of the reasons is that we implement what we call the Practice Development Process. It is a monthly system of management that gradually works to objectively improve the business, repetitively over and over.  It integrates into your current systems and does not take that much extra time.  But in the end, it saves you a great deal of time, extra work, and lost revenue.

To learn more about the 3Goals Practice Development Process: 3Goals PDP

The 3Goals Practice Development Process for Chiropractic Success

Four steps to continuously develop and improve your practice

The Practice Development Process is a simple, yet powerful practice building system that can help take you and your business to its full potential of a systematized, team driven and profitable business.

Practice Development Process icon

It transforms your practice. Month by month, it helps move your practice to a more profitable service oriented business that runs at near full capacity – with less ups and downs that demand your time and extra work.

It is based upon the idea of constant improvement.   

The principle of constant improvement in management science has been a major factor in the success of large manufacturing corporations around the world. The success of the Japanese automobile manufacturing rests heavily on a process of constant improvement called Kaizen (kai = change, zen = good).    Motorola developed its own program called “Six Sigma”, a process of continuous improvement.

Kaizen

We have adapted these processes to be applied in practice management and call it the 3Goals Practice Development Process (PDP).

The Practice Development Process has four steps:

  1. Access
  2. Plan
  3. Supervise
  4. Document

Integrate This Process As Part Of Your Team Meetings. The first two steps, Assess and Plan, are usually done before or during the first staff meeting of the month. Supervision goes on during the month to ensure that the plan gets completed. At the end of the month, successful procedures are documented in a practice playbook for future training and assessments.

Your Consultant and Coach. This process is best done with your practice and business coach.  Each month, the two of you should work through step 1 and 2. During the month, your coach may also be able to help with the implementation of the plan.

THE 4 STEPS OF THE PRACTICE DEVELOPMENT PROCESS:
1.  Assess and Review.  At the end of the month, look over the statistics and note what areas improved and what areas didn’t. Then check what was actually done, or not done in each area. Use your departmental checklists from your Practice Playbook if you have started this.assess and review

Many business owners still manage without looking at objective indicators. They manage by emotions, mistakes, fear, “bright ideas”and  other flighty factors that ultimately hold a clinic back, or often just burn it out.

Effective clinic managers, like an athletic team coaches, base their actions first on actual outcomes and performance monitors. These are your daily, weekly, and monthly practice statistics. PM&A has developed a specialized form of review which is called Practice Analytics System which we display on our client’s personal Practice Dashboard’s.

This assessment also includes reviewing checklists of the key procedures and whether or not key duties were done.

  2 Plan. Work out the key areas you want to work on in the next month. Pick just one or two areas that will make the biggest difference and make a list of a few action steps that will help improve the area in your office you have targeted. Get the actions assigned with a date on when they should be done.

game plan

 

3 Supervise.  Regularly monitor the implementation of the action steps with yourself, your team, and your consultant. Provide help where needed to get them done.

4  Systematize. You do not want to keep inventing the wheel, so at the end of each month, document any procedure that worked well.

List all successful activities for each department and “lock them in” as standard operating procedures. Keep what works, throw out what doesn’t. Start with just a checklist of key procedures. Later, you can write or videotape a description of each procedure. It is from this that you will do your training and “coaching reviews.” Use your playbook often: refer to it and practice.

playbook

 

Gradually, you should have your own system of practice management and patient management and have it outlined simply in your Practice Playbook. For example, the “Smith Chiropractic System of Patient Management.”

 

IMPLEMENTATION SCHEDULE
Week 1. First Week of the Month: Do Steps 1 & 2 – Assess and Plan
Week 2. Supervise. Coordinate upcoming activities. Study and Train. (Optional: Separate Marketing Meeting)
Week 3. Supervise. Coordinate upcoming activities. Study and Train.
Week 4. Supervise. Coordinate on upcoming activities. Celebrate and party for a great month! Add to Practice Playbook.

 

REPETITION
Do The Practice Development Process Every Month.
The success of this process derives much of its power
from a simple principle from Aristotle.

aristotle

“We are what we repeatedly do.
Excellence, then, is not an act, but a habit.”

This often referenced quote is from a series of lectures he was to have given at the Greek Lyceum on ethics (300 B.C.).   We could say, then, that continuing to do the Practice Development Assessment, and all of your procedures and systems, is ethical and leads to excellence. The contrary would also be true.

 

GOALS AND CONSTANT IMPROVEMENT
It is important to keep in mind WHY we are doing the PDP each month.

It is assumed we all want to improve, that improvement  is possible, and that we have higher purposes and goals.  Our patients do. That is why they see us and  we help them improve and get closer to their goals at each visit.

By consistently working the 3 Goals  Practice Development Process each month you, the practice, and each team member will also get closer to the higher goals each of you share.

goals sun

Kaizen: Constant Practice Improvement – From Wooden to Deming

What improvements do you need to make in your practice for 2016?

Managing your practice is similar to managing a sports team in many ways. There are goals, rules, plays (procedures,) skill development, strategies, winning and losing. There is also coaching and training.

The teams that win the most constantly work to improve. But the improvements often focus on just the refinement of the basics.

One chiropractor I worked with told me stories about his experiences with John Wooden. Coach Wooden was a very successful basketball coach who coached the UCLA basketball team to 10 national championships over a 12-year period.

Here is what Coach Wooden has said:

“When you improve a little each day, eventually big things occur…. Not tomorrow, not the next day, but eventually a big gain is made. Don’t look for the big, quick improvement. 

Seek the small improvement one day at a time. That’s the only way it happens – and when it happens, it lasts.”

 

In Japan they have something called Kaizen. This means continuous improvement. Part of this was developed by another Midwesterner (Wooden was from Indiana), Edwards Deming (Iowa).

Kaizen

The Deming Cycle is a process of continuous improvement that helped grow the Japanese car industry in the 60’s to what it is today. For a long time, Detroit auto companies weren’t that interested in what Deming had to say – and, of course, we can see how that turned out for them!

Constant improvement takes discipline. Those of you who had to practice a musical instrument or an athletic skill in school remember the daily routine. Improving the little things can get boring and when a colleague calls with excitement about this new seminar or gadget or website, many doctors are off to the chase the “shiny things.”

Innovation needs to happen, certainly. But the real successful businesses and teams continually work to master what they already do.

Mastering the basics is always the key to success. Deliberate practice, study and good coaching. And this takes discipline and… a certain degree of humility to admit you can personally improve.

But since you are not a full time coach and mostly work IN the practice, you have to schedule specific times to work ON the practice. But what do you work on? ICD 11? (Yes… it IS on the horizon!) More E.H.R?

Well, maybe, but these are not the areas that will significantly improve your business over the long run and take it to the next level.

To help you uncover what should be improved, you can use our updated Practice Progress Grid. You can go over it with your team and plot where you were, where you are now… and then where you want to be next year! (Link is below.)

This can help reveal what organizational and engineering steps you need to build a better business machine for 2016.

In most cases, the improvements don’t have to be major. They just have to be continuously refined. But some areas that are holding you back from your goals can be hidden or overlooked.

If you want to dig deeper, we also have our Practice Development Assessment(PDA). It takes more time to complete but gives you a more complete analysis. (The link is below.)

The world is changing faster and faster. You have to constantly improve to keep up, let alone, to stay ahead. And if you don’t… well, your patients will be going to those offices that are.

From all of us at PM&A, we look forward to your continued improvements and to helping you get closer to your goals in the New Year.

Ed Petty

Link to Practice Progress Grid
Link to Practice Development Assessment (No charge for first 15 users, $25 thereafter.)

Presidential Award Given to Dave Michel of Petty Michel & Associates

Dave's CSW Award

Dr. LaGuardia, Dr. Conway  with David Michel of Petty Michel & Associates

MILWAUKEE, WI – November 27, 2015 – Petty, Michel and Associates (PM&A), a national chiropractic practice management company, is pleased to announce that David Michel, a partner with PM&A, was recently awarded the 2015 Presidential Award by the Chiropractic Society of Wisconsin (CSW). The award, presented during the Awards Ceremony at the CSW’s second annual 2015 Health & Wellness Summit, held at the Kalahari Resort in the Wisconsin Dells this past October 9th through the 11th, identifies:

  • Those who have made significant contributions to the mission of CSW
  • Those who have served selflessly expecting little in return
  • The acknowledgement is to give thanks and recognition to the individual for all their hard work and commitment

Mr. Michel serves on the Board of Directors for the Chiropractic Society of Wisconsin (CSW). The CSW is a member driven and member controlled State organization that develops and maintains positive relations with consumers (patients), chiropractors, legislators, lobbyists, insurance companies and medical providers.

Dr. Jay LaGuardia, President of the CSW, when presenting the award to Michel, stated:  “We would not have been able to achieve the success we have thus far without his valuable service.”

David Michel has been involved with the Chiropractic Society of Wisconsin since its inception in 2012.

Petty Michel & Associates (PM&A), a practice development company, was founded in 1988 as an alternative to conventional practice management seminar programs.  For more information, go to: http://www.pmaworks.com

The Marketing Flywheel versus the “Paleo” Practice

If you are like many chiropractors, other doctors and professionals, you are wasting potential revenue and don’t even realize it.

Before I tell you how this happens, let me give you a definition that I have been using for years that has helped many offices.

Definition of a Practice

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

OK. Keep that definition in mind.

Now, here is how you can lose extra income and create extra work for yourself and your team: You start out spending a great deal of time and effort on generating new patients and then on processing them. You get to know the new patients and hear their stories. You empathize with them, ask them questions, and examine them. You explain what you have found about their condition and worked out what you see as their best option for treatment.

During their first few visits you are sensitive to how they are responding to your care and so continue to communicate with them. You put all this work into your new patient in order to help them follow your treatment plan and get better.

But as the patient improves and their frequency of visits decrease, your focus on them lessens. Your attention gravitates to the new patients.

When the patient has moved through your care plan, they often just drift back out into their community with an inadequate lifeline back to your office.

You have invested in, and created, a great relationship with your patient. Wouldn’t it be a good idea to stay in communication with them? They know you and like you and your team — shouldn’t you keep the connection alive and active? Just because their health condition has improved, don’t you still have approaches to help them become healthier and happier?

They have family and friends that can use your help now. They also belong to businesses and other groups that could use your help. Why let this relationship atrophy? Why not secure that lost income as well?

The Other “Paleo” Practice

In some sense, the business is constantly starting and stopping. It is nomadic. This is the other “Paleo” practice: each day when the sun comes up across the plains, you are out hunting for and gathering new patients. This may be good for a diet, but not if you want a low stress practice. Wouldn’t it be better to create a business where existing long time patients would routinely stop by for care and refer their family and friends? This would save you a lot of effort, money, and stress, wouldn’t it?

The Practice Flywheel

A practice should be supported by business systems.

These systems are like an engine. An engine has starts and stops, but it also has a flywheel. The flywheel is a heavy wheel that, once it begins to spin, continues to do so with much less effort than it took to get it going.

A good practice is supported by a business flywheel, or a number of flywheels as there are different sub-engines in the business.

For internal marketing, the flywheel is the conversation that you first began. You want to keep it going and going. After you get it spinning in high gear, it takes little effort to keep it humming along.

How Do You Do This?

You put in place a system of constant communication with your patients when they are NOT in the office through e-newsletters, hard copy newsletters, notes and cards, Facebook, and any other medium available. And of course, there is also personally seeing them at events in your community – county fair, grocery store, restaurant, salon or barber shop, etc. You want to keep the conversation going.

A very effective method is through electronic newsletters. Done right, and they usually aren’t, these newsletters can improve the numbers in your office.

We have tested this and found that the offices that do have personalized newsletters to their patients have more returning patients, more referrals, and more wellness visits as a result. Hence, more revenue and less stress about generating new patients.

See link below for a procedural article on what we have found that seems to work best for e-newsletters. Your customized e-newsletter can fuel your Facebook page, website, hard copy newsletter, and other mediums. We have worked out a relatively simple and very cost effective system that offices are using now to make this work.

Keep in mind that if your patients are not in listening to you, they will be listening to someone. For example, there are about 80 ads for drugs every hour on television (http://www.topmastersinhealthcare.com/drugged-america/) and this statistic is more than ten years old. It has been estimated that each of us are bombarded with about 2,000 advertising impressions per day. How many of these ads influence your patients toward unhealthful products or services?

Customized newsletters, and the cascading communications that they can feed, cost little but they help to keep the patient flywheel – and the communication – going. And in so doing, the patient wins, the community wins, and so does your business.
-Edward Petty

Publishing Your Newsletter  Does your mailing bottleneck when it comes to time to do the monthly newsletter Follow our easy steps to get your newsletter out “simple and fast”.

Newsletter Content –  9 suggested topics to include in your monthly newsletter to keep the conversation going.

Your Newsletter: CONTENT

The purpose of your newsletter is to keep the conversation going. It is designed to sustain the relationship that you have started. It can even help create new relationships. It serves to remind the patient that you are there for them and can continue to help them.

Marketing IS communication. Nothing beats live two-way communication – in person or via the phone. But next to live communication, the personal letter is best. The letter is a tried and true form of communication.

A newsletter is NOT a brochure, or a pamphlet, or regurgitated “content.” It is a personal communication from you to someone else.  Too many newsletters are mass produced and have generic types of “content.” The one thing that is becoming more valuable in today’s world is authenticity. This is important because it creates trust – which is also scarce.  So, keep your newsletter personal, even “folksy” and your patients will feel that the real you is talking to the real them and will have a greater impact.

Components of a patient newsletter should include some the following:

1. Letter from the Clinic Director
A short letter to the patients from the Clinic Director anchors the newsletter. If you include nothing else, this is the most important part of your newsletter.

It can be short or long. Shorter is better, with only 4 or 5 paragraphs. A longer letter also works ONLY if it is compelling. A worthy story or rant against some injustice…these can work. If it expresses your VOICE, it will work.

Your letter should usually include some reference to you personally. For example: “Yesterday, when I was taking my kids to school, my youngest mentioned she was told that she needed to receive 43 vaccinations next week….”

You can include some health news, with statistics and cite a reference, or refer to an article in another part of the newsletter. You can include office news. Refer to a photo attached of the new carpet, painted wall, or gift from a patient.  New research, celebrities utilizing similar services, recent chiropractic success cases in the office, clinic expansion or renovation, new computer system, and personal adventures … all of these are good.

This can also be done via a short video as well.

Whatever you say, it should be delivered as if you are talking to just one person, perhaps the last patient you just saw.   End the letter by saying something like… “I look forward to seeing you soon.”

2. Health Tips
Information for a “Health Tips” column, such as “Health Sleep Habits for Kids” The topic should be consistent with the time of year (September – back to school month) or Community Education Program theme (Children’s Health). Dr. Mercola has built his empire with great health tips from his newsletter. If you are not a subscriber, I encourage you to look into it. (www.mercola.com)

3. Special Promotions
Information on any upcoming promotions, spinal care classes, community education lectures, or anything else of a special nature.

4. Staff News
Include any news about staff, such as a new baby, new staff, new staff promotion, continuing education or seminar attendance. Pictures please.

5. Doctor/Clinical News
Include news about doctors, such as new seminars attended, advanced training, specialties, new associates, new diagnostic or treatment equipment, etc.

6. Patient News
Any news that is appropriate about patients, such as patient of the month, patient success stories (include photograph of patient), patient news: “Joe Smith wins the lottery and enrolls at Palmer!” Ensure you have a signed release from any patients that you want to include information about. Some clinics like to include a copy of their “thank you for referring board.”

7. Community Education Calendar
List the dates, times, places, and other pertinent information about community events that you will be sponsoring during the next month or quarter.

8. Just for Fun
Begin a recipe column. Assign this to one of the staff as appropriate. For example, if your office manager’s name is Jean, have a column called “Jean’s Recipes”. Each month, Jean can feature a different recipe, including, for example, the doctor’s favorite special chili recipe. Recipes should be simple (or at least not take up too much space). “Jean” should make some comments about the recipe.

9. Cartoons and Jokes!
Newsletter CONTENT Checklist

Submitted in digital format (Via computer).  Bonus if you include photos or even a video.

  • Letter from the Clinic Director
  • Health Tips
  • Special Promotions Upcoming
  • Staff News
  • Doctor/Clinical News
  • Patient News
  • Community Education Calendar
  • Just for Fun
  • Cartoons and Jokes