Author Archives: Edward Petty

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 Theory of Constraints: How Bottlenecks Can Suffocate The Growth Of Your Chiropractic Practice And What To Do About Them

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

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

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

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

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

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

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

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

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

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

 

SOME CHIROPRACTIC EXAMPLES:

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

 

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

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

 

REMOVING PRACTICE CONSTRAINTS

Here are some steps to take to remove bottlenecks.

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

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

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

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

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

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

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

 

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

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

Sometime

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

He Fired the Office Manager

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A few months ago a chiropractic office manager called me. She said that her doctor had fired her.

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

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

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

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

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

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

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

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

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

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

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

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

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

Don’t get fired. Get fired up!

A Short History of How Everything Else Has Cost You Hundreds of Thousands of Dollars and (nearly) Killed Your Dreams as a Chiropractor

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When you started your chiropractic practice, you took on 2 roles: “Doctor” and “Everything Else.” As your practice grew, you became busier in your role of doctor. That is what you wanted. That was good.

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

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

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

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

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

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

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

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

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

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

= = = = = =  =

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

Your Chiropractic Brand

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A brand is the representation of you in the marketplace. Well defined, it can cut through the thousands of health messages people hear each day so that your message is heard distinct from all others.

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

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

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

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

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

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

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

Registration for Chiropractic Marketing and Management Webinars

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How to Register

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

Guest Registration Form

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

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

You can also download a calendar for upcoming webinars: LINK

Improving Team Performance and Developing Community Services for a Chiropractic Office

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This month we cover a couple of import topics, both of which can bring you more income if managed correctly: Chiropractic Staff Performance and Community Relations Marketing.

TEAM PERFORMANCE

How well does your staff perform their duties?

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

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

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

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

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

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

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

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

Our webinar this week covers just this topic.

 10 Tips on How to Be An Effective Team Trainer

Tools and Tips for Fast Team Training That Pay Off

Thursday, March 8th, 12:30 CT

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

 ===============

 COMMUNITY SERVICES: External Marketing

We all live in caves.

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

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

What’s so hard about that?

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

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

This is the subject of our next marketing webinar.

 Scheduling Effective External Events and Generating External Referrals

Learn how to schedule effective events in this short webinar.

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

 

How to Register

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

Guest Registration Form

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

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

You can also download a calendar for upcoming webinars: LINK

The 5 Levels of Chiropractic Business Leadership

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What level of leader are you?

Join us for a unique webinar on chiropractic executive leadership. This webinar goes over the levels of leadership skills you need to be a successful chiropractic CEO in your practice.  

 We will reference the work by John Maxwell and his book on the levels of leadership. Maxwell states:”… everything rises and falls on leadership.”

Chiropractic does not fail you. Tens of thousands of chiropractors and millions of patients over the last 115 years can attest to its effectiveness.

But just because chiropractic delivers, or just because you are a skilled doctor, does not mean that you are a skilled CEO. Lack of small business executive leadership training has stunted the growth of so many otherwise prosperous doctors.

 Starting in 2012, we have begun a new program focused on freeing the doctor from practice drudgery and high stress roller coasters by beginning an executive training program. We are calling it the Freedom Package.

In this webinar, we will also review an actual consulting case, complete with stats and personnel profiles (all anonymous) demonstrating a level of chiropractic business leadership.

On our panel will be a successful chiropractic CEO of a multiple doctor office for 25 years, Dr. Tom Potisk.

Date: Thursday, February 23

Time: 12:30 Central Time

Prerequisite: Doctors must have been in practice for 4 years or more, and own their own business.

How to Register:

For guests, you may register for this webinar for $65 which includes “5 Levels of Leadership” by John Maxwell mailed to you. Go to the Registration Page below.

 For all active PM&A clients, you can register immediately at the Registration Page link below.

Once you register, you will automatically receive your special log-in access number where you can participate via computer, or by telephone only.

Registration Page

If you’d like more information visit our website HERE.

February Freedom Webinars

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Freedom PackageThis is an invitation to get your motor running — and to head out on the Freedom Highway…

We have three webinars this month designed to help you get free from financial and staff stresses, and free to follow your own dreams.

You know…as long as you provide good clinical care, then all you need is effective marketing, a motivated team, and good leadership.  Just three – to be free.

So many of our offices have been surging forward over these last several years and recent months — because they have provided better leadership, team building, and marketing.

Hop on the Freedom Highway with us… and take your patients with you as well. They too want to be free … free of pain and poor health.

FEBRUARY WEBINAR SCHEDULE


**February 9th, Thursday,  at 12:30CT, we start off with a training webinar on management and team development. We will be discussing how to hire the right team member.

How To Hire The Right Team Member

  • How do you know if you really need more help?
  • How do you promote for another staff member?
  • What traits are best for what position?
  • What about different personality types?
  • Screening and the interview
  • The first 30 days
The presentation is approximately 30 minutes followed by a 30 minute panel discussion with two long time professional C.A. office managers.

**February 16th, Thursday, 12:30CT, we focus on tools and tips for marketing your services.

“Marketing Tools and Tips”
  • How to make Earth Day your Day
  • Powerful internal marketing scripts
  • Report of findings trick
  • Setting up Community Events (Next Month -Lots more on this subject, including screenings)

The presentation is approximately 30 minutes followed by a 30 minute panel discussion.

**February 23rd, Thursday, 12:30 CT, a special Executive Briefing

just for clinic owners.

Executive Briefing: Case Study of one doctor’s attempt to grow his business. What he did right, wrong and what you can learn from his journey.
  • We will show the graphs, report on the personnel, clinical and marketing changes, and tell you what happened and why. An inside look.
  • Learn from others mistakes and success.
The presentation is approximately 30 minutes followed by a 30 minute panel discussion with other doctors.

How to Register

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

Guest Registration Form

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

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

 

You can also download a calendar for upcoming webinars: LINK 

 

Hope to see you at our trainings and briefing.

Ed

Freedom Package Webinars for 2012

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INTRODUCTION

For 2012, we will be offering an ongoing program of training and support for chiropractic marketing managers, office managers, and chiropractic doctors as CEO’s.

We are calling this the Practice Freedom Package. Its purpose is to help free the office from financial concerns, day to day managements worries, and give it the freedom to follow its greater purposes.

Over the years we have observed that the key barriers to achieving practice success are organizational.  The barriers do not lie with chiropractic. It is not a matter of chiropractic failing the office, but the office failing chiropractic.

These failings occur as a practice grows beyond its ability to effectively manage itself.  The capacity restraint ultimately stems from the doctor who is too busy doctoring to run her growing business.

This package of webinars and services is designed to help the doctor and the office overcome these organizational limits.   More information about how and why this program works can be found on by following the link below.

FREEDOM PACKAGE WEBINARS: COURSE DESCRIPTIONS

♦♦♦♦♦ Chiropractic Practice Marketing Webinar♦♦♦♦♦

When. The 3rd Thursday of each month at 12:30 Central Time.

Description. You will learn principles and accompanying action steps which will help you generate new patients from other patients, from external sources, as well as reactivate former patients and better retain the ones you have.

Each webinar will cover at least 4 practical marketing procedures that are effective in generating more patients.

Who should attend. Designed particularly for chiropractic marketing coordinators and managers, doctors and office managers.

♦♦♦♦♦ Chiropractic Practice Management  Webinar♦♦♦♦♦

When. The 2nd Thursday of each month, 12:30 Central Time.

Description. You will learn fundamental principles of management with specific applications to managing a chiropractic practice and business.

Each webinar will cover at least 3 practical action steps to improve individual and group performance, efficiency, and productivity. Also, tips on working with your doctor and how to provide more support for her or him as a doctor and as the CEO.

Who should attend. Designed for office managers, practice managers, and doctor owners

♦♦♦♦♦  Executive Management Webinar♦♦♦♦♦
The Doctor as a CEO

When. Starting in February, the 4th Thursday of every other month, 12:30 Central Time.

Description. Using actual case studies for examples, we will see what worked and what didn’t for doctors and their teams.  We will uncover the basic principles of effective leadership and management in case and see how to translate this to your business.

This is training on how to be a prosperous CEO.

Who should attend. This is only for doctors who own their own business.

♦♦♦♦♦ Discussion Group/Share Session♦♦♦♦♦

After the presentation is over, we will open up the group for those who want to stay to ask questions and also to offer their experiences and advice to share with others.

This is often the most popular part of the program as other professionals really want to hear your stories and ideas. So, hang around and share and get to know your fellow teammates from other areas of the country. (Must be ready to contribute and share a successful procedure.)

♦♦♦♦♦ Follow Up Materials♦♦♦♦♦

After the presentation is over, you will receive an email with a link to a private vault of marketing materials referred to in the most recent webinar.  There will also be a short summary of our discussion. Additionally, attendees will have access to our private Practice Marketing and Management Library of information and customizable tools for practice building which you can use in your practice.

♦♦Calendar of Classes [Link]

♦♦More information about how and why the Chiropractic Practice Freedom Package (Lots more info here, though not complete.) . Link

The Promise of the New Year

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Lake Michigan, Milwaukee

Happy New Year! It is now 2012.

It is a New Year – fresh with prospects for new opportunities and adventures.

It will come at us fast, we know that. It will have challenges, though we don’t know what they may be exactly. There will be struggles and successes.

But we are given this opportunity, this chance, this privilege to play this game and to do our best at it. And for this, we are grateful. We can learn from our past and work to make this year exceptional – for ourselves and for all those whom we touch in body and spirit.

This year holds within it a promise for each of us – the promise for prosperity, for helping more people get healthier, and for each of us to spend more time following our own greater purposes.

It also holds a promise for all those who will look to you this year for help.

As the days of this New Year continue to dawn, we wish you success in achieving your goals in chiropractic and in life. We are all in this together – and you can count on us to work with you and to give you our best efforts and knowledge to make this a winning season and a winning year.

Chiropractic Promotions for the New Year

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Seems like every office we talk to or visit these days is busy – crazy busy – with patients and computers and Christmas.

But the New Year is approaching – fast. 2012 only has 12 months and the first one starts in just about two weeks. And then, before you know it, it’s February and you are wondering what you should be doing for marketing and getting the word out about your services.

 

So as not to be left behind, you should begin the New Year with a strong marketing strategy.

 

Below are some fast tips to help get you started:

 

But first… PROJECT X-3. We are finishing adding the final components into our new 2012 program, temporarily called the Project X-3. This is just the working title and we will be announcing the new program soon with all the details. It is designed to help lift you and your practice onto and into a whole new level of prosperity and fulfillment in the New Year.

 

**Schedule Patients Now. Health Never Takes a Holiday. Poster. If you are active with PM&A, you can also find a customizable version on our Members site, along with other promotions under “monthly promotions.”

 

**External Referral Sources and Event Locations. Make a list of every location where you participated in a promotional type of event. Include any business or professional that sent you a referral or helped you in some way. Then, make sure you send each a card or a gift, or just stop by and wish them well and that you look forward to continued relationship with them in the New Year.

 

**Marketing Meeting. Schedule a thorough marketing meeting soon, maybe right after Christmas. Spend a couple of hours making a list of what has worked and what you want to do and then schedule these things over the next several months. One example we recommend is:

 

**Be an Authority and Educate. People want health care information.  This is proven by the fact that 80% of Internet users search for health information on line, according to PEW Research.  8 out of every 10 people at some time are looking for health information when they go to the Internet. That is significant.

…2 ways to do this is to schedule workshops and health “awareness weeks” for the New Year. People want to know the latest. This gives you an opportunity to teach. Yes, you do have to do your homework and it takes time. But it is time well spent because as you study and prepare, you will find that you will become motivated about your subject. Besides, at least 1/3 of your presentation can be your spinal care class, so this saves you time. These types of community education programs or services not only help you generate direct new patients, but give you an excuse to promote your office and services. Sample Poster Clients can find many more customizable posters and fliers on the Members site under: Marketing Materials/ Community Education.

You can find more ideas about upcoming promotions to start your New Year here. Link

 

Best wishes for a high volume 2012!

 

Ed

“Thank You” to All of You Who Work in the Chiropractic Profession

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It is that time of year when we take a moment to give thanks and in so doing, we want to say “Thank You” to you.

Thank You Very “Doggone” Much as a matter of fact. Thank you for all you do to care for and help your patients.

You all are part of a great profession that helps millions of people each day. And because of you, chiropractic and the chiropractic way of life has persisted and grown and is now more accepted than ever before.

You are braver than most, work harder than most and genuinely care more for your patients than perhaps other care professionals are allowed to. It could be said that you are the best defense against a drugged zombied society, but it is definitely true that your loving care helps much more than you have been recognized for.

So, just a note to say that we are grateful for all you do.

“THANKS”

Chiropractic Patient Service

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Remember Me?

I’m the fellow, who goes into a restaurant,
sits down patiently and waits while the
waitresses do everything but take my order.

I’m the fellow who goes into a department
Store and stands quietly while the sales
Clerks finish their little chit-chat.

I’m the man who drives into a petrol
Station and never blows his horn, but waits
Patiently while the attendant finishes
Reading his comic book.

Yes, you might say I’m a good guy.

But do you know who else I am?

I’m the fellow who never comes back, and
It amuses me to see you spending
Thousands of dollars every year to get me
Back when I was there in the first place…
And all you had to do was show me a little courtesy.

~Author unknown

Printable Version

Your Chiropractic Root System and Patient Retention, Referrals, and ROI

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Updated: April 2016

When people go to the grocery store for produce they are mostly just interested in their plump cucumbers, zucchinis, or other vegetables.  They don’t much care about the garden that actually produced these nutritious wonders of nature.

But a lot of work goes into a well managed garden. If you don’t take good care of your garden, you won’t have its fruits and vegetables.  It’s that simple. And a good part of a garden takes place underground in a network of roots.  Roots provide water and minerals to the plant, and keep it in place when the wind blows.  The top part of the plant, its stem, can get mowed under by a lawn mower (I have done this) and the plant comes back to life – because of its strong root structure.

Your office is kind of like a garden.

It produces healthier people. You take care of your team, polish up your systems, do some training, and you will continue to have a productive “health garden” that produces healthier people.

And the roots? 

In this analogy, the root system is the loyalty and good will of your patients. Here’s how:

Many offices struggle to get new patients.  Even offices that have been in business for years and years.

Why?  No roots.

If some doctors spent the same time and attention – and money, on giving extra care and service to their existing patients as they did on trying to hustle up new patients, they would have more patient visits than they would know what to do with.

Why?  First, because the service and care was SO extraordinary, patients would refer their family and acquaintances because they would want them to receive similar treatment as they had.

But more obviously, existing patients would never drop out of care. (Some would, of course.) They would continue to come back for wellness visits. How busy would your office be now if all the new patients you ever started still came in for services? You couldn’t handle…there would just be too many patients!

Over the years, there have been many studies to support the fact that it is more expensive to chase after new patients than it is to keep the ones you have.

 “A common rule of thumb is that the marketing costs of landing a new customer runs three to five times the costs of retaining an old one.” (Total Customer Service, Davidow)

Some articles talk about it costing 10 times the amount to get a new customer as to keep the ones you have.

I am all for getting new patients, but do you also keep your existing patients? And do they refer family and friends and work associates? And why do your patients leave? An interesting survey pointed out that most companies believed it was because of price, or that the needs of the customer changed. However, from the point of view of the customer, they left because of poor service. (The Loyalty Connection: Secrets To Customer Retention And Increased Profits By Bob Thompson, CEO, CustomerThink Corporation Founder, CRMGuru.com, March 2005)

 

There are a number of procedures to improve your services to patients – to help generate stronger and more productive “roots”, or healthy patient relationships. Let’s focus on the most fundamental: Communication.  To put it more accurately, let’s call it “conversation.”

BEGINNING THE CONVERSATION

A conversation is a dialogue, a giving and receiving of communication back and forth. It is an interactive exchange of thoughts. It shows that you respect the other person and that you are interested in them and what they have to say.

Many patient conversations are one-way, from the staff and doctor to the patient. They are also rote, robotic, and too scripted to be genuine.  Do an audio recording of how the front desk answers the phone or how you do a consultation and you might be able to see room for improvement.

The conversation usually starts with the first phone call. Does the prospective patient feel that the front desk is listening – really? Is she interested, or just reading her script and trying to get to her next task and hang up the phone?  Does she introduce herself and show interest and even gratitude for the call?

It is these little things that make such a big difference.  Think about how you like to be treated when you contact a business…

In the consultation, do you really listen and seek to understand the patient, even though it is like the 5 millionth time you heard about someone’s low back pain?

In your report, do you have a conversation with the patient, or do you just rehearse your script to the patient while they are nodding in appeasement?

You see so many patients… and have so many tasks… that real conversations are too often sidelined.  You don’t have much time, usually. But in the time that you do have, you have to be present. You have to be THERE, with all of your attention on the patient, and not on your next task.  That moment with that one patient will never happen again. It is its own time that just you and that person share.  The Japanese have a saying for this: “Ichego Iche.”  One time, one moment. This is a plaque that is often found in tea rooms in Japan.

You have started to create a relationship.  Now, you have to continue to nurture it. This is done by continuing the conversation – and of course, great clinical and administrative service and care.

With each patient encounter, you have to be interested, attempting to understand and then get understood. Improve this and you are well on your way to better patient retention and referrals.

CONTINUING THE CONVERSATION

But when your patients are not with you, you have to find ways to continue the conversation.

How?

Your Newsletter.
You can easily set up an email newsletter with an a provider such as Constant Contact or Mailchimp. Send these out monthly or even twice per month. The most important aspect of these letters is to keep them real, personal, as if you were writing to a friend.  It could simply be a few paragraphs from the doctor relating a recent case success, or a home health tip. You can also include patient testimonials and a review of a recipe.

But we are inundated each day with hundreds of emails so keep in mind that old fashion snail mail still works, and in fact, works better.  It does cost, of course, but the return on investment makes it worth it.  A hard copy newsletter will have “shelf life,” and can be read and reread.  Most emails are overlooked -there are just too many of them.  Send out a hard copy newsletter every 4-6 months.  It can even just be a one page foldover, self-mailer.

Other Mail.
Cards are very considerate. Just think about the few you receive. You may still have them! A system can be set up to send out birthday cards, welcome cards, humorous reactivation cards, bereavement cards, and congratulation on starting your “wellness program” cards, as well as other cards each month.  These all help keep the conversation going.

Social Media.
Facebook is your primary social media with your patients. This can be similar to your newsletter.  Like email, it has become glutted with ads and “content” information.   Ask your patients to “LIKE” your page so that they can stay in touch with the office and receive new information about health and upcoming office events.  Some offices even hold special contests only for their Facebook “friends.”  Then, post regularly fun and education information. For example:

 “Our patient, Burt, just got accepted back into his hockey league thanks to chiropractic. Here is a photo of Burt and Dr. Smith and his new puppy eating apple pie made by Rose, a long time patient who can’t stop bringing us apple pies!” (Of course always get patient approval to post their picture.)

 

Upload patient testimonials, in writing or even videos. If they are interesting, other patients can comment, or even share.  And if anyone does comment, make sure that you comment back.

Delegate these types of communication to your team, but you have to be the one to ensure that the conversation continues.

If you have good roots, there is nothing to fear.  Insurance reimbursement can decrease even more, the economy can decline, staff changes can occur, but if you have taken good care of your patients, they will take good care of you.  Conversations with your patients will help nurture a strong “root system” that will keep your office productive, no matter the storms that may come.

SUMMARY – TAKE AWAY:

 When the patient is on the phone or in the office:

  • Be present and attentive.  (Present Time Consciousness “PTC” as Jimmy Parker would say.) Be genuinely interested.
  • Seek to understand the patient.
  • Get your point understood and have a conversation.

When the patient is out of the office – continue the conversation:

  • Snail mail real newsletters and cards mailed.
  • Emailed newsletters.
  • Get Facebook “fans” and post local/personal news.

Zucchini’s and Chiropractic Businesses

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Home grown zucchini's

It has been a good summer.  The crops are coming in.

Growing a practice and developing a business is much like farming. It takes nurturing, care, and just the right about of help at the right time.  A plant can seem to be dormant while underground its roots are growing and getting strong.  Sometimes practice improvement seems to occur slowly even though we may be working hard.  It could be that that you are just developing the “root” system before your practice is more productive.

Your practice follows natural laws – it has its own innate life force.

Just like a zucchini does.

You have to trust in your own goodness as you do in the power that made you and gave life to your patients. That Power — it also runs through your office and eavesdrops on your thoughts and intentions.

You have to smile about the truly awesome benefits your patients and you receive with chiropractic, which we all too often overlook.

It’s not about insurance or money or policies and procedures or schedules or management or marketing or meetings – which we all can use at the right time to the right degree. In the end it’s about the help we provide and that help should not be separated from the love in which it is given or the joy that it produces.

There is truly a lot to celebrate.

It’s a good procedure to look for and have many celebrations with your patients and those you are close to. Don’t be shy about it.

Keep nurturing your practice and it will continue to produce happy patients.

Billy DeMoss Shakes Up Appleton Wisconsin at Petty Michel Seminar

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Billy DeMoss, ChiropracTOR

Dr. Billy DeMoss gave a heated and edgy presentation for 3 hours to chiropractors and their staff in Appleton, Wisconsin, Friday night, Aug. 19th. Full of anecdotes from his own practice, along with statistics, slides and videos, “Billy D” reminded everyone what chiropractic and natural health care is all about.

He talked about how providing chiropractic care is actually fun and how you should have fun in your office. He stated that patients want to come to a place that is enjoyable, where staff and doctors are having a good time in a positive atmosphere.

But he also explained that it takes a great deal of work to have a successful office. He recounted the days that he had to do manual odd jobs just to make it through school. He works hard at his office but keeps it fun.  “If you want a more successful and profitable practice you are going to have to work for it.”

“The days of the $200 dollar office visit are fading,” he said.  Workers Compensation reimbursement in California has been cut back and some money motivated chiropractors have abused the system. But money is not the goal, and never has been, he said.  Serving people will always be rewarded financially, but that is not our primary objective.

He emphasized that our main goal should be to teach and adjust. Some doctors complain about doing screenings or lectures, but Billy asks the audience: who do we do it for?  Are we worried about inconviencing ourselves or do we want to help people get healthier?

He discussed issues such as vaccinations, diet, United States health statistics relative to other countries, and said that the chiropractors were the ones best poised to take a leadership role in the health care of the U.S.

After 3 hours of Billy’s high energy, the mesmerized and energized crowd gave him two standing ovations.

One member of the audience who owns a small farm and who was not a doctor or staff member, said he wished there were more people speaking out like Dr. Billy DeMoss. He said it was one of the best presentations he had ever seen.

The next morning,  Phyllis Frase spoke to staff and doctors about how to be a “Rock Star” C.A.  Phyllis also gave a dynamic talk and will be speaking at the Cal Jam in California, February 24-26.

PM&A encourages all who can make it to Cal Jam to do so.  I attended 2 years ago and it was absolutely the most unique and refreshing chiropractic seminars I’ve attended in 20 plus years. Well worth the time and money.  More info about CAL JAM.

Dave Michel, Billy DeMoss, Dana Pittner, Phyllis Frase, Ed Petty

 

CATCH DR. BILLY DeMOSS SPEAKING MONDAY NIGHT, AUGUST 22 AT LAKE GENEVA, WI.  FOR MORE INFO, CALL: 262-275-5005

Video here

Photos here

Making a Chiropractic Patient Community

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Is it just YOUR office?

Or does it also belong to your patients?

One office we have the privilege of working with has been smashing its past records – month after month. We plot their growth on charts and nearly every month have to adjust them to keep the lines on the chart. And it has been in business for over 20 years.

Why? Well, there are a number of reasons, really.

But a key factor is that it has created a patient community. That is, it has created a systematized business where all the patients still feel that they are part of the clinic’s “family.”

They have created an environment where patients feel they belong, that the clinic is also THEIR clinic.

The principle behind this, and why it works to generate more patient volume, is that everyone wants to have friends and belong to like-minded groups. Facebook, for example, and the rise of social networking is simply a new twist to a basic impulse we all have for belonging and fellowship.

So from a practical marketing point of view, the more you include your patients as part of your chiropractic “family”, the more apt they will be to stay, pay, and refer.

For example, we have done our share of patient focus groups. Focus groups are informal discussions with 7 or so patients where we ask them about their likes, dislikes and general opinions of clinic activities. We’ve been able to learn things from the patients that we might not otherwise have known.

But what we also learned and hadn’t anticipated was that those attending suddenly started to be more active in the office. They kept their appointments and they started to refer more of their family and friends.

OK, so back to our client’s office: Each year, they give away t-shirts with the clinic name. The only requirement is that the patient has to wear the shirt at the local county fair.

This year, they sponsored a “T-Shirt Contest.” The contest was to help the office come up with a slogan for the back of the T-shirt.  The winning slogan would receive a 6 day pass to the fair.

The suggestions are…hilarious.  Some are good, some are fun, and some are just plain silly.  But.. the point is, many patients are eager to contribute.  (Some of the suggestions are below.)

 

It is no wonder, by the way, that this office which has been in business for over 20 years in small town, has been breaking its all time records for production month after month. (SHOUT OUT: Congratulations to Team Bartz Chiropractic!)

The lesson to be learned here is that it pays to empower your patients and make them feel like it is their office too.  Here are some ideas:

FRIENDLY CHATTING. Yea, I know doctors and staff aren’t supposed to spend much time socializing with the patients. I have heard that some consultants tell doctors to forbid staff to talk to patients other than talking “TIC” (chiropractic), doing a two handed hand-shake,  and mentioning the patient’s name 14 times at each visit.  Well, that is just silly.

A practice is a relationship and like any relationship, it simply has to be genuine. Be genuinely interested in your patients, like any friend.  All else can then follow.

NEWSLETTERS. A real newsletter just continues this chatting – between friends.  It can be both email and hard copy, and should include a column from the doctor. This continues your conversation with the patients.

Include survey results and patient successes and news about staff, doctor, etc. Keep it a “non professional” bulletin about your chiropractic patient community. Nothing glossy from some big company New York City. Keep it just short of being gossipy – but with pictures.

SUGGESTIONS FROM YOUR PATIENTS ABOUT UPCOMING EVENTS. The t-shirt slogans are a perfect example, but you can also survey patients about what color to paint the wall or color for the new carpet.

TESTIMONIALS FROM PATIENTS. These are another way patients can contribute to your purpose of helping more people to find better health, naturally.  It can be their purpose too.

FOCUS GROUPS. Get 7 or so of your patients, old and new, together for a luncheon and ask them survey questions about the office, promotions, advertisements, your services, etc. Best done by someone other than the doctor.  Mention the results in your newsletter.

# # #

Some examples:

T-SHIRT CONTEST ENTRIES FOR A CHIROPRACTIC OFFICE SLOGAN FOR THE  COUNTY FAIR

To be healthy and feeling fine, keep your spine in line at Bartz Chiropractic

Get your back in tact Jack….John…..Sue…. Larry at Bartz Chiropractic

You don’t even want to KNOW how bent outta shape I USED to be!

Back your Future with Chiropractic Care  (flaming tire tracks picture)

Make Your Day!  Help is on the way at Bartz Chiropractic

Get ACTIVATED at Bartz Chiropractic so you can spend the week at the Fair

Get a BOATLOAD of relief at Bartz Chiropractic (life jacket picture)

Got Pain? Be FAIR to yourself, see Dr Bartz!

I only have one spine, so I keep it in line at Bartz Chiropractic

IT NO LONGER SMARTS, WHEN YOU SEE DR. BARTZ!!

(Front)  Are you living with a pain in the neck??  (back) Dr Bartz CAN HELP!  Bartz Chiropractic Elkhorn, WI

It’s FAIR to say Dr Bartz Keeps me Healthy EVERY Day!

NO PAIN…………MUCH GAIN!!!!

Changing lives….One Adjustment at a Time!

Happy Bones = Healthy Life!

Don’t Slack…..Fix your BACK

Bartz Chiropractic, your adjustment Junction!

Less yacking, more Cracking!!

A HEALTHY SPINE WILL MAKE YOU SHINE!

BE WELL-ADJUSTED, BE HAPPY, BARTZ CHIROPRACTIC

MOOO’VON OVER TO BETTER HEALTH AT BARTZ CHIROPRACTIC (COW PICTURE OVER THE moooo)

A lifelong journey of health starts with CHIROPRACTIC

Put your life BACK IN LINE with Bartz Chiropractic Care

Walk STRAIGHT to the FAIR

Dr Bartz will CRACK you up!!

Dr Bartz is a “god” Chiropractor

Back aligned, feeling fine!!

Electronic Health Records and Chiropractic

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There is more and more attention being placed on the topic of Electronic Health Records. For those of you who are not familiar with this subject, you can find basic information on the web sites of CMS (Centers for Medicare and Medicaid Services) and of course, Wikipedia.  There are other sources, but reader beware: many have ties to software companies (and their advertising and promotional distributors) that are trying to make a case for buying expensive software now.

Here is a Q&A with Dave Michel and one of our clients regarding this subject which may be helpful in understanding what is going on:

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

Dear Dave,

Dr. H wanted me to e-mail you with some of our questions and concerns. We are hearing a lot of different things the more people we talk to about it. We are hoping that you can shed some light on the situation. Here are some of our questions:

Is the deadline for reimbursement this October 2011? Or do we have until October 2012?
There is no deadline at this point. It is not a requirement and, even if it is, there will be an exemption for small offices (usually less than 10 FTEs).

Is there a checklist of things that need to be completed in order to be compliant? Do we need to have digital x-ray in order to be compliant?
Yes, there is a checklist. If you google CMS EHR Incentive you will find a couple on the CMS website (skip software vendor websites …). Digital x-ray is NOT a requirement.

Is it a tax credit or would we receive a reimbursement check? Will it just cover the EHR software or will it cover equipment upgrades/replacement as well?
Beginning May 2012, you would be possibly eligible for up to $18,000 per year in incentives paid as a check to each provider. The limit would be based on 75% of your prior year’s Medicare reimbursment. IF you are “an eligable provder” and you have demonstrated “meaningful use”.

How much should we expect to spend on this process? And how much will we get reimbursed? Is it a percentage or the exact amount? And is it a guarantee?
Great questions. EHR software for chiros ranges between $2.5 – $27k. Add to that the cost of conversion in your office (thousands) and the reduced efficiency (eg if the new program adds 2-3 minutes to each patient encounter). This is going to be a big process.

Dr. H  wants to know “what happens if we don’t become compliant?”.
Nothing. Yet …

Thank you so much for taking the time to answer our questions.
No problem! Bottom line (if you haven’t picked up on this so far …): I am not a fan of any of the EHR programs currently out there. They either add too much time to each patient visit or they produce a SOAP note that would not pass an audit / records review. There is NO guarentee that Big Government is going to be mailing out $44k checks to each provider for doing something that will really not improve the heath care delivery system

Most of what you have seen are from companies marketing their products (seminars, EHR software, etc). There is NO mandatory deadline (yet) to convert to EHR and so far, I have not received confirmation from CMS that chiropractors will receive any money or incentives to convert to EHR. I do have a letter in to CMS to get an official word and will let you know. It does not make sense to me that CMS will give each chiropractor $44,000 to convert to EHRs when the CMS program is going broke. But I will let you know.

For questions about EHR, feel free to contact Dave at Dave@PMAworks.com