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.

Economic Factors

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We all know or have heard that the number one reason that a patient drops out of care, based on surveys, is that they experienced an “attitude of indifference” on the part of the doctor or the staff.

Most offices nod knowingly and are assured that their office cares about the patients, that their staff show concern, that their doctors have the patient’s interest at heart.

But what is an “attitude of indifference?” How does it manifest in a clinic? What does it feel like to a patient?

A patient experiences an attitude of indifference when they feel they are the 38th visit on a 60 visit day. They experience an attitude of indifference when they feel like they are on visit 15 of a 36 visit treatment plan and that everything is the same as the last 13 visits.

They feel an attitude of indifference when the doctor says, during the ROF, that he will give them some home exercises, and then doesn’t. Or when the doctor instructs them to attend the spinal care class as an important part of the treatment plan and no one schedules them for it, or when the front desk says they will order a supplement for them and a month goes by without the order, or the doctor says she will do a re-exam and then keeps putting it off, or when the doctor is running 5-10 minutes behind each visit or worse, comes in late.

Normally, you may still get that patient to follow through. But put yourself in the patient’s shoes. They are feeling better, even feeling “healthy” now, they have a $30 copay twice a week, and they have just heard that the company their husband works for may be laying off some people.

90% of the population right now, according to USA Today, is worried about the economy. Many have been affected, and many more are concerned – they are uncertain. When will things get better? Are we heading down farther? Am I going to have any money left?

When people are uncertain, the decisions they make are either “no” or “maybe” (which isn’t a decision but a postponement). They don’t decide that now is a great time to spend more money. Not on cars, not on restaurants, not on healthcare.

Expressing an attitude of interest is an “every visit” manifestation. That patient’s visit is not the 38th of the day or the 15th in their treatment plan – it is a singular, unique moment in time that will never occur again. It is a one and only opportunity to make an impact and a difference in that patient’s life. When you talk to them about the weather (“gee, cold out today, isn’t it?”) or tell them a joke in the treatment room or bs about the Packers – and if that is ALL you do that visit, you are just more white noise in their life, just another piece of spam in their mental inbox.

You have to manage a patient’s care EVERY visit, you have to work to make a difference in that patient’s life EVERY visit. If you don’t, that is an attitude of indifference. There is no other way to put it.

There are four critical factors that go into growing during a recession. These are:

1)    Great customer service. During a recession, other businesses cut back on the front end. People want and need good customer service. They deserve it from your office.

2)    Excellent patient financial plans, well communicated. The first response in some clinics when times get tight is to tighten up your financial plans. “All patients have to pay their copay before they see the doctor. No copay, no visit.” Do this and watch your practice drop by 50% (actual case).

3)    Step up your marketing. Great customer service and flexible financial plans don’t mean anything if no one comes in. Marketing is a variable expense and one of the first areas businesses cut. There were over 650 auto makers in the US before the great depression. After, there were six. Clinics are closing, going out of business right now. You can pick up market share.

4)    Increase your patient education. Patients aren’t going to blindly come in “because you said so”. Educating patients on wellness, having a wellness report of findings, and a “can’t resist” wellness financial plan are keys to building your practice.

Following the 3-Goals principles, review the above four points. Implement them personally. Review them with your staff and see how they can implement them further. Review them again and refine them.

There has never been a better time to grow your practice.

Success Strategies for 2009

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We enter the New Year in unprecedented times. There is no denying this. We do not live in our offices as islands, separated from the rest of the country or world.  Some websites will tell you that the end is near. I have been reading doomsayers since the 70’s and they still sound the same. I think it bolsters their ego and gives them a cause, but that is just my opinion.

But it would be wrong to pretend everything is as it always was and we live in prosperous times. Not just our economy, but the world’s economy is going through massive, even revolutionary changes. But there are, and have been, other changes taking place as well. In the last 15 years, electronics have gone through many unthinkable transitions for us coming from the mid 20th Century.  Social changes world wide have taken us beyond the Third Wave, as Alvin Toffler described in his book.  And, there is the ongoing “Wellness Revolution” and “Green Revolution”, which those of us in the chiropractic profession can take pride in the fact that we have been in the forefront. Needless to say, the “Times Are a Changing.”

But with this change comes opportunity. The country is going through a severe “cleanse”: parasite cleanse, colon cleanse, you name it.  It is a time that offers many new avenues for growth and prosperity.

Jeffrey M. Stibel, an entrepreneur and brain scientist writes in recent article in the Harvard Business Review:

The 2008 recession is an economic firestorm unlike anything the country has seen since the Great Depression. But 2009 is shaping up to be a trigger for an unprecedented surge of innovation that may be one of the most important turning points in the last 100 years. (article)

Let’s look at some general strategies that will help you prosper in this New Year. We offer a few below and will mail out more practical action steps soon.

  1. First, don’t panic. Danger is always near, especially for a small business owner. So what else is new? Whether it is your association’s alarming headlines about how doctors are earning less or chiropractic gurus advocating working for massage therapists, negative news is all pretty routine, really.  People have always been around to promote the bad news. So what?  Good news is hardly ever promoted.
  2. Motivation. It is fine to face the brutal facts, but what is happening with a Wall Street investment company is not as important as what is happening in your community.  There is bad news. Negative news can distract and dishearten not only you, but also your staff and patients. Limit your exposure to national news and talk shows. Get the facts, fine. But more importantly, every day, look for new reasons to renew your purpose and drive to achieve your goals.
  3. Appreciate your profession. Chiropractic works. It has, it does, and it will.  People benefit from it. People need it, in hard times and good times. These are facts that do not change. You have a skill that you will always have and that can’t be shipped to Asia and that will always be needed and effective. It is a million dollar skill.
  4. Your success is just between you and your patients. You don’t work for a corporation.    You are an independent business professional as well as an independent health care professional. Except from you patients, you can’t be fired.  But they can fire you. So, take care of them better than you ever have. The chief difference between you and other options they have is chiefly the connection you generate with them. What is the quality of relationship you have developed with your patients as a result of your extra-ordinary service and care?
  5. Health is Wealth: Sell Health.  Get across to your patients and community that health is the only real wealth and this is what your office is uniquely prepared to deliver. Regardless of the employment condition of your patients and potential patients, their health is their greatest wealth. If they are healthy, they can work 3 jobs if needed. If they are not healthy, they won’t be able to work even one. This is why they have to work on maintaining and improving their health. This has to be a recurring message you get across to your patients.
  6. Constant improvement.  But only the best business will survive and thrive. Your business organization has to become better, or die.  We have seen mediocre practices struggle along that did not and would not improve their procedures. In better times, they could still survive. These types will more than likely go the way of the dinosaur unless they step up their “game.”  I am not advocating “social Darwinism”, but it is an observation that the better (healthier) companies survive and thrive, and poorly managed ones fail.  We recommend adopting a policy of what we call the “Practice Development Process”. (Small plug: this is what we do and teach.)
  7. More for less. With a process of constant improvement you can work out how you can get more done with less effort. Economize does not mean don’t spend money. It means spend money better. Get more “bang” for your buck. For every dime you spend, you should get back half dollar, more or less.
  8. Triple your patient base. Whatever you have planned for marketing, triple it. Some of your patients may not be able to see you as many times or pay the same fees as before. If this is the case, and I am definitely not promoting this, you have to talk about #5 above.  You will also have to increase your volume of patient visits. It is no longer “how much you can get from how little, but how little you can get from how much”, to paraphrase an old quote from B.J. Palmer.

Over the Christmas, most stores did poorly, except for Wal-Mart and McDonalds. I am not advocating
reducing your fees. You probably do not charge enough as it is. But, you have to be prepared to offer different plans
based upon the time of payment (payment on assignment, at time of service, or in advance.), as well as other
programs.

Now is a great opportunity for growth and entrepreneurship. You are the captain of your ship as it crosses the seas
through storms and gales.  Stand at the helm (steering wheel) as the misty wind blows and know that you can beat
any storm and take your crew and passengers to sunny skies and calm waters.

It is a challenge, an adventure, and a worthwhile goal you and your team can achieve.

We will be there too.

See you on deck!

Rule #9 by B.J.Palmer, Developer of Chiropractic

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The average businessman has long since forgotten Rule No. 9, “Don’t take yourself too damn seriously.”

Thousands of businessmen have one fault in common. They are so close to their own thoughts, their own minds, their own selves, desk, office friends, employees, clerks, detail, correspondence that they suffer from the illusion of the near.

They are with what they think, see and do so much at a time that they take it all too seriously and thus suffer from the nearness of themselves to themselves.

I now live in a town where I am sold to everybody. They call me “B.J.” everywhere. I live in an immediate family of some 5,000 whom I bring to that city, who love me and I love them. These people appreciate what I do for them. They tell me and I listen to the plaudits of deeds well done. People come from far and near to thank me for what I have done, via some salesman. All of which makes me take my detail seriously. I suffer from it.

YOU need the vision of the far. I need it. I keep my grip (suitcase) packed and when I begin to take my reform work seriously, right then is when I book a few Rotary, Kiwanis and other club talks and hide myself away from my thoughts, ideas, work, students, school, friends, that I might get myself away from myself, that I may walk the streets of strange towns, see strange faces, listen to strange tongues, that I may get the proper perspective of myself.

Many people suffer with a constipation of thought and a diarrhea of words. Many a man has the eyesight of a hawk and the vision of a clam.

Going away from home makes a man shut up and think. It also teaches him to overlook the hawky detail and gain a distant vision of himself, his service and his Big Job.

Every man owes it to himself, his people and his service to go away about every so often. The more detail he has, the oftener he should go. The more worries, the more he needs to go. The bigger his work, the longer his vacation should be.

He should go to conventions, attend luncheons, go fishing or hunting, anywhere that he may get away from himself; that he may sit on the banks of the river and there see himself at his desk, with his people, on the job. It is surprising how foolish all of us look when we gaze at ourselves after we get away from ourselves and see ourselves as others see us.

Many a man realizes without analyzing. A certain clothing merchant of our city is noted for his ancestral business qualities. Business and money are his gods. Yet this same man told me but recently that he is now playing golf two afternoons a week. I inquired as to how he could get his mind into that state where he could make it pay. He tells me that the next morning he works three times as hard and accomplishes more than three times as much work. He comes home tired, sleeps sound, wakes up refreshed and piles in solid. Playing golf, he realizes the vision of the far without the mental analysis that accomplishes the end. He stumbled upon the conclusion and even yet doesn’t know. You and I can go into this with comprehension and intention.

I am told that John D. Rockefeller rarely went near oil fields; that Mr. Carnegie knew little about steel itself; that John Patterson spends months in Europe away from his huge plant to know better how to run it when at it; that James Gordon Bennett managed the New York Herald from Paris; that Mr. Pulitzer manages the New York World from afar; that Mr. Wanamaker spends and Marshall Field did spend four months out of twelve in Europe for the express purpose of gaining vision; that a Boston department store manager is responsible for this statement:” I must study other business at least THREE MONTHS every year in order to manage my own business properly the OTHER NINE.’

We should get away from ourselves, our office, our business to get the proper perspective on its services.

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What Do You Think About When the Phone Rings?

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You are sitting there, trying to finish your notes. You hear your phone ring. You are a bit behind. Maybe slightly irritated by an arbitrary denial of an insurance company and you haven’t yet planned out tonight’s evening with the family, spouse, or friend.The phone rings again.

What are your thoughts? What are your feelings?

Do you kinda wish it wouldn’t ring? Is it a bit of an interruption? Do-you-just-want-to-answer-the –dang-phone-to-stop-the-ringing-so-you-can-get-back-to-your-work?

Essentially, your thought is “Stop.”   It is: “Don’t call me.”  “Phone, don’t ring, don’t interrupt me!”   I am sure this has happened to you – even if ever so slightly or subconsciously.

Now, imagine if your front desk has these thoughts when the phone rings?

To some degree, even the most devoted and hard working staff can reactively feel put upon by phone calls. Or, in fact, by walk-ins. Or, in fact, by any patient encounter. I have seen this happen on the front desk when the doctor was busy with patients.  But remember, this can happen with even the most ethical team member, including you!  I have seen doctors do this too. (Extreme examples: “Oh, only two people for the spinal care class – cancel it.” “Oh, just Jim is coming in, reschedule him. I am going to leave early. It is MY office and I can do what I want.”)

Our thoughts can and do determine our behavior and affect how we treat others. Our environment actually mirrors our thoughts.

You may have heard or read about this scientist in Japan. Fascinating experiments. The fellow’s name is Dr. Masaru Emoto and was also in the movie, “What the Bleep Do We Know?”

According to the movie, Dr. Masaru Emoto claims that crystals formed in frozen water reveal changes when specific, concentrated thoughts are directed toward them. He says that he found that water from clear springs and water that has been exposed to loving words shows brilliant, complex, and colorful snowflake patterns. In contrast, polluted water, or water exposed to negative thoughts, forms incomplete, asymmetrical patterns with dull colors.

You can check out Dr. Emotu’s new book, The Hidden Messages in Water.

So, if our thoughts can affect the formation of water crystals, they probably can have significant effect on our office.

Going back to your front desk, realize that the staff on the front desk have tremendous control over the office, nearly as much as the doctor does. The front desk can be a magnet for your patients, and attract, or repel them.

When the phone rings, you want your front desk, and all staff thinking “YES.”  “Call me. Phone –  ring now.”  “I can hardly wait to talk to this person and see how they are. I am interested in them and how they are doing. I want to help get them come in for care — and their family too.” “They must be really really cool and nice if they are calling us.” “I WANT to know more about them.” “I am grateful for their call and appreciate the effort they made in calling us.”

These are good thoughts.  These are positive thoughts that can help bring in more patients.

You can practice this with your staff at a team meeting.

ACTION STEP. As an example, someone acts as the prospective patient calling. The person acting as the front desk assistant should answer the phone with the attitude of really not wanting to talk to the person. Act it up. This can be funny. Try it a few times.

Then, do the same rehearsal with the front desk assistant positively anticipating the phone call, wanting the phone to ring, and then eagerly answering and talking to the prospective patient.

Keep it the role playing brief. You can and should do it again. It should be fun and act as a reminder to one and all that we should want to meet new people, talk to existing patients, and look forward to phone calls. We can always dismiss the occasional telemarketer or wrong number.

This can also be rehearsed in other types of patient encounters, from taking the new patient back to the exam room, sitting down to do a financial consultation, or checking a patient out and collecting their payments.

(Note to PM&A clients & members: Your PM&A Coach is experienced in these types of trainings. Have one of us facilitate one of these trainings next time we visit your office.)

ACTION STEP. And speaking of how our environment does mirror us, here is a little trick you can use.  Get a real mirror, about 4 inches by 4 inches, and put it at the front desk counter so that the team member can see it. You can write something on it like: “Are My Teeth Showing?” “Am I Smiling?” And staff, you can also put one of these in your doctor’s office on any day that he is feeling grumpy. It applies to us all.

So, the next time the phone rings, smile. Be interested and curious in who is taking the time to call.  Make your thoughts happy so they help create an office that is brilliant, colorful, and full of happy patients.

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[Petty, Michel & Associates offers special practice development programs designed to help you achieve your goals. Give us a call for more info: 414- three three two -4511]

3 Goals Management Introduction

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3 Goals Management System

How to Achieve Financial Abundance and Practice Freedom
A unique practice development strategy and process created by Petty, Michel & Associates

An Introduction

Goal Driven
We all have goals.  When we were younger, they might have been brighter than they are now, they might have been clearer, or seemed closer.  Maybe yours still are. Or, maybe, they have become dulled with wear and tear, with disappointments and frustrations.

But we are goal driven creatures and our goals stay with us. The better we can define these goals in concrete terms, the more likely we are to achieve them.

What All Doctors Want — The 3 Goals
Ultimately, all doctors would like to create a practice that allows them to provide the highest quality care to the most people for the most profit.

Most doctors want to do this with professional and personal integrity. Maybe most importantly, they want to be able to do this in such a way that they are not chained to their practice, slaving at their work at the expense of their personal and family lives.

This is a fundamental goal for all doctors, so fundamental that we call it Goal 2.

Even more fundamental, however, is basic survival and solvency. We call this Goal 1.

But nobody works just for money.  Whether it’s saving the planet, helping your grand kids, assisting the poor, or funding your church, we all have higher goals.

Goal 3 are your higher purposes.

All three goals can and should be achieved, and with over 20 years of experience, we have put together a practice development system that allows doctors, and their teams, to achieve all three goals.

The 3 Goals Practice Development System is a step by step approach to help your practice grow naturally to its full potential and stay there.

Goal 1
Goal 1 is survival. In business, this means solvency. Are you making enough profit to pay your bills? To achieve Goal 1, solvency and survival, you have to move fast.  It requires passion, energy, and an aggressively friendly approach to getting your services known and delivered. For the patient, you can think of Acute Care. For a staff position, you can think of 20 – 30% proficient.

Goal 2 and the Practice Development Process
Goal 2 is a fully functional, franchise-able, sale-able, and sustainable business that is very profitable.   For a patient, it is a maximum spinal correction. For a staff position, it is 100% proficient and competent, rain or shine.

After you have achieved Goal 1, you can now start identifying those procedures that worked best. You can write these down on checklists. These checklists will become your Practice Playbook.

With more staff training, you can delegate more procedures to staff. As you continue to grow, you refine your procedures and continue to train your staff so that they become more competent.

Every 2 months, or as needed, you assess your list of successful procedures and add to them, or revise them.  Every week you work on improving them, and train your team on them.  Much like any athletic team, you practice and review your plays and procedures.

We call this process the Practice Development Process. It helps you to continually improve the practice and gradually take the office to Goal 2.

Getting Organized: The Baseball Diamond
To get to Goal 1, organization is not vital. Production, speed, and promotional activity is. However, getting to Goal 2 requires good organization.

Imagine a baseball team that stands around the pitcher’s mound with the pitcher. A batter hits a fly ball to the right field. The whole team goes to chase it. Once they reach it, they realize that no one is on the first or second base to throw the ball to in order to stop the runner. They are all out in right field.

Many offices operate this way. For example, in some offices the front desk does insurance, the insurance department does therapy, the therapist schedules appointments, and the doctor takes time off to buy office supplies.

Moving the office upward to its peak capacity includes all areas of the office improving: first base, third base, centerfield, etc.  If you only have a few of the departments doing well, the other departments will hold down the entire growth.

Goal Three
Our greater goals give us meaning.  These are the accomplishments we want to have said we achieved at the end of our lives. They are based in love, hope, and faith. They are for our heritage, our parents and those upon whom we owe so much; they are for our legacy, our children and their children; they are for our community and the fellowship we share with rich and poor.

Goal three is your “Give Back” goals, to your family, to your community, and to yourself.

All Three
This is your road map up and out of the roller coaster. These three goals form a sequence, but you have to keep all of them in mind as you travel up your road to success.

This is directed to a business owner, but also applies to team members and how they can improve their competency. It applies to patients, and how they travel from acute care, structural care, to wellness.  It actually applies to many activities.

You have to be willing to shift between goals, and if you find yourself suddenly in the poor house, you have to lose your self-important attitude and run like a rookie again until you build your business back up to Goal 1.

Where many doctors fail is that they are not willing to shift, either up, or down, as needed. Having achieved Goal 1, they are two insecure to delegate their duties to staff and procedures, or work on improving themselves. Many doctors, having achieved Goal 1 who should be working on Goal Two, feel the need to keep doing what they did to get to Goal One and so, quickly find them selves back down struggling just to survive.

It is easy to get lost, but now, with the 3 Goals Management System, you have a road map.

We have seen too few doctors achieve financial abundance and practice freedom. Hopefully, with the tools provided in the 3 Goals Management System, more doctors will be able to reach their dreams and help others do the same.

For information on our coaching and management consulting programs. LINK

(3 goals image copyright 2009)

Case Management in a Chiropractic Office

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Chiropractic Case Manager Job Description Summary

In many chiropractic offices the majority of the attention on patient care is on the first 5 to 12 visits. In some offices, it is only on the first 5 visits, or less. It can get so bad that the primary concern is only on getting more and more new patient first visits.

An old maxim in dental consulting is that the biggest cost to the dentist is the incomplete dental program. A patient who discontinues care after the first $1,000 of a total program of $10,000 just cost the dental office $9,000. This also applies to the chiropractic office.

Actually, many chiropractors are producing incomplete cases. This is not in the best interest of the patient’s health or in the viability of the office. Imagine a hygienist that only cleaned the upper teeth, or a baker that only baked his bread half way through. Yet, many offices are only getting their patients partially through their treatment programs.

The job of your clinic is to get your patients to complete their entire treatment program and on to a Wellness Program. During the course of a patient’s care, the doctor and staff may concentrate only on their specific duties with the patient, such as scheduling, treating (adjusting), collection, etc.  Usually no one has the job of overseeing the patient’s progress along the entire treatment pathway, through all the adjustments, scheduling, therapy, education, payments, until they finally “graduate” and go on to a Wellness Program.

Yet a full Wellness Program takes some of the pressure off of the need for a constant stream of new patients and makes for a smooth running office.

To help ensure that patients get complete and comprehensive care, the position of Case Manager should be held by someone in the office.

Who should be the case manager: It can be fulfilled by the doctor, or the therapy or back office assistant, or the front desk or even the billing and collections staff member.

Time spent as a case manager: It should take no more than one hour per week.

Mission: The mission of the Case Manager is to ensure that all patients move through the various departments of a health care clinic smoothly and quickly, ensuring that they get excellent service such that they complete their treatment program as quickly as possible.

Duties and Responsibilities

1.  Coordination. Once a week, or daily before treating hours, the case manager should get the doctor and essential staff together for a Case Management Meeting. A great time to do this is 20 minutes before the first patient for the day, or weekly for one hour. During this time, the appointment book or a list of active patients should be reviewed.

    This is the most important tool the case manager (or case coordinator) has. During these meetings, the following points, among others, can be reviewed on each active patient:

    • Patient’s Progress
    • Patient’s Satisfaction
    • Re-exam (last/next)
    • Re-x-ray, or other diagnostics
    • Re-x-ray, or other diagnostics
    • Re-reports (progress report of findings)
    • Supplements
    • Exercises, nutritional or other recommendations
    • Financial conclusion (Initial, subsequent, and transitional to Wellness.)
    • Education programs, such as spinal care class, special lectures, pamphlets, etc.
    • Awards, compliments, thank you for referrals, good attendance, etc.
    • Family and friends referrals
    • Transition or adherence to a Wellness Program.

    2.  Outcome and Statistics. Keep a statistic of “Completed Treatment Programs”. Once a patient reaches a maximum level of improvement they are ready to go on to Wellness Care. One way to keep this statistic is to track the number of patients beginning a wellness care program.

      3.    Patient Progress Card. Make up a general treatment plan for every patient in the form of a simple checklist. This would include all service procedures, therapy, diagnostic, as well as educational actions. The last steps would include transitional consultations onto a wellness care program. This could be called a Patient Progress Card, and placed in the patient’s folder.

      4.    Day 1 & 2 Procedures. Ensure that day one and day two procedures are well documented and kept up to date with current procedures, and a simple flow chart outlined.

      5.    Regular Visit Procedures. Ensure that regular patient procedures are documented, and a simple flow chart outlined.

      6.    Staff Training. Staff walk-throughs for day one and day two procedures, and other flow procedures rehearsed at least on a quarterly basis. The best offices practice monthly.

      7.    Financial Consultations. Financial consultations done on all patients as often as is needed.

      8.    New Patient Orientation. New Patient Orientation done on each patient.

      9.    Patient Satisfaction. Ensured patients are very happy with service.

      10.    Pathways. Pathways for different types of cases documented and reviewed by all.

      11.    Flow Charts. Flow charts for first three day procedures outlined and rehearsed.

      12.    Conversion. All patients completing services are converted to wellness or other programs.

      Outcomes. The major outcome of the position of Case Manager is “Completed Treatment Programs.” That is, patients who have completed any acute or chronic treatment programs prescribed by the doctor and have reached maximum improvement. This definition could be extended to include: a patient who has completed their active care program and is educated so that they will continue onto a wellness program.”

      Performance Monitors

      • Number of Completed Treatment Programs
      • Number of Patients Beginning Wellness Care Programs
      • Number of Wellness Program Visits

      It is easy to drop out important but not urgent actions with patients during their care. Ultimately, this leads to poor quality and a deterioration of results. With a Patient Progress Card, and the Case Manager System in place, quality and patient results will improve, and your volume will increase. Often it is not what we see that hurts us, but what we don’t see. It is the gradual omissions that eventually add up to an empty office. Ensure each patient completes all of the steps of their treatment programs.

      For better patient retention, increased referrals, improved treatment compliance, and more revenue, implement the Case Management System!

      Chiropractic Special Promotions

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      • What is a Special Promotion?
      • How often do you use them?
      • Why do you use them?
      • Are there times that you shouldn’t use them?
      • What is the key to their success?
      • Plus- 14 Questions for each promotion.
      • Plus- 24 examples of special promotions.

      What Is a Special Promotion?

      A special promotion is a promotion that is not a regular part of your standard patient marketing procedures.  Every clinic should have routine and recurring procedures that serve to promote its services.  This would include different forms of patient education, recommendations to patients to bring in family members for a check-up, the manner in which the phone is answered, newsletters, etc.

      On occasion, however, you may want to celebrate a special event, like the anniversary of our clinic, or hold a party for all of your patients for the holidays, or take part in a community wide donation program with your patients.  This is called a special promotion.  They can be targeted to your entire patient base, or just a section of it. For example, you could set aside a special day for just for kids or an after hours “Girls Night Out.”.

      How Often Are Special Promotions Used?
      Because these promotions can be directed at select groups of patients and non patients, you could have as many as one or two per month.  However, they do take up staff time to prepare properly and to execute each promotion effectively. Therefore, a special promotion every 2 to four months is usually adequate.

      Why use Special Promotions?
      There are a number of reasons to do special promotions.  First, of course, they can generate new patients.  But there are other reasons as well.  For example, handing out carnations to mothers on the week before Mother’s Day is done just for the goodwill– because it is a nice thing to do.  Another reason is that it can add fun for the staff by providing them with an activity outside of their usual patient services and admin duties.

      Another benefit of special promotions is that it draws attention to your office. Patients and non-patients see that there are extra exciting activities occurring with your office in addition to the great service you provide.  It helps create marketing “buzz,” or conversations about your office.

      When Not to Use Special Promotions
      If you or your staff are already stressed with extra work, major in-office changes, or have repeatedly done new patient promotions recently, do not schedule a special promotion soon.  You need to build up your routine and recurring internal and external promotional procedures for a while in order to “grow” more new patients.  A special promotion is like a special harvesting… you can’t pick apples off a tree more than once in a season.

      Special promotions can act like an artificial boost.  Often, the real energy has been built up in the office or in the community and a special promotion just “releases” it.

      You may have seen other doctors trying to run a special promotion in the newspaper over and over, usually for something free.  It may have worked once, and may work again, but probably not right away.  Continuous “specials” poorly targeted and improperly timed will grind your other promotions down to a halt.

      Preparation Is The Key
      Plan ahead.  At least 70%, of the work of a special promotion is in preparation.  Avoid “too little too late”, a common mistake with  many promotions.

      Plan several special promotions for the next six months.  You can always cancel them later if you have too many. You can tie them into seasons, holidays, special events, or anything that might be of particular interest to your community, to your patients, and … to you and your staff.  They should be kept fun and creative.  Everyone should be involved.  The event should be discussed at staff meetings, and different projects delegated to different staff, even the doctors.

      Different promotions can be delegated to different team members.  You can give each person the option of creating their own event.  In one office the Billing and Collections Coordinator took on the month of August and organized a  “Flea Market” on a weekend in the clinic’s parking lot.  Patients rented booths and a food vendor set up a shop, and health screenings were provided by the office. It was a resounding success.

      Lastly, someone should act as the Special Promotion/Event Coordinator to help keep things organized.

      14 Questions to Ask for Each Special Promotion

      1. Why are we doing this event and how does it align with our mission
      2. Who exactly is the special promotion for?
      3. Is the event just internal to the office, or just external, or both?
      4. Is the event designed to directly generate new patients, just generate good will, or both?
      5. What does the target market get out of it?  Why would they want to participate?  What is in it for them?
      6. What are we going to get out of the event?  How will it benefit our clinic?
      7. When are we going to have it?
      8. What is the duration of the event?
      9. What is our budget?
      10. How are we going to promote it?
      11. What needs to be done?
        1. Before the event
        2. During the event
        3. After the event.
      12. Are all of the duties listed above delegated to individual staff?
      13. Who is the coordinator for the event?
      14. Do they have time scheduled to prepare for the event?

      Examples of Special Promotions
      (I-Internal, E-External)

      1. Senior’s Day (I&E)
      2. Valentine’s Day (I)
      3. National Correct Posture Month (May) (I&E)
      4. Mother’s Day (I)
      5. Father’s Day (I)
      6. Kid’s Day (I&E)
      7. Back to School Day for Kids (I&E)
      8. Patient Appreciation Day (I)
      9. Community Appreciation Day (E)
      10. Open House (I&E)
      11. Grand Opening (E)
      12. Anniversary (I&E)
      13. Spinal Health Care Month (I&E)
      14. Food Drive (I&E)
      15. Toy Drive (I&E)
      16. Other donation drives, such as YMCA (I&E)
      17. Christmas gifts, coupons and health certificates (I&E)
      18. General referral coupons for friends and family members of patients
      19. Teacher’s Appreciation Day (I&E)
      20. Care to Share (Internal)
      21. Doctors with a Heart
      22. Girls Night Out (Internal/External)
      23. Cinco de Mayo Party
      24. Fireman Appreciation Week
      25. Blame Someone Else Day

      Example of One Doctor’s Successful Promotion

      For more articles on practice development for your chiropractic office.

      To learn about our Marketing Manager System.

      Family Referral Procedure

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      A systematized procedure for generating more chiropractic patient referrals.

      How many more patient referrals could you generate if you simply asked for them?

      Sure, your patients refer others to you now, but how many more could you generate if you asked for them?

      One of the best times to ask for referrals is at the beginning of care, just when they are starting to see some benefit. At this time, patients are excited about discovering your office and are more willing to tell others about your services.

      This usually occurs between visit 3-8.  After about 3 weeks, the ”newness” of the experience can wear off and the patient can settle into a routine.

      One procedure that we have seen effective is talking to the patient about a “Family Check-up Plan.”  We recommend that you present each patient with a “Family and Friends Guest Pass”, or “Get Acquainted Gift Certificate” for his or her family, and friends, good for a free spinal check-up as a routine procedure, usually on the 3rd visit.

      Below you will find an example of a script for your chiropractic assistant, procedure notes, and an example of a gift certificate. You can edit the gift certificate and insert your office name and other information so that it is customized for your office.

      SCRIPT AND PROCEDURE

      Front Desk Chiropractic Assistant: After the 3rd visit, as the patient checks out, the Front Desk C.A. asks the patient:

      “Did Dr. ABC mention our Family and Friends “Health Check-up Program?”

      Patient: Responds.

      C.A.: Explains or re-explains the program:

      “Well, Dr. ABC wants to make sure that the family members of our all patients are properly checked for spinal related problems. We call it our Family Check-up Policy.

      So many times he sees patients who come to us, in pain, who have spinal problems that could have been more easily corrected had we seen them sooner before they were in pain.

      Now, there is no charge for this. Dr. ABC just wants to make sure your whole family is checked and healthy.

      Any questions?

      Patient Responds.

      C.A. O.K. Here is a Gift Certificate you can give to a family member. It is good for (whatever you want to offer.) an 8-point spine and neck check-up and a consultation.
      And, (smiling), as a bonus, we are offering a 15 minute massage from our massage therapist as well.

      Patient Responds. That sounds pretty good.

      C.A. Well, it gets better. This coupon is also good for any family member. You can even use it for a friend of yours too.

      In addition, this makes you eligible for our Massage Therapy “Care To Share” Credit Program.  Every person you bring in allows you to receive a credit 15 minutes free massage on your account. This is our way of thanking you for sharing the benefits of chiropractic.

      Patient Responds. Wow. That’s great!

      C.A. Let me go over the card with you. (C.A. goes over how to fill out the card). Now, how many do you want?

      Patient. Well let’s see, my son, my sister, and her husband. That’s three.

      C.A. Great. Here they are. Let me initial them and get them numbered. Now they are good for 60 days. So try to encourage them to call and make an appointment before then.

      [Makes a note on a log, usually kept at the Front Desk. Ask the patient about who the gift certificates are for.  Try to become familiar with the family and friends of the patient. Make a note of whom they are. In the following days, you can ask about these people again, showing interest and helping to remind the patient to bring their family and friends in for a health check-up.]

      Patient. I will do it. Thanks!

      NOTES:
      Print the gift certificate on card stock and cut with a paper cutter. Your local copy shop can do this for you or you can in your office. The better you make the coupon, the more valuable it will be to the patient.

      Only hand the gift certificate out to the patient personally. Never let them lie around or on the desk. Treat them as $100 bills.

      If you miss the patient on the 3rd visit, ask them on the subsequent visit. Usually the 3rd to the 6th visit is the best time. The patient should start to benefit, and still be excited about the services he or she is receiving.

      (For customizable samples in Word format, active PM&A and Marketing Manager System clients and members can go to the MMS Members web site.)

      SAMPLE FAMILY & FRIEND HEALTH CHECK UP GIFT CERTIFICATE FILLED OUT.

      Much more of this information can be found in the Marketing Manager System computer program.
      Also, look for more free tips and tools to grow your practice. Link. Link.

      Chiropractic Newsletters

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      Newsletters to Your Patients

      Pity the poor practice newsletter!

      So misunderstood. Forgotten, neglected, and ridiculed.

      Scorned as too expensive, dismissed for eating up too much staff time, and disregarded because they just don’t “work.”

      But is any of this true…?

      Not necessarily.

      Too expensive? They can be. Fancy paper, color photos, six pages,  and sent first class can cost thousands.

      Take too much time? Oh boy, how true this can be!  Who is going to get the information and write it, format the newsletter, get the mailing list, organize the mailing, do the printing, add the postage, and take it to the post office?  That is a LOT of work, and costly staff hours.

      Do they work? After spending so much time and money on any other promotion, you would expect the new patients to come in for a good return on your investment. Often, this does not occur.

      BUT WAIT… it doesn’t have to be like this. IN FACT:

      Patient newsletters can cost as little .50 cents per newsletter. That includes, postage, paper, printing, and taking them to the post office.  The offices where we see them used regularly have shown an increase in patient referrals and in reactivated patients.

      Before we outline how to do it, here is why you should.

      Why You Should Do A Newsletter
      When a patient starts care with you, you and that one person, old, young, male, female, it doesn’t matter, that ONE person and you – have started a conversation. They confided in you about some things about which, outside of close family friends, no one knows. It is personal. Professional, yes, but the fact is, you and your patient have started a dialogue.

      It is your job to continue it. It is not their job to do so – it is yours.

      You are the doctor and they came to you. They reached out for help. All you have to do is to keep the conversation going. It may be one sided for a while, but they are listening.

      We are all spammed to death. It has been estimated that each one of us receives up to 3,000 to 5,000 separate advertising impressions each day in the U. S. People are numb to advertising. It is no wonder that your ads in the local paper just don’t have the pull they used to.

      Patients who have once been to you already know who you are. When they receive a letter from you, it is from someone who knows them.  You are communicating to someone who already knows you and knows that you know them.

      Statistics tell us that it is much more profitable to invest in keeping the patients you have, and marketing to them, than trying to procure new patients that do not know you.

      Patients stop seeing you because sometimes, Life gets in the way. Finances, personal problems, work, and after a while, they kind of just loose touch.  But you are mistaken if you think that your relationship with them is over.  Once someone tells you intimate details about their personal condition, a relationship has started. Think about who you have confided in personally. You feel a special connection to them, right?

      So, a conversation has started and by simply maintaining it, you will find that the patients stay with you longer, come back to care more frequently, and refer more of their family and acquaintances.

      How To Do A Newsletter
      For those of you who have the Marketing Manager System (sm)  computer program, there are a number of sample templates and examples that can be easily reformatted for your office.

      Newsletters are thrown away, of course,  but they are reminders and brief advertisements about your services. They should not look like another pamphlet – homemade newsletters work very well. Too fancy is too expensive and look like the regurgitated pulp that gets thrown in most health articles and brochures.

      Add a column just from you. We have a sample doctor’s column which you can use. On our members site for our clients, we have others.  Add some news, maybe one of Margie’s favorite non fattening brownie recipes, a snapshot, a testimonial, and a list of upcoming events. That’s about it.

      Put it on one piece of paper that gets folded over twice and become self mailer. Bid it out to local mailers and you will find that the printing, paper, postage, and mailing all comes out to about fifty cents each.  If you have 1000 patients to whom you are mailing, that comes out to $500. If you do the mailing every 4 months, it averages to be $125 per month.

      Make sure that one person is delegated to oversee the newsletter. It should not take but a few hours to do.

      Email newsletters are nearly free, of course, and can be effective.  You can capture the email addresses from your patients and send out personal newsletters using services such as constantcontact.com, aweber.com, or a new one icontact.com. There are many others that have simple templates where you can simple type in the information and send out.

      Homemade Newsletters versus Preprinted Newsletters

      There are a number of companies that will print and mail newsletters out to your patients for you.  There are also a number of chiropractic commercial websites that will send out prefabricated electronic email newsletters to the email addresses you supply them.  The advantages are obvious – someone else does all the work and patients receive a professional good looking copy in their mail box, or their email in box.

      We have seen these work, however we prefer the home made newsletter.  The reason is that professionally done newsletters are a bit like pamphlets – they look nice, but they are generic and soulless.  This can be particularly true of email newsletters. Some prefabricated newsletters make room for your customized inserts.  In this case, these might work well.

      The primary problem with the preprinted newsletter, whether “hard copy” or electronic, is that it can take you out of the loop. You cannot really delegate all of your patient communication.  You can delegate some of your communication, but the point is, you want to maintain a personal relationship with your patients.

      There is more to it than this, but don’t worry about getting it too prefect or too fancy. Funky, friendly, and funny is good.  Just do it and keep the conversation going. You will see your old patients returning, referrals increasing, and established patients coming in to thank you for that the recipe you put in your last newsletter.

      #  #  #

      [Petty, Michel & Associates offers special practice development programs designed to help you achieve your goals.  For more information on our 3 Goals Seminars, coaching programs, and products: Services Products]

      Organic Health Week

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      Special Promotion:  Earth Day and Organic Health Care Week

      Earth Day is celebrated this year on Tuesday, April 22.   As general awareness increases about the harmful affects of toxins on our body, as well as on our planet, chiropractic continues to rise as the shining star in the world of true health care solutions.

      Earth Day is a great opportunity for you to promote the benefits of your chiropractic services.

      You can set aside one week as a “Buddy Week” and encourage your patients to bring in family and friends for a discounted check-up and introductory service.  The discounted fee that they pay you for the introductory services can be used as a donation to a local park fund, or earth related charity.

      You can place posters in your office and at key locations around  town, such as coffee shops, hair salons, etc.  A simple press release or notice can also be placed on your web site, newsletter, patient statements, newspaper and community calendar.

      You can also order some buttons for you staff to wear. 300 of them cost about $120 and you can use them next year as well.  For a sample button provider, go here (www.affordablebuttons.com)

      Here are some sample buttons:

      This is an excellent time to take pride in your profession.  Chiropractic:  always organic, healthy, and ahead of its time.

      Sample Posters

      Spring and Meaning

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      Spring.

      And almost three months into the New Year.

      It was just 3 months ago when the New Year began. What about those goals you set? Those resolutions you made? How are you doing on achieving them?

      You know, it is just amazing, working with the great doctors and staffs that we do. It is so evident that success is so attainable. It is just peeking around the corner, waiting for you to do just that next key action that will propel your office to pick up the speed needed to take you to the next level.

      One doctor we are working with, after being in practice nearly 20 years, is hitting his best ever days and highest ever weeks this month. His staff have been emailing us their successes as if they are texting us from a rock concert!

      We live for this stuff, by the way – your successes. Many times after years of gradual improvements, it is so gratifying to see an office take off with stability.

      Another doctor who has been in practice for years has been breaking collections records. And volume…seems like it is nothing to have a 1000 visit month – with many if not most new patients coming in from referrals.  One doctor we work with routinely sees over 1000 visits each month, and each month works with his colleagues and associates to help them hit their best-evers. Another doctor had over 150 on the books for him to see yesterday (Wednesday).

      From our perspective, it looks like chiropractic is having a renaissance.

      Of course, this is not the case with all of our clients. Some are still laying foundations for future growth. Success can come, but sometimes only after years of implementing the right procedures.

      But what are these “right procedures”, and where do you look? Insurance department, clinic management and organization, marketing?

      Some of you may feel that you are in a rut,  that you and your practice are stuck. If so, take heart and have hope. Things can change and you can do better. We have seen it happen with many doctors in these last three months.

      There are so many distractions in our lives, and many of them are negative and disheartening. Demoralizing. Frightening. Discouraging. Yet, we see doctors who have been stuck, finally get things going and do better. After years of stagnation, we see them do their best ever.

      Practice development success is dependent on the quality of your systems and organization.  That’s 50%

      What’s the other 50%?

      Part II

      The other 50% is an “Inside Job.”  That is, your success is dependent upon the structure of your office, but also on the function of your behavior. The quality, and quantity, of your energy, your attitude, and your creativity is easily 50% the cause of your success, or not.

      So, if your numbers are down, you should spend half your time improving your systems, and half your time…improving yourself.

      Are you frightened stiff? Have you developed “hardening of the attitudes”? Are you resentful, a seething caldron of anger? Do you feel burned out, frustrated, or feel like you just can not make the changes needed?  Believe me, this manifests one way or another in your practice. And in all areas of your life.

      We all experience these feelings, among others, at times. Sometimes they are acute. But after you have been in business for a while, you may not even notice that you have become less than enthusiastic about practice.

      Yet, even if you were locked up in solitary confinement, you would still have the power of choice. You could still be creative.  Even if you were shackled, starved, beaten, imprisoned, you could still find meaning and purpose in your life.

      This is the basis of an entire branch of psychology as developed by a former prisoner of the Nazi death camps, Victor Frankl. His observations lead him to identify what he saw as the basic principles of living, including:

      1. “Life has meaning under all circumstances, even the most miserable ones.
      2. “Our main motivation for living is our will to find meaning in life.”

      Successful people have meaning in their lives.

      If you can find purpose and meaning in this very moment, in this day, with your next patient, with this year, your probability of success will be greatly increased. More importantly, you will find that what you are doing is more satisfying.

      Fear will vanish, hardened attitudes will become flexible, and your energy will return.

      Structural changes will need to take place, of course. Better clinic systems and organizational procedures will then take you to the top. And keep you there.

      We can help with all of these, by the way. But you should know and be reassured that chiropractic is happening. It is hip, it is popular, and it is growing, probably more so now than ever before.

      Naysayers say otherwise to promote their goods or services. They are sell outs. Don’t buy what they are peddling. Chiropractors have always been challenged and it is actually what has helped you be strong and survive.  Insurance cutbacks are not new.

      After more than 20 years in business,  we are still amazed each day when we hear of the stories patients tell of their success.

      Chiropractic works. It has, does, and will for at least the rest of this year. So, find your meanings and purposes, get help to upgrade your clinic procedures and organization, and make those yearly goals you set for 2008.

      Heck — why not beat them and make this year your best ever?

      Spring has its own meaning, its own purpose: to grow and create. This can be your purpose too.

      Every moment, every day. Right now.

      Your Chiropractic Practice Marketing Plan

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      How is your marketing plan?

      Do you have one?

      You really should have a marketing plan for your chiropractic practice, and it should be updated monthly, nudged weekly, and totally reviewed every three months.

      This may sound oversimplified, boring, or too too obvious, but in our experience, it is a major key to practice building.

      Sure, there are many other factors behind a successful business, but constantly marketing is essential. And, if your practice is not growing, it may be because you are not routinely marketing.

      And how do you make sure that you are marketing? Have a plan.

      A Marketing Plan Is Simply Marketing Activities Scheduled,
      Assigned, Regularly Supervised, And Measured.

      The key to effective marketing is simply planning. This is because marketing often just does not get done.  It is not that your marketing did not work. More than likely, it just didn’t happen.

      To overcome this, you need to schedule short planning times each week, and longer periods each month.

      This is the core of the Marketing Management System as we have developed it.

      Your marketing plans should include the following:

      •    Recurring Marketing-Oriented Procedures. These include not only your internal marketing procedures, but recurring clinical and administrative procedures as well. They are the usual recurring procedures that go on regularly in your office. Often overlooked and neglected, they are the most important form of marketing. They need to be reviewed and practiced regularly to be keep fresh and important. Because they are so routine, I usually schedule them last.

      Very successful offices rely mostly on these types of procedures. When you hear chiropractic doctors say “We don’t do marketing”, it is because they have their marketing as part of their internal procedures and they do these extra-ordinarily well. These could be the way the phones get answered, the report of findings, the new patient lecture, the simple consistency of patient flow procedures, great internal staff and doctor communication, staff training procedures, staff meetings, etc.

      •    Special Promotions. Hold special promotions every now and then. These could include a Kid’s Day, a donation drive, mother’s appreciation day, teacher’s appreciation week, etc. I walked into an office a few days ago and in the middle of a very cold, snow packed winter, the doctor and staff were wearing summer clothes, offering smoothies (without the run), with a big sign saying: “Welcome to Chiroville”, no doubt referencing “Margaritaville” and warm ocean lifestyle. What a refreshing and friendly surprise greeted each patient that day!

      •    Patient and Community Education Programs. These are usually held in your office. Educate your community through your office and patients by providing special workshops that are chiropractic or health related. Or, you can sponsor a special “Awareness Week”, such as a Headache Awareness Week, offering no charge or discounted condition specific screenings, consultations, and or exams.

      •    External Community Services and Networking Events. These can range from spinal screenings, to in office ergonomic workshops, lunchtime “Lunch & Learns” for local businesses, setting up referral sources with business or other professionals, or working in the food pantry twice a month feeding the homeless.

      There are other procedures, such as advertising, PPO soliciting and reviewing, yellow pages, web site, but many of these can be put onto a yearly, quarterly, or monthly recurring checklist.

      The above are various categories of marketing. But again, the most important part of marketing is doing it, and the key to getting marketing done is to schedule it and assign it and measure it.

      For the best reference, review the materials in your Marketing Toolkit which is part of your Marketing Manager System computer software, if you have it.

      Here is a sample marketing calendar for a chiropractic office.

      NOTE TO CLIENTS AND PMA MEMBERS: You may find a customizable sample calendar on our PMA Member’s web site.

      What the Moon Has to Do With You Success

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      The moon is back to normal again.

      Just a few hours ago, though, standing in the middle of a snow-covered playground near Lake Michigan, in the night sky at about 3 degrees above zero, it looked like a smudge. A grey brown spot that was almost black, like someone had tried to erase it with an old eraser, but part of its image still remained.

      For a few hours, the earth blocked out the sunlight to the moon, at least from our perspective. These unimaginably huge spheres of matter, nearly perfectly in balance, were gracefully moving like billiard balls in a ballet.  Compared to this, all else really seems insignificant.

      Before street lamps, car lights, TVs and late night computers, the night sky entertained us. Everyone could recognize the constellations, and an interplanetary event such as an eclipse was a very big deal. All our ancestors were stargazers – the night sky gave them the comfort of familiar signs, as well as wonder and awe. And mystery.

      Besides the city lights to distract us, we have our daily duties and deadlines that rivet our attention to the near. Your patients, your notes, your computer, staff members, phones; most things are just a yard stick away.  Like a ping-pong game, your focus has to be complete, quick, and close, or, you lose.

      When your attention drifts, patients think you don’t care, staff thinks you take them for granted or are displeased, and insurance companies can’t read your notes.   Success in practice requires keen attentiveness.

      You can’t survive asleep at the wheel, dreaming or daydreaming. To be a winner you have to be alert and actively attentive to your job each minute you are at the office.

      And if that is all you do, you soon will burn out.

      Studies have shown that you have to, now and then, disengage. Take a break. Learn Japanese. Play with your kids. Help the poor.  Pray. In their best selling book, The Power of Full Engagement, the authors offer studies and examples on why it is important to become involved in disrelated activities to balance our hectic if productive lives.

      All this goes back to the moon and the sky.  I don’t think we look up enough. The sky, the stars, and the whole natural God given world are about us, mysterious and awe inspiring.

      In business, we have to focus on the short term and build for the middle term. But it is the far away that calls us, if we can stop to listen.  What makes you curious, fills you with awe, love, and seems a mystery? What does your future whisper back to you, as if you could hear your eulogy years from now? What are your greater purposes?

      Balancing these three is the key to a successful practice, business, and life.  Your first goal is to play each day fast, full out, like a basket ball game you have to win. Your second goal is to gradually build a strong organization with the right teammates and the best plays that have proven to work for you. But your third goal, and there may be many, are why you work at all.

      If your business has plateaued and stopped growing, it is because one or more of these goals is not being worked on correctly.

      We have developed a general pathway and framework for doctors to move upward so that they can correctly work on and achieve all three goals. It doesn’t matter what technique you use, therapies, providers, or offices.

      We are excited and pleased about the development of this new approach to practice management and marketing and how it impacts our consulting and the results our clients can see, as well as our own business and personal lives.

      We will be publishing and just talking more about these three goals, but we encourage you to come to our seminars.   You can learn more about them by clicking here. 3-Goals Seminars

      And, in the meantime, as my old pal, Jack Horkhiemer the stargazer always says:  “Keep Looking Up.”

      photos from Microsoft and NASA