The 5 Engines of Practice Development
Which component or practice engine is most important?
Find out in this week’s article [LINK]
Like the Olympic athletes, as a chiropractor or practice owner, you have begun a venture few dare. Where you go, there is no hiding or coasting. You are immediately rewarded or penalized based on your and the entire team’s performance. There is no guaranteed tenure in your job or assurance that you’ll have business next month. It is all up to you and each member of the team.
Read Ed’s weekly newsletter to find out how to:
Read More[LINK]
It was at a large seminar. Maybe Parker, maybe a state convention, I don’t recall for sure. I was talking with some doctors I knew in the hallway when one of the sessions ended. The doors opened, and the doctors who attended the presentation began pouring out of the conference room. One of them joined us.
He eagerly discussed some new promotional projects he heard about in the session. He also said that he learned some new approaches to scheduling and billing. I was interested, so I asked him some questions. Once hearing about the ideas, I said that they sounded good.
But then I asked the WHO question: “Who is going to implement these new projects?”
He looked at me, suddenly changing his demeanor as if I had insulted him by asking him such an obvious and stupid question, and he walked away.
True story. But hey, that’s what we do at PM&A: ask the tough but obvious questions.
Time and time again, we have seen doctors and staff come back from seminars with useful information that never gets applied. And there is a reason for this.
THE MISSING “WHO”
The missing WHO is your manager.
Many practices do not have a functioning manager. And for those offices that do, their manager is usually not operating as fully as they could.
Every practice, whether large or small, has a set of departments or roles. Minimally, these include:
Beyond these, there is a boatload of other tasks that fall outside of the front desk, billing, and doctoring. Who does these? Who organizes these? Usually, the business owner, who is also the doctor, does.
Dealing with these tasks can take up valuable time and energy. And this is expensive. It costs more than most business owners realize. What is a clinical hour worth? $500, $1,000, $2,000. Having the doctor spend time on non-clinical or non-growth-oriented leadership projects is expensive!
There are so many benefits for a practice to have a manager that I have long considered why doctors and business owners don’t create and invest in this position. Even on a part-time basis, it makes practical sense.
I think these are some of the reasons:
And especially,
Because of these reasons, and a few more, we have launched our manager training program. I encourage all practice owners to create the manager position in their practice and then support it. If you are ready, I encourage you to consider our manager training program.
Our program starts the week after Labor Day and is filling up. Let us know if you are interested, and let’s talk soon.
Ed
“Based on our largest global study of the future of work, Gallup finds that the quality of managers and team leaders is the single biggest factor in your organization’s long-term success.”
It’s the Manager, by Jim Clifton and Jim Harter
With The Help Of The Better Angels Of Our NatureTuesday, July 16
Reporting… Milwaukee, WI
American politics and government are on display here.
The Republican National Convention is in town all week. There are estimated to be around 50,000 attendees at the convention.
And, of course, former President Donald Trump was in town after his near-death assassination.
What a monstrous difference two inches would have made!
I have lived through assassinations and assassination attempts. I clearly remember being excused from school when President John F Kennedy was murdered. A few years later, while in college, I remember hearing that Martin Luther King was killed. Being against the war in Vietnam, I was in full support of Robert Kennedy, who was also against the war and pledged to get us out of Southeast Asia. His murder still resonates with me. But there are others, many we don’t hear about, and many that are only attempts.
I always try to connect the dots. And as I do, look for more. How do these things happen? Are the perpetrators of such violence acting alone as we are told? Are we always told the truth? Does the government ever lie?
These are important questions. But I have a recommendation, perhaps a warning:
In sports, such as football, soccer, or martial arts, you need situational awareness. That is, you need to know what is happening outside your field of vision.
But more importantly, while doing so, you need to focus on what is in front of you.
The pitcher needs to watch who is stealing 2nd base, but his focus must be on the batter in front of him.
This applies in life as well. It helps to know what is going on in the world so that you don’t get blindsided or fooled.
But what is always most important is your patients. As a chiropractor, dentist, medical doctor, or any service provider, your customers are what is right in front of you. They, along with your fellow team members and your family, are what is most important.
One of my favorite books on history is The Soul of America, The Battle for Our Better Angels, by Jon Meacham. It looks at certain crises the U.S. has endured over its 250 years. It shows us that, despite serious challenges, time after time, reason and truth have prevailed.
In times of social unrest or uncertainty, I have seen the practice numbers of many offices go down. Doctors, staff, and patients react by contracting, pulling back, and hunkering down. I have seen other doctors go full-activist, spend time in marches, or become consumed with “doom scrolling!”
Don’t let this happen to your practice or to you. Situational awareness is necessary. Know your environment, question authority, and seek to discern the truth. I know you do this anyway.
But keep the patients in the forefront. Keep improving your practice, make it stronger, and help more people.
And have faith in what Abraham Lincoln said about the better angels of our nature.
In March of 1861, the mood in the U.S. was one of deep division and uncertainty. In his first inaugural address, Abraham Lincoln attempted to calm the tensions and unite the states.
“We are not enemies, but friends. We must not be enemies.
“Though passion may have strained it must not break our bonds of affection.
“The mystic chords of memory, stretching from every battlefield and patriot grave to every living heart and hearthstone all over this broad land, will yet swell the chorus of the Union, when again touched, as surely they will be, by the better angels of our nature.”
Staying focused on our goals to improve the health of more people,
Ed
Build a stronger business, increase your revenue, and enjoyment in and out of your practice.
Here’s what you need to know:
** Start Date: September 9th
** Registration ends August 30th or when the class is full
**Duration: 12 weekly classes
**Waiting List: Sign up now for exclusive program details!
Already on our list? Stay tuned—I’ll send more specifics soon. I’ll also schedule times to chat with you and answer all your questions.
Our last Practice MBA was a big success. Our latest version is even better, and I can’t wait to get it started with you.
Ed
—————————————————-
If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
Midyear Checkup for Chiropractic Healthcare Practices
It’s Halftime.
2024 is half over.
How’s it going? Are you closer or farther away from your goals?
Here’s a fast tip:
Stephen Covey says:
“All things are created twice. There’s a mental or first creation and a physical or second creation of all things.”
If you are behind in achieving your goals for 2024 in the real world, you may need to recreate them mentally.
Great performers and coaches encourage us to visit our goals and vision often.
Lou Holtz was a college football coach. Per statistics, possibly the best college football coach ever. He was the only college football coach to lead six different programs to bowl games and the only coach to guide four different programs to the final top 15 rankings. *
Mr. Holtz said a book by Dave Schwartz called The Magic of Think Big was his favorite book. The following is from Schwartz’s book:
“Look at things not as they are, but as they can be. Visualization adds value to everything. A big thinker always visualizes what can be done in the future. He isn’t stuck with the present”
“Belief, strong belief, triggers the mind to figure ways and means and how-to.”
I don’t think it ever stops – the importance of staying connected to your vision, your meaningful goals as well as the practical ones.
But what the heck? Go for it! And even if you don’t achieve all your goals, you will have at least played the game and had an adventure!
As Eckhart Tolle says:
“Life is an adventure, it’s not a package tour.”
Happy summer and happy times with your team, helping others achieve their goals!
Ed
P.S. Our Practice MBA is just 60 days away.
Think BIG! Our Practice MBA is back, and it’s updated and tailored for your practice manager and Big Thinkers like you.
Here’s what you need to know:
** Start Date: September 9th
** Registration ends August 30th or when the class is full
**Duration: 12 weekly classes
**Waiting List: Sign up now for exclusive program details!
Already on our list? Stay tuned—I’ll send more specifics soon. I’ll also set up times to chat with you and answer all your questions.
Our last Practice MBA was a big success. The new managers in chiropractic and other practices have effectively improved their practices and the stats show it. Our latest version is even better, and I can’t wait to get it started with you!
Ed
References:
Steven Covey: The Seven Habits of Highly Effective People
Eckhard Tolle — www.brainyquote.com
David Schwartz – The Magic of Thinking Big
Lou Holtz – Wikipedia
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If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
JULY 2nd
1776, Philadelphia.
The weather was cooler than usual, with intermittent rain showers. Some 50 members of the 2nd Continental Congress met at Independence Hall and finally agreed, after months of discussion,
“That these United Colonies are, and of right ought to be, free and independent States…”
We celebrate this declaration on July 4th in the USA as our Independence Day.
Aside from the summer cookouts, barbecues, parades, and festivities, we celebrate freedom – freedom from tyranny and freedom to pursue “Happiness.”
= = =
It could be said that multinational investment corporations, along with Bill Gates — whom Google Search offers up as the most powerful doctor in the U.S.*, have colonized the healthcare system in the U.S.
You and your team are independent chiropractic and healthcare businesses. You are not a colony of Big Pharma, Medicine, or Food. They have fought and marginalized you, but you have won and remain free. (**)
And it is not too big of a leap to point out that this is what you do for others: you help your patients and clients to become freer from pain, discomfort, and dysfunction. You help them become more independent from drugs and the toxic influences of our world.
As the July 4th celebration is for American Independence, I invite you to see this time as also a celebration for independent businesses and health care providers — like you.
= = =
Freedom is never free, and each of us at Petty, Michel & Associates appreciates your efforts to maintain and grow your business and help your patients and clients seek happiness.
So, THANK YOU!
Thank you for staying free and helping others do the same.
Ed and Dave, and all of us at Petty, Michel, & Associates
References:
* Screen capture of Google: “First search result when asked: “Who is the most powerful doctor in the U.S.”
** Contain and Eliminate, Howard Holinsky
=============================
If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
If you were going to buy a practice, wouldn’t you prefer it to be “turnkey?”
If you were to work as a chiropractic doctor or provider in another clinic, you’d want it to be “turnkey,” right?
Or, as a support professional and assistant, I bet working in a turnkey office would be your preference.
The term “turnkey” implies that the necessary operational elements of a practice are in place so that all the owner or practitioner has to do is “turn the key,” and the practice just goes!
A turnkey practice is so well organized that the stress level is low, the revenue is high, and the service outcomes are excellent.
Consider a scale of 1-5, where 5 is a turnkey practice, and 0 is an insolvent practice.
___5: Turnkey Practice
The practice is fully equipped and operates at close to full capacity. It is ready to be sold, to bring on additional providers, or just happily and profitably cruise.
There is a strong, established patient base ensuring regular revenue.
Administrative, billing, scheduling, and management systems are highly efficient.
The practice is financially robust, accumulating income over expenses each month.
The practice has a trained and established manager who ensures the seamless operation and continuity of all systems and procedures.
Staff are highly skilled, well-trained, and capable of independently managing the practice. Morale is high.
The business owner spends just a few hours each month on administration.
___4: Well-Established Practice
The practice is well-established and runs well.
There is a large, loyal client or patient base.
Administrative systems are efficient.
The practice is financially stable.
Staff members are trained and experienced.
The owner spends a few hours each week on administration.
__3: Growing practice
The practice is showing signs of growth.
The client or patient base is stable and increasing.
Administrative systems are more organized.
Financial health is improving.
Staffing is more stable, with ongoing training.
Owner works hard each week
___2: Basic Operational Practice
The practice has the basic elements required for operation.
There is a modest, gradually growing client or patient base.
Basic administrative systems are in place but may be inefficient.
Financial stability is tenuous but improving.
Staff are present but may lack competence or numbers.
Daily admin operations are dependent on the owner
___1: Struggling practice
The practice is operational but faces significant challenges.
There is a small, inconsistent client or patient base.
Administrative systems are inefficient or nonexistent.
Financial difficulties are prevalent, with cash flow issues and potential debt.
Staff may be minimal, overworked, or inadequately trained.
Owner stressed by dealing with administrative tasks
___0: No Practice / Insolvent
Once you have achieved turnkey practice, you can sell it for the highest price.
Or, you now have the option to add another provider profitably. There is no limit – if you develop each provider to a turnkey level before adding more.
But the third option is just to cruise and have fun seeing patients with a great team supporting you and the practice. This option allows you to continue helping your patients while integrating your personal life with your practice life.
In a subsequent article, I will list the key roadblocks, some of them hidden, that can get in your way from creating a turnkey practice. I will also show you how to get to a turnkey practice faster.
But just knowing this scale will give you a map to better chart your course to success.
Keeping the end in mind,
Ed
=============================
If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
One of our chiropractic clients just sent me a patient review.
It expressed a profound improvement in the patient’s life. It was moving!
I am sure you have similar reviews.
Patient testimonials are useful in marketing and demonstrating your credibility. There is software that captures and encourages positive reviews, and you can just ask patients to write something about their wins. You can also record the patient talking about their health success in a short video. These can be included on your website, social media, and in your newsletter.
But testimonials and reviews are more than marketing.
FIRST, they are a personal statement sincerely expressed by your patient. Your patients courageously express their wins so other people can learn about them. They are standing up for themselves and the doctors and staff that helped them.
This is not a small thing — you should personally acknowledge any review you receive.
SECOND, you and your team may not always see or appreciate the outcomes of your combined work. Aside from providing clinical services, there is also scheduling, payments, note-taking, patient communication, and marketing. Plus, everyone shares a hundred other administrative tasks. All of this eventually results in a great result for your patient.
In college, one summer, I worked in a cannery. I was a “tray boy,” I put trays of empty cans on a stand and then took them off once the cans were filled with fruit (pineapple) from a conveyor belt that never stopped. That’s all I did. I never saw the completed canned products, their labeling, or even enjoyed eating them. I was basically a robot, a cog on an endless conveyor belt.
Similarly, team members can focus on their specialties and not always see the transformative results they are helping to create with patients. Work can become routine, just an assembly line that never ends.
LASTLY, the testimonial describes your WHY.
The idea of “Why” was popularized by Simon Sinek and his Ted Talk and posted on YouTube in 2009. He uses a 3 ringed circle to illustrate this idea.
The outside circle describes WHAT the business does. The next inner circle describes HOW the business does what it does. And the innermost circle describes WHY the business does what it does.
“Every single person, every single organization on the planet knows what they do, 100 percent.
“Some know how they do it … But very, very few people or organizations know why they do what they do. And by “why” I don’t mean “to make a profit.” That’s a result. It’s always a result.
“By “why,” I mean: What’s your purpose? What’s your cause? What’s your belief? Why does your organization exist? Why do you get out of bed in the morning? And why should anyone care? … the inspired leaders and the inspired organizations — regardless of their size, regardless of their industry — all think, act and communicate from the inside out.” *
Everyone in your office, patients, staff, and perhaps people in your community, know WHAT you do. You provide health care. Some of your team members might know HOW you do it – what procedures you use and how they work for patients.
But to have a fully engaged and motivated team, and even a patient community, you need to keep connecting them to WHY the offices does what it does. And not just the office “mission statement,” but WHY this is your mission.
IN YOUR OFFICE
Thank each patient for their review.
Connect team members and their work with the clinic outcomes and patient successes.
Connect everyone, including yourself, with the WHY of your services.
Ed
P.S. IN OUR OFFICE:
When the doctor sent me their patient’s review, I realized that, for all of us at Petty Michel & Associates and our Goal Driven Training, this was our WHY as well.
—————————————————-
If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
A local hot yoga studio where I live usually sees their numbers drop in the summer. So, a few years ago, they instituted a solution to lowered attendance: The Yoga Challenge. Attend 30 times over the summer and be eligible for a trip with your guest to a week of Yoga at a retreat in Costa Rica.
I know the owners, and the program has been overwhelmingly successful.
Why is this?
Well, obviously, a week paid for in Costa Rica can be a wonderful experience and so is an appealing goal. But much more than that, there are the intrinsic rewards of personal achievement and playing for a bigger goal. 30 visits of hot Yoga over three months is an accomplishment – you couldn’t help but get in better shape — if you didn’t become dehydrated and wrinkled like a dried prune.
COULD THIS TYPE OF PROMOTION BE USED IN YOUR CHIROPRACTIC OR HEALTHCARE CLINIC?
The short answer is … YES!
We have worked with clinics that have had success with versions of this program.
Essentially, a Challenge is a game and we all like games!
Whether it’s puppies, babies, or the Olympics, the gaming spirit is part of our makeup. Can we win? Can we achieve it? Let’s go for it.
Computer games include the concept of gamification. (Fun Fact: The computer game industry is expected to hit $282 billion in 2024)* That does not even include revenue from professional sports or racing.
I cover all this subject in my book, the Goal Driven Business , and how to apply it to everyday practice.
You could meet with your team and discuss different versions of a “Care to Share Better Health Challenge.”
The goal would be to have fun getting healthier, helping others get healthier, and maybe win a few gifts!
“By accepting this Challenge, you will get healthier, help others get healthier, and maybe even win gifts!
To participate, patients receive tickets for completing health-oriented accomplishments.
Here are some examples of health-oriented activities:
Attend one of our Wellness Classes. (2 tickets)
Bring a guest.(2 tickets)
Post a review of our services.(2 tickets)
Keep all of your appointments. (3 tickets)
Refer a friend to a no-charge consultation with one of our doctors. (2 tickets.)
Exercise at least 3 hours per week (12 for the month). (3 tickets)
Tickets are entered into a drawing for several possible prizes at the end of the month.
What makes a program like this work is that it is also a game for your staff. If specific goals are met, then they, too, receive awards!
Everyone is in the game!
A Challenge will need planning and lots of cheer leading! As with any internal type of promotion, it depends on the level of synergy in the office.
Talk it over with your team and customize it. Make up your own Challenge. Set goals for visits, class attendances, introductory consultations, and/or new patients.
And, let the games begin.
Ed
*Reference: Gamification Fun Fact – https://www.statista.com/outlook/dmo/digital-media/video-games/worldwide
UPCOMING EVENTS
We have two upcoming events for you.
Improving Your Collections. On Tuesday, June 25 at 12 (noon) Central Time, Dave Michel and Lisa Barnett will present a free webinar to subscribers to this newsletter and our clients: The 6 Critical Components to Improving Your Collections. Click below to sign up.
Practice MBA for your manager (and you!). Our 2nd Practice MBA session for your manager and you as a clinic director is getting set to start later this summer. The results from our last one continue to be inspiring. One mature clinic I just checked in on yesterday has its revenue up 21% this year. If you are interested and not yet on the waiting list, please click below to find more info and reserve your space.
—————————————————-
If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
I just ran across a “study” entitled “The Relationship Between Health Literacy and Medical Costs. *”
Their findings:
Patients with lower health literacy had higher hospitalization rates compared to those with higher health literacy.
What does this mean? Let’s look at how Health Literacy is defined:
“Health literacy is the ability to obtain, process, and understand basic health information and services to make appropriate health decisions.” (U.S. Department of Health and Human Services) (HHS)
So, how is this working out for us in the U.S.?
The U.S. ranks last in a comparison of 11 high-income countries in terms of general health. This is despite the U.S. spending the most on healthcare compared to these nations.*
So, it can be reasoned that Americans aren’t getting much information on health care. Our people are fatter, sicker, and more depressed. Our kid’s health is getting worse.*
However, as the above study illustrates, there is a direct connection between educated patients and better health.
We already know this from experience in practice. I just thought it was interesting that there was a study showing this fact: better educated patients are healthier. They also refer more people for care.
Here are 3 approaches to improved patient education, though there are many others:
Inform while you perform. Educate your patients each day about some aspect of health care. This is also called Table Talk.
Care Class. It used to be common procedure in practice building to have regular new classes for patients. Not only were they educational, but entertaining. They built community. They also increased patient referrals, patient retention, and improved the motivation of those giving the talks. They cost next to nothing, except for the doctor’s and staff member’s time. In some offices, refreshments were added. In one chiropractic clinic I worked with would award attendees with clinic t-shirts and provide great pizza and had a full class!
Newsletter with a case study. When your patients are not in the office, send them a short note. Maybe add a video. Doesn’t have to be professional, just authentic and describe a successful case or some health tip that they can use.
I think that because we work and live in a health profession that we take health knowledge for granted. And it can be easy to assume people know what you know.
They don’t.
There is a chasm between what you know about health and what your patients know.
How full would your schedule be if your patients, and their family and friends, knew what you knew about how to stay healthier?
Health literacy is a term from the medical world that has obviously failed to bring about health literacy.
No surprise there.
But in your corner of the world, you can change this and increase true health literacy with all your patients. And help more people.
Seize the future,
Ed
References:
* American Journal of Public Health, 1998. Baker, D.W., Parker, R.M., Williams, M.V., Clark, W.S.,
* U. S. Ranks last. https://www.commonwealthfund.org/press-release/2021/new-international-study-us-health-system-ranks-last-among-11-countries-many
* Kids getting sicker. https://childrenshealthdefense.org/follow-the-science/54-of-us-youth-are-chronically-ill/?itm_term=home
—————————————————-
If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
Summer is a great time to promote your chiropractic and healthcare services. Winter hibernation is over, as is the enforced isolation from COVID, and people are out and about.
Communities are coming alive with farmer’s markets, bicycle riding clubs, coffee shop meetups, parades, art shows, and fairs of all kinds. You got yer Lions Club pancake breakfasts, church barbeques, donation drives, and 5-Ks.
Online social networking is fine, but it is extra powerful if backed up or done in conjunction with people and events locally in your community. In Real Life!
You can just show up and meet people. Let them meet you like an elected official when they run for office. (It is an election year!) You can also get a picture taken of the event and then use this in your internal promotions. That’s me in the photo above a few years back when I jumped into our local 4th of July parade and had my picture taken with our state representative, Sheldon Wasserman, M.D. (He told me his mom sees a chiropractor, and I didn’t care about what political party he was part of.)
You can get a list of upcoming community events from the Chamber of Commerce and schedule a screening, talk, or information booth, or volunteer your help in a charity drive. You can also just show up. Be neighborly.
There is often a run or walk as part of a donation program during the summer months where you and your staff can participate. We have seen offices proudly wear their office t-shirts and recruit many patients to do the same. Encourage and support your team members to participate on their own.
I’d assign a staff member or two to find events and opportunities to join. Make it a team activity.
You can power up all your activities by partnering with other local businesses.
And take your cards. As the old timers told me, the old school technique of practice building was “WOC – Whip out Card!” It’s physics: you put out energy and communication, and it will return to you.
When you are networking, you get to know people. Be interested in them and their interests. Then you can hand out your cards. You can also hand out coupons for a screening or workshop at your office.
As Woody Allen is to have said:
Eighty percent of success is showing up.
You can’t lose. It’s Summer. Get Outside. Enjoy the freedom!
And seize the day!
Ed
—————————————————-
If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
One of the best chiropractic offices we have had the pleasure of working with has the subject of this email as its theme: “Be the ripple.”
Today’s newsletter comes out early so you can listen to music while you go to work, while you are at work, and after work.
Music is therapeutic and fun.
“Music has real health benefits. It boosts dopamine, lowers cortisol and it makes us feel great. Your brain is better on music. (Alex Doman. TEDx talk, CEO Advanced Brain Technologies)
The tune linked to below has artists from around the world playing together, from Playing for Change: Ripple.
“We never know how far-reaching something we may think, say, or do today will affect the lives of millions tomorrow.” (B.J. Palmer. Developer of Chiropractic)
Be the change, create the ripple, and seize the future!
The new staff member said she could help with marketing by posting photos on Instagram and Facebook. The doctor said great!
I noticed a photo of a patient or the doctor with a short comment for a few weeks.
I usually had to search for the image. It often had a few likes or hearts. Maybe 5 at most. Then it stopped. The staff member had taken on other duties.
I had been asking the doctor to send regular email newsletters to his patients. He didn’t seem that interested, but we said we would help him put them together which would cost less than $100 per month.
He got us the content, and we put the newsletter together and sent it out. On the 1st day, over 500 people opened and looked at his newsletter. These weren’t strangers. These were patients who knew him, liked him, and trusted him. Most of them just hadn’t been in to see him for a while.
Linda, our manager and service coordinator, just conducted a quick survey with some of our clients. She found that the offices that consistently send out personal email newsletters have all had a positive impact on their practices. They have improved patient referrals, reactivations, and patient engagement.
Some of the responses included: “Increases volume.” “Patients refer.” “They love the recipes.” “[Patients] come into the office and comment that they saw a particular condition talked about in the newsletter that the office was not aware the doctor could help them with.” “Great response when promoting [a new service].”
Social media platforms are entertaining. They have to be because they are in the advertising business.
But unless you pay them for ads, your posts are shown at the whim of the platform. You have no control. Your readers are entertainment seekers and, even if they see your post, are often distracted by other posts and ads.
I have seen ad agencies use social media effectively to generate leads that become new patients. It can be pricey but worth it if done correctly. Done now and then, expert advertising on social media for a special offer for a limited time can work.
But if you do not regularly send personal newsletters to your patient base, you are wasting some of the goodwill you have generated over the years.
A practice is grown and sustained through communication and service to your network. The quality and quantity of your network, and how engaged it is with you, is your practice goodwill.
We are now in the age of Artificial Intelligence. Communications are manufactured. In other words, more and more communication is just plain fake.
But you are not fake, and neither is the easy dialogue you have with your patients. More than ever, people want authentic communication and relationships. Social media posts and ads just can’t compete with your short personal newsletters.
Here’s some tips on how to get your personal newsletter done fast:
Now, write about 2-3 paragraphs as if you were writing a letter to them about your thoughts. (Link below.)
You can certainly add other elements. But the most essential component is your original message. It is YOUR VOICE that keeps the conversation going.
Effective newsletters will improve patient retention and patient referrals and reactivate inactive patients.
Nurture and sustain the relationships in your practice.
And seize your future!
=====
Sample message from the doctor for the newsletter
“You know, when I was driving to work this morning I saw this fellow bent over with a walker walking down the sidewalk. I bet if I had seen him 10 to 20 years ago, he wouldn’t be in that condition.
It’s the whole idea of a hinge. If it isn’t used much, it will rust and get stuck. Your vertebrae are like hinges. You gotta keep them moving otherwise they will get stuck.
Exercise helps. So does stretching.
But now and then your hinges (vertebrae) can get stuck, and that’s when you wanna come on and see us.
Keep moving and stay unstuck, and have a great June.
Dr. Bob Marley”
Related articles for chiropractors and independent healthcare practices:
https://www.goaldriven.com/post/sample-patient-group-activities
https://www.goaldriven.com/post/part-2-of-the-best-known-marketing-secret
Women, in general, see healthcare providers including chiropractors, more than men do. (The ratio is about 60% women and 40% men.)*
This week, hand each person in your office a flower and ask them to give it to their mom, or a mom. And if they are a mother, give them two. You could make a deal with your local florist and in return, post a sign on the flower vase stating where the flowers came from. Always try to create alliances with local businesses!
And, call your mom. I know, not all of us can. So, thank the moms you do know.
They take care of us and our future.
Here’s to moms!
Ed
*https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name
Another post on moms! https://www.goaldriven.com/post/call-your-mom
At least half of your marketing success lies in how it is organized and managed. Short-term advertising or special promotions can work. But like a sugar rush, they don’t last.
Good marketing is planned and consistent. Marketing by the latest bright idea, or what your school chum is doing in Kankakee, is, at best, a short-term fix. So, use these 2 tools, and over the next 6 months, your new patients and returning patients will improve.
Make a list of all your successful marketing procedures and events. Organize it by daily, weekly, monthly, and yearly. You could have 20 procedures or events, from calling the new patient after their first adjustment and treatment, visiting external referral sources, your monthly newsletter, and a reactivation campaign in October as part of National Spinal Health Month. You can even include smiling! 😊
Give this list to an assistant to manage. (Download a free sample below.)
Then, review it every month. Ask these questions and take action as needed:
While your Marketing List includes most of your recurring actions, the Marketing Calendar shows your future scheduled special events. This would include upcoming events such as workshops, a special promotion like a food drive donation, a paid advertising campaign, a patient appreciation, or a booth and march in the town parade.
This is your plan for the next 2-4 months. Update it at least monthly. Post it in a communal area for the entire team to view.
Why post it?
Remember- where is the marketing department? That’s right – THE ENTIRE OFFICE! So, everyone has a role in “selling health.” Everyone is in the marketing department.
Just do these two actions – review your list and complete the actions on it, and schedule your marketing events on a calendar and complete them – and your new patients and returning patients will improve.
While these tools are simple to use, your challenge will be to keep using them. This will require persistence and discipline. As I recall Harvey Mackay saying, “Knowing what to do is not the same as having the discipline to do it.”
Keep doing what works and schedule your success.
Seize your future,
Ed
Download a sample Marketing List of procedures and events. [Marketing List]
See also
If you continue to work on improvement, you will see results. That’s just physics — a reduction of Newton’s laws, which state that causes create effects.
And if you keep improving what you are doing to make the improvements, the results will be even better. That, too, is physics. (See pages 47 and 256 of the Goal Driven Business!)
However, the results may not always be what you expect, at least not at first.
For example, you start adjusting your patient for their lower back pain. When they started with you, they also had a limp. After several visits, they stopped limping, but their back pain, while better, was still annoying. In time, their back pain was relieved as they continued with their care.
But what about the fact that their limp is gone, their gate is excellent, and they can walk and even run more easily? Didn’t anyone notice?
I mentioned this to someone who coaches people on weight loss. She understood immediately what I said. She referred to it as Non-Scale Victories. NSV’s, she called it!
I have been following the graduates of our first Practice MBA program carefully. I am delighted with the results, but they were not entirely what I expected. I had expected and hoped that practice numbers would increase! Well, this has been happening, in fact, in some cases, Best Evers in years.
But other pleasant surprises have been showing up. For example, chiropractic doctors mention how their offices are calmer and friendlier than before. Another acupuncture office is successfully bringing on a second associate, and another is expanding its marketing reach in entirely new and innovative ways. Even old system problems that have been buried for years are arising and getting resolved.
These and other practice improvements were not directly addressed in our training. I have been consulting for over 30 years and have never seen results like this.
I was at first puzzled by what was happening. I think I finally figured it out. Here are three reasons:
Imagine what would happen if you stuck to your exercise program consistently for a year! Yes, you might lose weight, build muscle, and improve your agility. But can you imagine how it might also affect other areas of your life?
But, like exercise, practice improvement gets put off too often. We focus on urgent practice issues, but because improvement, while important, is NOT urgent, we can tend to put it off.
We also aren’t inclined to notice nonlinear beneficial outcomes.
So, one of the lessons I have learned from our Practice MBA program is that if we continue to work ON improving our practice and ourselves, if we just keep at it, successes will occur – often in multiple areas. When they do, they should be recognized and appreciated.
Keep improving – your office, your patients, and yourself!
That’s our goal!
Ed
You have a practice if you are a doctor or a provider of any service.
Sooner or later, many of you must also create and run a business that supports your practice. This is where practice owners struggle.
It seems simple enough, but there is a wide gulf between a practice and a business that supports a practice.
Let’s look at some key differences:
Goals:
Structure:
Scalability:
Succession and Sale:
I spent 8 years researching the chasm between the practice and business models. I discuss this in my book, The Goal Driven Business.
You need to have a practice, of course. I define a practice as: “A network of relationships that are developed and sustained through communication and service.”
And so long as you are operating at 60% or less of your full capacity as a provider, your business concerns are manageable. You have the time to adjust and treat your patients, chat with them, and go to Costco for supplies. You are essentially a part-time provider.
To operate at full capacity, you need to create a business structure.
But doing so is like going from propeller airplanes in the 1940s to jets that go faster than 767 miles per hour, which is the speed of sound. The conventional airplane’s dynamics falter and control is lost as the speed increases. Many pilots lost their lives as their planes crashed in an attempt to break the Sound Barrier.
Similarly, there is a structural barrier, an Organizational Barrier, that causes growing practices to hit and likewise crash or stall.
The ideal is to continue nurturing your practice while gradually building a business infrastructure that allows you to operate at full speed, increase your profit, and still provide excellent service and outcomes. And at some point, pass it on profitably.
Despite the onslaught of advertisers that brag about million-dollar business owners in health care, real money is made by building an enduring practice supported by a solid business structure.
Love your patients and team, and improve your service. Strengthen relationships. Then, if you want to grow, schedule time to work on implementing the structural components for a business vehicle that will take you to your goals.
Want help in doing this? Contact me any time. Link
And read The Goal Driven Business.
Seize your future,
Ed
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Laying the foundation for an enduring patient relationship
I had advised a chiropractic office we had been working with for over a year to implement a new patient onboarding checklist. For one reason or another, this procedure just couldn’t be applied.
The chiropractic doctor wisely took our Goal Driven Practice MBA program with his practice manager last fall. They completed the program in December, and since then, I have been keeping track of their results. In almost all aspects, including key performance indicators, the practice has improved: collections, visits, new patients, and harmony!
The office seems to have come alive calmly and professionally.
While the practice has improved for many reasons, it has also put in place, finally, a new patient onboarding checklist I have been encouraging them to use. (I think I am happier about this than I am about all the other wonderful outcomes they are achieving!)
There are many reasons to improve the quality of the first 3-5 days of your patient’s care. Some studies prove it, but you don’t need studies (see references below.) You have your own experiences that verify the importance of first impressions. Any time you go to a new restaurant or retail business, how you feel about your visit will determine how quickly you return – if you ever do.
You know this, and so does your staff. But, like with any set of procedures, they will erode! I call this Procedural Atrophy. I cover this in my book, The Goal Driven Business (Page 159).
Procedural atrophy starts without notice. It’s not deliberate, but little actions start dropping out here and there. You substitute rote and automatic responses that replace thoughtful and lively communication. After a while, you wonder why your patient retention is low (patient visits per new patient).
A strong solution is to create a New Patient Log. (Email me, and I will send you a sample.) The first column has the patient’s name. Subsequent columns are for specific actions to take on each NP over the first 1-6 days.
The front desk can keep the log up to date. The doctors review it at the weekly meeting or even at the morning meetings. This is a form of case management to ensure all new patients (and returning patients) are receiving the care they need. I recommend the log be kept on a hard copy sheet, even on a clipboard. Digital is OK, as long as it is kept up to date and reviewed regularly in a group.
Here are some items that can be put on the New Patient Log:
Check and date when each of the following are done.
Of course, ensuring these actions are done is just the first step. The next step is to see that they are done skillfully and with a friendly and engaged attitude. Rehearsing the steps on the New Patient Log every two or three months can help keep the onboarding system in tune and groovy!
Keep it fun — and help your patients achieve their goals,
Ed
Email me for a sample New Patient Log ed @ pmaworks.com
Cool References:
A study by Abrahamsson et al. (2017) found that patients who received clear information and education about their treatment plan had higher levels of adherence and satisfaction with their care. https://doi.org/10.1046/j.1471-6712.2002.00083.x
Deyo et al. (2018) demonstrated that patients who received follow-up communication after their initial appointment were more likely to adhere to their treatment plan and report better outcomes. https://doi.org/10.2522/ptj.2015.95.2.e1
A systematic review by Ganguli et al. (2016) highlighted the importance of addressing patients’ concerns and questions in improving treatment plan adherence and overall patient satisfaction. https://doi.org/10.1377/hlthaff.2017.1130
Spikmans et al. (2003) found that patients who received take-home materials and regular communication from their healthcare provider had higher levels of treatment plan adherence compared to those who did not. https://doi.org/10.1046/j.1365-277X.2003.00435.x
Consequences of poor onboarding practices:
A study by DiMatteo (2004) found that patients who did not receive adequate education or support from their healthcare provider had lower levels of treatment plan adherence, leading to poorer health outcomes. https://doi.org/10.1097/01.mlr.0000114908.90348.f9
Lacy et al. (2004) reported that patients who experienced poor communication or a lack of warmth from their healthcare provider were more likely to miss appointments and not follow through with their care. https://doi.org/10.1370/afm.123
A review by Martin et al. (2005) concluded that patients who did not feel engaged or supported by their healthcare provider had higher rates of treatment plan non-adherence and were more likely to seek care elsewhere. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1661624/
Schectman et al. (2005) found that patients who did not receive clear information about the costs and financial options associated with their treatment plan were more likely to delay or forgo necessary care. https://doi.org/10.1007/s11606-008-0747-1
—————————————————-
If your practice building efforts aren’t taking you to your goals,
there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.
The Goal Driven Business
By Edward Petty
Bravery is one of the themes of our practice manager training program.
Brave, Not Perfect is the title of an excellent book by Reshma Saujani, and also from her TED talk with the same title. She states that our culture influences girls to be perfect while boys can be wilder, take risks, and make more mistakes. She encourages women to be braver.
I think this can apply to us all.
But this newsletter is about a success story. A story of bravery and integrity. It is also to boast about one of our managers who recently graduated from our Goal Driven Practice MBA program for chiropractic and healthcare offices and demonstrated these values.
As the practice manager, she also does the billing in this office. The chiropractic doctor had treated a patient who had suffered a motor vehicle accident. She submitted the bill to a 3rd party, reducing the what was owed slightly as the doctor agreed to discount some of the services.
The 3rd party company came back and said they could only pay 70% of the bill.
This was the manager’s response:
“Good morning,
“Thank you for letting us know.
“We provided 100% of the care that our patient needed; therefore, we require 100% payment of our services we provided. The original discounted offer of $X,XXX is no longer valid.
“We have decided to pursue the full amount plus interest, along with any court/attorney fees if we haven’t received payment in the full amount of $Y,YYY by March 7th.”
“Thank you,
[Signature]
“Manager of Chiropractic Health Clinic”
She received the full amount before March 7th.
Be Brave — with Integrity and Humor
Be nice, be fair, but first, be brave.
This can apply to scheduling patients at the front desk. It applies to reporting on the patient’s condition and treatment plan options. It applies to promotions and advertising. It can apply to training and coaching for you and your team.
It takes courage to become a doctor, to start a business, and even to work as a professional in an independent healthcare clinic. It takes even more to succeed at doing so.
But hey, it can be fun. And it helps to have some humor.
Our manager made a copy of the correspondence with the claims company with a copy of the check. She gave it as a surprise to her clinic director, who sent me a text with the image of what she gave him. On the copy of the email, she included a handwritten quote from the classic comedy movie Princess Bride:
“NEVER GO AGAINST A SICILIAN WHEN DEATH IS ON THE LINE.”
Stay Brave and Goal Driven — and Have Fun.
Ed
P.S. Our next management and leadership training program begins this summer. We have been retooling it and upgrading it. Only 7 students will be accepted. If you are interested, please get on the Wait List, and I will contact you soon with more information. Click here for Wait List for our next Practice MBA
—————————————————-
If your practice building efforts aren’t taking you to your goals,
there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.
The Goal Driven Business, By Edward Petty
Improving Your Chiropractic Patient’s Experience
Advertising has peaked. We are awash in ads coming at us from every possible source. We are hit with anywhere from 4000 to 10,000 ads per day.* With AI and ultra-sophisticated forms of targeting, it’s almost totalitarian.
The new marketing is customer service or Service Marketing.
Advertising has its place, of course, if it is to the right market, with the right message, and the right offer. But with all ads, the low-hanging fruit gets picked quickly, and new ones are needed.
There are other avenues of marketing your chiropractic services, but the importance of world-class service and outcomes is more vital than ever.
You’ve seen the stats:
Nothing is radically new about these numbers, but it helps to see them again.
And Service Marketing is not really new. But I believe it is and will be the dominant feature that distinguishes you from comparable providers. This is because content marketing has flooded the market. Therefore, call it service marketing or relationship marketing, turning each of your patients into raving fans who become salespeople for you is an intelligent marketing strategy.
But you must deliver the WOW!
CUSTOMER AND PATIENT JOURNEY MAPPING
Customer Journey Mapping is a relatively new term that has been hatched over the last 10 or 15 years in marketing. While the term is new, the concept is not.
Customer Journey Mapping is a procedure used to visualize and analyze customers’ end-to-end experience as they interact with, in this case, your practice.
It is essentially a flow chart.
It starts with a prospective patient’s first call to make an appointment. What do they see when they drive up to your office, walk through the door, and are greeted? It involves mapping out every encounter and even the likely emotion your patient experiences through Day 1, Day 2, Day 12, and so on.
And how far do you take your patient? Is it 8 visits and done? Do you take them through Acute Care, Corrective and Strengthening, to Supportive and Wellness? Do you have a map for your patients and do they know it? What are the milestones along the way? Are your patients excited about reaching them?
IMPROVING YOUR CHIROPRACTIC AND HEALTHCARE SERVICE
One of the exercises I covered in my book The Goal Driven Business, which has always been useful, is a complete Day 1 and Day 2 walk-through. It is rehearsing your flow chart or patient map.
Everyone watches while someone acts as a patient. I have often done this and acted as a patient. I will notice things that everyone has taken for granted — the old poster from 1989 still on the wall with the Muppets, a dead plant in the corner, a dead smile on the front desk, no explanation when I am dumped off on a therapy unit. Staff start noticing things as well. Redundancies show up, so do poor handoffs between the front desk and the doctor or from the doctor to patient accounts.
Zeroing in on how the phone is answered, an exam is done, or a report of findings is presented, you can find many small improvements that make a big difference on how your patients experience your office.
(Want me to set this up for you? Schedule a time and give me a call.)
Creating your patient’s experience is your most important marketing activity. Mapping it and practicing will help you create raving fans — that will generate even more fans.
Keep improving,
Ed
*The average American encounters around 6,000 to 10,000 ads or brand exposures per day. Source: “MIT Technology Review” article by Michael Schrage (Aug 7, 2017)
*Customer service stats. X: The Experience When Business Meets Design, by Brian Solis
—————————————————-
If your practice building efforts aren’t taking you to your goals,
there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.
The Goal Driven Business, By Edward Petty