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.

BARC Basic Activity Recovery Cycle

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yoga helps chiropractic care and practice management

Otherwise known as taking a break

We need to take breaks.

Small breaks every few hours, longer breaks every week, even longer breaks every several weeks.

Our bodies and our minds require periodic interruptions from our work, according to the Basic Rest-Activity Cycle theory, as discussed by Loehr and Swartz in their book, The Power of Full Engagement. We need to take time away whether we agree to it or not, it seems.

The authors present evidence that supports this theory and explains this cycle as activity and then recovery.

They say:

“We can only push so hard for so long without breaking down and burning out. Stress hormones that circulate chronically in our bodies may be temporarily energizing, but over time they prompt symptoms such as hyperactivity, aggressiveness, impatience, irritability, anger, self-absorption and insensitivity to others.”

“We live in a world that celebrates work and activity, ignores renewal and recovery, and fails to recognize that both are necessary for sustained high performance.

“The simple, almost embarrassing reality is that we feel too busy to search for meaning.”

So take small breaks and then larger breaks to disengage so that you can better engage with your patients and with each other to provide better service.

And support your team to do the same.

I’m not promoting this so you can let up on your production goals or so that you can be nice to your team. Far from it.

Production goals (New patients, Visits, Collections) need to be balanced with organizational improvement goals. AND THESE need to be balanced with greater meaningful goals.

So take some time to surprise your kids with a fun adventure, have a long lunch date mid-week with your spouse, spend a day volunteering, or travel to Costa Rica to play in the waves and take in some yoga.

Like I’m doing now!

Carpe Futurum (Seize your Future)

Ed

How to improve performance by taking more breaks is thoroughly covered in my book The Goal Driven Business which you can purchase here.

Goal Driven Business

 

 

Individual Team Development Plans

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Tips on Creating a Goal Driven Chiropractic Practice

A Goal Driven team member training to create a Goal Driven Practice by Petty Michel Associates and Edward Petty

Helping your employees pursue their professional goals will help them also pursue the clinic’s goals.

How?

Think of yourself. If you are working on learning a new technique professionally, you might feel more energized.

Why? According to Self Determination Theory, each of us has an innate or intrinsic drive to achieve mastery and competence. We want to improve our ability to control the outcomes we produce to better achieve our goals.

I would also add that helping your team members pursue their personal goals will increase their energy to do the same for the clinic’s goals. So again, think of yourself. Looking forward to that hunting trip, that vacation with your kids to Europe, or getting in shape at the gym can give you more optimism, hope, and zest for doing your best at work.

As Vitktor Frankl says:

It is a peculiarity of man that he can only live by looking to the future.

A Goal Driven clinic is systematized and motivated to achieve its goals. It achieves this partly because it takes into account different survival energies: the patients, the practice, and each employee.

At the first of every year, besides setting clinic goals, the clinic director can meet individually with each team member for a goal-setting meeting regarding their career and professional goals. (Download sample Individual Development Plan forms)

Staff members might be interested in different subjects, such as anatomy, human behavior, customer service, or marketing. Perhaps there are certification programs for staff. Meet with your doctors as well: what areas do each want to explore and study?

Work out the goals, then discuss different approaches to achieve these. Then, check back in 6 months on their progress. The practice manager can ensure that this happens.

You can also discuss the personal development goals of each team member. For example, perhaps they wanted to try a new sport, take a unique vacation with their family, or learn a new language.

This holistic approach to leadership and management is part of what we call the Goal Driven System.

Help your people achieve their professional and personal goals, and they be more energized to do the same for the clinic to achieve its goals.

 

Your Patient’s New Year’s Goals

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Your patients’ goals are why we are here.

They are why your staff came to work today and why you went to your last licensing seminar.

Your patients’ goals are why you have a practice and are in business.

So, what are your patient’s goals? What do they want?

On the surface, it is usually to relieve discomfort or pain.

So, like you do, after your initial consult, exam, and imaging, you tell them the cause of their pain and present your treatment program. They nod in agreement, and you begin care.

But when the patient sees the staff member to work out their finances and scheduling, they may have a glazed look and not be too sure what you just told them. Something-something about submarines, or joints, or spondy low dices.

The next week you wonder where they are. Your front desk does recalls. You spend money on more marketing to get more new patients.

You may have experienced a version of this in the past.

And at home, the patient may even feel that they got what they wanted or thought that they wanted. Maybe they feel better. But did they really get what they wanted?

There is a quote questionably attributed to Henry Ford: “If I’d asked customers what they wanted, they would have told me, ‘A faster horse!'”

I get the point. But what people wanted, though they did know about a Model-T, was to travel faster with less horse poop.

You know that four adjustments, in most cases, won’t provide the health solution that the patient needs. But your patients don’t know what you know!

Was that why they didn’t come back for another visit, because you didn’t educate them enough? No.

Was it that you did not motivate them enough? No.

An excellent book on sales that I recommend is by Harry Browne, The Secret of Selling Anything. Brown points out that people are already motivated. 

You don’t have to motivate your prospective patient when you initially see them. You just need to discover what is already motivating them.

This takes place in your initial consultation and history, which I feel is the most crucial part of the new patient onboarding process.

Brown offers these three steps.

  1. Discover. Discover through intense listening what they want. For example:
  • What do you consider most important for you about your health?
  • What do you think is the biggest problem regarding your health?

These questions, and others, open the door to understanding what the other person wants. And if they know you understand them and are authentically interested, they will be more inclined to listen to you and trust you.

  1. Summarize. The second step is to summarize what the patient said about what they want. This brings out what they said on the table so that you both can agree. For example:
  • So, as I understand it, you are looking to get rid of the pain, not for just a week, but altogether so that you can get back to playing polo with your grandkids, correct?

Now you both can agree on what they want.

  1. Solve the problem. The third step is educating them on what you have found after your exam and imaging. But you direct the education to exactly what they especially want. Now they are interested because you are addressing the motivation that they already had.

This is a simple procedure that is genuine and caring. Not always easy to find these days, so you will stand out from others by using this method.

I would even spend time now and then rehearsing this. Even the pro’s practice.

Brown is not the only person who has offered this procedure as it is so fundamental. But we can never be reminded of the basics enough. He also said:

…the secret of success is:

 Find out what people want and help them to get it.

Help your patients achieve their goals in 2023, and they will help you achieve yours.

Seize 2023!

Ed

The Future

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It is a peculiarity of man that he can only live by looking to the future.
(Viktor Frankl)

Traditionally, the first of any New Year is an excellent time to take stock of the prior year and make plans for the year to come.

Goals

In business, there are two (three, but for now, we will look at two) types of goals for your business:

  • Production Goals
  • Organization Goals

Setting production goals for where you want to be 12 months from now is the easy part of goal setting. The hard part is working out the organizational support you will need to achieve your production and collections goals. It could be more than you think!

But keep this in mind:

chiropractic and your services are never the primary barriers to practice success.

It is always management. It is the administrative issues connected with organization, including marketing, that gum up the work, gets in the way, slows your business down and holds you back.

Motivation

Part of management is managing your motivation. Yep… motivation needs to be managed. Keeping your spirits high and your drive strong is necessary for an organization to flow.

And this takes us back to your goals.

Visualizing achieving your goals will stimulate your motivation – and your drive. If you can’t see any way to your goals, well, that can be depressing. But if you can… if you can envision accomplishing your future goals, you will be motivated.

Viktor Frankl

I reference Viktor Frankl in my book, The Goal Driven Business.
Speaking of his experience in a concentration camp, “As we said before, any attempt to restore a man’s inner strength in the camp had first to succeed in showing him some future goal…”

He also said, “Even when it is not fully attained, we become better by striving for a higher goal.”

For your goal setting for the New Year, I recommend you start with your higher goals, the 3rd type of goal, which are beyond production and organization. For example, what brings you bliss? What gives you meaning?

  • Time with family and friends?
  • More vacations to more interesting places?
  • Going for the WIN of your best production and collections year ever?
  • Building a church?
  • Getting a diplomate in nutrition?
  • Improving patient outcomes?
  • Speaking out about health issues more?

Begin with these goals – the higher, wilder, richer ones. Then, look at your production goals, then your organizational goals.

I encourage you to dream just a bit and look at next year as your playground. What higher, richer, and wilder adventures would you like to accomplish?

Have some fun considering these types of goals and all the ways you would like to achieve them. This will add zest and a special spirit to your production and organizational goals.

Help with Your Future

We want to help you with your future. Your work is important, and helping you achieve your goals has been a driving force and a higher goal within our company for over 30 years.

For 2023, we have a few openings for our Private Client status on our Goal Driven Program.

If you are interested in working with us, please reply to this email, and we will schedule a time to talk.

All of us at Petty Michel & Associates want to help you achieve your goals in 2023

Seize the Future! (Carpe Future)

Happy New Year

Ed

Reference. More information on this is covered in sections in The Goal Driven Business, starting at page 19 and page 116.

Onboarding for New and Veteran Employees

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Just Focus on Goals and Expectations

The way you set up the initial relationship with your new employee will directly determine how well they perform in the first year of employment.

I don’t think that this is given enough consideration. You are in a rush to fill a position, and once you have done so, you are now just happy that it is done so you can get back to seeing your patients.

The new employee is given some training, but since everyone is busy, it is very brief and short-lived. As a result, the productivity of the new hire is held back.

New employees are not like plug-and-play appliances. Everything is new to them. The staff, the patients, the jargon, the flow of traffic, the procedures — all these which you take for granted, are to them, new.

The prospective new staff member never really knows what they are walking into. Is this going to be their best or their worst work experience? So, despite their smiling cooperation for the first few weeks, underneath, they may be worried that your business is not for them.

It can take 8 to 12 months for a new staff member to gear up to full capacity and performance. But the critical period in my observation is the first three months.

Orienting, training, and acclimating the new employee to their new job, new team, and new business is called onboarding.

Onboarding – the First 3 Months

You want each team member to be happy working with you and operating at close to their full capacity. This is what you want for yourself, right?

Once you make the decision and the new person is hired, your management work just begins.

A systematized onboarding procedure helps the new employee feel safe, that this is where they belong, and that they are important to you and your office.

As a result, a deliberate onboarding process will “increase new hire retention by 82% and improve the productivity by 70%.” (zippia.com)

I have seen this in action – both the right way and the wrong way!

We provide an onboarding checklist for our clients (which we are updating), but here are some fast tips:

1. Checklist. Assign the new employee a list of actions to be completed over the first 3 months that include orientation, study, and training. The checklist should also be assigned to a veteran staff member to help the new employee get through the checklist.
2. Ongoing meetings with the owner/doctor. You want to have the new employee have a good understanding of you and your history, goals, and plans to achieve them. Do this over lunch or coffee.
3. Relationship with goals. You want the new employee to have a relationship with the goals of the office. Go over:

a. The mission of the clinic and why this is the mission.
b. The clinic and team’s values. Who we are and how we are. (For example, we are care-aholics!)
c. The outcome of the clinic’s services. For example: happy, healthy patients.
d. Mission and outcome of their specific role.

4. Expectancy. They need to know that achieving the goals for their specialized role is what is expected. How they do it is important, but that they achieve them is most important.
5. Regular (weekly or biweekly) coaching reviews.

Re-boarding

You can do a version of this every 12 months with your key veteran staff. Why not?

Next to your skills, your reputation, and your patients, YOUR PEOPLE are your most valuable asset in your practice. Take care of them, especially when they begin, and they will help you take care of the practice.

Ed

 

Practice Fundamentals – Communication and Control

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“Get the fundamentals down and the level of everything you do will rise.”
— Michael Jordan

It’s always the basics. The fundamentals.

This is what all efforts to improve performance – and health — go back to.

All of your efforts in practice management boil down to communication and control.

All the books on procedures, patient management, and practice management can be distilled down to communication and control. Those are the basics you need to get to your goals and those of your patients.

  • Doctors, and staff, that have excellent communication with their patients have many referrals and a busy practice.
  • Doctors who communicate well with their staff have a happy and full practice.
  • Doctors that have positive control with their patients see their patients succeed.
  • And business owners that have proactive control over the office – are prosperous.

Of course, the inverse of these facts is also true. Whether out of fear, confusion, or fatigue, when these fundamentals are not administered, things don’t go well.

Communication

I was recently helping a doctor and the practice manager improve their patient financial consultations. The manager and doctor had worked out what to say that they liked. They called it a “script.”

A few months passed, and I noticed their patient retention had not improved. Neither had collections or other metrics. When we did some training on how the patient consultations were performed, we found that the staff focused on the memorized script, not the patient. Their communication was robotic, and they never got to know the patient. We replaced the script with a simple outline and let the staff get to know the patients. Visit average and collections improved.

Good communication is alive, interested, and empathetic. It results in understanding.

Control

Another office we worked with complained about low collections. They had plenty of new patients — the veteran doctor got great results. After investigating, we found that the report of findings and treatment plans were rarely completed, and scheduling was hit-and-miss at best.

And that’s not all. The doctor and staff often came to work just a few minutes before patients came in. Sometimes they came in late.

This office was out of control — and so were the patients.

Positive control is moving a project, patient, or condition from one status to a predetermined goal. This is what a procedure does. A well-run business has procedures, protocols, and systems that it adheres to achieve its daily and weekly goals.

Management

Management is implementing effective procedures, with excellent communication, to achieve goals.

In all your practice improvement efforts, check first if the procedures are being done, and then if they need to be improved or removed. Then, look at the quality and quantity of communication used to implement the procedures.

Improve the fundamentals — your patient and team communication and control — and you will have a prosperous and happy 2023.

Seize your future – with a smile!

Ed

What gets measured gets done

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Your Goal Driven Analytics Scoreboard

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

Sometimes you think things are worse than they are.

But then again, sometimes you think things are going better than they are. And then, BANG! Poop hits the fan!

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

Your Scoreboard

Your numbers are the best indicator of your Key Performance Indicators. They are your dashboard. Your Google maps. Your altimeter, as you take your business off the runway and up towards your goals.

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

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

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

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

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

Unfortunately, most offices do not keep clear and consistent track of their numbers.

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

Here are some fast tips for your stat analysis scoreboard:

  • Key numbers. Monitor numbers week-to-date and month-to-date, especially new patients, visits, charges, and collections.
  • Individual providers. If you have multiple providers, find some way to measure their production. This can help both of you manage performance.
  • Percentages. Use percentages, such as visits divided by new patients, to give you an idea of how long your patients are staying with you.
  • This year to last year. You should be able to compare this year-to-date with last year-to-date.
  • Line charts. We use line graphs plotted over a couple of years. These clearly show what is trending — up or down.
  • New patients. Track the sources of your new patients as well as the types of new patients.
  • Weekly reports. Have someone in your office give you a daily, or at least a weekly and monthly statistical report.

Keeping statistical analysis in place has proven so valuable for offices that many clients have asked us to keep providing their stat analysis for them years after completing an intensive service with us.

While this is not a major service we offer, we realize how useful it is in our Goal Driven System of management.

Therefore, we have decided to start offering our Goal Driven Analytics program as a service to more offices.

We are only taking 5 new clients on this program for now, first come, first serve.   It is moderately priced and, as most of our clients can verify, managing by the numbers is invaluable. To learn more about the program, we’ve posted some more info, with the link below. If interested, just reply to this email, and we can set up a time go over the details.

But whether we provide you with your statistical analysis or you set it up yourself, I can’t recommend a more valuable management tool for managing your business profitably. Not only is it effective, but it is fast!

Your analytics scoreboard will help you smoothly navigate to your goals.

To your greater prosperity,

Ed

More info on the Goal Driven Analytics Scoreboard.

Grateful for the Future

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Gratitude is not only the greatest of virtues, but the parent of all others.
(Cicero, Prolancio, 100 BC)

As many of us in the U.S. prepare for our annual Thanksgiving events, I wanted to offer a short perspective.

Daily events challenge us, and we struggle to deal with them as best as we can. Events in our offices as well as in our communities, country, and the world can be daunting.

So, it helps to pause, more often than we do, and appreciate the advantages we have from those who have come before us. Likewise, to be grateful for the people we know: our family, friends, and those with whom we work. And, of course, our patients. In small ways and large, we all help each other.

But I also want to mention our future and the opportunity it gives us all.

As we move through the Holidays and winter sets in up here in the Northern Hemisphere, the New Year comes at us again too soon. We live in uncertain times, but as business owners and health mavericks, now is not the time to hunker down as if to hibernate and hope that any storms that occur may pass us by.

They won’t. But we can prepare and seize the opportunities that lie ahead.

Forward-minded entrepreneurs always find a few new approaches to making things better while many business owners remain on the sidelines, wary of jumping into the game and fully committing.

The future offers us the opportunity to play and enjoy the thrill of creatively making a difference, however difficult.

So, enjoy the Holidays, and all those close to you, near and far, in the present and respects to those who have passed. Take time to nourish yourself and those around you. There truly is much to be thankful for!

But while doing so, also appreciate the freedom we all have to make a better practice and a better life in the years to come.

Seize the Day and Seize the Future. (Carpe Diem, Carpe Futurum)

With Gratitude for all you do,

Ed, and all of us at Petty Michel

Health Never Takes a Holiday

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fitness santas

Let the parties begin!

It’s beginning to look a lot like that special time of year. That very busy time of year with parties, food, traveling, shopping, cooking, and extra tasks.

A wonderful time of year. BUT…, please remind your patients that

Health Never Takes a Holiday!

They shouldn’t stop brushing their teeth, taking showers, or taking a pause from their yoga classes! These are all health activities that are just as important as their health program with you.

Yes, it’s OK to have an extra slice of pumpkin pie, stay up a bit later wrapping presents, or have a few drinks with an old acquittance, but encourage your patients to stick with THEIR health program.

Stopping and then starting again is tough. You lose your gains and momentum… so it is easier to just keep the ball rolling.

You can make a poster to help you remind your patients to keep working on their health. It also reminds you and your staff to keep your patients on track. Add something to your newsletter or a whiteboard with your Table Talk.

And in the spirit of the Season, you can click below to download free customizable sample posters for your patients. (We have many posters and patient scripts for our clients.)

Keep your patients Goal Driven to improve their health for a happier future!

Then, keep calm and party on!

Ed

Link to Posters- Health Never Takes a Holiday

Chiropractic Patient Education Prompters – Table Talk Grows Your Flock

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Imagine this scenario:

Written on a white board near the chiropractic patient adjusting area:

Last to show and the first to go.

Patient: Hey Doc, what does that mean, written on the white board there?

Doctor: Hi Sam, glad you asked. Just a reminder for me to explain that pain usually shows up after a health problem is present for a period of time, and usually goes away or lessens during the early part of our program of care. In other words, the pain can go away but the issue that caused it can still be present.

Patient: Oh, I got you! So, even though I am feeling much better, I better stick with the program, is that it?

Doc. Yep!

===

You know patient education is important. It improves outcomes. It improves retention. It improves referrals.

This is a simple procedure to improve your patient education: Assign a creative staff member the task of writing images or sayings that prompt the patient, or prompt you, to talk about a health subject. That’s it!

It prompts TABLE TALK.

Table talk is the BEST form of patient education and, for that matter, promotion. It comes from you, the doctor, during the most transformative time in your office.

Here are a few sample subjects you could post on a white board near your adjusting table:

  • How does chiropractic work?
  • Above Down Inside Out
  • Dr. You
  • Does chiropractic help with headaches?
  • Last to Show First to Go
  • Time, Repetition, Effort! [It takes time to restore your health, it has taken a long time for you to get into this condition. It takes repetitive work, like orthodontics. We will give you our best effort, you will have to do the same,]

Add a drawing now and then:

  • How is pain like an iceberg? (Draw an iceberg. [Iceberg Symptoms on top of the water, cause below in the water.]
  • How is spinal health like a rusty hinge? [This is when your vertebrae wears away when it becomes stuck.]
  • What happens to your tires when they are out of alignment? [Disks wear out faster like tires out of alignment.
  • Car Parked a garden hose. [When the hose is stepped on or kinked the water does not flow 100%. The same is true when you have a subluxation and your nerves are impinged. This affects everything your nerves are connected to.]
  • Safety Pin.
  • Orthodontics.

Just so you don’t get too serious, add a joke now and then:

  • I had to turn down the landscape company today…

****They wanted too mulch

  • The bartender says “Sorry, we don’t serve time travelers in here.”

****A time traveler walks into a bar.

===

This procedure doesn’t cost you. Like chiropractic (or our consulting!), it pays!

But only do it for two months at a time, otherwise it will lose its novelty for you, the staff, and patients. Run it 2- 3 times each year.

Once a month, meet with your team and come up with some new patient education prompters. This is also another way to educate your team in the process.

Keep the conversation going.

The more they know, the further they’ll go.

And seize the future.

Ed

Improving Patient Follow Through: The new patient log and checklist

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Working with different offices, we are always reminded of the fundamentals that apply universally. For example…

Once your patient has committed to getting better, it is your job, and everyone else on the team, to help them achieve their goals.

But in the busyness of everyday office interactions, essential steps along the way can become abbreviated or dropped out altogether.

At one office I recently visited, the patient visits and income were diving downward on a monthly trend. And this was occurring even though the new patient volume had been pretty steady.

When I inquired with the front desk staff, they told me that patients were sick, had money problems, were busy, and blah blah blah.

I asked if this was a new phenomenon. Did patients suddenly become poor, was there a new pandemic? What?

Didn’t get any real answers, as they were busy on the phones doing recalls trying to get people back in the office. The doctor wasn’t sure what was happening. To his credit, he loves adjusting and focuses on providing outstanding care – which he does, usually at a high volume.

Long story short, after investigating, I discovered that the doctor had changed up his treatment procedure slightly, and staff positions had changed. As a result, new patient financial consultations had dropped out. The patients had been getting excellent care but had no idea about their payments and were only scheduled for one visit at a time.

This was a pretty big change! A critical procedure just silently disappeared without anyone really noticing. (Sometimes it is hard to see the forest for the trees. Plug: Consulting doesn’t cost. It pays!)

Everyone at the office is a veteran, hard-working, and goal driven. A great team. But this missing procedure was costing them thousands and preventing patients from getting the full benefit of care.

We implemented several solutions that have worked for other offices.

One solution was the New Patient Log and Checklist. I gave them a sample to customize. It is a lined sheet on a clipboard. Each new patient is listed vertically on the left column, followed by other columns stipulating key actions that should occur on each patient. The Log would include such things as:

  • Report of findings and Tx Program.
  • Multiple appt. card.
  • Financial Consult.(When, by whom.)
  • First adjustment call.
  • Attend NP workshop.
  • Source.
  • If referred by patient, what is pt.’s name?
  • Thank you card to referring patient?
  • Type [ WC, PI, C, etc.]

You could add more columns, but the most vital aspect of this Log is this: it must be assigned to someone. You and the team can review the NP Log during your morning meetings or at weekly team meetings.

One of the lessons here is to always look for what you and your team are doing or not doing before you look to the environment for why your practice may be slipping – or booming!

And help your patients achieve their health goals by ensuring that they complete all the steps necessary along their health journey to achieve their goals.

Stay Goal Driven for a happier future!

Ed

PTC and the Subtle Art of Being There

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It was in the 80s at a Parker Seminar, which was in Reno that year, that I first heard the term.

In the opening session, Dr. Jimmy Parker talked about PTC. I was attending as a guest with a chiropractor who introduced me to chiropractic. What an introduction!

Dr. Parker explained that PTC stood for Present Time Consciousness. (Parker had quite a few of these abbreviations!) He explained that a doctor could deliver a much better adjustment if their attention on the patient were in the present time, not thinking about past issues or on future concerns.

I have come to learn that this is a vital but easily overlooked skill.

You can tell when someone is 100% paying attention to you, or maybe not quite, or maybe not at all. And this makes all the difference in the patient’s trust in you, how long they stay with you, and whether they refer others to you.

But maintaining PTC can be challenging in a high-volume chiropractic office or any health office. How many thousands of adjustments does it take until all patients start blending into to one?

A doctor who worked with Clarence Gonstead told me about one evening when he was shadowing Dr. Gonstead. It was around 9 p.m., and the reception/waiting room was full. The doctor said to me that he exclaimed to Dr. Gonstead that his waiting room was still filled with patients. He said that Dr. Gonstead turned to him in the hallway before they went in with the next patient and said, emphatically, “No. I only have one patient, and that is the one I am with now.”

That sounds like he was present with each patient, and perhaps that is at least one reason he was so successful as a chiropractor.

I have seen more than a few techniques, or hacks, that help keep doctors, and support staff, in the present with each patient. For example

  • Completing the visit.  Some doctors soundly end each visit, often confidently saying, “That was a good adjustment, and I am satisfied.” Ending one visit before starting the next visit creates a micro-break, a little space between visits.
  • Break up the day. Different approaches to breaking up the day seem effective. For example, busy offices usually have varied but ritualized lunch breaks. These might include such activities as weight training or exercise, marketing, team workshops, lunch with the spouse, guitar practice, you name it. Mid-morning and mid-afternoon 5-minute breaks can also be helpful. (Stay away from social media!)
  • Remove distractions. You want to remove distractions that can pull your attention to future challenges or past mix-ups.  Pre-shift and short weekly meetings can be helpful in this regard by sorting out administrative issues so that you are free to focus on patients – in the present.
  • Cricket clicker! I remember one doctor telling me that he used a steel clicker, a “cricket clicker.” He would click the clicker just before the next patient visit, which would help him mentally begin the next visit.  (Whatever works!)

I suspect that this is a high-level technique. One for the masters. It can’t be canned. Perhaps it is beyond technique. When accomplished, when you are totally present, the patient innately feels that you are there for them and them alone, and this perhaps speeds their recovery.

I would be interested to know how you maintain Present Time Consciousness. You can add your thoughts here on our blog.

Staying engaged in the present for a better future!

Ed

The power for creating a better future is contained in the present moment:
You create a good future by creating a good present. (Eckhart Tolle)

In Praise of Geekiness

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Are you a chiropractic geek?

Are you a health geek?

Here is Merriam Webster: Geek: “…a person with a high level of knowledge or skill in a field…” “an enthusiast or expert especially in a technological field… [The word geek has] seen increasing use with positive connotations, showing membership in a specialized group (film geek, beer geek) rather than social awkwardness.”

I like the word geek because it indicates someone who specializes in a field and is so engaged that they are not especially concerned with keeping up with what is accepted conventionally. In other words, they are a bit of a rebel.

Steve Jobs, for example, was a geek. A core value of Apple was a “power to the people” idea, that anyone could have a personal computer, not just the big corporations.

Wouldn’t Clarence Gonstead have been a geek? It would be difficult to find many chiropractors who were, or are, as engaged in chiropractic as he was or worked as hard.

I remember years ago when talking with a chiropractor over lunch and all he could talk about was the X,Y,Z axis, something about Euclidean geometry, and bilateral symmetrical function. I was trying to keep up! But there he was, in practice for over twenty years, talking excitedly about the last few patients he had seen. He was a chiropractic geek, for sure.

He also had a million-dollar practice with a very strong practice manager.

Great athletes are geeks in their field, studying and training harder than most. Same with musicians or chefs.

But it is easy to get distracted from your game. Collections, bills, staffing, procedures, marketing, insurance, taxes, and everything that goes along with running a business can cut into your productivity and dilute your concentration on your services.

Don’t let it.

Only the offices that give the highest quality services and deliver the best outcomes will survive, let alone thrive. Organize your administration such that it does not dampen your eagerness to engage with each patient, and continue to study and enhance every detail of your clinical skill.

And as a plug, this is why I wrote the Goal Driven Business – to help doctors be doctors, unfettered by administration, and free to express their skills and interests in their profession.

Organize your office so that you can focus on the science, art, and philosophy of your profession. Do so that you can look at chiropractic and its results newly each day, as if you just discovered its powerful potential to help people become healthier. Go deep on every level and rediscover your profession again, for the first time.

Be a geek.

Goal Driven to seize the future,

Ed

Case Management for Better Service and Retention

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Start Each Day with Service First

Do you want a fast, simple and very effective procedure that

  • Improves patient retention
  • Improves patient referrals
  • Improves patient service
  • Improves team coordination and morale.

Beginning Each Day With Service Goals for Each Patient

Too often, we start our days by first looking at the appointment book when the patients are already waiting for us. The staff may not know what special needs each patient has, or they may have been told something by a patient that should be passed on to the treating chiropractor.

A brief review of each patient can help coordinate patient services with the entire team.

Case Management Meeting Procedure

Meet with your team about 20 minutes before you see the first patient each morning. Review the patients individually that are coming in that day. You may not need to go over every patient, especially if you have a full book.

Discuss each patient and what the goal of their next visit should be. Do they need therapy or rehab procedures? What kind? Is it time for their progress exam? Did they voice a concern to a team member that you need to know about? Do they need another financial consultation or educational materials? Should they bring in their spouse?

You can also discuss new patients – what do we know about them? Are they a friend of Rihanna or Marge Simpson? Do they live in the high-rent part of town or in a trailer down by the river? Are we all looking forward to meeting them?

More Than Case Management – Keeping It Fun.

Aside from case management, the morning meeting helps get the day started. Everyone can see how each other is doing, say Hi, and be on deck all set for the day.

I have seen chiropractic offices do short exercises (practice what you preach!), such as a plank or wall sit exercise.

I have seen jokes told. For example, everyone is assigned a spot on the Bad Dad Joke Rotation. One joke per day. The most joke for the week (the best one) gets free lemon and beet juice!

You can set reasonable goals for the day – new patients, visits, case completions, etc.

You can add a motivational quotation or review the mission or a core value.

I have personally seen this applied in many offices. Often, the primary chiropractor would get to the morning meeting first, and anyone who came in late was duly noted!! One office did this procedure in the morning and then again before the afternoon crowd came in after lunch.

Assign this as a procedure to your manager, case manager, or front desk coordinator. But make sure you support it 100%.

I have seen case management meetings work for a few months and then, like many procedures, fall by the wayside.

It only works if it is done.

In the end, everything we do is to help each patient reach their goal of better health, and this is the ultimate goal of case management meetings.

Over to you!

Carpe Posturum! (Sieze the Future)

Ed

Goals, Motivation, and Discipline

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“People often say motivation doesn’t last.
Neither does bathing — that’s why we recommend it daily.”
(Attributed to Zig Ziglar)

I want to thank you for continuing to subscribe to this newsletter.

It has morphed into a kind of Tuesday’s Tips for Goal Drivers.

It includes weekly practice development tips, reminders, nudges, and even sometimes…insights. We include what we have seen that works, or doesn’t, in all types of chiropractic and other offices.

This newsletter has gained momentum over the last year from the publication of my book, The Goal Driven Business. It is written for that part of us that strives to achieve our goals.

The value of goals just can not be overstated. But “goals” cover a wide range of concepts and so can become confusing or even worse, boring.

But by frequently reconnecting with WHY you do WHAT you do, what you do becomes easier and more effective. And even more fun.

Why you do what you do is your motive — or your motivation.

Motivation to achieve your goals is senior to organizational procedures — but still needs organization to support its drive. When organization fails, as it often does, motivation is weakened. And organization is directly dependent on having the discipline of doing what needs to be done.

I don’t see the subject of discipline brought up too often in practice management conferences or discussions. It’s embarrassing, perhaps. Whether it is coming in late to see patients, not doing a thorough case review, or neglecting your support team, the little oversights can take a toll on our motivation.

Attending new seminars can give you a temporary buzz and momentarily motivate you. But unless you and your team have the discipline to stick to your values and procedures, the drive to your goals will lose its energy.

In his book Good to Great, Jim Collins talks about how successful businesses create a culture of discipline. He says, “It all starts with disciplined people…Next we have disciplined thought. You need the discipline to confront the brutal facts of reality, while retaining resolute faith that you can and will create a path to greatness.” “Finally, we have disciplined action.”

In a less academic way of saying the same thing, Mike Rowe said, “Work ethic is important because, unlike intelligence, athleticism, charisma, or any other natural attribute, it’s a choice.”

The way to stay motivated is to stay true to your mission, values, and procedures and to frequently take time to face the “brutal facts” of your performance and your WHY.

Like bathing, the process never ends… and keeps you clean!

Seize your future,

Ed

Reactivation: Fast, easy, and healthful promotion.

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This promotion has rarely failed. It is simple, fast, and not gimmicky. It is aimed at patients who have not been in for a while.

Patients drift off, and life gets in the way, but your patients still know you, like you, and trust you. And, like all of us, they could now use a nudge to improve their health.

So why not send them a personal letter? In your own words, tell them to get their rear back in here so they can stay in the best of health for the winter months.

Special promotions work best if they are linked to a genuine cause. In this case, the cause is National Chiropractic Month and also the fact that you have a sincere desire to ensure that people you have seen in the past continue to do well.

Special promotions also have an offer. It could be a free service or a discounted service, or the fact that your payment will serve as a donation to a worthy charity. It could also just be special Halloween organic pumpkin cupcakes from your local bakery (give the business a plug for a discount!) when they come in.

Make the offer for the entire month of October, or perhaps just for the last week.

Headline the letter with something like

It’s Chiropractic Checkup Time

October is National Chiropractic Month

You can then, for example, use your own words to say:

Our records indicate that you may not have been in to see us for a while. If that is the case, I’d (for multiple doctors – we’d) love to see you and like to offer you…[your offer.]

Remember, postural and spinal problems are often present long before any pain occurs. Therefore, getting a periodic chiropractic exam is good health insurance to ensure you remain healthy. Chiropractic is great for helping with back pain, headaches, arm and leg pain, and many other problems.

But even if you aren’t experiencing pain now, don’t wait until you have a problem. I sincerely believe the old saying, “An ounce of prevention is worth a pound of cure.”

You can also encourage them to make appointments for their family and friends.

Even if you have all the patients you can handle, this is still a good reminder for those you have seen to stay healthy.

Because that is their goal as well as yours.

Seize the future,

Ed

Going Public or Going Purpose

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Be like a juvenile delinquent!

The chiropractic model for care follows three main stages, according to many patient educational articles. These are 1) Relief, 2) Correction and 3) Maintenance and Wellness.

I am sure it could be nuanced into other levels or worded differently, but these three make sense to me — so much that it inspired me to write a book – The Goal Driven Business.

But I had another inspiration.

I read a book about a young French-Canadian rock climber who lived in Southern California and was not finding the equipment he needed. So, he became a blacksmith and started making his own. In the late 1950s and ’60s, he started the Chouinard Equipment Co and made climbing gear for other climbers. He also wanted better outdoor gear, and so founded Patagonia, a clothing company.

The name of the book was Let My People Go Surfing. It was by Yvonne Chouinard and tells the story of how he grew Patagonia.

Patagonia, now a 50-year-old company, has done very well financially. It has also done very well for the quality of its products and services and its employees. But it is also driven by the goal of making Earth healthier.

Patagonia demonstrates three goals I believe every business has: 1) profit, 2) expert service and people, and 3) higher purpose. In my book, I reference examples of how the best companies focus, knowingly or unknowingly, on these three goals.

The best offices I have worked with over the years have also been committed to these three goals. They cared about providing the best service to their patients, but also to their staff. They were committed to helping as many people as possible be healthier. And, of course, they insisted on profits.

Chouinard, with his family, own Patagonia.

That is until this month. Valued at 3 billion dollars, Chouinard announced that they are giving the company away. He could have sold it to … Amazon, for example, or they could have made it a public company. Instead, he donated it to a fund called the Patagonia Purpose Trust. He says, “Earth is now our only shareholder.”

“Instead of “going public,” you could say we’re “going purpose.” Instead of extracting value from nature and transforming it into wealth for investors, we’ll use the wealth Patagonia creates to protect the source of all wealth.”

I encourage you to look into Chouinard’s lessons on business, which he acquired through trial and error as we do! I have some links over on the blog (see below.) There are many business lessons to learn by studying the trials of other business owners in different types of businesses.

But I guarantee you that if you commit to these three goals, in the long run, just like with your patients, your business and your life will thrive.

And one other note!

I think ol’ Yvonne would have been a natural chiropractor. He reminds me of you guys. In an interview in 2017, he says:

“One of my favorite quotes is if you want to understand entrepreneurs, study the juvenile delinquent because they’re saying, you know, this sucks. I’m gonna do it my own way. And that’s what the entrepreneur does. They just say this is wrong. I’m gonna do it this other way. And that’s the fun part of business actually.”

So, have fun, and seize the future,

Ed

For links and other references, go to our blog here: Goal Driven

Ed Petty in front of Chouinard Equipment Company, Ventura California

 

Patagonia home page
https://www.patagonia.com/home/

Interview with Chouindard
https://www.npr.org/2018/02/06/572558864/patagonia-yvon-chouinard

News articles
https://www.reddit.com/r/climbing/comments/xebzib/yvon_chouinard_gives_patagonia_to_charitable/

https://www.inc.com/yvon-chouinard/patagonia-ceo-let-my-people-go-surfing-why-company-mission-is-not-profit.html

Book
https://www.barnesandnoble.com/w/let-my-people-go-surfing-yvon-chouinard/1124064053?ean=9780143109679

Are You Ready For Flu Season?

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Are ready for flu season?

Big Pharma is.

If you haven’t seen the ads yet, you will soon. And so will your patients and potential patients.

It’s just business. “The global influenza vaccine market size was valued at USD 7.02 billion in 2021. The market is projected to grow from USD 7.54 billion in 2022 to USD 13.58 billion by 2029.” (Market Research Report, Fortune Business Insights, Sept 2022)

So, what does this have to do with practice and business development?

Your Unique Selling Proposition

In a practical sense, you are the uncola of the cola healthcare world.

You are health doctors – not disease doctors or drug doctors. However you want to frame it, you can define what you do as different than the pharmaceutical alternatives in such a way that you stand out from the crowd.

Remember, it is not necessarily what you do that counts. It’s what you stand for.

You stand for natural health. As Simon Sinek reminds us, “People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”

Better Service and Better Health

In my book, the Goal Driven Business, I reference how consumers want more information about their services and products. Especially in this age of abundant and ready information. Patient education is not a chore, it is a service that, if it is well presented, patients appreciate.

But even more, you know about the immune system and what improves it. But natural approaches to boosting the immune system are not emphasized by the medical “information” that is promoted and posted. But you know better: adjustments, exercise, vitamin D, C, and all the rest. Acupuncture too!

It does take a little more time to educate your patients and community. But think of it as a clinical service that makes you unique and special. Think of it also as a marketing expense.

Pride and Purpose

There might be another reason to educate your community on natural approaches to viruses, one that is more personal.

You might feel that your patients and neighbors are being misled and that vital information is being kept from them. You may want to right this wrong!

And lest anyone tries to reframe you as unscientific, the leading cause of death is errors in medicine.(2)

So… the Flu Season is on its way. Go for it!

Enter the race and position yourself and your team as the good guys, the Natural Health Clinic that gets results. And by the way, don’t overlook that you all need to practice what you preach!

There is a very large portion of the population that is seeking a more natural lifestyle. Google search terms show strong interest in natural remedies. You will appeal to them — they are just looking for a health-oriented team to help them maintain and improve their healthy lifestyle.

Seize Your Future,

Ed

Links to the above references and others on the blog, here:

Learn how to create a Goal Driven practice that is more profitable and fun – get The Goal Driven Business

Preparing for Autumn

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“When you fail to prepare, you’re preparing to fail.”

John Wooden (QuoteInvestigator)

September is upon us, and Autumn is just ahead.

I encourage you to be thinking about your practice development plans for the last quarter of this year – October, November, and December. Let’s start with some fast ideas on promotions:

  • October is National Chiropractic Month (Used to be National Spinal Health Month). October 16th is World Spine Day. Not sure who comes up with these “Observances,” and I don’t really care. Don’t think it makes much difference… You can call October “National Get Your Rear in Here Month” if you want. I like to use the word “national” as it seems to imply that everyone now must comply and “report in.” It’s official, at least in your office.
  • November is a good time for “Cause” promotions. These are promotions that are linked to a worthy charitable cause that you feel genuine about. Word of warning: Don’t fake it. TV stations that promote “Toys for Tots” are so obviously insincere that I can’t believe they still do them. Find a charity that you and your team, and patients, want to support. Done right, you’d be surprised at how popular these promotions can be.
  • December is an opportunity to hunker down with all your patients, active and inactive. Parties, events, showing some gratitude and best wishes for the New Year.
  • Improvement Goals. Look at what you can do to improve clinic performance, including:o Continuing education for you.
    o C.E. for your team. Seminars, webinars, podcasts, books!
    o Team trainings in the office.
    o Individual team member training in the office.
    o Procedures: “How can we do this better?”
    o Software updates
    o Backlogs eliminated
    o Decor

• 2023 Sometime in November, you should also look at your plans for January. The New Year also approaches fast.

All this may seem a bit much to consider, but time waits for no one.

Schedule a couple of sessions this month with your team and do some planning.

GET PREPARED

And Seize the Future,

Ed

You can find links to references in this newsletter and more on our blog here:
https://www.worldspineday.org/

https://www.chiroeco.com/plan-now-for-national-chiropractic-health-month-2022-theme-announced/

https://pmaworks.com/observations/chiropractic-practice-marketing-ideas-for-fall-2016/

Staff as Support Professionals and Experts

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staff experts as professionals“No company, small or large, can win over the long run without energized employees who believe in the mission and understand how to achieve it.”
Jack Welch, former CEO Boeing

There is a direct relationship between motivation, skill, and the outcomes achieved in your practice.

One doctor we work with told me that, after being in practice for over 30 years, he is now getting better results than ever before. I have watched him continue to train, study, and practice his skills over the years. As a result, he feels he is on a whole new level of expertise. He has discontinued most of his external marketing efforts. He routinely sees 100 visits per day and has brought in another doctor to help.

But you, as the doctor, are only ½ of the equation. The other half is your staff. Even if you are the best in your state, if your team is not equally as skilled and motivated in their areas, the quality and quantity of your services will be impacted.

You want everyone on your team to be professionals on the road to becoming experts.

They may not know that this is what is expected. Perhaps they consider their job is, well, just a job. Some doctors refer to their staff members as secretaries or girls. I know! The early 1960’s still lingers.

A Big Shift from Employee to Expert

Make a shift in how your employees view themselves and how you view them as well.

I have been recommending to doctors that when they interview potential employees, they let them know that in 1 year, they are expected to give part of the lay lecture to patients on health care.

I also recommend that staff study and report what they learned at staff meetings. This lets them know that they ARE professionals, should be knowledgeable and need to take responsibility for what they know.

Also, teaching is another approach to learning, as in the adage: “To teach is to learn twice.”

To stress the importance of training, I sometimes ask a staff member to answer some basic questions about chiropractic when I am at a team meeting. For example, I might ask them to define “subluxation,” or “what are the effects of a subluxation,” or what does “pain is the last to show and the first to go” mean? Often, the staff member stumbles or can’t answer. After a tense moment, I lower my head and look at the doctor. Then, I help the staff member with the answer so they don’t feel bad.

I teach a specialized exercise program part-time. Have for years. I have learned that the student’s performance is directly linked to how well I have taught them.

Your Employees are Your Students

Your employees are your students. This is often overlooked by clinic owners and here is why: they are focused on just 2 roles — doctor and owner/entrepreneur.

However, there is a 3rd role most doctors are reluctant to fulfill, which is the manager or CEO.

As CEO, you are responsible for the training and coaching of your team and hence, their performance. This is a style of management sometimes called Servant Leadership or Servant Management.

You want and really need an expert support team. A team of experts support the doctors will greatly improve the quality and quantity of services and make your life much easier. To achieve this, you’ll need to take on the CEO role. At first, this may seem to add extra work to your already busy week. But in time, things improve.

Done right, you will have a Goal Driven Practice driven by a Goal Driven Team. Still, there are real barriers to becoming a Practice CEO and creating a support team of Goal Driven experts.

Look for our new program in 2023 where I will teach the Fast Flow CEO System as part of several Goal Driven trainings for next year.

And if you haven’t purchased The Goal Driven Business yet, do so. Required reading!

Seize your Future,

Ed

If you are interested in being part of a limited number of offices trained in Goal Driven Management and the Fast Flow CEO System, click here for updates in the months to come.[ special email category]