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.

Improving Patient Follow Through: The new patient log and checklist

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

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


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

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

“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.

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

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?

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

“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

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]

The Phone Experience and Your New Patients

I just read about a new study sponsored by a tech company (Invoca.com*) that sought to understand the buying habits of consumers better.

It revealed that as inflation increases, the expectations of customers do as well.

It pointed out that inflation has consumers rethinking their more expensive purchases, including health care. However, almost two-thirds (63%) report that they’re still willing to pay more to get better customer service.

While consumer shopping is based on price, they’re also demanding better experiences. The survey found that more than three-quarters of respondents (76%) said they would stop doing business with a company after just one bad experience.

When respondents ranked the possible reasons why they would stop doing business with a company, a bad phone experience was second only to high prices.

Another interesting fact I noted was that most consumers ranked the phone as their preferred channel when they needed help regarding a purchase. They may go to your website, but the vital moment occurs on the phone. Not texting, emailing, or even visiting the office in person, but the phone call is the preferred method of contacting you.

And the preferred use of the phone in the 2022 survey was up 8% since 2021.

How your patients and potential patients are treated on the phone has an enormous impact on your weekly practice numbers. I would estimate that up to 20% of your volume could fluctuate based upon the great experience or poor experience someone has with your front desk.

The ebullient nature of the staff person you have plays a key role, but so is that staff member’s experience while working in your office. For example, I have seen visits go up when a new happy-to-be-hired front desk staff member takes over the front desk, only to see the numbers dip after they become discouraged a few months later.

The front desk is the most demanding role you have in your office. They need to always be “on,” eager, and interested in phone calls while at the same time checking people in, collecting money, and chatting with patients as they can.

I have spent occasions rehearsing with the front desk on answering the phone. It is simple, but done correctly, it is an art.

Even if your front desk team are pros, positively rehearse with them now and then – tell them even the experts practice daily!

Constant improvement is the road to excellence, and excellent service is needed in our post-Covid world.

And in the end, all this study points to is that common courtesy, genuine interest in and care for each other, being authentic, and kindness are more valuable than ever.

Ed

*https://experience.invoca.com/2022-invoca-buyer-experience-report/p/1

Just Gabbing

 

I was once hired by a dental clinic years ago. Numbers had been headed the wrong way (down). Visiting the office, I discovered that no one talked to one another. This was the doctor’s policy. The staff didn’t talk to each other, or to the doctor, and the doctors only talked with the patients. Patient communication was limited, short, and almost brusk.

For about 3 months, I worked with the staff and two doctors to get them together and communicate. No marketing, no policies, no strategies… just gabbing. They got to know each other better. They also discussed issues in the office and started having ideas for improving things.

Also…stats went up!

The doctor was not happy and accused me of not working, just talking! Despite my urging, he didn’t manage by the numbers, just by some old-school idea of working on an assembly line where no one was allowed to talk.

The work ethic of the Industrial Age was that you “clock in,” leave your life behind you, work like a machine for 8 hours, and then “clock out.” You worked at a machine as a machine.

But people aren’t machines.

Minor confusions and then disagreements can accumulate in any relationship. Imagined or real offenses occur. It does in any family, for example. Relationships stiffen when this happens, like a hose in winter with summer’s water frozen.

Relations can be warm and friendly or deteriorate to a cool façade. The internal relationship within the office team ultimately affects both the quality and quantity of the clinic’s performance.

Relationships can be difficult, no doubt. People are complicated, and life is constantly throwing each one of us different curve balls. This is why relationships need regular maintenance. Your family relationships, for example, require time for communication and working things out when there are differences. Planning vacations, reviewing budgets, children’s school and sports activities, and much more takes work.

The same goes with your office family.

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

I have used this definition for years. I am sure there are other definitions, but this has worked.

This definition applies to your patients. Give them great service, engage in meaningful and empathic communication. They will get better, and they will stay with you longer.

This definition also applies to generating new patients: Expand your network. Get people to know you and how your services can help them.

But this definition also applies to your staff: create and maintain a great relationship with your teammates – and support them.

You must schedule time each week for each other. Staff meetings, training sessions, marketing meetings, lunches, one on one meetings, square dancing (good exercise!) – whatever the venue, make the time to communicate and support each other. This simple act with your staff will help you provide the best service and outcomes to your patients. And help you reach and stay at full capacity.

Keep dancing and …Seize your Future,

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 new book, The Goal Driven Business.

Brutal Economics: A hidden expense.

You have more expenses than you’ve probably considered.
 
Your biggest expense, like that old poster you have had in your reception room since 2012, has become invisible.
 
What is this big expense?
 
Well, one of the goals we work with in the Goal Driven System is the Full Capacity Goal.
 
This goal can be easily overlooked as we are focused on patient care, reimbursements, staffing schedules, vacations, and a thousand other tasks that require our attention.
 
The reason the use of goals is so effective in practice management is that they help you see the Vital Few from the Useful Many. (These terms are often used in reference to the Pareto Principle of 80/20.) The Vital Few are those factors (20% or less) that produce 80% (or more) of the results.
 
If you are not operating at close to full capacity, you are wasting money.
 
For example, if you could see, 160 patients in a week, given your schedule and good support, at $65 per visit, that would equal $10,400 per week. On a monthly basis, this would work out to be 640 visits and about $41,600 in revenue. This would be 100% Full Capacity.
 
You know from experience that your expenses are a lot higher than most realize. First, there are fixed expenses that you must pay out regardless of the performance of your business. And after everything and everyone is paid, after all accounts are settled, what is left over is yours.
 
At 70% capacity, that is not much. At 50% capacity, that is nothing.
 
Of course, you don’t focus on stats and money when you deal with patients as a doctor and as care givers.
 
But as a business owner, you must.
 
Numbers, analytics, Key Performance Indicators –– these make up your scoreboard and give you the best feedback to help you manage the performance of your business.
 
We carefully analyze our clients’ numbers each month and encourage they do the same. We also plot them on graphs and charts to notice trends. These are our x-rays.
 
Lately, we have realized that there is one number that gets overlooked in the hustle and bustle of business management. That is to what degree the office is operating at its full capacity.
 
In Goal Driven Analytics, we have been testing a “business capacitometer.” It displays, much like a speedometer or tachometer, the percentage of full capacity that the business is operating.
 
But you can easily do the same. Here is how:
 
  1. Weekly Visits. Determine the maximum number of visits you could see comfortably each week if you were reasonably supported with software and staff. ______
  2. Full Capacity Goal. Multiple this by 4 (I know, 4.3 is more exact): ___ This is your Full Capacity Goal.
  3. Percent of Full Capacity. At the end of the month, divide the number of visits you saw by your full Capacity Goal and you will get the percentage that shows you how the efficiency of your practice. E.G. You FCG is 800 and you saw 600 = 600/800 = 75%
Work towards maintaining 90% or above. Find the capacity constraints and remove them.
 
This is also very helpful if you have multiple providers – other associate chiropractors, massage therapists, other services, even your rehab or therapy departments. After agreeing on what volume would be full capacity, each month they can see their level of performance.
 
Last note: It is not about the statistics. While stats are your best indicator, remember … it is not the stat that is important — it is what they represent. A helped person!
 
Seize the Future,
 
Ed

 

Take a Stand: Define and Promote Your Brand

Using your brand to generate more patients, increase retention, and recruit top talent!

Promoting your brand has not been an important or even viable method of marketing for most chiropractors.

But that is no longer true.

Brand marketing needs to be part of your marketing mix. I will tell you why, but first, let’s define our terms:

Brand marketing is different from direct response marketing. Brand marketing focuses on generating awareness of your office, while direct response aims to generate new customers.

A smaller business with limited resources must focus on direct marketing rather than brand marketing. This is especially important when you begin.

Once your practice is maturing, your patients know you. You are the brand. You probably don’t plan on growing the business any further so there doesn’t seem to be any real need to promote your brand in the community.

But now there is.

More competition for patients

Franchise health companies are stepping up their activities. For example, the Joint Chiropractic, which filed with the SEC for around $35 million 10 years ago, and is a public traded company, acquired an additional 7.5 million in funding just two years ago. Their website says they have more than 600 locations, and I have seen their marketing activities in Wisconsin.

Physical therapy franchises are spreading, such as FYZICAL. According to its website, it has grown to more than 448 locations in 7 years as of 2021. In addition, acupuncture franchises, massage franchises, and dental franchises are on the rise.

Competition for Qualified Employees

You can also see increased competition if you have been recruiting doctors, providers, or support personnel lately. Job seekers can acquire a startling amount of information about you and what it is like for employees to work with you. They are interested in your culture, benefits, and values – which are all part of your brand.

What Makes You Different and Better

It could be said that your brand is: what makes you stand apart — and better – from all the comparable alternatives.

It is your Unique Selling Proposition.

A well-defined and promoted brand will help you:

  • Generate pride and loyalty in your patient base
  • Encourage more patient referrals
  • Improve team morale
  • Generate referrals from external referral sources
  • Improve marketing recruitment efforts for top employee talent

How to Define Your Brand

Once again, it all goes back to goals. (Doesn’t everything?)

What is the mission of your office? What are its values? What are its valuable outcomes?

This Is a Distillation Of Your Story: why you are a doctor, why you are in business, and what brings you joy daily?

Answer this for yourself, and then ask your staff:

What makes us special?

Survey a few of your patients: what makes us special from other providers? Why did you choose us?

Your brand showcases all this into an identity that people can know, like, and trust.

It can be somewhat symbolized with a logo and tag line, like the Nike “shoosh,” and the tag line: “Just Do It.” It can be represented in your newsletters, your office decor and cleanliness, the appearance of you and your team, and in all aspects of your promotions on social media.

But primarily, it must be demonstrated each day by you and your team living up to your values, your commitment to your mission, and providing world-class service and outcomes.

The world is moving faster, and we all have to work to stay ahead. And if we do it right, not only will it be rewarding but also fun.

Carpe Posterum (Seize the Future)

Ed

Need help with your branding strategy? Schedule a call and let’s have look at the best strategic options
SCHEDULE NOW

 

Capacity Constraints: Hidden Practice Barriers

Fixing the weakest links.

Your practice should flow smooth, fast, and uninterrupted, like a clear mountain stream.

Most offices, unfortunately, have hidden dams that slow or even block the flows within their office. This limits growth and increases stress.

For example, I have often seen the front desk so clogged with paperwork that new and active patients were inadvertently discouraged from coming in.

Every department and function of your practice is vulnerable to innocuously seeming events that add friction that choke production. Interruptions in the billing department, poor note-keeping systems for doctors, too many therapies to choose from, insufficient space, staff unclear of their goals, staff driven into apathy by being micromanaged… there are many potential opportunities for roadblocks.

Generating more new patients to increase your patient volume is usually a good idea. But often, the increase in volume is short lived because the office had too many hidden log jams and wasn’t set up for the higher patient volume. Even the doctors, while saying they want more new patients, can become fatigued by the end of the day and privately look forward to lighter days.

There are several remedies for these clogged flows.

First, clear up the goals and outcomes of each department. For example, the goal of the front desk is not “completed paperwork.” (A “Fully Scheduled Day” would be better!)

Second, you can review and refine the flow of patients into, through, and out of your practice. Draw a patient flow chart. Start with your new patients. List the sequence of actions your new patient goes through on their first day at your office. Later, you can do this for their second and third day. You can later work out a flow chart for reactivated patients, re-injured patients, and different types of cases.

Then, you and your team can rehearse the entire sequence to see what is missing or what needs to be eliminated.

I cover this in The Goal Driven Business:

Broken flow patterns that remain invisible “clog up” the system and slow down everyone’s best efforts to produce valuable outcomes and excellent service. These are bottlenecks. Discovering and eradicating them is a significant function of the Goal Achievement Process.

In his 1984 book, The Goal, Eliyahu Goldratt introduced what has come to be known as the “Theory of Constraints.” By making a chart outlining the flow of your customers, for example, you’ll better identify “leaks” or constraints which lessen your ability to achieve high quality and quantity customer outcomes.

As Goldratt states, “Since the strength of the chain is determined by the weakest link, then the first step to improve an organization must be to identify the weakest link.”

Every three months or so, do a “walk-through” with your entire team, where someone takes on the role of customer. This rehearsal will bring to light many duplicated or omitted functions. You’d be surprised to discover that many of the tasks you assume are done for your customer are actually skipped or poorly linked in. Sometimes you find tasks from decades ago, that no longer apply, are still being done.

Be an engineer to your goals and discover the constraints holding your office back, and remove them.

Be…… A Goalineer!

Ed

PS For those of you who have purchased my book, The Goal Driven Business, you are welcome to schedule a no-charge consultation to see how you can remove your bottlenecks and achieve your goals. SCHEDULE NOW

If you haven’t purchased the book yet, please do so here.  BUY THE BOOK

Health Screenings in 2022

This past weekend, outside our local grocery store, the Village (what they call a suburban town out here) closed off the main street and had an art fair. So I took a few minutes to look around before I headed home with my organic veggies!

There were maybe 30-40 10×10 tents with various artists displaying their works. The day was hot, and I was in a hurry. Suddenly, I stopped when I saw an old familiar sight, one that I hadn’t seen for a few years. There it was-a chiropractic health screening booth.

That’s right… s c r e e n I n g s!

The signs said, “Spinal Health Screening” with the name of the corporate chiropractic company which now has offices in a few states in the Midwest and in WA, according to their website.

Now, for the most part, I like screenings and, if done right, recommend them. I would not be overstating the fact that we have personally participated in hundreds of screenings in hundreds of venues over the years. (I still have a couple of PVC Posture Analyzers in my garage.) We have personally trained well over 50 “Screening Technicians” and hundreds more in seminars and via our marketing manuals. We used screenings when we opened up our 24 offices here in Wisconsin.

Now that people are less in fear of being murdered by one another for carrying the COVID, outdoor events are resurfacing.

Here is a short list of benefits of screenings:

  1. Generate new patients.
  2. Reactivate former patients.
  3. Create new external referrals sources
  4. Create goodwill and good publicity. (We won an award for our booth at a county fair once which was pictured in the local paper.)
  5. Meet people in your community.

Here are 5 essential ingredients to help you achieve these benefits:

  1. Friendly. Whoever is in the booth should be friendly, casual, and having fun. Therefore,
  2. Short shifts. It should not be an endurance contest—a few hours at most. Get in, greet people, talk with them, screen the interested few, and get out.
  3. Training and positive experience. If you have a non-doctor in the booth, for Pete’s sake, train them. Ideally, they could be a staff member who already knows the excellent outcomes you produce and can easily recommend you.
  4. Be interested in people. Are they in pain? Have they seen a chiropractor, acupuncturist, P.T., M.D. for their issue? Where do they work? What do they think of the Milwaukee Brewers Baseball club’s chances this season?
  5. Unserious. As B.J. Palmer said in Rule #9, “Don’t take yourself too damn seriously.” (to get a copy of Rule #9)

Get out there with your people… they need you!

Ed

PS BY the way, just curious… please reply if you would like a short webinar on what we have seen works best for screenings.

STARTING your day- Goal Driver procedure: Case Management

We are starting a new month… and the 2nd half of the year.

For all doctors and practices, the action of STARTING is important.

In fact, how you start your day is more important than you might realize.

Too often, I have seen doctors rush into the office in the morning and not greet their support team. I have even seen doctors come in late after their patients had been waiting to see them.

In most cases, the doctor’s attention is already somewhere else and not on STARTING the day with their team. They are still CONTINUING from the previous day so that workdays seem to blend together. Mentally, I am sure this brings about extra stress — feeling like work never ends or that you must toil endlessly on an assembly line that you have no control over.

Instead, make each day new. Yes, this is a cliché, but that doesn’t diminish its importance. You create your new and unique day. If you don’t, today just blurs into a continuation of earlier days.

It really all goes back to GOALS. You should START each day with the end in mind.

Goal Driver Procedure: Morning Case Management

We recommend that you start the day with your team 15 minutes before patients come in. Review the numbers and flow for the day, and coordinate patient care. This is a kind of case management meeting. Set goals for the office for that day. Tell a joke.

Morning case management meetings are a great tool to help improve the performance of your practice. Assign this to your manager, put it on a checklist, and make sure it gets done each day.

Now, for a joke: What sits at the bottom of the sea and twitches?

A nervous wreck.

(Let that sink in!)

Carpe Posterum (Sieze the Future)

Ed

Here in the United States, July 4th is a date we celebrate each year, commemorating the independence as colonies from Great Britain.

And I can’t help but see a parallel between those hardy souls in the American colonies that wanted their freedom and, well, you! Chiropractors and their teams.

To colonize means to “take control of a people or area, especially as an extension of state power… to take or make use of (something) without authority or right.” (Merriam-Webster)

It could be said that the profession of medicine has been colonized by a few corporate interests. Same has been happening with other professions and industries. A few large corporations own and control more and more businesses that were once independent.

But for the most part, chiropractic as a profession has remained independent.

It hasn’t been easy, what with the AMA and Pharma coming after you, as was disclosed in the Wilk’s trail. (That was just a speed bump for them!) But Team Chiropractic has won its independence and freedom due to the courage of those who have come before you.

And it also comes from your continuing courage today.

So, this Fourth is also about your independence and your continued efforts to do the BEST for your patients and your communities.

Celebrate this!

Yes, it is just another day at the office. But this weekend, have an extra cool drink and recognize your leadership and courage in standing up for the true health of your patients and your community.

Stay free, and help others do the same.

Ed

Where Everybody Knows Your Name: Creating a Chiropractic Community

Used to be a popular TV program called Cheers back in the 80’s. It was modeled after a bar in Boston with the same name. As a situational comedy, Cheers presented a familiar group of customers who came to the bar to have a drink, but also to relax, socialize, and have good cheer.

 

Patients come into your office to improve their health and find relief from discomfort. But they are also looking for something more.

 

Remember that a practice is a network of relationships created and sustained through communication and service. That’s my definition. There are other definitions, I’m sure, but at the foundation, communication is critical.

 

It can be a lonely world where there seems little time for real communication – or friendship.

 

You are more than a doctor, and your staff are more than just support professionals. You and your entire team are part of a caring family, a community of like-minded people who are committed to health and helping each other achieve it.

 

Creating a community is a big deal in businesses now. For good reason… Belongingness has been identified as an intrinsic motivation we all have, according to Self-Determination Theory. But it can be contrived and gimmicky if it is not genuine.

 

In the best offices I have visited, staff and doctors formed a work family… genuinely caring for each other as well as for their patients. The patients were also included in the family. Sometimes, I would see them spending too much time gabbing at the front desk or bringing fresh produce for the doctor from their garden. I would even see patients just stop by the reception area to chat amongst themselves, catching up on shared concerns and local news.

 

Yes, the best practices have policies and procedures. These are the systems that help ensure fast and efficient service in high quantity with high quality.

 

But procedures cannot take the place of a real person interested in and caring for another person.

 

In very lay terms, the spine is the structure that supports and protects the function of the spinal cord. It is the function that counts, that comes first.

 

Many offices have their function impeded by tangled up, omitted, or unfollowed procedures and policies. You definitely need a strong infrastructure to have a prosperous low stress business. But the reason, the goal for good systems includes having good communication with your patients and each other.

 

There are many troubling issues we all face. Make your office a place where people want to go for better health and better friendship.

 

A place where everyone is glad you came and where everybody knows your name.

 

Ed

 

Theme from the sitcom Cheers
“…Making your way in the world today takes everything you’ve got.
Taking a break from all your worries, sure would help a lot.

 

Wouldn’t you like to get away?

 

Sometimes you want to go

 

Where everybody knows your name,
and they’re always glad you came.
You wanna be where you can see, our troubles are all the same
You wanna be where everybody knows
Your name.”

 

Carpe Posterum (Sieze the Future)

 

Ed

Your Best Business Investment: Did you make First Adjustment Calls?

When was the last time you called your patient after their first adjustment?

We’ve advised this for years, and it is one of the many items on our Marketing Checklists. The procedure was simple: the staff handed the doctors a slip of paper with the names and numbers of patients who had their first adjustment that day. Then, on the way home, the doctor would give the patient a call to see how they were doing. I remember hearing from the staff that the patients loved getting a call from their doctor and felt it was an extra effort to ensure their well-being personally.

I was reminded of this when my wife, Barbara, took a phone call from the MD from whom she recently received a light skin surgery. She was impressed and delighted. (“Wow,” she said after the call. “I think I’ll call to schedule more surgeries this month!” She’s funny!)

But we live in a world where we are becoming more insulated from each other. We almost interact as much with Artificial Intelligence, electronics, and automation as with live people. Automation runs our shopping, our money, and our communication, even much of our medical care.

I just read a report this week that Google suspended an engineer from work who said that an AI program at Google was now sentient (conscious). He said that he had “startling talks” with a chatbot program.* And never mind the masking, social distancing, and lockdowns which I am sure we haven’t seen the last of.

It seems that honest, caring, and genuine interest from a live person, especially from someone who knows us, are vanishing human qualities.

And this is the niche where you and your team are uniquely qualified to own.
As entrepreneurs, we focus on business matters – we look at our scoreboard, analyze the numbers, and review our accounts receivable. We look at how we can grow our business and improve the bottom line. And all that is fine and part of our job.

But all the numbers, the paperwork, all the administration and marketing are for nothing if the personal connection you have with each patient is absent.

And this is what makes your service exceptional – the quality of connection you and your team have with each patient. The genuine interest in and authentic care for each patient, and the outcomes you deliver, are the heart and soul of your business.

Improving this is the best investment you can make for long-term success.

Carpe Posterum (Sieze the Future)

Ed

(Yahoo News)