10 Practice Development Strategies for Chiropractors in 2015

[If you think that you could make more money selling pharmaceuticals, injecting patients with vaccines and promoting flu shots in front of your office, these recommendations are not for you. For those matters, you might want to ask Palmer Chiropractic College or the Wisconsin Chiropractic Association for their opinions.]

What strategic moves should you be taking now to make sure that you have a better year in 2015 and in years to come?

After reviewing current literature and statistics, and based upon my observations and experience, I have put together a report which makes a number of recommendations that can be helpful to you. I have also included an extensive list of references for your further study.

The report contains a lot of information and so it is only for the serious practice executive. It will be a useful resource for you to refer to while you implement some of the suggestions I offer. Reading time is about 15 minutes. It offers new views on practice marketing, management, and leadership, with 25 specific recommendations.  To go straight to the main course, go here:

Here is a shorter version:

Executive Summary – 10 Strategies to Prosper and Flourish in 2015 and Beyond

1. Know Your Environment. The Medical-Pharmaceutical industries are spending more to dominate the market place. Their efforts are becoming more pervasive in reach and more covert in manipulation. At the same time, wellness statistics continue to grow. More people are turning to organic foods and are focused on wellness.

2. Marketing Positioning. My recommendation is to embrace the popular movement towards natural health and own it. Be its champion. You are the Healthy Life Doctors. This is your niche.

3. Unique Selling Proposition. Stay committed to your core services, but articulate your Unique Selling Proposition to your specific market niche(s). Not everyone is your patient. Select certain markets that are already reaching for your type of services: people fed up with drugs, baby boomers who want to stay healthy, mothers who want to avoid drugs for their children, athletes, employers who want healthy employees, etc.

4. Get More For Less. Watch your economics but don’t get stuck in a scarcity mindset. Central to economics is a return on investment -ROI. Invest in yourself and especially in making your support team expert professionals. Learn and apply the Pareto Principle (how 80 percent of your results come from just 20% of your efforts).

5. Insurance or Cash? Yes! Take insurance but don’t kowtow to the Insurance Cartel. There are millions of people who want help and can pay for it and are just looking for a solution. You have to let them know that you have their solution.

6. Shift from Personality Driven Practice to Team Driven Business. The successful offices of the future will be team driven and systematized. Each team member has to be an expert as a specialist, as a team member, and as a marketer. And each should try to achieve this as well. The doctor will delegate most marketing and administrative details to others.

7. Shift from Solo Practice to Group Practice. For those of you who are ready, you should join forces with other doctors in a group practice. This has not had a lot of success in the chiropractic profession as it has in other professions, but the time is right now to band together synergistically as brothers and sisters. There are many good reasons to do this now. However, it has to be set up — and maintained — correctly.

8. New Role: CEO and Leader. Why do CEO’s get paid so much? Because they can make such a positive difference in the business. Up to now in your career you have taken on administrative and marketing projects mostly from the role of doctor, or perhaps owner. The CEO role probably has not been emphasized. Shifting to the role of CEO changes everything. Growing a business becomes easier, you have more time available, and you make more money.

9. Seek Out and Integrate Your Greater Purposes with Your Business. The power for your office, and you, comes from those things that mean the most. This would include your family and your spiritual pursuits. But our world is smaller and we live in a networked economy and culture. Your office, in its own right, has to be a leader in your community and environment and contribute in some way beyond its walls. This also includes having a voice in your professional organization. Your greater purposes also include your personal hobbies. Since you are not working on an assembly line, many of these purposes should be integrated into your work.

10. Get an Executive Coach. Why does corporate America spend over a billion dollars on executive coaching? Because the return of investment proves to be at least 7 times, and in some cases, 10-49 times cost. Executive coaching doesn’t cost – it pays.

An executive coach is different from a clinical coach. An executive coach will help you be a better CEO – a better leader, marketer and manager who builds a team driven business which allows you to delegate most non clinical duties.  He or she will help you sort out what tasks will produce the greatest positive effects for your business, and help you get those tasks done. He or she will be your partner, counselor, confident, coach, teacher, drill instructor, and friend.

The future has never looked brighter, but the challenges are not slight. This makes your success all the more important – and sweeter.

Ed Petty

 

Giving Thanks – Appreciating Each Other

I know you are busy now.

We all are.

We fly through our days, adjust and treat patients, make our calls, do our paper work, and then rush out to our personal lives.

But often we are like bus drivers, driving so fast that we drive past of our bus stops where our passengers are waiting for us.

So this is just a short note to remind each of us to stop, now and then, and say thanks. (And I know you know this, but a gentle reminder never hurts.) Over here in the U.S., we are celebrating Thanksgiving Day, so it is a customary holiday for us. But we really need to give thanks daily.

Gratitude is a powerful attitude and a feeling that we can use and regularly adopt to make our lives better. But its practical application derives from the fact that it is a basic recognition of a deep truth that we probably too often overlook.

The truth is that we are given so much — and that there is so much goodness in the world that deserves our appreciation.

And so this is a note to also let you know that all of us at PM&A are truly thankful for the work each of you do.

We know how hard you work and we know how much you help your patients and your community and we sincerely honor it. In fact, it is the reason we do what we do.

Unlike other management companies, we have seen you in your offices, talked to your staff, and know your numbers. We know that you don’t really get the appreciation that you deserve, but thankfully, you are not waiting around to receive “thank you” cards! Each of you are too busy helping others.

You really are the leaders in health care. You haven’t sold out. You are strong in your principles and motivated in your mission. And so are we. How each of us arrived in this line of work — who knows? Perhaps it is part of a plan, or a calling… but here we are.

I think it is safe to say that each one of you also appreciates the good work of each other across this planet in helping others get better naturally – even though you haven’t all been introduced. We are all connected by our basic efforts to help others get healthier.

And when you think about what we are all doing to help others, there certainly is a lot to be grateful for. It can almost give hope that the world can be, and will be, a better place.

With much gratitude and best wishes,

Happy Thanksgiving to one and all.

Happy-Thanksgiving

Patriot Project: Chiropractic Care for Military, a Recorded Interview

Phyllis Frase, consultant with Petty, Michel and Associates recently met up with Dr. Carol Ann Malizia in Texas.  Dr. Malizia began sharing her story of her involvement in helping military personnel obtain chiropractic care and the Patriot Project.

Below is  a recorded interview where Phyllis talks with Dr. Malizia as she shares her thoughts on the current climate of military health care today compared to years ago, how she became involved in the mission, and what the Patriot Project is all about and how you can get involved.

Patriot Project Interview (mp3-36 min)

Dr. Malizia mentioned a few books for followup reading:

  • 24/7 The First Person you must Lead is You, by Becky Halstead
  • 1 Degree of Change, by Dr. Georgia Nab
  • Steel Will, My Journey through Hell to Become the Man I Was Meant to Be, by Retired Staff SGT Shilo Harris
  • ArmyOneSource 10 hr training/certification

If you’d like to contact Dr. Malizia she can be reached at camdc63@aol.com 

If you’d like to learn more about the Patriot Project visit: Patriot Project

Patriot Project: Helping Military Families with Their Health Care.

Patriot Project

You may have heard about the Patriot Project.

The Patriot Project is a grass roots movement to provide chiropractic care to all active military, their families, wounded warriors & all gold star dependents.

Chiropractic care is included in veteran’s health benefits but has not been made readily available for all wounded warriors. Many of the ailments are currently being treated largely with pain medication and psychotropic drugs but can be relieved more conservatively with chiropractic care.

It is important to offer our active duty non-drug, non-surgical options for their painful conditions and Doctors of Chiropractic offer such care with attention to the optimum function and health of the whole person.

The Patriot Project aims to make chiropractic care readily available for ALL active duty personnel, military veterans & their families including all gold star dependents.

Thursday November 20th Ms. Phyllis Frase will be interviewing Dr. Carol Ann Malizia, D.C., who is on the Board of Directors of the Patriot Project. She recently heard Dr. Malizia speak at Parker Seminar in Texas and was very moved by her compassion for our veterans and what she has done to help them.

On our webinar you will learn how the Patriot Project can help you grow your practice, and in return, how you can help our veterans.

Register now for Patriot Project – an interview with Dr. Carol Ann Malizia moderated by Ms. Phyllis Frase on Nov 20, 2014 12:30 PM Central Time at:

https://attendee.gotowebinar.com/register/1716307227105199105

After registering, you will receive a confirmation email containing information about joining the webinar.

If you need assistance registering please contact Linda Skiles at linda@pmaworks.com or 262-749-0221.

For more information about the Patriot Project and Dr. Malizia:
Patriot Project

Swiss Army Knife of Chiropractic Practice Development

Ever see a one of those Swiss Army Knives?

I have one. It shows up now and then in one of my drawers.  I always forget how many applications it has and I am always surprised when I keep pulling out more.

Well, there is a particular practice building tool that works like a Swiss Army Knife for your office.Swiss army knife isolated

It is inexpensive, almost free, yet this one tool serves many purposes more effectively than most anything else you can do in your office.

You could call it the Swiss Army Knife of Practice Development.

Once you, and your team, and especially your patients watch Bought, you will understand the power of the Swiss Army Knife of Practice Development.

This one tool can be your most effective marketing procedure. It can be your best therapeutic modality or ancillary service. It can also serve as your best tool to boost team productivity.

But like with my Swiss Army Knife, it can easily get taken for granted and NOT USED.

I can guarantee that IF you energetically use the Swiss Army Knife of Practice Development, your patients will stay with you longer, they will get healthier, your team will be more productive, you will generate more patients, and, yes, you’ll see your collections increase.

What is the Swiss Army Knife of Practice Development?

Education.

Education brings about an increase of awareness and results in a motivation to make a change. It does this for your patients in terms of improving their health, in motivating them to get others to use your services, and in helping to make your team even more purposeful.

You know chiropractic and what it does for people. Each day, miracles occur. It gets almost routine. You know how chiropractic works and you know why it works. Your patients do not. And most of your staff only have a general, and perhaps forgotten understanding.

By educating your patients you are fortifying them with knowledge that makes them aware of the power of your services and the importance of continuing care. It counteracts the propaganda they receive in the form of hundreds of ad impressions we all receive each day for drugs and bad food. It increases their awareness and will motivate them to not only continue with their care, but to benefit more from it.

This will, in turn, encourage them to bring in their family and friends to see you. They may even encourage you to speak to their work place or organizations.

Education can motivate your staff. I have seen numbers go up 25% quickly once the rest of the team was educated more on chiropractic and natural health care.

Lastly, education motivates you.

Education is your least expensive modality or ancillary service, it is the most cost effective marketing tool you have, and costs nothing to educate your staff.

Here are some sample actions to take to improve your educational activities.

  1. Look at your office as an educational facility even more than a care facility. You increase people’s knowledge so that they can take more responsibilty for their health, and for those they care about.
  2. Spend a hour or more each week studying. Read, listen to audios, go to seminars, have lunch with a colleague. Call your coach!
  3. Watch a movie with your staff such as Bought, Doctored, Food Inc., and then have a discussion period afterwards.
  4. Staff Meetings. Go over a case history or two.
  5. Patient Care Class.
  6. Start a Lending Library and position your office as an educational facility.  Even  if you lose a few books or DVD’s each month, it is worth it as your patients will see that you are serious about health and health education. Give each staff member a bonus for a book report presentation at a staff meeting.

There are many ways to educate yourself, your team, and your patients.  Done right, education turns into enlightenment and this will produce a greater return than many other activities you do.

Like a Swiss Army knife, health education serves many purposes. But also like a Swiss Army knife, it has to be kept out, used, not hidden away in the back of a drawer or on a bookcase.

Marketing Plans for Your Chiropractic Office This Fall

As we move from the summer months into fall, I thought that it might be helpful to preview some marketing ideas for the rest of the year.

Below is a link to several articles on our web site referencing marketing procedures and programs for the autumn and the early winter months.

Marketing is basically physics: for energy to come in, energy has to go out.

Ideally the energy is well directed and of a high quality, but mainly, it has to get out.  Quantity first, then gradually, improve the quality.

But everything is done twice: first in your mind and then in the world. First comes the meta-physics, then comes the physics

This is why the most important and first step starts with you – your faith, confidence, and belief in what you are doing and especially, why you are doing it.

Organizational system failures or personal situations can often get in the way that distract us and cause us to lose sight of our purpose or of the great results we have achieved for others in the past.

And, there will always be the negative few that seem to outweigh the positive many.

Sometimes we focus on the “barking dogs” that come out to chase us for a while rather than concentrating on the fire we are racing towards to put out.

Marketing is about communication. It is an “outflow” that sooner or later, directly or indirectly, generates an “inflow.”  It is your creative voice that is either filled with mission and purpose, or is forced and desperate. Stymied by failures or disappointments, our “voice” can recede to a whimper or a mumble.

But the fear that can grip us is mostly an invention because too often, we take things too seriously.

The fact is, as Ben and Rosa Zander point out in their book, The Art of Possibility, most of life is just “invented.”  I listened to Ben Zander, the conductor of the Boston Philharmonic Orchestra, give an inspirational presentation at the chiropractic seminar called the WAVE in San Francisco in August.

He advised that when we slip and make a mistake, we should just throw out our arms, lean back slightly and exuberantly and say: “Fascinating.”   We just can’t take things too seriously and instead we should move on passionately expressing ourselves. Not bad advice from a maestro whose goal is to get musicians to play better.

You could also go out to a field or park and just yell: “I am the greatest and the world loves me and wants to come to my office.”

Don’t be surprised if the universe cooperates.

Marketing your services, like helping people get better, should be enjoyable. It should be fun. You should be smiling and laughing.

And you know, as the song goes:

♪ When you’re smiling, ♫When you’re smiling,♪
♫The whole world smiles with you,♫
♫When you’re laughing, ♫When you’re laughing,♪
♪The sun comes shining through,♫
♫Wishing you plenty of smiles and all the best,♪

Ed

Click Link for more Marketing Articles

Here is a great rendition of the song by Frank Sinatra

https://www.youtube.com/watch?v=351l62Yx0oI

Patient Retention in Chiropractic and Delivering Happiness

In our webinar on chiropractic patient retention, we reviewed some basic procedures that can be used to decrease patient drop outs.

More significantly, we looked at a new paradigm for patient retention that many businesses are using successfully.

If your visit average is less than 60, then you can benefit from the material we covered.

The webinar also included a short presentation on an effective patient recall system used many years by Linda Skiles, former Chiropractic Assistant of the year in WI. The forms discussed in the webinar are located on our PM&A members site.

We discussed why patients drop out of care – the basic reasons, and ten strategies you can put into place to improve your visit average .

One of the last strategies examined a company called Zappos. This is an online shoe selling company that began in 1999 and ten years later was selling a billion dollars worth of shoes.  We looked at a couple of key features on how it did this.

Under the strategy of “Take Care of Each Other”, we reviewed their ten core principles.  According to the founder and CEO ,Tony Hsieh, employees are hired in part based upon these core values. He discusses this in his book, Delivering Happiness.

These are the ten core values that Zappos employees live by:

  1. Deliver WOW Through Service
  2. Embrace and Drive Change
  3. Create Fun and A Little Weirdness
  4. Be Adventurous, Creative, and Open-Minded
  5. Pursue Growth and Learning
  6. Build Open and Honest Relationships With Communication
  7. Build a Positive Team and Family Spirit
  8. Do More With Less
  9. Be Passionate and Determined
  10. Be Humble

What are the core values of your office? Have you defined them? Should you? Does each team member live by them?

Below are two links to two short videos that illustrate how Zappos applies these core values. The first is a music video put together by Zappos and their employees. Just fun – and maybe even inspirational.

Then, watch as Rachel Ray anonymously calls in to place an order on Zappos and see how she is treated.

Zappos illustrates the strategy we call: “Taking Care of Each Other” and “Creating a Community.”  Both of these are effective strategies that can help increase patient retention.

You can use these videos at a staff training meeting and discuss how it could apply to your team.

If you are an active client, you can also watch the webinar on our members site.

Your patients may come to you for health and relief, but they stay because of friendship and how you make them feel as people. By hiring the right team members and helping each other stay true to patient centered core values as exemplified by Zappos, your patients will want to come back and see you again and again.

If you are having trouble viewing the video above, please click this link:

http://youtu.be/4gHlEBU_NSg

If you are having trouble viewing the video above, please click this link:

http://www.youtube.com/watch?v=td-nVat6cLY&feature=colike

Disruptive Technologies: Why Cal Jam Is the Future – and You are Too

Petty Michel Following the Force to Cal Jam

 Next week, a few thousand chiropractic professionals will attend a chiropractic seminar called Cal Jam sponsored by the Dead Chiropractic Society.  (Some of us from PM&A will be attending as well as a number of the offices with whom we work.)

Cal Jam is what could be called a disruptive event.

I take this from a term used in technology called “disruptive technology” or “disruptive innovation.” It refers to a product or discovery that forever changes the future. It creates a true paradigm shift. For example, the automobile, telephone, and of course, the Internet. We see this happening with FaceBook and soon, perhaps with Bitcoin, drone home deliveries, and other culture shifting technologies.

Cal Jam is a seminar that is unlike all past seminars I have attended or know about.  It is, in itself, a paradigm shift.  I have been traveling off to chiropractic seminars for few years now. The first one I attended was back in 84 or 85 when Dr. Parker (Dr. James Parker) had it in Reno one year. Had the chance to talk to him then up in his suite.  Since then, I have been to maybe a 100 or more over the years. Cal Jam is dif-er-ent.

Petty Michel & Associates is not really a seminar company, but we encourage them. Seminars can be useful for teaching, motivating, selling, and networking, but we find that the real work begins and ends in the office, where you work on the office. Like the old phrase: “Education Begins at Home.”

But Cal Jam is unique.

  • As a whole, Cal Jam is not about itself.  There may be speakers or vendors that have invested a great deal and need to promote themselves, but the theme is not about Cal Jam or any one management company or product.  It is really about the bigger issues of Chiropractic and Health.  So, there is kind of a lack of self-importance which is very refreshing.  It genuinely puts chiropractic and the health of your family, friends and community first.
  • Cal Jam starts with chiropractic and then takes off to vital issues affecting health.  It takes on critical – and controversial — health subjects that go way beyond the conventional and challenges you to learn how they affect your patients and what you can do about these issues.
  • Principles and history. It has presenters that deeply discuss chiropractic principles and history, the foundation for your profession which is often overlooked and, in our years of on-site work,  a major reason for many floundering practices.
  • Totally classy. In fact, the digs are luxurious. The venue is in a modern performing arts center that is nothing short of first class.
  • All done by just one practicing Doc. It is championed by just one person, Billy DeMoss (supported by Mary Jane), a practicing chiropractor who lives and works in an office just like all the tens of thousands of other chiropractors. Chiropractors like you. He is not school president, he is not a practice management seminar speaker, and he is not selling supplements or equipment.  So, in many ways, he is just like you.
  • Purpose. Except for this: he is authentically driven by a greater purpose to promote chiropractic and good health to such an extent that is is creating this thing called Cal Jam.  And by his actions, he sets an example for you. You have to ask yourself: “Besides growing my own business, what could I also be doing to significantly help others?”
  • Rock and Roll.  Lastly, I have never attended a rock concert that was also a seminar.  This is my 4th Cal Jam. It is fun!

It is not too late to hop on a plane and attend Cal Jam. The seminar is modestly priced. Go to Cal Jam.

But if you can’t, you can apply its spirit – the spirit of honestly helping others improve their health.  And being disruptive.  This may go beyond your comfort zone, but it will be worth it.  It is no news that chiropractic is, and always has been, a disruptive health system. Imagine, adjusting someone rather than having them receive back surgery! Back surgery brings in a lot of money to hospitals yet at least one study cited estimates as much as 90% are unnecessary. I am you as doctors see this first hand. But chiropractic has frightened and upset the medical monopoly for years, as evidenced in the 1988 Wilk vs AMA case.

Be just a bit disruptive. Have fun and be friendly and don’t take yourself too seriously. But be something new and fresh in your office and in your town. Get people off the couch, off their drugs, get them adjusted, educated and moving. This is what people, more and more, know they need.  For that IS the spirit of chiropractic, in my opinion.

And if you want, turn up the jute box – or Internet radio. Get your patients dancing to some rock and roll music*… and you can have the spirit of Cal Jam every day.

*“Just let me hear some of that rock and roll music, anyway you choose it,
It’s got a back beat, you can’t lose it, Any old time you use it.”
(Chuck Berry)

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Where in the world is Phyllis speaking now?

While we are struggling to stay warm here in the Midwest,  our Phyllis Frase will be heading to sunny Puerto Rico the weekend of February 1 and 2nd to share her expertise on the Chiropractic Front Desk and better communication in a chiropractic office.  Last report was the weather was 86°.

PPMs CAs Boot Camp_Flyer (3)

 

We’re certain she will “light a spark of chiropractic passion” for the CA’s in attendance and we only ask that she brings some of the warmth back home with her.

Your Biggest Chiropractic Bill Each Month

Fotolia_56486655_XS

You may be overlooking your biggest bill. Most chiropractors do.

What is it? If you are in the upper Midwest or Eastern part of the US in the winter of 2014, it might be your heating bill.  It has been pretty cold.

How about personnel or marketing? Your lease? Staff benefits? How about your pay? (Probably not, I would guess.)

In running a chiropractic business, many doctors try to maximize the profit of their business by reducing expenses. They often get this idea from their accountants, and, from a certain perspective, it is a good idea. But accountants are trained such that their primary function is reporting income for tax purposes and not managing business finances.

You definitely need to review your Profit and Loss and Balance sheets regularly. Sometimes you can get carried away with expenses, not noticing that things are getting out of balance when you have 4 x-ray units, 15 computers and only 1 staff member.

But what your financial statements don’t show you, and what your accountant isn’t trained to see, is your ROI – your return on your investment.

And what is your biggest investment? (Pause while you consider this question….)

It is YOU.

And what is your biggest bill? What is your biggest expense?

It is the income that you could and should be making that you aren’t.

Your biggest bill is the amount of money you could be making if you were operating at your full capacity but aren’t.

Here is an example: Let’s say you are relatively healthy and are capably of seeing  200 patient visits per week comfortably. This excludes new patient visits.  This averages out to about 860 visits per month.  Let’s drop it down to 820 visits for vacation days, etc.  Now, let’s say you collect only $40 per visit, average. This would mean you would be collecting $32,800 per month.

Let’s leave aside the possibility you could collect more per visit and imagine that you are seeing 150 visits per week, or 645 visits per month, or 605 if we take out a few visits for vacation days (40 visits per month).  At $40 per visit, this leaves you with $24,200 per month, or $8,600 LESS than you should be making each month.

In other words, if you could and should be making $32,800 per month and you are only making $24,200 per month, you are essentially writing a check for $8,600 EACH MONTH, payable to “Inefficiency, Inc.”

You are wasting that much each month as a negative return on your investment on yourself.

This is so brutal to face that most doctors would rather look the other way.  But whether you squint at it, or not, the reality is there: you are wasting your hard earned cash each month that you are not operating at full capacity. You are throwing away a portion of the time, training, and sacrifices you have made to get to where you are now.

It is as if you are writing a check, each month, for the amount of money you should be making, but aren’t.

Savvy CEO’s and large corporations understand this.  They need to get the full measure out of their investments. As a result, they invest heavily into solutions that improve production and services so their business can achieve full capacity.

One investment that shows the greatest return is corporate training and coaching. This is a huge industry: corporate training grosses $138 billion yearly in North America and executive and business coaching is at $9 billion a year and growing.

Various studies show that executive coaching brings back a return of 5 to 8 times the investment.

Obviously this speaks to our services, but beyond us, coaching and team training help you get the most out of your biggest investment – you.

Read a book, go to a seminar, watch a webinar, participate in 4 Mastermind groups, and get an executive coach to help train and guide you. Invest in yourself so that you can take the necessary actions to reach your full capacity.

In today’s economy, you need to get more out of what you have.

Quit wasting money. Invest in yourself. You can afford it.

Ed Petty

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References

GOOD TO GREAT: The 1st Step in Taking Your Chiropractic Office to Greatness

Jim Collins, author of Good to Great, after researching many successful companies, noted that great companies “confronted the brutal facts.”

Cover_Good_2_Gr8

“All good-to-great companies began the process of finding a path to greatness by confronting the brutal facts of their current reality.”

If you want to take your chiropractic business to the next level —the 1st thing you need is an exact and honest picture of where you are now.

You see, you can’t get to “THERE if you aren’t exactly clear on where “HERE” is.

You may be looking at where you want to go — visualizing your goals — and you should. But before you head out on your path you should really look at where you are now and review your strengths and weaknesses.

It is goal setting season now. If you don’t clearly assess your current practice condition, a year from now you may be right back where you started.

In a hurry to get THERE, we often don’t spend enough time really LOOKING at and assessing what is honestly going on HERE.  In fact, it has been our experience that most doctors do not face the blunt facts right in front of them but instead try to “solve” their practice challenges with a new solution.   It is similar to a patient embarking on a new treatment program without first receiving a thorough examination.

We have often seen a doctor set goals designed to fix a challenging practice situation in one area when the problem was really emanating from another.  For example, your external new patient difficulty may really be coming from messes in your office management.

How is your front desk team member doing (really) after her husband lost his job? What is going on with that therapy procedure you wanted to implement three months ago? Is my billing coordinator writing off too much? How many new procedures has the front desk been given over the last 6 months? How much money am I spending/not spending on marketing? What’s going on with our newsletter program? Where’s my blue coffee mug?

Sometimes we just can’t see the forest for the trees. We become so accustomed to what we do each day that we can overlook what can be choking off our growth – or potentially fueling it to the next level. Plus, we are busy.

Half the battle of growing your business is in squarely observing what is in the way, as well as recognizing what are your greatest resources.  Only then can you effectively set your goals.

To help with this, we have developed a practice assessment specifically for chiropractic businesses. It digs into your office and measures 11 different dimensions of your operation.  Our first version of this was created nearly 14 years ago and has been used successfully since. This new version is even better.

Much like a functional assessment for your patients, this survey inspects vital areas of your practice and gives each a score. From this, we make a chart that gives you a portrait of what areas are strong and what may need immediate attention.  We also provide a written interpretation of the assessment.

Originally, this assessment was used with our active clients as part of their service. Using this assessment tool as well as practice statistics, we could uncover what areas of their business needed the most correction. We also discovered untapped or underutilized strengths that could help energize the office. At regular intervals, we could reassess and note the improvements and what to work on again.

We are now offering this assessment again as a special service which includes:

  1. The assessment
  2. Graded and plotted assessment
  3. Statistical analysis with charts
  4. Phone consultation
  5. Written report with practical action steps.

Each question will provoke a greater understanding of your practice. With the results of the assessment charted and the consultation, you will obtain a new perspective of how your office operates. You will also see more clearly what needs to be done to bring it to the level of success that you desire.

Practice Statistics. Of course, you can’t evaluate a business without also analyzing its performance monitors. Most offices keep practice numbers – somewhere.  Unfortunately, they are rarely reviewed properly.  We know how to analyze them and show you your ratios and the trends that they reveal. If we do not have your current practice statistics already, we will request them on a separate form. After interpreting your statistics, we plot them on charts and correlate them with the results of your Practice Development Assessment.  Together, this will allow us to give you an excellent overall analysis of your business and what needs to be done to take it to the next level.

 

Send in when Completed.  When you have completed this assessment, you can fax or email it back to us at Services @ pmaworks.com or Fax: 877-868-0909.   We will score and chart each section of your assessment and set up a time to discuss the outcomes with you. We will also send you the results with our written observations and recommendations.

The standard fee for this for non active clients is $250.  

NOTE: As of January, 2014, for a limited time promotion, we will be charging only $25. This is almost free, but I don’t want to take up our team’s time with people who aren’t seriously interested in this service. If you take us up on this assessment, I will assume you are hard core about improving your business. As hard core as we are!  🙂 Use the promo code  CPDAPROMO to get the discount when you click the link below.

Ed Petty

To purchase: LINK

 

 

The Fundamentals Apply…As Time Goes By

I want to pass on some tips and ideas about chiropractic marketing and so the title above may seem a little misleading. It is a taken from a classic movie, a romance actually.  I will get to that in a moment.

To start off with, I have pulled out some promotional ideas from our chiropractic Marketing Toolkit on our Petty, Michel and Associates Members Site and in the Chiropractic Marketing Manager System program that you might want to use for this month, November, or December.  You can find them here on our web site.

There are many variations of each, and thousands of different promotions, but those listed have worked and at least can help prompt you and your team to come up with your own customized programs.

I wanted to send these out and draw your attention to the importance of marketing because you may have been distracted lately. I know I have. There has been a great deal of noise over the last several months, some of it frantic, about new HIPAA regulations (watch out for the HIPAA Police!), ICD 10,  PQRS and other Medicare measures, and now the Affordable Care Act (Obamacare). And now we also have the government gridlock and debt and so on and so on.

The environment in which we do business is always changing.  And the rate of change is increasing.  It is like a sea that sometimes has big waves and sometimes little waves. At times it storms and at other times there is a dead calm. And we are the sailors and we have our ships and come what may, we sail our vessels and deliver our goods.

But the fundamentals of our businesses do not change.  And marketing is a basic fundamental of business.  In fact, it IS business.

As a doctor, your focus is on patient care, on quality clinical procedures and outcomes. And, as a doctor, it should be.

But your other role is “business person,” and business is all about the market place.  Like the summer Farmer’s Market, it is where you put something of value on display that others want.

Peter Drucker, the father of modern management theory, looked at marketing as the entire purpose of an organization.  In his book, Management: Tasks, Responsibilities, Practices (811 pages!), he says:

There is only one valid definition of business purpose: to create a customer.  Because its purpose is to create a customer, the business enterprise has two – and only two basic functions — marketing and innovation. All the rest are costs. Marketing is the unique distinguishing function of business.

He goes on to say:

Marketing is so basic that it cannot be considered a separate function (i.e., a separate skill or work) within the business, on par with others such as manufacturing or personnel. Marketing requires separate work, and a distinct group of activities. But it is, first, a central dimension of the entire business. It is the whole business seen from the point of view of its final result, that is, from the customer’s point of view. Concern and responsibility for marketing must, therefore, permeate all areas of the enterprise. (Page 63)

In other words, your entire office is the marketing department.

The top 3 reasons your marketing does not work adequately are:

  1. It isn’t done. (It is done, but only now and then, irregularly and half-vast.)
  2. No one is assigned and responsible for doing it.
  3. Those assigned to do the marketing are not given the time to get it done.

There are other reasons, of course, but these are the top three and formed the basis of our Marketing Manager System, developed in 2001.

You know all this, but it helps to be reminded now and then.

And I am reminded of the theme song in the movie, “Casablanca.”   The movie stars Humphrey Bogart and Ingrid Bergman and is a classic romance from 1942.  You may wonder what a romantic movie has to do with business and marketing, but who says that business and marketing can’t also be romantic?  (I have been accused of being unromantic before, but perhaps I have just been misunderstood!)  Shouldn’t you be in love with the work you do in chiropractic?  Shouldn’t you love your patients and be passionate about the story your office has to tell?

With apologies to Herman Hupfeld, the composer of “As Time Goes By”:

You must remember this
Promotions must not be missed
On you they do rely
The fundamentals things apply
As time goes by

It’s still the same old story
A fight for market share and glory
A case of do or die.
The world will always welcome your loving care
As time goes by.

Upcoming Medicare and Reimbursement Changes: To Survive and Thrive – You Need to Study and Train

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.”  Alvin Toffler

 

I don’t see this discussed much – at least not enough.

It’s called: STUDY.  Study is similar to training, which includes practice, and both require real personal effort and engagement to be effective.

You may want to study more but just don’t feel like you have the time to do so.  It does take time away from other activities. It can be confusing, tedious, and even seem belittling – sitting down and grinding over information, trying to figure out how something works. Practicing and roll playing can seem even worse.

But the return on your investment is worth it.   And nowadays, you have to constantly study just to stay up to date, let alone get ahead.    For example, for those of you in the insurance departments – patient accounts – you have probably had to learn many new things lately. You may have had to upgrade your computer programs for electronic health records. You have had to learn about “meaningful use” and other new terms.

But wait, there’s more!
INSURANCE
I checked in with our resident billing expert, Mr. Dave Michel, and he informs me you have the following headed your way:
  • June: new CMS 1500 claim form
  • July: PQRS implementation
  • Sept 7: WPS to NGS (Medicare administrator change in several Midwest states.)
  • Oct: new ICD 10
  • January major provisions of the PPACA and required EFT and ERA

For those of you in charge of patient reimbursement, you will have to learn about these new programs, train and then get them correctly implemented.  You have many resources from which to learn, including: association seminars and webinars, the CMS website, Chirocode.com, NGS web site for those of you in the Midwest, the PM&A Members website and Facebook page.  There are other resources as well, but the point is that you will have to study, learn, and work it out and get it implemented.

FRONT DESK AND OTHER CLINIC DEPARTMENTS
This also applies to every other job in your office. Each team member should be able to write a book about their department and job within five years and be capable of presenting a full day seminar on what they do to other chiropractic staff.

The front desk should be experts in customer service, sales for scheduling, and excellent in many other skills.  Therapy and rehab staff should know the physiological affect their machines and protocols produce for their patients. They too need to be exceptional at patient education, customer service, and as compassionate as the patient’s mother.

YOU ARE PROFESSIONALS
These are high standards, but you are professionals. You don’t work on an assembly line at the Ford plant. We now live in a networked economy. We have long since passed the Industrial Age, even though most of our management techniques still seem tied back to when “Father Knows Best.”

There is no getting around it, this is a new age. Alvin Toffler, quoted above, wrote about post the Industrial age for business in his book, The Third Wave. The second wave was the Industrial Age – and the third was and is the Information Age.

It is 2013 and your patients are smarter than patients have ever been and expect more.  They know about you before they call you and report on you after they see you so the whole world knows how you treated them.

You have to be better.  You have to study, learn, train.  In a tough economy, patients will go to the best and  bypass the rest. You have to be the best.

A NOTE TO DOCTORS
This apples to you doubly. Beyond the continuing education credits, I suggest you consider challenging yourself to constantly work on improving any and every aspect of your clinical craft like a true artisan. Like a scientist. And like a philosopher.

But you are also a CEO, which includes an entirely different set of skills. As the owner and manager of your business, you need to perfect your skills as a leader, manager, and marketer.  This is so horribly omitted (or perverted) in many programs as to be either laughable or criminal.   Once you do learn these subjects, you can delegate most of them and we can show you how, but you need to learn them nevertheless.

ONE HOUR PER WEEK
Stephen Covey talks about how you have to “sharpen the saw.”  You can cut a tree much faster if the saw is sharp and that sharpening is called training and study.  According to the American Society for Training and Development, since 1991, annual training budgets in the U.S. have grown from $43.2 billion in 1991 to $156 billion in 2011. Obviously, business sees an ever increasing need for training.

Encourage your team to take at least one hour each week to study some aspect relating to their job.   Encourage them to attend seminars and webinars and tele-classes, and have them give a presentation for the entire team at the next team meeting about what they learned.  You can give them a bonus if they give a book report about a book they read in the Lending Library.

YOUR PATIENTS
Lastly, this also applies to your patients. One of the primary functions of your office should be the training and education of your patients.  They need to take responsibility for their own health and in order to do this – they need to know what you know.  Regular care classes, a “lending library” and of course, warm “table talk” by doctor and staff help.

***SPECIAL TEAM TRAINING TELECLASS WITH PHYLLIS FRASE AND DANA PITTNER TUESDAY, MAY 21, 

12:30pm – 1:30pm CDT – “Dialogues and Dilemmas

Take time this Tuesday to listen to these dynamic ladies discuss solutions to the 10 most common conversations staff often gets stuck on with patients.

Learn how your staff can share and educate your patients on the chiropractic lifestyle.  What you can say at the front desk, in therapy, financials, etc.

There is no charge for this teleclass. For active PM&A members, you will find it on you Members site in a few days just in case you missed it.

JUST RELEASED: New Chiropractic Music Video – “Munson Style”

Just released: A new professionally recorded music video by Dr. Cindy Munson, a chiropractor in Plymouth, Wisconsin.   It features her staff, family, and some of her patients.

The more times you watch it the more little clever trivia you can find. The scenes were well thought out.

What is remarkable about this office, which is actually demonstrated by this video, is the exceptional leadership provided by Dr. Munson.  With her great staff, she has created a true chiropractic “Dream Team” – a group of professionals working together for the betterment of their patients and their community.

Feel free to let Dr. Cindy know how you liked the video or any thoughts or questions you may have.

We are proud to say that we have worked with Dr. Cindy and her team for many years.

www.drcindymunson.com

April Teleclass: Affordable Care Act:How Will it Affect Your Chiropractic Practice?

“2014 will bring the greatest changes to the health insurance industry in our lifetime. This is not bull or scare tactics. The face of health insurance – already vastly different than it was ten years ago – is about to undergo a dramatic and seismic change.” -David Michel

Join us this Thursday April 18th, 12:30 CST to listen to Mr. Dave Michel of Petty, Michel & Associates discuss the Affordable Care Act.

Mr. Michel will discuss:

  •  Are your financial plans set for further limits on care?
  •  Can you continue to treat your patients based on your philosophy?
  •  Are you ready for mandatory changes to your Dx, your EOBs, the HCFA CMS 1500 claim form, and HIPAA? All coming in 2014?

If you can catch this class as it happens, it is free! Otherwise they will be in our vault for those of you who are active members with us.

To Register visit: Surviving, Striving and Thriving Through the Affordable Care Act

Finding the Right Mix for Your Chiropractic Promotions

THE PROMOTIONAL RIVER

I sometimes receive emails and calls from chiropractors requesting a quick fix for their lack of new patients.   I often wonder if they ever got the idea of symptomatic care versus corrective and wellness care.

Effective marketing requires more than just a killer advertisement or long copy reactivation letter or a spinal screening.   It has been said that good marketing doesn’t depend on one promotion to get 50 new patients, but rather 50 promotions each generating one new patient.

Generating a high volume of new patients in your chiropractic office requires multiple channels of communication.   Consider how a river grows – through lots of tributaries. The Mississippi starts out like a creek, but then other creeks run into it and it grows and grows.

We call this the promotional mix – the blend of different approaches you use to communicate the benefits of your services.

On the following page, we have listed just a few important categories of effective promotions for your office.  Of course, there are others, but we have found that these work well and can act as a good foundation.

Mississippi

FOUNDATIONS OF PROMOTION

Effective promotion starts with individual and team motivation. It then should be entwined with all of your basic routines each day, from the way the phone is answered to the consultation and patient examination.

Beyond this, you can schedule specific health topics months in advance and offer them as workshops or “Awareness Weeks” where you provide a free screening exam and info.

Occasional special promotions should be scheduled, such as “Kid’s Day”, and community services should also be scheduled, such as screenings, relationship building with external referrals sources, and workshops.

Your presence on the Internet has to be constantly added to.

These are some of the main categories of your promotions, though advertising and public relations events can also occur now and then.

PromoMix(larger image)

KEY PROMOTIONS   


1.   Motivation.  You and your team’s desire to promote the benefits of your services create the energy to make your marketing work. Constantly nurture this.  Start with WHY?

2.   Basic Service and Chiropractic Care Procedures.   This is your foundation. Marketing is embedded in the heart of all the basic duties you do every day.  You should constantly review and try to improve on the marketing aspect of your procedures.  Be ever more cheerful, more genuine, more caring, and giving of extra-ordinary care and service.  Have “Present Time Consciousness.” It is helpful to have a checklist of these procedures to review.  Little things can slip aside and go unnoticed and a checklist helps flush everything out for inspection.  Work on a procedure or two every month so that you are constantly improving.

3.   Special Promotions. These are promotional events that can be internal, external, or both. For example, flowers to women on Mother’s Day, a Kid’s Day, Community Appreciation Day, Anniversary Day, etc.  They can be tied in with holidays, community days, parades, donation drives, etc. Most have an offer for a free service, but not all. These are IN ADDITION to the monthly education themes. Schedule these every other month or so. Promote these on the Internet and in newsletters.

4.   Community Education Program  (Monthly Health Themes) We have found that this program gradually builds momentum and if managed well, brings in more patient referrals, external new patients, and returning patients directly and indirectly. Here are some steps to make it successful.

a.    Select monthly themes around a condition or healthful topic. Can include headaches, kid’s health, motherhood, nutrition, cooking class, exercise, golf clinic, etc.
b.    Schedule a workshop time or “Awareness Week” (free screening exam last week of the month)  at the end of each month.
c.    Customize a poster. Samples on our Members site or make up your own.
d.    Do a YouTube video on the subject the month before. Post on Facebook, web site, YouTube channel and embed in your email
e.    Send out an email notice promoting the event, with a link to the video Health Tip, testimonial, etc.
f.    Send a hard copy newsletter with testimonials mailed to some of your patient files now and then (3 months) and all files every 6 months.
g.    Posters distributed locally and as statement stuffers.
h.    Press releases can be sent to local papers/electronic calendars.
i.    Ads are an option.

5.   Community Services. These are scheduled each month and include screenings, workshops and external referrals source development (MDs, businesses, DDS, auto body shops, etc.)

6.    Keep The Conversation Going: Internet And Newsletter.  Update your Internet presence and post new info regularly. Set a goal of how many hours it gets worked on each month, eg.  1 hr a week.  You could also use a checklist (we have one on our PM&A Members site). This would include Facebook postings, YouTube, directory sites (Yelp, Healthgrades.com. etc.), and search engines (Google, Bing, etc.).  And, of course, your website/blog.  Add patient testimonials, photos, and health tips. Keep posting – but keep most of the info local and “newsy,” just short of gossipy.  Also, send out electronic and hard copy newsletters with similar newsy content and notices for upcoming promotions, talks.

7.   Public Relations and Advertising.  Radio ads and print ads promoting specials events can be helpful now and then. Public relations such as press releases and donation drives can add long term good will and should be done a few times a year

3 Month Marketing Planner [Link]

2013 – Teleclass Schedule – Poster

phone

We are excited about our upcoming teleclass schedule for 2013 which will start this Tuesday, March 19th.

We have an awesome line-up of teleclasses for you and your staff in the areas of chiropractic philosophy, office procedures and reimbursement.

Class description and registration can be found on the calendar on this site.

We have also prepared a poster you can print and post on the wall in your staff commons area for an easy view of upcoming class.  [Link]

If you can catch these classes live, they are free! Otherwise they will be in our vault for those of you who are active with us.  Hope to “hear” you in class.

6 Reasons Why CalJam is Important for Chiropractic

grandpaskater

1. It is fun and promotes that chiropractic is and should be fun.

2. It’s founder and promoter is in practice, adjusting people of all ages, just like you.

3. It focuses on the purpose of chiropractic and the chiropractic lifestyle.

4. It defines and promotes the unique role chiropractic has in the market place – as a HEALTH profession that works, is not owned or used by pharmaceutical companies or other corporate monopolies, is vitalistic while also being scientific.

5. It promotes the idea that helping people to get healthier does not have to be a grave, stuffy, or serious activity.

6. And just like Dr. Billy DeMoss demonstrates, we all can work on higher purposes – professionally and personally —  while at the same time adjust people daily (APD) and run a business.

There are other reasons, but the ones above should be included.  Please add others below.

I hope you an make it to CalJam this year.

Some of us from PM&A are going and if I see you, let me treat you to the nearest greenest, anti-inflamatory drink nearby, or a piece of buffalo jerky, whichever is handier.

And if you can’t make it, you can always follow Billy on YouTube.

And either way, in your own way, you can always follow your own higher purposes and keep jammin in your corner of the world.

 

Chiro-jamming in an office near you..

Ed, and all of us at PM&A

===

CalJam.org

Dead Chiropractors Society

Chiropractic Maintenance Care: Medicare Settlement Means No More “Improve or You’re Out”

In what could be a landmark decision for chiropractors that have long asserted that regular chiropractic care for seniors with chronic conditions actually saves Medicare money and keeps seniors active and independent, an agreement has been reached.

A Federal Judge has approved the proposed Settlement Agreement in the Medicare Improvement Standard case, Jimmo vs. Sebelius, [Link] clearing the way for thousands of Medicare beneficiaries to receive needed health services to maintain their current level of functioning. While not specifically aimed at chiropractic, the exciting implications remain.

The settlement, which represents a significant change in Medicare coverage rules, ends Medicare’s longstanding practice of requiring people to show a likelihood of improvement in order to receive coverage of skilled care and therapy services. It specifically pertains to “…those with disabilities or suffering from chronic illnesses such as Alzheimer’s disease, Parkinson’s disease, ALS, lung disease.” (ital added)

The Agreement, which is retroactive to the date of the suit was filed, January 18, 2011, includes skilled services covered by Medicare Part A and Part B, such as speech, occupational and physical therapy, nursing and home health services, even when the goal is maintaining the patient’s current condition rather than requiring that the patient improving.

The Medicare law has never supported the “”improvement standard.” Nevertheless, for decades beneficiaries have been denied needed services because they are not improving or have “reach a plateau”, sometimes with devastating results. The Center for Medicare Advocacy says providing maintenance services will save money in the long run, preventing decline, hospitalizations and need for more expensive services.

The official approval of the settlement means the Center for Medicare and Medicaid Services (CMS) must develop and implement an education campaign to ensure that Medicare providers are not denying coverage for vital maintenance services to those with any chronic illness who meet other qualifying Medicare requirements.

The “maintenance standard” is effective immediately. Importantly, this does NOT change anything at this time for you, your documentation, or your patients. Even though we have not seen the official documentation that Chiropractic Maintenance Care is included in this settlement, we are hopeful and following this closely.

More Info:
http://blog.aarp.org/2013/02/06/amy-goyer-medicare-pays-for-skilled-therapy-for-maintenance-with-chronic-illness/