Why You Should Keep Smiling in Your Chiropractic and Healthcare Office

receptionist at chiropractic office working with a customer

More Chiropractic Jokes Please!

In the late 80s, when I took my son to his first adjustment, I noticed bold but innocent cards on the doctor’s front desk counter.

They said, simply, KEEP SMILING.

Over the years, I have often seen this card at chiropractic events and offices – almost as a chiropractic tagline: KEEP SMILING!

I would love to know the history of this phrase, and if anyone knows, please come over to the Blog and explain it, or hit reply with the info and I’ll share it with your permission.

I have seen it on a chiropractor’s envelope from the 20’s, so I know it goes back a while.

SMILING MAKES YOU HAPPIER AND HEALTHIER

Getting those smiles out will improve your mood and improve your health.

IT’S SCIENCE.

Something the chiropractors of the 1920s and before knew.

“When you smile, your brain releases tiny molecules called neuropeptides to help fight off stress. Then other neurotransmitters like dopamine, serotonin and endorphins come into play too. The endorphins act as a mild pain reliever, whereas the serotonin is an antidepressant. One study even suggests that smiling can help us recover faster from stress and reduce our heart rate.”*

Try right now — SMILE!

See! It works.

OK then, DON’T SMILE. Gotcha. It works. :- )

Smile, laugh, and the whole world smiles with you. Frown, and you frown alone.

SMILING IMPROVES PRACTICE PERFORMANCE

But smiling can also improve your practice.

A happier office will have better performance.

“Smiling can have a positive impact on our performance at work. Research has shown that when we smile, we experience a boost in mood and a reduction in stress levels. This can lead to increased productivity and better performance on tasks.”*

2 METHODS TO SMILE MORE IN YOUR CHIROPRACTIC HEALTHCARE OFFICE

Old School Trick: Front Desk Mirror

Place a mirror facing towards the staff on the front desk. It should be so that it can be seen by whomever is working at the desk and answering the phones.

Place a caption on the bottom of the mirror. Something like: SHOW YOUR TEETH!

People can tell if you are smiling when they talk with you on the phone.

Morning Meeting Jokes

For your morning case management meetings, one person is assigned to tell a joke. The next day, it is someone else’s turn to tell a joke. Each team member must tell a joke.

Yes, the jokes are usually dumb, and it can be embarrassing. But it is also can be funny!

And besides, there is B.J. Palmer’s Rule Number 9:

“Don’t take yourself too damn seriously.”

So, that’s it.

Don’t be so serious!

Smile more, and you’ll find more things to smile about.

To help get you started, I found some chiropractic jokes and put a few of them below. More are on our Blog. (Also added an acupuncturist and dental joke.)

Have a funny day!

😊

Ed

Some bad jokes!

I never believed that chiropractors could solve my back problems.

2 weeks later, I stand corrected.

Did you hear about the chiropractor who got in trouble with the IRS?

It was for back taxes.

What do you call two chiropractors who’ve got each other’s backs?

Vertebros.

My chiropractor and I got into a terrible fight in the middle of my neck treatment.

Now I have to spend the rest of my life looking over my shoulder.

What’s the difference between a chiropractor and a proctologist?

You go to one if you need your finger cracked and the other if you need your crack fingered.

I went to the acupuncturist the other day.

When I got home my voodoo doll was dead

Be kind to your dentist.

He has fillings too.

My chiropractor is serious as hell.

But he still cracks me up.

“But Quasimodo, what makes you think you need to see a chiropractor?”

“Oh, it’s just a hunch…”

I go to the chiropractor because my wife told me to.

At least I assume that’s what she meant when she said, “Prove to me you have a spine.”

I had to quit going to the chiropractor …

I felt he was always trying to manipulate me.

Does anyone remember the joke I made about the Chiropractor?

It was about a weak back.

Went to see my chiropractor for the first time in a long time.

First thing he said when I walked into his office was “Glad to see your back!”

How many chiropractors does it take to change a light bulb?

Only one, but it takes 24 visits.

Good friends are like chiropractors.

They have your back and set you straight.

Don’t ever let a chiropractor tell you a joke.

It’ll hit your funny bone.

One thing I have learnt this year is to never trust acupuncturists

They’ll stab you in the back the first chance they get.

My dentist mocked me today, saying that even though he’s much older than me, he has healthier teeth.

I said it must be because he has the better dentist.

References:

*Grin and Bear It! Smiling Facilitates Stress Recovery-  https://www.psychologicalscience.org/news/releases/smiling-facilitates-stress-recovery.html

*Smiling: The Surprising Benefits You Never Knew About – https://psychologily.com/benefits-of-smiling/

*New Study Suggests Smiling Influences How You See the World-https://www.psychologytoday.com/us/blog/the-right-mindset/202008/new-study-suggests-smiling-influences-how-you-see-the-world

*The Health Benefits of Smiling-https://intermountainhealthcare.org/blogs/the-real-health-benefits-of-smiling-and-laughing

—————————————————-

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.

goal driven business book for CEO and Office Managers by Edward W Petty.

The Goal Driven Business, By Edward Petty

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How to Grow a Chiropractic and Health Business

How to grow a chiropractic business

I was recently invited to my son’s wife’s family’s apple butter cookout. Yep, that’s right, cooking apples over an open fire. It’s a tradition.

It is also apple harvest season up here in the northern Midwest. You got yur Honey Crisps, Honeygolds, Snowsweet, Fuki, Jonathans and others. Lots o’ apples!

Harvest time.

I bring this up because, well, it applies to your office. Here’s how:

THE LAW OF THE FARM

There is a metaphor called the “Law of the Farm” or the “Law of the Harvest.” Stephen Covey refers to this in his book, The Seven Habits of Highly Effective People. (I include a link to a short video below)

The concept comes from the observation that apples come from farmers farming. An apple orchard requires tender, loving care over the entire year from growers who plan and carry out disciplined regular work to ensure a bountiful harvest.

Aside from occasional droughts or freezes, if your harvest is poor, it is not because of the “apple spirits,” or that maybe you had a bad childhood. It is because one or more of the necessary preparatory actions needed to produce the apples were not done.

There are no shortcuts. Getting angry with the apple trees does not help.

YOUR CHIROPRACTIC AND HEALTHCARE PRACTICE IS LIKE A FARM

The Law of the Farm, or the Law of the Harvest can be applied to your practice in the following ways:

  1. Long-Term Planning. Just as a farmer plans their crops well in advance, a business should set clear goals and strategies for the future. This includes defining your mission, the key values of your team that determine its culture, the outcomes, and production goals.
  2. Investment and Resources. Just as a farmer invests in seeds, land, and equipment, you must invest in your resources wisely. First and most important, invest in your people, including yourself: training, coaching, and hiring. Marketing, in one form or another, is always a necessity. Updating software and equipment, occasionally, or the décor of your office is also an investment.
  3. Consistency and Diligence. Sticking to what works is vital. This is why I recommend job checklists as part of the Goal Driven System. It takes discipline to keep doing what works, but consistency brings about confidence in your patients and your team. Daily tasks and routines are like tending to crops regularly.
  4. Patience and Adaptation. Just as a farmer must wait for crops to grow and adapt to changing weather conditions, chiropractic practice owners must be patient and adaptable. Success may not come immediately, and you will face unforeseen challenges. Being able to adjust strategies and remain patient when unexpected failures occur is critical.

Looking at your practice as something you need to grow to produce excellent outcomes is a useful exercise.

Patience can be tough to master as a business owner when you have invested everything on the line. But if you have done your preparation, as all farmers must do, most of your concerns are for naught.

The Law of the Farm is a principle from which you can draw many associations to your practice. As an exercise, you might discuss this with your team: How can we apply the Law of the Farm to our practice and improve our service?

APPLES DO NOT COME FROM THE GROCERY STORE

Similarly, happy patients, completing their chiropractic or healthcare treatment program, being relieved of pain, healthier, and referring others do not come from the new well-advertised social media ad campaign. All the shiny new ads and promotions don’t make up for the Law of the Farm.

There are no shortcuts.

You reap what you sow — and nurture and take care of.

We are all farmers!

Ed

PS I also discuss this in The Goal Driven Business, #15 Goal Driven Principles, page 262 Be a Farmer: Grow Your Business and Your Customers

Watch this short video about the Law of the Harvest.

https://resources.franklincovey.com/mkt-7hv1/law-of-the-harvest-2

How Gratitude Can Improve Chiropractic and Healthcare Practice Performance

Be a Good Finder

One business owner (a dentist this time, not a chiropractor) I worked with years ago seemed to always be in a bad mood.

He was quiet and basically ignored his staff. His opinion was that he paid them to work, they should work hard, and that was it. But his office wasn’t doing well, so he called me in. I made several visits to his office, each time simply working to improve empathetic communication with his team. I coached him on listening to each staff member and to simply acknowledge them for their contributions.

A few months later, we saw his practice grow. Numbers were headed up!

I remember this because he was always complaining to me that I wasn’t doing anything for his office! His constant criticisms and lack of appreciation were the real problem, but he didn’t see it. While I was countering his abusive lack of gratitude for the support he was receiving from his staff, I tried to coach him on his issue.

Apparently, he was a good dentist, but to his strife and possible forever struggles, he was both a poor clinic director and student.

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Employee Performance

So, I just want to mention and remind us all how important it is to be grateful and express gratitude.

When gratitude is expressed to others, many benefits occur. A simple “thank you” goes a long way in improving the morale and ultimate performance of others. Of course, it must be genuine. Counterfeit praise is easily seen through and can do more harm than good.

According to Tom Rath, co-author of How Full Is Your Bucket, “Gallup polling has revealed that 99 out of 100 people say they want a more positive environment at work, and 9 out of 10 say they’re more productive when they’re around positive people.”

He points to research that shows when a work team has more than three positive interactions with managers for every one negative interaction, it is significantly more likely to be productive. The point is not to keep managers from correcting or reprimanding but just to express more praise.

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Gratitude is Good Health Care

“The practice of gratitude can have dramatic and lasting effects in a person’s life,” says Robert A. Emmons, professor of psychology at UC Davis [my alma mater!] and a leading scientific expert on the science of gratitude.

“It can lower blood pressure, improve immune function and facilitate more efficient sleep. Gratitude reduces lifetime risk for depression, anxiety and substance abuse disorders, and is a key resiliency factor in the prevention of suicide.” **

According to UC Davis Medical Center, “Gratitude is associated with higher levels of good cholesterol (HDL), lower levels of bad cholesterol (LDL), and lower systolic and diastolic blood pressure, both at rest and in the face of stress. It also has been linked with higher levels of heart rate variability, a marker of cardiac coherence, or a state of harmony in the nervous system and heart rate that is equated with less stress and mental clarity.

“Gratitude also lowers levels of creatinine, an indicator of the kidney’s ability to filter waste from the bloodstream, and lowers levels of C-reactive protein, a marker of cardiac inflammation and heart disease.”**

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Be a Good Finder

You don’t have to have a PhD to understand that people respond well when they are noticed for something they did well.

So, this newsletter is just a reminder.

And I know that some of you, chiropractors, acupuncturists, dentists, vets, Vitalistic or not, have experienced the phenomenon of quantum entanglement with your patients – or even with your team. Being a “good finder,” creating positive relationships, and thinking positive thoughts about others — if genuine — often do bring positive effects. I have seen it, and I am sure you have too.

So, be a Good Finder…

…and More Good will find you.

Ed

https://health.ucdavis.edu/medicalcenter/features/2015-2016/11/20151125_gratitude.html

 

More New Chiropractic and Healthcare Patients Through Positioning

Joe Montana and chiropractic

Positioning is a marketing term that refers to how your services are perceived in the minds of customers or potential customers.

For example, you get two different concepts when you think of a Timex $40 wristwatch and a $10,000 Rolex. In selling these products, advertising deliberately tries to position each in your mind so that they are different but appealing.

The fact is, they do about the same thing. But, positioning them can make each more appealing to different groups of people. In marketing Timex watches, for example, they might show busy people working or athletic people with a tagline that says: “takes a licking and keeps on ticking.” On the other hand, Rolex offers images of elegance or authoritative men in suits. Both of these appeal to different groups of people with different wants.

HOW CAN POSITIONING GENERATE MORE NEW PATIENTS FOR YOUR OFFICE?

Let’s start with the position chiropractic has in most people’s minds. According to a Gallup Poll in 2015, 60% of Americans think chiropractic is effective for neck and back pain. Only 11% disagree. The rest don’t know or are neutral.

That means that, in consumers’ minds, you guys generally have the position of treating neck and back pain. Here is one approach to using this:

NATIONAL PROGRAM – Spinal Health Month

You can position your services with a national health campaign. This is what Big Pharma did with the COVID jabs, and what they do with flu shots. It’s manufactured marketing, of course, and promoted authoritatively as part of a national program.

You can do the same! (An application of guerrilla marketing!)

And remember, your stats are better than Big Pharma’s and corporate medicine! (You should probably ensure that your patients know this.) While respecting the good work of individual MDs and certain medical clinics and organizations, which there now seems to be more of after COVID (E.G. FLCCC), keep in mind that the U.S. medical system comes in LAST compared to other industrial countries.(link below)

The American Chiropractic Association promotes what they call National Chiropractic and Health Month in October. Also, Congress recognizes October as National Spine Health Awareness Month. And although a bunch of MDs also promote this, you could use it. I recall when the ACA, and maybe the ICA, promoted October as National Spinal Health Month.

I don’t think it really matters. You can promote your own National Spinal Health and Fitness Month and position your services next to this campaign. We have done this over the years very successfully. Figure that your campaign is more helpful and therefore more legit than those promoted by the drug industry and its lackeys and mercenaries.

There are dozens of approaches to this. I’d be happy to spend a few minutes with you to give you some ideas that have worked. You could:

  1. Send out reactivation letters. “It’s Spinal Check-up Time!” and offer a free screening, discount massages, or just healthy cupcakes.

  2. Put a banner in your office; “October is National Spinal Health Month — Schedule your family for a Health Check-up.” Print up a poster and fliers and encourage your staff to have patients bring in those they care about for a check-up.

  3. Send out an email promotion for this important national event.

ATHLETES

How about another example, maybe for November?

Despite the little medical emphasis on the importance of exercise, people are finding out on their own how vital physical activity is to maintain their health. To some degree, more people are becoming amateur athletes.

Go with this!

Position your services as designed to improve athletic performance. Stay in the Game Longer! Position your services next to famous athletes who testify how chiropractic was essential in achieving their accomplishments in sports. (Link to some chiropractic athletes below.) Promote the fact that all U.S. professional football teams have chiropractors. In fact, you can look up your team’s chiropractor. (link below.)

You could call the team’s D.C. and possibly get a quote or meet with them for a photo opportunity. You could meet with the local high school coach, promote this, and arrange screenings for their players.

By positioning your services next to successful high-performing athletes, the audience can easily make the association that your services must improve physical and functional performance.

So those are a couple of ideas for using positioning to generate more new patients, reactivate former patients, and keep the ones you have.

You’re the coach. Get the team in for care!

Seize the WIN!

Ed

Pro football chiropractors.

U.S. Health system ranks last.

Athlete quotes on chiropractic

Some promotional ideas for October:

Gallup poll on chiropractic favorability.

—————————————————-

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.

goal driven business building methodology

The Goal Driven Business By Edward Petty

goal driven business buy now button
 
 
 
 

Five Patient Wants In Healthcare and Chiropractic

Based upon surveys, patients want the following from their doctors and health providers (References below):

  1. Quality of care: Patients prioritize high-quality care from their doctors and health providers. This includes accurate diagnoses, effective treatments, and positive outcomes.
  2. Communication: Patients value clear and effective communication with their doctors and health providers. They want their concerns to be heard, and they want to be well-informed about their treatment options.
  3. Empathy and compassion: Patients appreciate doctors and health providers who show empathy and compassion towards their needs and emotions. They want to feel understood and supported throughout their healthcare journey.
  4. Timeliness: Patients desire timely access to healthcare services, including appointments, test results, and treatment plans. They value minimal wait times and efficient care delivery.
  5. Patient-centered approach: Patients want their doctors and health providers to involve them in decision-making processes and consider their preferences and values. They appreciate personalized care that respects their individual needs.

What would happen to your chiropractic or healthcare practice if you and your team committed to a 12-month Patient Service Program to improve how your office meets these five Wants? You could give each category 20 points and have everyone give each one a grade from 1 to 20. The consensus might end up with a grade of 80 points, or 70, or 92 when all 5 are added together.

Then, over the next 12 months, everyone could work together each month on each category by refining the procedures and improving service skills. You could schedule in-office team training and individual training through seminars, webinars, and even books.

Guess what would happen to the patient referrals, patient retention, and goodwill as things improved? What would happen to staff morale as their competence increased each month and they saw that patients became happier by working on improving service?

SYMPTOMATIC VERSUS STRENGTH BUILDING MANAGEMENT IN CHIROPRACTIC AND HEALTHCARE

Symptomatic management focuses, as it sometimes must, on the urgent necessitates that immediately increase income. But chasing symptoms, putting out one fire after another, is a trap we can all fall into. You stay busy. There are challenges that you overcome. So, it may seem that you are moving forward. But the months and then years go by, and you look around and are still doing what you were doing years ago. Nothing has changed.

Excellent management addresses urgent concerns but also carves out time to strengthen the skills and procedures of the service team. It builds for the future. And it does so by training, coaching, analyzing and steadily improving each of the 5 service categories, the 5 Wants. Over the long run, this gives patients what they want, and everyone wins.

Help your patients get what they want.

Carpe Futurum (Seize the Future!)

References: Patients’ preferences. PubMed , HCAHPS: Patients’ Perspectives of Care Survey

—————————————————-

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.

 
goal driven business building methodology

The Goal Driven Business By Edward Petty

goal driven business buy now button

Chiropractors and Other Doctors: Do You Placate Your Patients?

 

Goal Driven to tell the truth. Chiropractic, business management

Faith, Confidence and Belief

It is an oversimplification to say that chiropractors, and other doctors, who remain true to their principles and goals are less stressed and more productive.

And make more money.

But I’ve seen it.

You need Faith, Confidence and Belief (FCB!) in yourself, in your knowledge and skills, and what your office can do for people. (I learned about FCB from Dr. James Parker at a Parker seminar years ago.)

With these qualities, you can tell the truth and be honest. And stick to your guns.

A naturopathic and chiropractic doctor I follow on a social media site said this:

“If someone was poisoning themselves slowly with their lifestyle habits, you bet I let them know. Isn’t that what doctors are supposed to do? Truth be told, most everyone already knew. People aren’t stupid, just in denial.

“Last time I checked it’s our job to tell them the facts. Not placate them or worry about hurting their feelings with said facts…Because that’s what most doctors are doing. They beat around the bush so as to not offend.

“Of course, I was always professional and kind, but I still called a spade a spade.

“The word doctor means teacher, not enabler.”

CASE ACCEPTANCE AND FOLLOW-THROUGH FOR YOUR CHIROPRACTIC PATIENTS

From a marketing perspective, people buy from those they trust. And they trust people who have certainty.

If you equivocate – dodge the facts – your patient will see that you are unsure what the heck you are talking about. They will be less likely to commit to a care program or follow through.

On the other hand, if you apply your knowledge and skill with certainty and confidence when you look at their case, explain it to them, and recommend a treatment plan that is best suited for them, their chances of commitment and follow-through are very high.

WHAT GETS IN THE WAY OF YOUR TRUTH

One of the benefits of seminars is that your convictions can become rekindled. You are reminded of your truth.

But after a week or so, back at your office, the fire of your passion begins to dim. And rather than gliding through your day, it starts to feel like you are plodding through mud.

What gets in the way of your pure-hearted and stalwart convictions about health and your principles and purposes?

And what is it that slows you down?

ADMIN. Administration. Everything that is NOT patient-related. The organization and running of the support machinery of your practice start to pull you into its noise, worries, corrections, and sometimes drama.

Policies, procedures, and people do not all move smoothly and cooperate conveniently or get implemented as excellently as you hope. And this can be a major distraction.

Practice management can get messy!

This is why organizational structure and management are so very essential. Maybe not when you are a wild entrepreneur just starting out. But as your business grows, administrative details flood in – and clog up the works. More than most doctors realize!

AN ORGANIZER FOR YOUR CHIROPRACTIC ADMINISTRATION

The solution is to take time to work ON your business.

Then, assign someone to be your MANAGER to help you improve the organization and take care of the admin.

They will need training and you’ll need to work with them.

And to be direct, and not to beat around the bush, if you don’t do this, you will be forever stunted in your practice growth and work-life balance. And you will lose money.

But with an organizer, someone who is managing your practice administration, you will be less distracted and more grounded in your truth to help your patients get and stay on the best track for their health. And, your practice will be more profitable.

Our high-level training for your manager (and you) begin September 18. For more info below.

Keep to your truth,

Ed

Advanced Practice Manager Training, Beginning September 18.
Find out about it here.

MUSIC You made it this far, so enjoy some music – as a tribute to Robbie Robertson – The Weight – Playing for Change.

 

The Biggest Factor in your Chiropractic or Heath Practice’s success?

You might say it is clinical expertise. Or motivation? Or marketing Or …philosophy.

After visiting chiropractic offices nationwide for over 30 years, I can tell you that none of these factors are the most fundamental. Important, yes. But sooner or later, they all get derailed and sidetracked because of one factor — management.

HOW GROWTH TRAPS YOU AS A CHIROPRACTIC AND PRACTICE OWNER

Growth creates its own barrier. As you see more patients and your visit volume grows, so does your administrative and marketing duties. In fact, they grow about twice as fast. But for the most part, they aren’t noticed as you are busy with patient care. After a while, tasks backlog and pile up, staff get confused, and the floor cares in and down goes your practice.

As you grow, you run into a mostly invisible organizational barrier. This creates a big dilemma: How can you be at your best as a caring, empathetic doctor focusing on delivering the highest quality outcomes possible to your trusting patients — while at the same time managing a growing business.

You can’t.

You need a trained, Goal Driven manager to take care of the practice administration for you.

IT’S THE MANAGER!

But you don’t have to take it from me.

Michael Gerber pointed this out in his famous book, The E-Myth, in the 1980s.

And recently, after analyzing hundreds of businesses and thousands of business people, Gallup scientifically came up with the following conclusion:

“Based on our largest global study of the Future of Work, Gallup finds that the quality of managers and team leaders is the single biggest factor in your organization’s long-term success.”

A PRACTICAL MBA FOR YOUR PRACTICE MANAGER AND YOU

There are no intensive training programs for practice managers in the chiropractic profession. There sometimes are some short classes at seminars on various “management” subjects, but nothing formal or comprehensive. And nothing for doctors to be trained as CEO’s, though some chiropractic colleges offer two-year MBA programs for $20,000 or more.

Over the last year, we have been building a training program for practice managers.

The program is primarily for managers, but doctors will also receive training as Clinic Directors. It is an 11-week program with 30 short classes taught in live webinars over 11 weeks. It includes round table discussions with the managers, weekly homework for the manager graded by me, a private manager’s club, and many other innovative teaching procedures.

The outcome is a Goal Driven practice manager and practice Clinic Director who knows how to move their practice forward to achieve its fullest potential and comfortably stay there.

Over the next several weeks, I will post articles and videos on practice management and leadership for you and your practice manager in addition to the usual Tuesday emails.

If you are interested in this program, just reply to this email, and we will contact you.

I am only accepting a maximum of 7 offices as this is the first Founder’s Round for charter members. So don’t wait if you are interested. The class is filling, and once we are full, that’s all I can take.

MANAGEMENT SUPPORTS EVERYTHING IN A CHIROPRACTIC AND HEALTHCARE PRACTICE

You can attend seminars and learn new adjusting techniques, buy new therapy equipment, and purchase all the advertising you can. But when the rubber meets the road, you need people and systems to support you. Who will train and coach your team, write up and practice new procedures, and handle the growing administrative responsibilities?

If you have a trained manager and you have been trained in our new Fast Flow CEO Method, the admin tasks will be managed proactively and responsibly.

And you know what? Managers want to be trained. They want to improve and be more valuable to the practice.

WHEN YOU NEED A PRACTICE MANAGER AND WHEN YOU DON’T

If you are operating comfortably at 40-50% of your full capacity, you have the time to be the practice manager yourself. If you want.

But if you are growing, operating at 80% or more of you full capacity, or if you have a large practice, with multiple doctors, providers, or ancillary services, you are losing revenue if you do not have a trained Goal Driven practice manager taking care of practice administration.

MANAGEMENT TIP FOR THE WEEK.

Do what you do best.

And delegate all the rest.

Ed

The Best Leadership for Your Chiropractic and Healthcare Practice

Improving productivity through greater engagement.

I try to base all my practice and business recommendations on observations I have had and also on the research from those of others.

Dave Michel and I have an advantage: we are not doctors and therefore are not biased on any particular type of clinical practice. We are managers and not doctors, so we don’t advise that you do it “our way.” We look for what works and what is best for the patient, the practice, and the owner.

After viewing hundreds of practices, I distilled down the essential elements of what we saw that were most effective and least effective. I then integrated research from other business scientists and laid out a simple growth and practice development plan that was not based on any one doctor’s personality.

Jim Collins is one researcher whose information we incorporated into our work, Eliyahu Goldratt, Stephen Covey, and scores of others, including Michael Gerber.

MICHAEL GERBER

Gerber’s book, The E-Myth, states that, from his experience as a business consultant, people who start a business have three roles: the entrepreneur, the technician, and the manager. By his definition, the technician would be the doctor or health care provider who would also have the role of business owner or entrepreneur.

Most doctors focus on being doctors and making a living as business owners or entrepreneurs.

The manager role is short-changed. It is a difficult role to fulfill as who has time to manage and see a full load of patients. You are paid for providing service… not for managing. Right?

In a practice, the “manager” is really the CEO, or Clinic Director — whatever term you care to use.

This role breaks down into three major functions, all supporting the delivery of clinical services and generating income for the practice and business. These three functions are:

  • Leadership
  • Management
  • Marketing

A good portion of these functions can be delegated using the Goal Driven System, as discussed in the book, The Goal Driven Business.

I want to zero in on leadership.

LEADERSHIP

Gallup states that it has done extraordinarily comprehensive and long-term studies on leadership. They report, “The most effective leaders rally a broad group of people toward an organization’s goals, mission and objectives. They lead. People follow.”

In their studies, they have found that people need or seek the following from their leaders:

          • Trust
          • Compassion
          • Stability
          • Hope

This is what your team wants from you as their employer and Clinic Director.

One of the biggest challenges in all offices is a support team that loses its motivation and is no longer engaged. If you can develop these 4 feelings in your team, their motivation and production will improve.

The big challenge, which is not usually resolved in most practices, is how to be an effective leader and take care of a full caseload of patients.

MANAGEMENT

This is where the function of management comes into play.

The function of management is THE lever, THE Leverage Point (Principle 13 in The Goal Driven Business), that allows leadership to function and a practice to reach its full potential.

I will reveal new information about this next week, but for now, consider the 4 needs employees seek from you as their employer. Write them down on a piece of paper and consider them your goals in your role of Clinic Director.

Seize the Future through Trust, Compassion, Stability, and Hope.

Till next week,

Ed

Strengths Based Leadership – Gallup, 2008
E-Myth Revisited, Michael Gerber

Reach and Maintain Maximum Cruising Altitude in Your Chiropractic or Healthcare Practice

A chiropractic or health care practice flying high.

As a chiropractic or healthcare business owner, you ultimately have 1 of 3 destinations you want to achieve.

  1. Cruise at Maximum Altitude. Reach your full operational capacity, stay there and cruise, accumulate wealth, and enjoy the ride.
  2. Cruise at Maximum Altitude and Expand. Reach your full operational capacity, then clone yourself and bring on other doctors, providers, or heaven help you, other offices.
  3. Attain Maximum Altitude and Sell. Reach your full operational capacity and sell your business.

Operating at full capacity would be adjusting and treating as many patients as possible comfortably with full staff support. It would be your maximum production level where you, and all the doctors and providers, were fully booked.

Getting to your full capacity is one thing. Staying there is another altogether.

There are several reasons why it can be so challenging to maintain your maximum capacity. Some causes are apparent, some hide in plain sight, and some are difficult to recognize, accept, or overcome.

Here are a few:

  1. You are a chiropractic or healthcare entrepreneur. You like the challenge of growth. But you get bored easily. After you reach the top of the mountain, you look around for another challenge, and in the process – oops! You stop doing what worked.
  2. Passion, Inspiration, & Fast Marketing. You can often achieve high production because of sudden inspiration from a recent seminar or tapping into a new marketing niche. In either case, passion doesn’t last forever, and fishing holes are soon fished out.
  3. Your team is not ready. You don’t have the team in place to support the higher volume.
  4. Doctor AND CEO. You don’t have the time and energy to provide high-quality care to more and more patients AND manage your business at the same time.

Other snares, barriers, landmines, pirates, and even false prophets block your growth, pull you down, or lead you astray and keep you from hitting your maximum altitude, but the above four are common.

Here are remedies to the above 4 hurdles:

  1. Yes, you are an entrepreneur but keep doing what works. It may need some adjusting now and then, but if you were calling the new patient after their first adjustment and treatment when you were growing and doing well – keep doing it!
  2. Generate your own inspiration weekly. Read, watch videos, go to where you go for spiritual revival, and talk to positive colleagues. Talk to your coach(s)! You could go to a hospital or talk to nurses and see what happens to people who didn’t see you! Remember, the Power comes from above down and then inside out.
  3. Invest in building your team. It takes time to build an expert team. Ensure you hire right and then regularly coach your team.
  4. Systems. The dilemma of being an expert doctor while also a competent CEO is solved by implementing systems, especially management systems. Michael Gerber discussed this in his book, The E-Myth, a standard text for most owners of service businesses. My book, the Goal Driven Business, expands upon it.

Apply these 4 remedies now — and when you do reach your full capacity, you will have a much easier time staying there.

If you are looking for a guide or a flight instructor to help you reach your cruising altitude, let me know!

Seize Your Future,

Ed

Three Phases of Chiropractic Care are Like 3 Goals for the Patient

chiropractic, goal, driven, chiropractor, petty, michel

It was a warm summer day when I was driving my Kawasaki Intruder south down Highway 101 in Oregon near the California border when the fog rolled in. Although I had gloves on, they didn’t help. Hitting a cold fog bank on a motorcycle, the wind chill hits you hard. I was cold, but when I noticed that the front wheel was shaking because I was shaking, I decided that was enough. I found a roadside motel and called it a day.

After a two-hour shower just to warm up, I settled into a chair in my room and started reading some material from a client’s office. It talked about the 3 Phases of Care for patients. I knew about these phases, though never paid much attention to them, and I don’t expect many doctors I worked with paid much attention to them either.

Then, it hit me: these Three Phases of Care are like three goals of care:

  1. Relief – Goal 1
  2. Correction-strengthening – Goal 2
  3. Maintenance-Wellness — Goal 3

Then I had this kinda mind-blowing experience: Could these three goals for patients also apply to three goals for a practice? This was a mind-altering question, and after the room stopped swirling, the answer was obvious – YES. The three goals for a patient were similar to the three goals for a practice.

  1. Profit — Goal 1. (This comes from immediate production from marketing. Not enough cash flow is painful!)
  2. Service — Goal 2. (The best quality at full capacity comes from a strong practice where all major issues are corrected and in alignment.)
  3. Higher Purposes. — Goal 3. Our why, our mission, our reasons for Goals 1 and 2.

From this experience, we named our seminar series in 2008 – 2010, The Three Goals. And it was from this that I later named my book, The Goal Driven Business.

3 GOALS FOR YOUR CHIROPRACTIC AND HEALTH ORIENTED PATIENTS

I think to be agreeable and to give patients what they think they want, doctors often focus on relief care, and once the patient feels better, the patient leaves. Trying to convince patients to stay longer can seem like pressuring the patient, or it just takes up too much time.

Yes, educating your patients on correction and wellness does take more work. But your patients want this. They just don’t know it. They are symptom oriented – trained and treated by a medical system rather than an actual health system.

The hardware store thinks it is selling a hammer to a man. Yes, but they are also selling something that puts a beautiful painting on a wall at his home that makes his wife happy. The hardware store is selling… a hammer, a hung artwork, and happiness.

As the doctor, are you selling just a hammer, or are you also selling happiness?

3 GOALS FOR YOUR CHIROPRACTIC AND HEALTHCARE PRACTICE

Unfortunately, the habit of only treating symptoms carries over to practice management. We don’t take the time or feel we have the time to invest in ourselves, let alone our staff. Constant training, coaching, and sometimes counseling for yourself and your team are required to become stronger and more in alignment with the goals of a healing office. In the end, this improves income, service, and practice freedom.

For happier patients and a happier office, apply all 3 Phases of Care, or Goals, to your patients and to your practice.

Ed

I can show you how this is possible. Read the Goal Driven Business and contact me!

What Is Effective Chiropractic Practice Management?

You would think that management, by now, as a subject, would be scientific. That corporations would employ skilled managers with their MBAs from prestigious universities that effectively applied administrative technology to nurture their companies.

Nah, it’s not like that.

A research study was conducted by Nicholas Bloom* and others aimed at determining how effectively management procedures were being used in U.S. companies. They found that only 15% of U.S. companies scored above a 4 on a 5-point scale. More than 30% scored a three or lower. Companies outside of the U.S. scored much worse.

Management is primarily personality driven – a little like politics and show business. And sometimes, the mafia. Some companies do well because there is a dynamic genius at the helm. Others do well because they were there at the right time. Others appear to do well because of the money they borrow, steal, or collude with government regulators.

I know some very successful chiropractors who are good managers. But they were good mostly because of their temperament and not because of their conscious use of management techniques.

Unfortunately, most management focuses on supervision. It is a form of spectator-ism and policing. Like watching robots on an assembly line and reprimanding errors and deviations.

Good management focuses on improvement. First, keep things working, then how can we all improve it? It is servant based.

In my book, Goal Driven Business, I cover this as part of the Goal Driven System.

For practical purposes, management has two different functions:

1. Keep doing what works.

2. Continually look at how the procedures and systems could be improved.

If it worked yesterday, you should do it today and also tomorrow.

Then, improve it – little by little.

If you want to make a big change, when the entrepreneurial spirit hits you, do a trial run first. Don’t disrupt the systems that are working.

A good number of practice problems occur for one reason:

You stopped doing what worked!

This applies to the front desk, patient accounts, new patient onboarding, team management, and marketing procedures.

If it worked once, it would probably work again. Just improve it if it is outdated – and if that doesn’t work, revert to what worked.

I know – your workdays can get boring and sometimes you want to go and chase the shiny things. Fine. But keep doing what works until something proves itself to be better.

I will be teaching a management course later this year. If you are interested, let us know and we’ll get you on the waiting list. It will be for you and your manager. Each class will be small to allow for more personalized instruction.

Good management underlies all your activities – managing your patients, your practice, and even your life. And especially your future!

Seize the future with good management!

* Harvard Business Review, November 2012 Nicholas Bloom

—————————————————-

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

The Goal Driven Business By Edward Petty

Networking for Chiropractors and Health Providers

 (This is part 2 following the last blog on the best known marketing secret.)

Networking is a marketing method that generates referrals from your direct efforts, from your patients, and from outside referral sources you have established. This is not only the most cost-effective form of marketing for new patients but helps to retain the ones you have.

YOUR PRACTICE IS A NETWORK

If you think about it, your practice itself is a network. A practice is a network of relationships created and sustained through communication and service. This is my definition, though yours could be similar.

Networking is simply creating a connection with another person in which you both share an interest in common and enjoy talking with each other.

Networking is getting to know people — who know people.

But I would also add – getting to know people you are interested in. Effective networking can’t be faked.

THE 4 COMPONENTS OF NETWORKING

I have seen 4 major components of effective networking:

  1. Genuine interest in people. The best health networkers are interested in their active patients, inactive patients, and people in their community.

  2. Genuine interest in the services they provide. The best networkers are excited about their services and what they can do for people.

  3. Give in abundance. Effective networkers are givers. They provide excellent clinical service as well as free assistance, such as health tips, special events, referrals to other providers or services, a book, or a smile. And they educate others about the health subjects their services address.

  4. Organization. A structured program needs to be in place to ensure net-working continues.

Venues for Networking

Table Talk. This is your private time with your patient. Be curious about them and how they are doing. Then, tell them about what is interesting to you about their health, about health subjects, and your services. Often, patients may see you for back pain but may not know that you also treat headaches and other issues.

Continue the Table Talk. Follow-up with your custom newsletters. I stress this routinely. You have hundreds, if not thousands, of people you have seen whose trust you have earned. You have started a relationship with them — why neglect it? This is why, for those offices on our new Mastery program (more about this soon!), we insist on sending out personal, customized emails for you monthly.

Social media is fine, but it is different. Posting a success story or an upcoming event is fast and easy. This helps with social proof and brand awareness. I have also seen it useful in short spurts for advertising, driving readers to a lead page, or making a phone call. But organically, few people will see your unboosted post. “If you have 2,000 Facebook fans usually only 2-5 people will see each post you publish” says Stuart Marler from Retriever Digital. (Mail Munch)*

Internal Events. In-house events from workshops on health to organic farming, barbecues, appreciation days, and yoga classes — the ideas are endless. And even if only 3 people show up, well promoted, you create the image that your office is an alive and vibrant health center.

External Events. There are the usual events: the Lions Club pancake breakfast, the local parade, the 5K Walk-Run, the art fair, the County Fair, and all the summer events that local communities host. These are great opportunities to meet new people.

Some doctors network with their church, or their local school affiliation as a high school coach, or with women’s groups like La Leche. Some doctors become involved with an ethnic group, and network with them. Se Habla Espanol? Often the connections are made via the patient.

You can also start creating your group. Visit the autobody shops and create a PI referral network. Or become the go-to source for local ballet, dance, and drama participants. Or, become THE motel chiropractor in town.

ORGANIZING YOUR NETWORKING

Organization. The biggest barrier to networking is a lack of internal structured organization supporting your marketing. I covered this years ago in the Marketing Manager System. Similar to the systems for your front desk and billing departments, you should have routine procedures, stats, and someone in charge of your marketing projects. And they need guaranteed time each week to work on the marketing.

Team. Each member of your team should be a trained and motivated networker – both in and out of the office.

The goal of networking. The goal of networking is the same as the mission of your practice: to help as many people as possible become healthier.

Stay interested and curious — give abundantly and educate.

Let’s do it!

Ed

Need some tips on how to improve your networking? Let’s talk.

* https://www.mailmunch.com/blog/email-marketing-vs-social-media

—————————————————-

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

The Goal Driven Business By Edward Petty

 
 
 

Failure to Follow Through

It is the ‘follow through’ that makes the great difference between ultimate success and failure, because it is so easy to stop. — Charles Kettering

Failure to Follow Through

If it worked once it probably will work again

There is a management disease that many businesses, including chiropractic and other health practices, can suffer from. It is called “Failure to Follow Through.”

I noticed this at one of the first offices I worked with in Northern California – years ago. Their numbers were down. When I visited their office on a hot summer day, the reception room was empty, and few patients were scheduled. I noticed they had a thick binder of photos of patients and staff on the lower shelf of a dusty bookcase. The photos showed happy staff, doctors, and patients. There were also patient success testimonials, several years old.

We all met together for a staff meeting. I asked the doctor and staff if they could name a few specific actions they did back then. I said, “let’s start with marketing.”

Well, it turned out that they ran advertisements for a bi-yearly promotion. So I asked if they had done this in the last few years. “No” was their answer.

“What else were you doing at the time,” I asked. They said they always discussed financial and scheduling arrangements away from the front desk. Are you doing that now? “No.”

What else were you doing during that time? “We used to call the new patient after the first adjustment.” They also did progress exams. “Doing it now?” “No.”

The list went on and on.

Being the brilliant practice management scientist that I am, I encouraged them to re-implement what they had been doing. They did, and a few months later, the office was filling up again.

Practice Management

If it worked once, it probably will work again. Make minor improvements as needed, but why change the system if it is working?

Well, you can get bored, right? Or a staff member who knew the system left and their duties were not replicated by someone else. Or, everyone gets bored, so you feel the need to change things to bring excitement back into the office, and key procedures quietly start disappearing.

Discontinuing your successful procedures can create a roller coaster ride for your practice, with numbers going up and then down. And this can cost you thousands, even tens of thousands of dollars.

A checklist of successful procedures is essential, but that is not enough. They need to be reviewed regularly.

That, too, is not enough. We need to keep the practice environment fresh and lively while still maintaining those activities that are helping us grow and develop. We are not on an assembly line, and we are not robots!

I cover this in my book, The Goal Driven Business. (See Goal Driven Principle #17, Goals, Games, Groundhog Day). This is part of the Goal Driven System of practice development and includes checklists, reviews and coaching, and other components, such as gamification.

Gamification is a new term for an old principle: we like to play games! As video games became more prevalent, businesses saw that they could adapt elements of gamification to help engage employees and customers. Nothing new, really.

To make your office feel new again, you can think of a new promotion for this summer or new colors to paint the office. Spend a morning reviewing your goals, mission, and policies, and then go to a spa for a reward! One office creates a health theme each year and makes t-shirts promoting the theme for staff and patients.

Keep it fun — but stick to your winning ways.

Patient Management

ALSO… like practice management, patient management can also be affected by failure to follow through. Your patients need help to adhere to their treatment plan to achieve their health goals.

Stick-to-itiveness is simply being true to our goals.

Make improvements along the way and keep it fun. But help each other and your patients follow through.

Your goals are waiting for you!

Ed

Practice Fundamentals – Communication and Control

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

It’s always the basics. The fundamentals.

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

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

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

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

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

Communication

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

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

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

Control

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

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

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

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

Management

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

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

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

Seize your future – with a smile!

Ed

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

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

The Missing Role in Your Practice

The cause of almost all relationship difficulties is rooted in conflicting or ambiguous expectations around roles and goals. Stephen Covey

The reason many offices have a difficult time growing has to do with missing roles.

A role is the identity assumed to perform a series of tasks that produce a specified outcome.

In the hundreds of offices that we have visited over the years, the doctors take on essentially two roles: doctor and owner. This works in the beginning for a few years as the practice grows. In time, however, the practice begins to roller coaster. Numbers go up, then they go down, cycling up and down until everyone fatigues and just settles.

There are several causes for the Practice Roller Coaster. There are hidden barriers that hold an office back and sabotage its growth. These are covered in my book, The Goal Driven Business.

One of the barriers has to do with a missing role that most business owners overlook. Can you guess which one that is?

Let’s look at goals: What is the goal of a doctor? “A healthier person,” right?

What is the goal of a business owner? A secure and solvent business. Dividends from ownership.

What is missing? The doctor can achieve their goal by seeing 10 people a week. As a business owner, they can keep their overhead very low – perhaps working out of their home. But is that what you really want – to see 10 people a week out of your house? Overhead is low and you are getting good results. So, what is missing?

The CEO – the chief executive is the missing role. The goal of a CEO is a very profitable business that operates at full capacity providing world class service and delivering extraordinary results.

The CEO is the chief manager, leader, and marketer, which are the three functions that drive the business to its goals.

Sometimes we hear the doctor being referred to as the “boss,” but boss is not a well-defined role. “Boss” is generally recognized as the person who gives orders and makes decisions. However, it is an overlay of an existing role, as in a “bossy” doctor or “bossy” owner. The role of a CEO is much more than this.

Most providers are too busy providing services to do much managing – and besides, they are paid for their services, not their managing or leadership. Doctors are trained to manage patients, not businesses.

Still, this is a role that must be fulfilled as distinct and separate from the owner or provider roles if the business’s full capacity is to be achieved.

Three Functions of the CEO

The role of CEO includes these functions:

  • Leadership: Leadership is all about goals. It defines where you are going and why and helps everyone you work with embrace this knowledge with commitment. Leadership includes your mission, long-range plans, values, and … the insistence upon achieving them.
  • Management: Management deals with how to get to the goals. Management works to ensure that people and procedures are effectively working and improving.
  • Marketing. Marketing includes procedures and projects that help generate new patients/clients and retain them. Marketing is business, and business is marketing.

Once your practice is at least at 50% capacity, a couple of hours spent each week on effective leadership, management, or marketing activities as a CEO is worth 8 hours or more doing anything else. For example, time spent going to a seminar – perhaps 20 hours including the transportation, may increase your numbers for months afterward. A little can go a long way.

Because the role of practice CEO must be very part-time, we have developed the Fast Flow CEO System for the Goal Driven Business. This can take as little as 2 -3 hours per week, depending on the scale of your business. Here are five components of the Fast Flow CEO System:

  1. Get Out to Work On. Regularly take time to get out of the business so that you can work on your business.
  2. The CEO Works for the Business. The business does not work for the CEO. Sure, the business works for the doctors so that they can provide better service to the patients. But that is for the doctor. Sometimes called “servant leadership,” the CEO is the Chief Coach, helping others understand the goals and how to achieve them.
  3. Team Members. The CEO works to create team members who take on a portion of departmental management, marketing, and leadership.
  4. Manager. The CEO creates the role of manager and delegates a team member to assume this as a part-time role. The manager can take on much of the CEO’s daily and weekly duties.
  5. Study. The CEO studies leadership, management, and marketing to improve their skill as a CEO. Leaders are … readers!

Certainly, all this requires some skill and training – and coaching! But just clarifying the role of CEO and its expectations as distinct from the roles of owner and doctor (or “boss”) will significantly improve your chances of breaking out of the Practice Roller Coaster and achieving your goals.

Ed Petty

March 14, 2022

Are Your “Engines” Driving Your Practice?

A service business needs 5 different engines to become a Goal Driven Business

Five engines drive your business to its goals.

If these are installed and firing at 100%, practicing will be enjoyable and profitable. When these engines are not fully performing, the daily demands of running a business shift to, and fall upon, the owner.

These engines are functions and characteristics of a dynamic team that drive the practice toward its goals.

Many offices that seem to be doing well are driven by heroic owners fighting each day to grow their practices, and not by their engines. But this isn’t easy to sustain. At some point, it becomes too much, and they settle into a comfort zone below their abilities. As a result, their long-term goals remain unfulfilled.

This is the plight and path of the entrepreneur – brave, independent, but too often without a map on how to build a strong business that drives itself.

The five engines that drive a business to its goals are:

  1. Marketing
  2. Leadership
  3. Management
  4. Service
  5. Personal Integrity

I want to begin passing on tips on the marketing engine– what is working now and my best estimation of what will be working in the future. Marketing is vital, for without paying customers, the other engines won’t work and aren’t needed.

But before I do, I want to invite you to look at your business and gauge the health of each of your engines.

You can do this by reviewing how successful you are at achieving each engine’s outcomes (goals) and giving them a grade from one to five (1-5). 5 would be the point where the engine is achieving its goals.

  1. Marketing. Abundant new patients and goodwill with local allied businesses, organizations, and your community. A waiting list practice. (1—5: ___)
  2. Leadership. A business with clearly defined goals that are agreed upon and pursued happily. (1—5: ___)
  3. Management. Expert team members, acting as an expert team, implementing simple but effective procedures. (1—5: ___)
  4. Customer Service. Customers (patients, clients, customers) who are extraordinarily satisfied with the services they receive and their outcomes. (1—5: ___)
  5. Personal Integrity. Each team member is happy because of the positive and and responsible manner in which they manage their personal lives. (1—5: ___)

By grading each engine’s “output,” you can immediately see what needs the most work.

But these engines do not work independently. One affects the other so that there is a synergy created. As one improves, so do the others. The opposite is also true – the more one engine dies down, the more the other ones do as well.

It could be said that everything begins with leadership, and that may be true. But unless you are marketing your services, there will be no one to lead!

So next week, let’s look at a few effective marketing strategies and tactics that will help drive your business to its goals.

And by the way, how to achieve a 5 for all your business engines is described in The Goal Driven Business. If you haven’t read it yet, I encourage you to do so.

A great new February to you all,

Ed

Key Updates and Workarounds For the New ICD-10 Codes That Impact Your Office.

icd-10, key updates for 2022Dear Chiropractors and Staff:

Are you having issues with not getting reimbursed due to the new ICD-10 codes and the deleted low back code? Having difficulty getting reimbursed from Humana and BCBS due to precertification requirements and other crazy denial codes?

Please read below where I provide you three key updates to the ICD-10 Codes and some workarounds that are of interest to your revenue cycle.

UPDATES: ICD-10 code Changes relevant to chiropractic

1. Deleted code: M54.5 low back pain.

2. NEW codes to replace the above deleted code include:
• M54.50 Low back pain, unspecified
• M54.51 Vertebrogenic low back pain
• M54.59 Other low back pain

3. Other Chiropractic-Relevant New codes added:
• M45.A0: Non-radiographic axial spondyloarthritis of unspecified sites in spine
• M45.A1 : Non-radiographic axial spondyloarthritis of occipito-atlanto-axial region
• M45.A2 : Non-radiographic axial spondyloarthritis of cervical region
• M45.A3 : Non-radiographic axial spondyloarthritis of cervicothoracic region
• M45.A4 : Non-radiographic axial spondyloarthritis of thoracic region
• M45.A5 : Non-radiographic axial spondyloarthritis of thoracolumbar region
• M45.A6 : Non-radiographic axial spondyloarthritis of lumbar region
• M45.A7 : Non-radiographic axial spondyloarthritis of lumbosacral region
• M45.A8 : Non-radiographic axial spondyloarthritis of sacral and sacrococcygeal region
• M45.AB : Non-radiographic axial spondyloarthritis of multiple sites in spine

NEW Cough codes:
• R05.1:Acute cough
• R05.2: Subacute cough
• R05.3: Chronic cough
• R05.4: Cough syncope
• R05.8: Other specified cough
• R05.9: Cough, unspecified

WORKAROUNDS
If you have claims to send (hopefully only a few) with DOS prior to October 1, with low back pain diagnoses, what should you do to ensure they do not reject by the clearinghouse and payer for adjudication? Your clearinghouse should, by now, be updated to include accepting claims with the old M54.5 code IF the DOS is prior to 10/1/2021. The commercial payer claims adjudication systems should also be updated now to accept claims prior to 10/1/2021 DOS if you billed with the old M54.5 code. Please make sure to get any outstanding claims with DOS prior to 10/1 submitted as soon as possible, if you have not already. If you only have a few claims going to commercial, you also have the option of sending these on paper instead of through your clearinghouse. Do not do both.

State Medicaid programs and Medicare will still require the use of the M99 codes for billing, so continue using those codes for these claims.

HUMANA is requiring pre-authorizations on all chiropractic therapy codes. The latest news is that starting in January, there will now be three entities that will be doing the pre-authorizations. a. Optum, b. Humana itself, or c. A new vendor, Cohere Health. Humana has advised us that the entity will be selected based on the patient’s policy.

When you verify a patient’s benefits you will need to make sure to ask:
if preauthorization on your therapy/rehab codes is required on the member’s policy,
which entity will be preauthorizing/reviewing,
and the process to follow when requesting services requiring preauthorization.

Not getting paid by BCBS, with crazy denial codes? No one at BCBS to help? You’re not alone. Offices across the country are experiencing this. So what can you do at this point? First, do a claims audit on your BCBS claims. Do you have the GP modifier attached? Is preauthorization on therapies required on the patient’s plan using AIM Specialty Health?

Your other option is to ask the patient to call into BCBS and advise that claims are being denied even though they have been billed out correctly. We do have scripting available to help your patients with the communication. Click here and request more information.

Questions? We’re here to help!

Lisa Barnett
PH: 920-459-8500
Email: lisa@pmaworks.com

“Increasing your collections through better billing and documentation”