How To Develop Your Niche for Greater Profit and Better Care

Posted on August 19, 2021 by Edward Petty

Develop Your Niche for Greater Profit and Better Care with goaldriven.com

You can try to sell ice water to Eskimos or sandbags to desert dwellers, but you would go broke.

You need to offer your services to those specific people who would want them. The more you do this, and the better you do this, the larger your customer volume will be and the more profitable your business will become.

So, what is your market? Who are those people who want to see you or are looking for what you have to offer?

It is people who want to relieve a health issue more naturally.

And this market is growing and certainly becoming more motivated.

You wouldn’t think it, though. The media would have you believe that everyone is spending their time in drug stores, behind masks, maintaining social distancing.
The governmental “agencies,” looking out for us, are warning us about new “variants” that are “surging.” But, what is apparent is what is NOT talked about!

What is that you ask? Oh, that would be Health!

Do you hear them talk about better food, more exercise, more sunshine, better nutritional support, or natural health care services? How about proven medicines already in the public domain? I don’t think so.

Why not? Well, I don’t know, it might have something to do with …money.

This may not seem marketing-related, but I think that it is essential to examine the environment that your market is dealing with. The people who want natural solutions to their health issues, those that you want to reach out to, find themselves in a sea of conflicting, even frightening, messages.

We can look at the ongoing debacle in Afghanistan. Scared civilians falling out of airplanes after we spent over two trillion dollars and the lives of 47,000 civilians over in Afghanistan. Why? Well, money. (1)

Was the “war” a failure? Not for the stock market, especially for Lockheed Martin, whose stocks increased 1,236 percent since 2001. Other weapons companies like Raytheon, Boeing, Northrop Grumman, and others all saw their stock climb. (2) So, the Afghan war was a success – for these companies and their CEO’s and stockholders. Selling the idea of stopping terrorists was a profitable campaign – for some.

Could there be a parallel scenario with drug companies? Could the government be working at the behest of another industry besides the Military-Industrial Complex? Well, for its COVID vaccine alone, Pfizer expects to generate 33 billion this year. (3)

In both cases, it was the marketing use of FEAR that justified enormous changes in our lives. Fear of terrorists, fear of a virus.

But here’s the thing: You can scare all the people some of the time, and some of the people all the time, but you cannot scare all the people all of the time.

There is a large percentage of the population that want better health naturally and do not necessarily buy into fear-based propaganda. In fact, the constant omission of health solutions amidst the drumming for drug solutions may just motivate health-oriented people to more staunchly pursue better health!

Look at the sales of organic food. As you can see from the graph below, organic food sales have been on a steep uptrend. Sales of organic food were 16 billion in 1999, and has been rising continuously, reaching 106 billion in 2019. (4)

And here is a more recent chart of health supplements and their expected rate of growth (5):

These consumers want better health. They don’t want poison. Big Tobacco was clever with its marketing strategy and fought hard, but it eventually lost. Monsanto (Bayer) has worked every angle, but it too is slowly losing its fight to keep Roundup, which contains a cancer-causing chemical called glyphosate, in the marketplace.

Though not broadly promoted, Big Pharma companies have been fined billions for their illegal activities, including killing people (Merck, Vioxx).

Your market is right there, with you. They may not all be speaking out, but they know, or at least sense, that something is not right. And, they want better health.

Almost every office we work with has been seeing their numbers rise over the last year or two. Why? I want to think our coaching and new systems have something to do with it, but the fact is, your market is hungry for trustworthy health solutions and providers.

You don’t have to froth at the mouth against Big Pharma, but you certainly can stand up for natural health. This is your province. You own it, and always have. So let your community know that you are on their side for health, natural and wholesome, without additives. Peer reviewed for thousands of years!

They are looking for you. Just let them know where you are, who you are, and what you can do for them. (You can also add, WHY you do what you do!)

Here are few steps to better engage your niche – and help more people:

Position yourself as a natural healthcare office, clinic, or facility. “See us to feel better and be healthier — naturally!”
Celebrate your patient and client successes. Be happy with your patients. They may underappreciate their health successes. Most do, in fact. Be their cheerleader and give them positive, but genuine, support for their health improvements.
Get their OK, in fact encourage them, to Share the Care.
1. Patient testimonials published on all media – website, social platforms, even YouTube.
2. A homemade monthly newsletter from you.
3. Case histories you talk about
4. Staff successes! Patients look at how cool the office is. If the team says it’s great, well, it probably is!
Take time to study your market and the environment it is dealing with. Yes, this will take time. But you are a professional and a leader. To educate others, you need to be educated yourself. Study the science, get the verifiable stats, the first-hand reports of others, and draw your conclusions. No one is sitting out this game. You need to be prepared.

There are many different methods you can use to tell people where you are, who you are, and what you can do for them. But know that they are out there, people who want healthier solutions to their health issues. This is your niche.

And they are looking for you right now.

Seize the week and help more people.

And buy my book – The Goal Driven Business. Read and use it. It will help take you to your next several levels!

Download the PDF [HERE]

Fight the Nocebo Effect

Posted on March 21, 2020 by Edward Petty

I am sure that all of you are trying to stay up with unfolding events regarding the virus and the governmental recommendations – and enforcement — to deal with it.

We are, as well.

I am sending this email out to encourage you to watch an informative video by Del Bigtree, who reviews the facts and numbers of the virus pandemic. It is a bit long, so I am sending this out this weekend in case you have more time to watch it.

I have also included an article by Bruce Lipton. Dr. Lipton is a cellular biologist who taught medical students at the University of WI medical college and often speaks at chiropractic seminars.

Plus, an article that states 99% of those who died from the virus had other illnesses.

(Links below.)

We must watch out for the GENERALITY of the virus. For example: “COVID-19 could kill us all!” “Who says?” “They do.” “Who is “they.”” “The authorities.” “Who are the authorities?” “Those who are in charge.” You have to break it down and be as logical as you can.

I recommend that you review these sources, add to it what you are learning, and using your best judgment, continue educating your team members and patients/members/clients!

Be the lighthouse in your community.

Education and knowledge displace fear and uncertainty.

Let’s eradicate what Dr. Lipton calls the “nocebo” effect — the opposite of a placebo.

And let’s continue our fight to help people get healthier!

Keep educating,

By the way, no one is saying you must close your office. Even in California where San Francisco has a “Shelter in Place” or strict quarantine. For example, the California Chiropractic Board of Examiners, on their website, states:

Should My Practice Remain Open?
The Board does not have authority to close businesses or practices solely as a result of COVID-19.

YOUR SERVICES ARE VITAL!

The Exec. Director of the Kansas Chiropractic Association, in a letter to their state Governor (March 20, 2020), stated:

“We understand that with the severity of the current pandemic hospital emergency rooms may soon be filled with patients complaining of pulmonary symptoms. We offer our services in diagnosis and treatment of musculoskeletal complaints presenting to emergency rooms. Many Doctors of Chiropractic have arranged to be a referral point for their local emergency rooms on these conditions.

“We are prepared to see these patients in our offices that are already taking every precaution available to prevent the transmission of COVID-19.”

REFERENCES

Del Bigtree Coronavirus Quarantine March 19

Bruce Lipton Cornonvrus 2019-Covid-19 UPDATE

Bloomberg News March 18, 2020 99% of those who Died From Virus Had Other Illness, Italy Says

Yearly Goals…Be a Homesteader

Posted on January 10, 2019 by Edward Petty

Sometime back in the late 1800’s, my great great grandfather homesteaded land in Oregon. The way I understand it, he found a plot of land he liked in the southern part of the state. This was his goal. He and his wife then settled on it.

You too can be a homesteader.

You have a chance to stake out your own plot in 2019. You can define where you want to be in the future… and then work it so that it is yours. And if you don’t, well, you will still be somewhere, just not where you want to be.

Life is this river and it just keeps rolling, and we are on it. We are not leaves floating rudderless. We have some choice about where we want to be 12 months from now. We can set a course and navigate and sail or row or jump out and paddle ourselves to where we want to be.

This is why we set goals and a course of action. We don’t want to wind up broken and dead on the rocks, or stuck idle in a rancid stinky lagoon that goes nowhere!

But when you do set goals for your business, or even for your career, they are often too lop-sided. They are not holistic. You might say that they are symptomatic. We may only shoot for the amount of money we want to make. This isn’t bad, it just isn’t enough. It is too superficial.

If you want to make more money, you have to see more people. If you want to see more people, you have to take better care of them. To do so, you have to improve your services. To do this, you have to improve your expertise and the expertise of others who see your patients. Lastly, you can’t be an old grouch, unhappy with a poorly managed personal life.

You are in the business of improvement! To improve people, you also have to improve your business. To improve your business, you have to improve the professional skill of each member of the business. Lastly, each member of the team has to work on self-improvement.

Make these into your goals.

DRIVE each other to achieve these goals.

Be GOAL DRIVEN!!

IF this is done, how could you – or anyone lose? Everyone wins.

So, to keep it simple, see the attached worksheet. Set your goals for each area, and every three months, ESCAPE to a place where there is no interruption, your “laboratory,” to confront how you did and make any necessary adjustments to your plans and continue your journey to your yearly goals.

Yearly Goals Worksheet — Link

Set aside 2 or more hours at the beginning of the year and the beginning of each new quarter (3-month period) to review your past and set new goals.

To do this, you must get away. Turn off the phones and remove ALL distractions. You are going to your Goals Laboratory and humbly review the past and boldly make new plans for the future.

You will fall off the rails, so every three months, you will have already scheduled time to review your failings and triumphs and reset. You can now get back on track and re-plan and go forward to the next three-month marker.

Use the worksheet to help you have a Goal Driven year.

Good travels and Bon Voyage.

— Ed

Yearly Goals Worksheet

How to Deliver Goal Driven Extra-Ordinary Customer Service (Part 2 of 2)

Posted on November 13, 2018 by Edward Petty

“Our future will be our results.” Clarence Gonstead, D.C.

How do we overcome these barriers to extra-ordinary service?

Let’s first define “service.” Service in a professional service firm or professional practice includes two categories:

A. Outcomes. These are the results from the provider.
B. Customer experience. This comes from what the customer experiences as they move along their pathway through your business.

Let’s begin with your goals.

1. Define and Commit to Your Highest Goals.

To create world class outcomes and service, you first need to review your most senior goals. Then, you have to ensure everyone understands them, agrees to them, and commits to doing everything possible to achieve them.

Setting purposeful goals over a lunch meeting does not take into account the sacrifice and effort that will be necessary to achieve them. You may commit to your own goals, but like New Year’s resolutions to go to the gym, you get distracted and discontinue after a few weeks. Some of your team may say they understand the goals – even agree to them – but in fact are only passengers along for the ride.

So, you should review and recommit to your goals each week. Be insistent, allowing for shortfalls now and then, but not compromising in the long run. Be true to your goals or make new ones. Spend time on these three:

a) Mission
This is the purpose of your office. It should be short and to the point and should include something about excellent service and outcomes and helping as many as possible.
b) Core Values
These are the standards for professional behavior and performance. List what values you consider most important in providing health care.
c) Patient Outcomes
Define where you are taking your patients. Relief care only? Or are you taking them further to better health and wellness?

Be true to your goals.

2. Outstanding Outcomes Come from Expertise

Because of your clinical skill, you can produce wonderful outcomes. But can you do even better? Here are some masters in their field as examples of professionals that never stopped improving their craft:

Music: Pablo Casals

Pablo Casals was a cellist – regarded as the best that ever lived. He was born in 1876 in Catalonia, Spain. In 1963 he was awarded the Presidential Medal of Freedom by President John F Kennedy, and in 1971, two months before his 95th birthday, he performed for the United Nations and accepted the U.N. Peace medal.

Casals was talented, but he practiced daily. There is a story about Casals and his training regimen:

He [Casals] agreed to have Robert Snyder make a movie short, “A Day in the Life of Pablo Casals.” Snyder asked Casals, the world’s foremost cellist, why he continues to practice four and five hours a day.

Casals answered: “Because I think I am making progress.”

Food Preparation: Chef Jiro Ono

If you want and value good sushi, Chef Jiro Ono is your guy. He was 92 at the time of this writing. He still works in his small restaurant in Tokyo that holds only 20 people at a time. The waiting list can be over a year. Still, at his age, he works on perfecting every aspect of the sushi, from selecting the exact right fish early at the fish market, to the exact texture of the rice. And every night he considers how he can improve on that day’s production. He is considered the foremost sushi chef in the world. (Jiro Dreams of Sushi, David Gelb 2011 documentary, Wikipedia)

“Once you decide on your occupation… you must immerse yourself in your work. You have to fall in love with your work. Never complain about your job. You must dedicate your life to mastering your skill. That’s the secret of success…… Even though I’m eighty-five years old, I don’t feel like retiring.” Jiro Ono (Jiro dreams of sushi, 2011)

Health Care: Clarence Gonstead

Clarence Gonstead was a chiropractor, born in 1898 and grew up in Wisconsin. In 1923, Dr. Gonstead graduated from Palmer Chiropractic College and began practicing. In 1939, he built a new chiropractic office in Mount Horeb, Wisconsin.

Because of the growth of his practice, a new Gonstead Clinic of Chiropractic was completed 1964. It was a two-level facility with 29,000 square feet. In 1965, adjacent to the new clinic, a full-service motel was built. Gonstead’s reputation as a remarkable chiropractor had spread beyond the United States and he had patients flying in from all over the world. To assist these patients, he set up a limousine service between the Madison, Wisconsin, airport and the Gonstead clinic about 30 miles away. Patients with their own private planes could fly in and land at Gonstead’s personal airport located next to his home on the outskirts of Mount Horeb.

With no marketing, his practice grew so that that he was seeing over 250 patients per day, working six-and-a-half days a week. He often treated his last patient at 2:30 in the morning.

Gonstead studied and improved his craft. He was not, as a founder of a chiropractic college would later say, a “commercial chiropractor.” He was focused on results and said: “Our future will be our results.”

Eventually, he began teaching others his system which is now recognized around the planet as one of the most effective and popular forms of chiropractic technique. He encouraged other chiropractors to study and to “Practice. Practice. Practice. Never stop.”

So, be like Jiro, Pablo, or Clarence! Use “deliberate practice” and look to see how you can improve your skills and methods so that your customers can achieve their goals faster and better.

Never stop improving your craftsmanship.

3. Delegate Administrative Duties to a Goal Driven Team

It is almost impossible to focus on excellent patient outcomes and run a growing business at the same time. You need a strong support infrastructure. This means professional team members that are trained and motivated to apply procedures that are both simple and effective.

Chiropractic works. Not having a smooth-running support structure is the primary element that is in your way from developing your practice to its full potential.

This has been the major focus of our work over the last 30 plus years. We have found that the better the support, the better the outcomes and the happier the doctor and staff.

Improve your people and systems.

4. Create an Upbeat and Supportive Work Environment

“If you go into any organization that’s customer-facing, you can tell in five minutes when the employees are feeling abused. They retaliate on the customers.” Jeffrey Pfeffer, professor at Stanford University

The way the employees are treated directly affects the service that they will provide to the customer.

Sure, work can be stressful at times. Maybe someone snaps at someone else. This happens in any high-performance activity. But as long as we all share the same mission and values, we can address our personal slights to each other and move on.

It is everyone’s responsibility to create a cheerful work environment for each other. If you are having fun, so will our patients.

Smile more — and make work fun!

5. Give Your Patients Information. Educate Them!

“If I’d asked customers what they wanted, they would have told me, ‘A faster horse!’.” Henry Ford.

Of course, you give people want they want – what they consider urgent and important.

But people didn’t want a faster horse, they just wanted faster transportation. Horse, car, airplane… they wanted to get to where they wanted to go – faster. They just didn’t know about how simple, fast, and easy a Model-T was.

You must show them through education that you have what they want and need.

Most offices provide relief. That is what the patient is aware of and willing to pay for. But since you are providing a product that is not tangible using procedures that are invisible, your customer may have a difficult time understanding anything beyond the “quick fix.”

They may know they want more but lack the understanding of what is available.

I know I need to pay my taxes, but what I really want is to pay as little as possible. I also would like to contribute to my children’s education. With some education, my accountant could make me aware of different strategies that would take me to my full goal.

“Customers are thirsty for more information and knowledge,” according to studies by ThinkJar, a customer strategy consultancy.

To deliver your best and complete outcomes, you need your patient’s motivation to do so. It is a path and a partnership that you travel together.

The better that they understand their condition and your unique remedy, the easier it will be for you to help them achieve the best outcome possible.

The more they know — the further they’ll go!

6. Making the Patient’s Experience Extra-Ordinary

Making the patient experience “WOW” takes a team effort.

If studies show that customers discontinue a service mostly because of a lack of interest on the part of the service provider — and your own personal experience validates this fact, then the solution is simple. Just be genuine and interested in your patients. Be empathetic. Take the time to be totally present, in the “now,” and have “present time consciousness.” You only have 1 patient, and that is the one you are with, or about to see.

Then, when you practice with your team at team meetings, focus on this: the level of honest interest, curiosity, and care.

Practicing scrapes off the “barnacles” that attach to us all as we soldier through our work days. Here are some training tips for working on improving customer service with your team:

a) Review the Customer’s Journey

Lay out the pathway to and through your services. Do this with your team.

This begins even before your patients contact you. Who are they? Mom’s, seniors, kids? What brings them to you? What other solutions have they tried before they came to you? Get to know them and empathize with their condition.

b) Flow Chart

Then, list the sequence of actions, or a flow chart of what occurs from first contact through their first service and leaving. Drawing this out with your team will expose many areas for improvement.

c) The Walk-Through

Against this flow chart, you and your team can now look at where you can add more benefits for your customers.

I have found that practicing a “walk-through” reveals many hidden plusses – and embarrassing weaknesses, in service. The doctor or a team member takes on the role of a customer. They then travel some portion of the patient pathway with the usual team in their roles, acting as if they are dealing with an actual patient.

You are guaranteed to find areas where service can be improved.

d) Add More Value

Bain Consulting, an international management company, identified 30 different elements of value relative to consumer needs in an extensive study. They categorized these customer values into four categories:

- Functional values, such as quality, variety, time efficient, simplicity, reduces effort, and reduces cost.
- Emotional values, which included entertainment and fun, aesthetics, rewards, and attractiveness.
- Life Changing values which included affiliations, community, and greater purpose.
- Social Impact. An industry example was Tom’s shoes, a shoe company that donates a pair of shoes to underprivileged for every pair purchased by a customer.

In their research, Bain noticed that the companies that had the highest ratings on the most values had more loyal customers than the rest. They also found that these companies had faster revenue growth than others.

Good service pays. Great services pay even better!

With this in mind, look again at your flow chart and notice where you can add more value to your services. Start with the direct service to your customer, the “functional” areas of your business. For example, how could your customers receive their services:

Faster
More conveniently
Less expensively
With less effort
With greater simplicity
Receive child care while in the office
And also acquire a understanding their condition and their care program

In the next category that Bain used, what kind of “emotional” values could you add, including:

Fun and entertainment
Rewards
Design/Aesthetics
Attractiveness
Reduced Anxiety

The next two categories relate to higher purposes. “Life changing” and “Self-transcendence,” including:

Affiliation/belonging – Create a wellness or health club, have patient barbeques and get togethers.
Social Impact – Schedule yearly events to help the less fortunate, clean-up drives, and health and environmental causes.

In the years to come, Customer Service will take the lead in all your marketing efforts and will be the factor that sets you apart from comparable alternatives.

Edward Petty

The Merry-Go-Round: Planning for a Prosperous Practice in 2018

Posted on December 15, 2017 by Edward Petty

Progress in practice is made by steady persistence and passion.

In Angela Duckworth’s new book, she calls this “Grit.”

Think of evolution, think of growing crops… think of growing children! Whether it is child development or practice development, growth is achieved through steady and unrelenting nurturing and adjusting according to circumstances.

I recommend you take some time to do some planning before the New Year gets in high gear. January and February are good months to do this. Do it by yourself – and do it with your team. But…

Don’t reinvent the wheel… Just make it go faster with less effort.

The Vital Few

A few of our actions are always more productive than most of the other actions that we do. Unfortunately, we can get distracted and spend far too much time on activities that, in retrospect, just don’t give us that much of a return.

The “vital few” actions that have helped you the most will be camouflaged, even countered, by the “trivial (but useful) many.” This is a term used by Nathan Juran, famous for his approach to business and quality improvement and the Pareto Principle.

And, I would like you to consider this: In many respects, your business has succeeded in ways that – perhaps – you have not yet recognized. Therefore, I don’t recommend abandoning all you did last year and start chasing the newest “shiniest” procedures that seem appealing.

The key is to dust off all your actions from 2017 – review everything you did — and see the great things that worked and the victories you and your team achieved.

Then, just find better approaches to do more of this!

Diamonds in Your Office

The idea of having diamonds in our backyard, a story made famous by Russell Conwell (1843 – 1925) of the 1800s, applies. There are many variations, but it goes something like this: there once was a man who wanted more wealth, so he sold his house and left in search of diamonds. Years later, penniless, he happened back to his village where he roomed at a shelter for the poor. The shelter was supported by a grant from a local resident. In inquiring who the resident was, the diamond searcher discovered that it was the person to whom he had sold his house.

One day he paid a visit to his old house, now renovated into a beautiful estate. He talked to the new owner who told him that he had become rich. He said that when he bought the house, he needed to do some digging in the backyard where he discovered thousands of diamonds.

The moral of the story is obvious: you already are rich – you already have the diamonds. You just need to polish them.

Many of the components of your future success are already in your office. But we overlook them, or use them once and then forget about them, like teenagers looking for the next new article of clothing to make a fashion statement.

As entrepreneurs, creatively – we are all looking for that next dopamine high… and seek the next new “shiny” thing.

You have a show on the road. Just make it better. Make it fresh. Set a new standard, and make a new game to “level up!” Add a few new things here and there, but keep doing what is working.

Looking for Your Diamonds

Review what has been working for you. Reaffirm it and keep at it. Look at what hasn’t worked that well and fix it so that it does, or drop it like barbell that you have been holding over your head for too long.

By yourself, and later, with your team, here are some areas to look into:

____1. Review Your Mission Statement. Does it apply? How? Does it need to be customized? Beyond your mission, what is your WHY? Does the mission satisfy this?
____2. What Are Your Outcomes? For example: “People relieved of pain, healthier, educated so that they can and will continue to improve their health… and refer others?” You can also define Minimal Viable (Valuable) Outcomes, e.g., “A patient who accepts care.” Etc.
____3. How Is the Office Vibe? This is determined by your values and how everyone is living up to them. Are these values posted for all to see and check how they are “measuring up?” Are they defined? Do we need to add more, change some, delete some? Should we better define each value? Should we add:

• Trust. Are we worthy of trust with our patients and ourselves?
• Mission Oriented. Do we help each other cheerfully achieve our mission – each day?
• How well are we living up to these?
• How can we live up to these better?

____4. How Were the Numbers? Up, or down?

• When the numbers went up, what did, or didn’t we do? How can we improve upon this?
• When the numbers went down, what did, or didn’t we do? Should we improve or discontinue those actions?

____5. Individual. What can each one of us do professionally this next year to improve our ability to contribute to our team and its mission?

Some of this should be on simple, brief checklists and memo’s. Add it to your Practice Playbook. Document it so that it can be referred to for training and coaching in the future.

Merry-Go-Round

Imagine that your practice is a merry-go-round, the kind you find at children’s playgrounds.

It takes a lot of energy to push it and get it going. But… once it is moving, it takes less effort to gradually get it going faster. And faster! And faster…

Take some time to review how you are pushing your merry-go-round. What procedures worked better for pushing it faster? Focus on these… Makes these better.

Go faster… and push less.

And as you do, watch those, including yourself, hold on tighter and smile bigger.

Enjoy the ride!

With admiration,

–Ed

Patient Education: A Simple and Fun Method for Chiropractic Offices

Posted on June 20, 2017 by Edward Petty

Patient education is definitely a clinical function. But… it is also good marketing.

And note that your entire office IS the marketing department and each team member has a marketing role.

To help everyone on your team better participate in patient education, use this simple and fun method:

Get a whiteboard and place it where patients can see it. Assign someone to write something on it each day so that your patients, or you, can comment on it.

For example, you could write:

What does this mean?

“Pain is the last to show
… and the first to go.”

This will be a cue for the doctor or a team member to talk to your patients – and can also provoke your patients to talk to you.

Here are some other examples:

“What does a chiropractic ADJUSTMENT do?”
“How is pain like an iceberg to your health?”
What does A.D.I.O. mean?

At your morning team meetings, or weekly meetings, go over each subject so everyone has a better idea on how to educate patients on the topic.
For active PM&A members, go here for a more complete list: PMAmembers.com

The 3 Key Ingredients to Motivating Your Chiropractic Team

Posted on May 8, 2017 by Edward Petty

Most of your staff are not engaged in the success of your office. Most of them JUST DON’T CARE.

At least that is according to a 2015 Gallup report that interviewed over 80,000 working adults.

The report showed that there are twice as many “actively disengaged” workers in the workplace as there are “engaged” workers who like their jobs. The percentage of U.S. workers in 2015 considered engaged in their jobs averaged 32%. The majority (51%) of employees were “not engaged,” while another 17% were “actively disengaged.” (“Actively disengaged” means that they are actively sabotaging their work.)

But let’s say your office is different, which I am sure it is. You are motivated enough to read this article and I am sure that is reflected by your team as well. But all the same, take a look with me at the level of motivation of your office.

How was your last team meeting? Were you there? Was everyone sitting on the edge of their seat and contributing new ideas and plans on how to reach new goals in the office? Or, were most everyone pretty silent?

Sure, your employees smile and look busy when you are around, and often work hard and they do care. But really, how much?

What would your office be like if the motivation, creativity, and level of pro-activity was always very high at “10,” or even ranged from 7-10? If they felt that it was “their” business, where they took responsibility for the quality and quantity of outcomes, and regularly worked to improve the business – and themselves?

I have been reviewing the subject of motivation for some time, from my own experience over the years and from what social scientists have reported.

I have incorporated certain principles into a new system of business management that are specifically designed to unleash everyone’s innate motivation – including business owners like you!

Motivation is the foundational in a chiropractic office, or dental office, acupuncture – even with therapists and other service firms. It is a bedrock for any healthy practice and business.

Here is one very useful principle specifically about motivation and how you can use it to generate more engagement – and productivity — with your team.

3 Goals System of Business Management: Principle #5

Self-Determination and Motivation

Everyone wants their own sandbox to play in.

You do. This is one of the reasons you went to school – and why you started your business.

We all want to have something that we can call our own where we can create and demonstrate our competence. What we get in return is feedback that we can do something good, that we have power, that we can make something beneficial happen, that we can … make a positive difference. If only to ourselves, we can say: “Look what I did. I did this. This is my creation.”

You can see it in children, for example, when they bring you their colored scribbles on crumpled pieces of paper to proudly show you their great work of art. This is their sandbox.

Of course, we all work for money. But we also have deeper motivations that if tapped into and nurtured, can be very powerful. By harnessing these motivations, and then linking them with others who have a shared goal, we can create a dynamic team driven business that is very profitable.

This has been explored by social scientists who have studied what has come to be called Self-Determinism Theory. I have also seen it in action. Essentially, it states that we all have innate drives and inherent needs that motivate us to be more self-determined rather than determined, or controlled by, outside forces.

External motivation, like the fear of being fired, can only motivate us so far. Threats, criticisms, negative reinforcement may produce short term action, but in the end, they demotivate, or worse.

The level of employee motivation has a tremendous influence over the success of your business.

An unmotivated staff, one that only becomes engaged to the level of “I will perform just good enough so that I don’t get fired or criticized,” will weigh the office down.

Self-Determinism Theory (STD) has three components, all of which easily apply to your business. These are:

Autonomy
Competence
Relatedness.

And by the way, while reading this, consider how this also applies to you as well!

Autonomy

You do not want your treatment plans second-guessed by a clerk in an insurance company. Neither does your front desk want you breathing down their necks about where all the patients or practice members are, or why they used the blue pen. You should train and educate your team, but then get out of their way and let them succeed or fail.

Think of helping a child ride a bicycle. Sure, they will need your help for a while. A push now and then. Perhaps some training wheels. But you will have to let them fall down a few times and allow them to get the courage to get back on the bike and succeed. You can continue coaching them to improve, but you must let them go.

Even if you see employees appearing idle, or having brief personal discussion with another employee, back off. Tolerate minor errors. Give your team some rein. Come back around later to coach them and train them to improve. Mostly educate them on the mission of the office and of their roles, and get them to understand what outcomes they are supposed to be producing. Once they see that the statistics measure their performance, they will be more self-directed and want to do all they can to win the game!

We all want to be free to create our own enterprises, even if we work for someone else. As long as what we do is in line with the purpose or mission of the business and our role, there should be no problem. This helps us demonstrate our competence, which is the next element of Self-Determined Theory.

Competence

Doing a good job, all by itself, is its own reward. It pushes away self-doubts and shows us, and others, how good we really are. It is positive reinforcement.

And the better we can do a good job, the better the results will be, which demonstrates to us just how awesome we truly are! Plus, as we increase our skills, we also will find that our duties are easier to perform.

Your team wants to improve their skills. Help them do so.

Sign them up for seminars, webinars, give them monthly reading assignments, and give them a coach or three of them. But this has to be done in conjunction with your supervision. You will need to guide them through the training so that they see how it applies to their roles and the business as a whole. Quiz them on what they are learning and have them give presentations to the team on what they are learning. The old maxim applies: “to teach is to learn twice.”

And where possible, make sure they earn certificates and can wear pins or insignia that testify to their competence. This goes along with Game Theory – people win at one level and then want to go to the next level. They want their “badges.”

Business owners throw staff into their jobs and expect them to produce with little or no training. Without exception, the offices I have seen that provide more training and coaching for their team — do better. Companies spend an enormous amount on employee training. $161 Billion in the U.S. last year (trainingindustry.com). And, it pays off.

One study showed a comparison between car companies and how many hours they trained their new employees: Japan spends an average of 364, Europe averages 178, and the United States – 21 (Pfeffer –The Human Connection).

And you can guess which country has cars with the best frequency of repair record.

Children want to be super heroes and wear their capes.

Don’t we all!

Relatedness.

This is the feeling of being connected – and there are two aspects to this.

Family. First, “relatedness” is the feeling of not being left out of the “loop” and of being included. Staff meetings help with this as does the general work environment. This is the sense that we are in this venture, job, and profession together. That we are part of a family.

Keep your team involved with your decision making. Give them some of the issues you are dealing with and encourage their input. They are stakeholders – it is their office too!

Greater Purpose. The other aspect of relatedness is that people generally want to be associated with a greater purpose. The more that each member can connect to the greater purpose of the group and make it their own, the more motivated they will be. Taking it a step further, if employees have higher goals of their own that coincide with the organization’s and they are allowed to pursue them within the organization, there would be no reason for employees to work anywhere else.

Train your team, let them own and creatively improve their own areas – and help to do the same for the entire office. Nurture camaraderie and a spirit of family – and always remind them – and yourself — why we are doing what we are doing.

Do this, and not only will your business be more successful, but you too will be more motivated and have more fun in the bargain.

# # #

Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness. Ryan, R. M. & Deci, E. L. (2017) and Why We Do What We Do: Understanding Self-Motivation Paperback – August 1, 1996

© Edward W. Petty, From the upcoming book: “Three Goals: A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.” By Edward Petty, due to be published sometime before the Singularity. © May, 2017

Our Shallow World – and What Your Chiropractic (Acupuncture, Dental, Medical) Patients Really Want

Posted on March 15, 2017 by Edward Petty

We live in a shallow and superficial culture. It is fast talking, faster messaging, with abbreviated emotions and texts.

No one seems to really care, or takes the time to care.

Communication has become digitized and synthesized. We forward messages from some people we know, and from many we don’t, to people we know, and to many we don’t. We are addicted to our smart phones and “phub” each other. (Phub: The practice of ignoring one’s companion or companions in order to pay attention to one’s phone or other mobile device. Google.)

We buy things from “clouds” that seem to know what we want, as if they had been eavesdropping on all our personal affairs.

The Age of Artificial Intelligence that cares more for us than people who “friend” us is growing faster and faster.

Yet, somehow, shallow works. It is practical. It is fast and efficient. When I ask you “how are you?” I really don’t have the time to hear about how your kids did at their Christmas play, or how you like your new socks. I have my own deadlines and have to go.

We are caught up in minimal viable encounters. They are functional, but they provide the only the minimum amount of care. Any less, and there wouldn’t be any service at all. They are “duct tape” solutions.

This is our life now. The fast, the short, the immediate.

For all its practical aspects, this is the first goal in any business exchange. We must provide the outcomes and services that are initially wanted by our patients. This is a “drive through” consumer culture that moves quickly for things that are wanted. In return, business is trained to provide the minimum quickly, efficiently, and yet is still valuable.

But just because our society is shallow, does not mean that your patient is.

This may be the culture in which they have adapted, but privately, your new patient might not have been satisfied with the services they have been receiving from others. And as the expert and professional, you know that it is likely that they have been short-changed on their care.

No doubt, your patient wants relief – now. But if you want to know the truth, they probably want more than just a quick-fix.

Your patient is looking for someone who genuinely cares. They are hoping to find someone who listens, empathizes, and someone they can trust to help them get what they really want.

What do they really want?

Ask them:

What is most important to you about your health?

Then, find out why.

This is a broad and open ended question. It takes the both of you through the quick-fix drive-through to get to, finally, what they really want.

If I have a painful tooth, I would see a dentist to at least treat it enough so that it wasn’t causing me discomfort. But if the dentist asked me what I really considered important about my dental health, I might say that I would like cavity free teeth that never caused me pain. I would like all my teeth and gums to be healthy and look good until I am at least 105.

The dentist would then repeat back to me what I said that was most important about my dental health so that we could agree that this was my goal — something I wanted. With this disclosed and agreed upon, we could now dig into my history and perform the exam to see what was going on that was causing the symptoms.

Once all this was done, he would explain to me not only what was causing my pain, but what I needed to do, in the long term to get my mouth 100%, which we already agreed upon I wanted.

I definitely don’t want or need a hard sell for something I am not sure I need.

But if you find out what I really want and let me know that you can deliver, you won’t have to sell me. I am already motivated.

Confrontational Anxiety

Confrontational anxiety is that stress you, and your patient, can feel when discussing the length and expense of your recommended treatment plan. But it melts away and evaporates if you work towards what the patient really wants.

There are many different approaches designed to help get the patient to agree to a more complete treatment plan, including scripted words or phrases for the doctor and staff to say. Ultimately, the patient must trust you. They will have to understand what is causing the symptoms, what it will take to get better, and the benefits to be had. In the end, you will want to work out your own procedure. (Give us a call, we can help!)

Realize that your new and prospective patient is just barely trusting you, as it is. They would like to trust you more. They hope for more than just a “pop and pray” (“…and hope that they pay”) treatment and adjustment from you. What they usually offer you, or present to you as a new patient, is a symptom that may have deeper causes. Their condition is probably not new. They likely have had it, or some aspect of it, for some time. Only when it becomes more acute do they come to see you.

The analogy of the iceberg is useful.

Your patient wants relief, but also wants everything in life that the pain hampered or prevented. This might include less recurring episodes of pain, the ability to resume their hobbies and sports, improved performance in life activities, stronger immune function, better balance, increased knowledge to improve their health, more happiness, better weight management, and more energy. You can and should make a list of at least 10 benefits that come from a patient completing their treatment plan.

I buy a new car not to just have a better ride, but to feel that I have a better life. I pay for a cleaning service because I want a cleaner house, but deep down, I really do so because I want a happier wife.

Patients are too often short-changed because of a culture that is fast and shallow. You don’t have to be – and you can give your patients complete and thorough care. This is what they want – once they understand their condition and what you can provide. And, once they trust you.

Be interested in your patient and go deep to find out about their health, their history, and what they really want. Then, educate them on how the both of you, working together, can best help them get what they really want — and what you want and can deliver.

© Edward W. Petty, From the upcoming book: “Three Goals: A New Practice and Business Building Methodology That Is Simpler, Faster, And More Effective and Fun than What You Are Doing Now.” By Edward Petty, due to be published sometime before the singularity. © 2017

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Phyllis Frase to Speak at the Chiropractic Society of Wisconsin Fall Summit on Referrals and Retention

Posted on September 20, 2016 by Linda

Welcome back to Wisconsin Phyllis!

We are excited to have Phyllis returning to Wisconsin to join us at the Chiropractic Society of Wisconsin Fall Summit.

The Fall Summit will be held October 21st through the 23rd at the Kalahari Resort in Wisconsin Dells.

Are you and your team registered? If not you will want to as Phyllis will be presenting to doctors and staff all day Friday. She will be covering the following topic:

“The Secrets of Referrals and Retention”

What’s the secret? The pixie dust? The magic potion to creating patients that stay pay and refer for a lifetime?

In this class you will walk away with what makes a patient pay and value their chiropractic care. This interactive class will help you create great customer service and learn easy, solid systems and procedures that will take your practice to the next level. Included is low stress, low cost marketing ideas that you can implement on Monday morning.

For more information on Phyllis visit: Our Experts

To register for the CSW Fall Summit visit: CSW Fall Summit 2016

David Michel to Speak at Moraine Park Technical College – 4/8

Posted on March 3, 2016 by Linda

David Michel will be speaking on Friday, April 8th from 9:30 – 11:30 at Moraine Park Technical College in West Bend.

His topic “Overview of Medicare Billing for the Chiropractic Specialist” is open to the chiropractic public with limited seating for around 50 people. If you or your staff are interested in attending please let David know so he can inform Dr. McLean.

David can be reached at dave@pmaworks.com

Your Most Important Set of Chiropractic Office Procedures

Posted on January 18, 2016 by Edward Petty

An Introduction to the Practice Development Process of Continuous Improvement

A key difference between a successful and profitable chiropractic business and a roller coaster type practice can be traced back to procedures and systems.

Many practice problems occur because procedures are not established, consistently followed, and regularly improved. This has been the secret to franchising. Starbucks may offer new products and services now and then, but for the most part, they follow their checklists and manuals of successful procedures. The local New Age coffee shop down on the corner with the unemployed guitar player usually lasts for about a year before the owner’s savings and inspiration dry up, along with the last cup of coffee.

Of all the categories of systems in your office, what would you say would be the most important?

☐Patient Accounts (Billing/Collections) Systems
☐Marketing Systems
☐Front Desk Systems
☐Therapy and Clinical Support Systems
☐ Doctor Systems
☐ Business Systems (Payroll, Financial Planning, Taxes,)
☐ Leadership
☐Office, Practice Management Systems

My guess is that you usually keep most billing procedures in place as… obviously, you need to be paid. And, you will usually keep most front desk procedures in place. These deal with patients and patients are obviously in the office, or not. And you, of course, follow your clinical procedures.

Your marketing procedures come and go, at least they do in most offices. They are just not consistent. This is why I put together the Marketing Manager System in 2000. The biggest error in most offices with their marketing is that it simply isn’t done consistently.

But the most important category of systems is not so obvious. These are the management procedures and systems. Why are these most important? Because they keep all the other procedures in place and are continually being improved upon.

Why do you think CEO’s are paid so much money? Because they are in charge of the management of a business and are able to increase its bottom line by the millions. They have procedures that they follow and insist that others do as well. These procedures all add up to systems.

Over the years, Petty Michel and Associates has been very successful at increasing the revenues of practices. One of the reasons is that we implement what we call the Practice Development Process. It is a monthly system of management that gradually works to objectively improve the business, repetitively over and over. It integrates into your current systems and does not take that much extra time. But in the end, it saves you a great deal of time, extra work, and lost revenue.

To learn more about the 3Goals Practice Development Process: 3Goals PDP

The 3Goals Practice Development Process for Chiropractic Success

Posted on January 18, 2016 by Edward Petty

Four steps to continuously develop and improve your practice

The Practice Development Process is a simple, yet powerful practice building system that can help take you and your business to its full potential of a systematized, team driven and profitable business.

It transforms your practice. Month by month, it helps move your practice to a more profitable service oriented business that runs at near full capacity – with less ups and downs that demand your time and extra work.

It is based upon the idea of constant improvement.

The principle of constant improvement in management science has been a major factor in the success of large manufacturing corporations around the world. The success of the Japanese automobile manufacturing rests heavily on a process of constant improvement called Kaizen (kai = change, zen = good). Motorola developed its own program called “Six Sigma”, a process of continuous improvement.

We have adapted these processes to be applied in practice management and call it the 3Goals Practice Development Process (PDP).

The Practice Development Process has four steps:

Access
Plan
Supervise
Document

Integrate This Process As Part Of Your Team Meetings. The first two steps, Assess and Plan, are usually done before or during the first staff meeting of the month. Supervision goes on during the month to ensure that the plan gets completed. At the end of the month, successful procedures are documented in a practice playbook for future training and assessments.

Your Consultant and Coach. This process is best done with your practice and business coach. Each month, the two of you should work through step 1 and 2. During the month, your coach may also be able to help with the implementation of the plan.

THE 4 STEPS OF THE PRACTICE DEVELOPMENT PROCESS:
1. Assess and Review. At the end of the month, look over the statistics and note what areas improved and what areas didn’t. Then check what was actually done, or not done in each area. Use your departmental checklists from your Practice Playbook if you have started this.

Many business owners still manage without looking at objective indicators. They manage by emotions, mistakes, fear, “bright ideas”and other flighty factors that ultimately hold a clinic back, or often just burn it out.

Effective clinic managers, like an athletic team coaches, base their actions first on actual outcomes and performance monitors. These are your daily, weekly, and monthly practice statistics. PM&A has developed a specialized form of review which is called Practice Analytics System which we display on our client’s personal Practice Dashboard’s.

This assessment also includes reviewing checklists of the key procedures and whether or not key duties were done.

2 Plan. Work out the key areas you want to work on in the next month. Pick just one or two areas that will make the biggest difference and make a list of a few action steps that will help improve the area in your office you have targeted. Get the actions assigned with a date on when they should be done.

3 Supervise. Regularly monitor the implementation of the action steps with yourself, your team, and your consultant. Provide help where needed to get them done.

4 Systematize. You do not want to keep inventing the wheel, so at the end of each month, document any procedure that worked well.

List all successful activities for each department and “lock them in” as standard operating procedures. Keep what works, throw out what doesn’t. Start with just a checklist of key procedures. Later, you can write or videotape a description of each procedure. It is from this that you will do your training and “coaching reviews.” Use your playbook often: refer to it and practice.

Gradually, you should have your own system of practice management and patient management and have it outlined simply in your Practice Playbook. For example, the “Smith Chiropractic System of Patient Management.”

IMPLEMENTATION SCHEDULE
Week 1. First Week of the Month: Do Steps 1 & 2 – Assess and Plan
Week 2. Supervise. Coordinate upcoming activities. Study and Train. (Optional: Separate Marketing Meeting)
Week 3. Supervise. Coordinate upcoming activities. Study and Train.
Week 4. Supervise. Coordinate on upcoming activities. Celebrate and party for a great month! Add to Practice Playbook.

REPETITION
Do The Practice Development Process Every Month.
The success of this process derives much of its power from a simple principle from Aristotle.

“We are what we repeatedly do.
Excellence, then, is not an act, but a habit.”

This often referenced quote is from a series of lectures he was to have given at the Greek Lyceum on ethics (300 B.C.). We could say, then, that continuing to do the Practice Development Assessment, and all of your procedures and systems, is ethical and leads to excellence. The contrary would also be true.

GOALS AND CONSTANT IMPROVEMENT
It is important to keep in mind WHY we are doing the PDP each month.

It is assumed we all want to improve, that improvement is possible, and that we have higher purposes and goals. Our patients do. That is why they see us and we help them improve and get closer to their goals at each visit.

By consistently working the 3 Goals Practice Development Process each month you, the practice, and each team member will also get closer to the higher goals each of you share.

Kaizen: Constant Practice Improvement – From Wooden to Deming

Posted on November 17, 2015 by Edward Petty

What improvements do you need to make in your practice for 2016?

Managing your practice is similar to managing a sports team in many ways. There are goals, rules, plays (procedures,) skill development, strategies, winning and losing. There is also coaching and training.

The teams that win the most constantly work to improve. But the improvements often focus on just the refinement of the basics.

One chiropractor I worked with told me stories about his experiences with John Wooden. Coach Wooden was a very successful basketball coach who coached the UCLA basketball team to 10 national championships over a 12-year period.

Here is what Coach Wooden has said:

“When you improve a little each day, eventually big things occur…. Not tomorrow, not the next day, but eventually a big gain is made. Don’t look for the big, quick improvement.

Seek the small improvement one day at a time. That’s the only way it happens – and when it happens, it lasts.”

In Japan they have something called Kaizen. This means continuous improvement. Part of this was developed by another Midwesterner (Wooden was from Indiana), Edwards Deming (Iowa).

The Deming Cycle is a process of continuous improvement that helped grow the Japanese car industry in the 60’s to what it is today. For a long time, Detroit auto companies weren’t that interested in what Deming had to say – and, of course, we can see how that turned out for them!

Constant improvement takes discipline. Those of you who had to practice a musical instrument or an athletic skill in school remember the daily routine. Improving the little things can get boring and when a colleague calls with excitement about this new seminar or gadget or website, many doctors are off to the chase the “shiny things.”

Innovation needs to happen, certainly. But the real successful businesses and teams continually work to master what they already do.

Mastering the basics is always the key to success. Deliberate practice, study and good coaching. And this takes discipline and… a certain degree of humility to admit you can personally improve.

But since you are not a full time coach and mostly work IN the practice, you have to schedule specific times to work ON the practice. But what do you work on? ICD 11? (Yes… it IS on the horizon!) More E.H.R?

Well, maybe, but these are not the areas that will significantly improve your business over the long run and take it to the next level.

To help you uncover what should be improved, you can use our updated Practice Progress Grid. You can go over it with your team and plot where you were, where you are now… and then where you want to be next year! (Link is below.)

This can help reveal what organizational and engineering steps you need to build a better business machine for 2016.

In most cases, the improvements don’t have to be major. They just have to be continuously refined. But some areas that are holding you back from your goals can be hidden or overlooked.

If you want to dig deeper, we also have our Practice Development Assessment(PDA). It takes more time to complete but gives you a more complete analysis. (The link is below.)

The world is changing faster and faster. You have to constantly improve to keep up, let alone, to stay ahead. And if you don’t… well, your patients will be going to those offices that are.

From all of us at PM&A, we look forward to your continued improvements and to helping you get closer to your goals in the New Year.

Ed Petty

Link to Practice Progress Grid
Link to Practice Development Assessment (No charge for first 15 users, $25 thereafter.)

Chiropractic Marketing and a Staff Member Conspiracy

Posted on July 10, 2015 by Edward Petty

This is a tale of a staff member conspiracy.

It is about a hidden and quiet plan by scheming staff members.

The planning took place towards the end of 2014 in a chiropractic office next to a river. By a lake. But that is not important.

Quietly, Ann and Betty met to discuss how they were going to fix the … situation. (I changed the names, but the rest is true.)

Dr. JM is an excellent and respected doctor who has a loyal following of patients. But as much as he wanted more new patients — as he was only generating about 6 per month — he just could not bring himself to do much marketing. And this is in spite of the excellent advice and support of his faithful and expert coach and consultant (moi).

But secretly, the two ladies hatched their own private strategy. And it worked.

More new patients started to come in. In fact, on my last visit to their office, they had three new patients come in, more than they usually see in a week.

What exactly did these enterprising chiropractic assistants do? Hmmm?

Maybe you could do the same?

Yes, you can and here is what they did:

Betty, the office manager, and Ann, the front desk coordinator, got together and worked up a procedure for generating patient reviews on Google.

The office manager wrote up a procedure for patients on how to post a review on Google. Ann, who calls most of the patients “honey” and says that they are all “her” patients, can be very forward and, well, controlling. She would simply get the agreement of key patients to make a review. She then gave them the procedure that was on a slip of paper and told them to go forth and spread the word.

In time, with her friendly but insistent nudging, they would. And now, their doctor has over twenty great reviews spread out over many months. The new patient increase is coming from people calling in off of the Internet.

Everybody is a reviewer.

People buy on the Internet from reviews. This is like word-of-mouth of old, only now it is a 4 or 5 star review. In fact, Amazon, the world’s largest online retailer, uses reviews as their primary marketing tool. Once you buy something from them online, you are continually asked to post a review about what you thought.

I recently posted a review for something I purchased and found out that I have a “review rank” of 16,678,570. (But at least I earned 1 “helpful vote”, so that is nice.)

There are now many web sites that a consumer can go to review you.

Everyone is a reviewer. It is the new currency used to buy and sell products and services.

Get reviewed.

To help you, we have provided links on our blog for the following:

Article for staff on how to generate web reviews. (PDF)
Procedure sheet for patients on how to make a review on Google. (PDF)
Procedure sheet for patients on how to make a review on Facebook. (PDF)
A patient log for the staff to follow up on patients who have agreed to post a review. (PDF)

If you are an active client, you can go to our members site and download the same files as customizable WORD files. Get Reviewed info on PMAmembers.com

Start your own conspiracy to help share the successes of your services. But… get reviewed and watch the new patients come in.

8 Fast Tips on Chiropractic Team Training

Posted on March 9, 2015 by Edward Petty

$70,000,000,000.

That is 70 billion dollars and was the amount spent by corporations last year (2014) on personnel development in the United States. Corporations spent $130 billion worldwide.(Reference below.)

Large corporations recognize the value in developing and training their employees as a good investment. This fact also applies to smaller businesses but is not always acted upon.

I have often seen production held back due to poorly trained, educated, and motivated support staff. Here are some fast pointers on training your team.

1. CULTURAL BARRIER
Your team may not consider themselves as professionals. Perhaps you don’t consider them professionals either. Some doctors still call their staff members “girls.”

But we have long since passed the Industrial Age and have moved through the Information Age to the Networked Age. We are in a knowledge and networked economy and offices that do the best operate as a team of professionals.

In hiring and then training your team, you may be dealing with an unconscious cultural set of values that places health care service workers as “Girl Fridays.” The front desk, rather than having the challenging role of increasing the office visits through her or his skill, can be looked at as an underworked secretary and receptionist.

This idea can be harbored by both employee and employer and as a result, no one has the goal of training to becoming a professional.

It may take YEARS for your staff to become experts, but that should be their goal and yours as well.

As the CEO of your business, ensure that your team members understand that you want them to become experts and leaders in their field. Then, make sure they get good monthly training in-house, at seminars, receive coaching, attend webinars, and study books.

2. KNOW-IT-ALL BARRIER
This applies more to newer employees, but it can apply to all of us. When starting a new job, the new employee must understand that while their past experience may be useful, for now, they are a “freshman” and they need to learn as if this was the first job they ever had. In Japanese martial arts (taken from Zen Buddhism) there is a term called “Shoshin”, meaning “beginners mind.” Even when you are a black belt, you should always strive to learn as if you were just beginning with no preconceptions.

3. ROLES AND GOALS FOR TEAM TRAINING

Team member. (Defined by mission statement and company core values.)
Specialist. (Front Desk, Patient Accounts, Therapy, Etc.)
Marketing. (We all sell health.)Remember that each role…has a goal.

4. END IN MIND
Training begins and ends primarily on the purpose of the role as well as on the outcomes of the role. If these are really clear, the team member can better understand the details. Too often we start training a staff member on HOW to do the job rather than WHY. Train on the WHY first and often as we all can get caught up in the details and lose sight of the end goals and our mission.

5. ENGAGEMENT
You might find that many people, staff and patients, do not have the best study habits. Staff members will nod in agreement when you ask them if they understand how to do something you just explained. They will think they understand how to do a procedure, yet when the time comes for them to do the task, they don’t do it.

Because of this, training should include participation and engagement. We all learn by doing. All training should include quizzes, challenges and or practical exercises that require the team member’s demonstration of what they’re studying. For example:

Terms. Clear up the terms. You would be surprised how many of your staff cannot define even the basic words such as “health”, “subluxation”, “toxic”, etc.
Have them demonstrate a concept. Rehearsing, role playing, quizzes, or requiring demonstrations can help your team become engaged with the information and more skilled in application.
Training frequency. Ideally, team member training should take place weekly. Maybe you cannot get the whole staff there, maybe the veterans only go once or twice a month, but the rookies can get short sessions weekly. Make sure the time is uninterrupted.

6. EDUTAINMENT
All training should be entertaining, fun, and motivating. Challenging is fine, as long as each individual leaves the training with the feeling of accomplishment. OK to be serious now and then, but in the end, it should be enjoyable.

7. LENDING LIBRARY
Make sure you have a full library of books and movies about health for your patients. This is also for your staff. Give your team members a $30 bonus for a book report given at staff meetings and a $10 bonus for every report on a DVD from the library. All staff should watch Doctored, for example, and then discuss it.

8. ROI
Keep in mind that team training does take time, but it offers a positive return on the investment. Team members become more motivated and their moral goes up as their competence increases!

Team training does not cost… it pays.

[1] Forbes.com forbes.com/sites/joshbersin/2014/02/04/the-recovery-arrives-corporate-training-spend-skyrockets/

10 Practice Development Strategies for Chiropractors in 2015

Posted on December 31, 2014 by Edward Petty

[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

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

Posted on February 19, 2014 by Edward Petty

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 4^th 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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Your Biggest Chiropractic Bill Each Month

Posted on January 23, 2014 by Edward Petty

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

Posted on January 3, 2014 by Edward Petty

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

“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:

The assessment
Graded and plotted assessment
Statistical analysis with charts
Phone consultation
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

2014 Appointment Calendars

Posted on November 15, 2013 by Linda

It’s that time of year again!

Many of you are starting to make multiple appointments for your patients which automatically takes you into 2014.

Below are some helpful appointment calendars that you can use help get those appointments scheduled and keep your patients on their treatment plans.

Appointment-Calendar 2014

Personal Appointment Calendar 2014

PMA members can find a word doc version of the calendars, for customization, on our members side under the Front Desk Library