Category Archives: Case Managment

The Patient Handoff

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doctor and two women introductions.

Improving your patient’s experience.

There are subtle and brief moments in your practice when you and your team can earn or lose your patient’s trust. It can make the difference between your patient agreeing to your care program or finding a reason to delay the decision.

Excuses can be easy to dream up. There are hundreds of reasons why someone can’t, or won’t, agree to a care plan or follow through with their care. But the reasons presented may not be the actual ones.

Surveys show that customers cease their relationship with a business when they experience an attitude of indifference on the part of the employee or business. People hate to be ignored.

You know this, so you ensure you and your team communicate well with patients at the front desk and during the report of findings and case presentation. These are obvious communication events.

But just as important, but not always as obvious, is the communication that occurs when the patient is transferred from one staff member to another.

This is called the Patient Handoff.

For example, the doctor has spent time reviewing the exam and imaging findings with the patient and correlated them with their history. The doctor explains the health issues and the care plan to the patient. The patient nods in agreement. With other patients now waiting to be seen and the doctor feeling rushed, the doctor may leave the patient and ask another staff member to schedule the patient for care and to work out their finances.
It would take another 3-5 minutes for the doctor to introduce the patient to another staff member and relay the key information to them in front of the patient. It would be minutes well spent.

“Hi Betty (Patient Accounts Specialist). This is Sam. He works out at the same gym as I do over at Acme Fitness. He wants to keep up with his workouts so I have worked up a treatment plan to help him recover from low back injuries. I’ve included the info in the back (hands written report to Betty). Could you schedule him for his appointments and discuss his payment options?”

“Sam, any questions or comments?”

“No.”

“Ok, great. I look forward to working with you here at the clinic and also at the gym. See you soon.”

After the report of findings is a handoff event that can be too easily cut short or skipped altogether. Another handoff I have often witnessed omitted entirely is introducing the new patient to their therapy and rehab services.

We are all in a hurry, but these patient care transition points hugely impact how your patient experiences you and your clinic.

In sum, patient handoffs help with the following:

  1. The continuity of care ensures that the patient receives consistent and appropriate care throughout their treatment plan.
  2. Minimizing misunderstandings or errors in their care.
  3. Improving your patient’s satisfaction and trust in you and your clinic.

Take time to do thorough patient handoffs, and you will see retention improve, referrals increase, and happier patients.

Working towards a healthier future,

Ed

Failure to Follow Through

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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

Improving Patient Follow Through: The new patient log and checklist

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

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

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

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

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

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

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

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

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

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

We implemented several solutions that have worked for other offices.

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

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

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

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

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

Stay Goal Driven for a happier future!

Ed

Case Management for Better Service and Retention

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Start Each Day with Service First

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

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

Beginning Each Day With Service Goals for Each Patient

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

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

Case Management Meeting Procedure

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

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

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

More Than Case Management – Keeping It Fun.

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

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

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

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

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

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

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

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

It only works if it is done.

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

Over to you!

Carpe Posturum! (Sieze the Future)

Ed

STARTING your day- Goal Driver procedure: Case Management

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

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

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

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

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

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

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

Goal Driver Procedure: Morning Case Management

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

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

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

A nervous wreck.

(Let that sink in!)

Carpe Posterum (Sieze the Future)

Ed

Facebook versus Email and “Conversational Commerce”

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It’s a New Year!

And if you are just reading this in March or September, it’s a new month or a new week!

Whatever time of year it is, it is always time to get the “Word” out your servcies.

It’s time to tell everyone in and around your office and community — about your chiropractic and professional services and how they should get them now!

But what is the best way to do this?

Well, obviously, with each person you see when you are seeing them. You – and your health team – have a captive audience. Sometimes referred to as “Table Talk,” this is your way of educating your people at the time of service.

You can augment this with new patient workshops that motivate, educate, and entertain your people. It is a free class but is part of their treatment program because you have found that people “get better faster and stay healthier longer if they get a better understanding of the health process we are doing together.” Also…“It assists with your treatment program and you get a better return on the work you put in. It is just a good investment!”

Then…don’t forget your team. They need to hear about the successes and case stories of how their office really helps people.

But your patients aren’t always in your office. What then? Shouldn’t your conversation with them continue? Other vendors are certainly getting their “word” out. Pharmaceutical ads are pervasive.

What about people who have not discovered you yet – how do best tell them about how you can help them and why they should see you?

Many of you make posts on Facebook in hopes that this will help market your services.

Does it?

What about email? Some of you subscribe to template emails that go out to your patients. How is this working?

I have some strong feelings about this subject — but first I wanted to see what others have said and what the studies show. Here is the question:

Which is the better medium for marketing:
Facebook or Email?

Which works better?

According to most of the surveys that I have seen, email is the winner.

But comparing both mediums is like comparing apples to oranges — both work depending on how much time and expertise you put into it.

But it stands to reason that if you have someone’s email, they are a subscriber and have given you permission to address them personally.

From a sampling of various studies and surveys (references at the end of this article):

“Where is the first place you go online in a typical day?”

  • Email 58%
  • Search portal 20%
  • Facebook 11%
  • News site 5%
  • My company’s website intranet 3%
  • other 3%

“Where do you look when you want a deal from a company that you know?”

  • Email: 44%
  • Company website:43%
  • Search engine (e.g. for coupon codes): 6%
  • Facebook: 4%

Email reaches 79% of the people you send it to (this is the global average inbox placement rate). On the other hand, Facebook’s organic reach has declined to about 1 to 6%, depending on your total number of fans.

So the stats and studies seem to show that you are going to get a better ROI from email.

Over the years, I have observed that patient referrals, patient visit average, and reactivations improve with regular emails.

Facebook and social media can help create familiarity and trust. From this you can direct people to your website for upcoming events or information. You can also buy ads that target specific types of potential patients and set up workshops or make special offers. I have seen this work on occasion very well

But the algorithms, or computational rules, for Facebook and other mediums are always changing and what worked last month may not work this month. Currently, Facebook is becoming more of a “pay to play” medium – peppered with inspirational forwards and political rantings!

With email, you own your list and make your own rules. Plus, it is nearly free.

Email is a direct and personal letter from you to another person.

It is authentic and genuine. It is the reader – and you, personally. It is not manufactured “health news” which is just a mash-up of articles from 1998.

In this busy and more automated world, genuine communication is becoming scarcer… and more valuable.

The biggest challenge is simply getting the email out.

Actually, this is the big problem with all of your marketing – who is going to do it — and when?

We have found some simple procedures that work for getting this done which I offer below. But first, let’s look at the future.

The Future: Trending…

The future medium will continue to be more direct communication for selling. The trendy term is “conversational commerce.”

“Consumers are increasingly relying on messaging apps for all forms of communication, whether personal, business, or commerce. … Messaging apps are becoming the preferred means of communication.” (emarketer)

Messaging is personal, it is one to one.

According to a research commissioned by FacebookIQ and Nielson:

“53% of people are more likely to do business with a business they can message.”

 

This means, when people visit your Facebook page, if they can chat with you personally, half of them will be inclined to come in for a visit.

You can take a look at a couple of applications – Chatfuel and Manychat – for inexpensive chat programs that you can add on to your Facebook.

You can also ask your webmaster to install a chat system on your web site. An example is websitealive.com.

But the force of all this is personalized communication, something that emails and sales letters and video letters have always done and continue to do better than Facebook.

A few weeks ago I received an email newsletter from a yoga instructor I have followed off and on for a few years. I had question so I sent her an email thinking she might answer it. She did. What’s more, she included a short personal video – directly to me! I am now considering buying her DVD’s when I hadn’t even considered it before.

So how are you going to “Get the Word Out?”

I recommend personally. One-to-one. In a conversation in the office and out of the office through email and maybe… chat.

A Simple Procedure to Get Your Emails Out

  1. Someone in Charge. Assign someone to coordinate your email messages and newsletters. (They can also coordinate Facebook and Chat.)
  2. Time to do the Work. Give them at least 4 hours per month to get it done.
  3. Monthly/Weekly Reports. Have them give you a monthly written report and review it with them. (Advanced: Include email stats and Facebook stats this month and if they are up or down from the prior month. Analytics!)
  4. Email Content. The email should have a 3-4 paragraph (or more) candid letter from the doctor written as if she is talking to “Mildred” or “Jeff,” or just to one patient in particular. You can call it “Health Notes from Doctor Ed.”Or, publish it as a short newsletter, and include a recipe (My Grandma’s Buffalo Chili. I don’t like it but everyone I have ever met loves it. In fact, my uncle claimed it got him his wife, Mildred. Here is a picture of Milly (lucky guy!)” [show picture]
  5. Dictate it on your way to or from work and have someone edit.
  6. Email Service. Use Constant Contact, Mailchimp, or another service and send out your mail.
  7. Frequency. Do this 1-3 times per month. Keep it simple.
  8. Promotions. Attach a monthly promotion to it every now and then.
  9. Funky Office Fluff. Add recipes, success story, local news, or other interesting notes every now and then. (Think of over the back yard fence, neighbor to neighbor, chatting about local news.)
  10. Continue the Conversation. But most important is continuing your conversation with patients. The email is just you continuing your “Table Talk.”
  11. Messaging! Add a messaging application to Facebook and to your website.
  12. Don’t Get Addicted to Social Media. Don’t get sucked into Facebook drama!*

Remember that a practice is a network of relationships built and sustained in part by communication. Now and then attach a promotion to your email and this is one of the least expensive forms of marketing you will ever do.

Keep the conversation going…and going and going.

Till next time,
Ed

(*Facebook Drama. Social networking definitely has positive uses. But, according to one of its founding executives, it has negative effects. In an interview at Standard School of Business, Chamath Palihapitiya, (known as “C.P.”) who joined Facebook in 2007 and became its vice president for user growth, says that he feels tremendous guilt for the company that he helped make. Facebook, and others he says, have succeeded by “exploiting a vulnerability in human psychology.” “I think we have created tools that are ripping apart the social fabric of how society works,” he told an audience at Stanford Graduate School of Business. He hasn’t used it for years and won’t let his kids use it either!

“The short-term, dopamine-driven feedback loops we’ve created are destroying how society works,” he said, referring to online interactions driven by “hearts, likes, thumbs-up.”

It is a great interview that you can watch or listen – link at the end of the article.)

https://www.campaignlive.com/article/facebook-study-53-consumers-likely-shop-business-message/1404632

Email Marketing vs. Social Media: Is There a Clear Winner?


https://www.mailmunch.co/blog/email-marketing-vs-social-media/
http://image.exct.net/lib/fe641570776d02757515/m/1/SFF1-TheDigitalMorning.pdf
https://returnpath.com/wp-content/uploads/2015/10/2015-Deliverability-Benchmark-Report.pdf
https://support.getresponse.com/uploads/2016/01/The-State-of-Email-Marketing-by-Industry-January-2016.pdf
http://image.exct.net/lib/fe641570776d02757515/m/1/SFF14-The2012ChannelPreferenceSurvey.pdf

11 Reasons Why Your Email List Beats Social Media


https://manychat.com/
https://www.websitealive.com/alivechat/
https://www.emarketer.com/Article/Digital-Content-Advertising-Key-Revenue-Generators-Messaging-Apps/1013247#sthash.OEDM1ML5.dpuf
https://www.campaignlive.com/article/facebook-study-53-consumers-likely-shop-business-message/1404632
Talk on social consequences of Facebook. https://www.youtube.com/watch?v=PMotykw0SIk

Patient Compliance in a Chiropractic Office

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The success of your chiropractic practice is directly related to the level of patient control you and your staff have with your patients.

No matter if you are the best healer this side 1895, or if your office is perfectly modern and your team is the friendliest in town, you will fail in business if you are weak on control.

Once your patients agree to their treatment plan, can you get them to comply? If you can’t, they won’t really get or stay healthy and neither will your practice.

You have to be friendly and have good communication, of course. But you also have to be a coach. A good coach, if you have had one, is just a bit and demanding. They are this way because they care. They care about winning and they care about their players.

If you care about your patients “winning” back their health, and staying healthy, then you have to be willing to be assertive about them sticking to their schedule of care.

And if you aren’t being insistent with your patients, we know that the pharmaceutical companies certainly are with their constant commercials and medical prescribers.

Who do you want to win that contest with your patient?

Health Never Takes A Holiday!

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Holidays

Holidays are a time when chiropractic patients can find many reasons not to keep to their schedules. To help you and them stick to their health program, you can pre-schedule them for the entire month of December.

We have made a couple of posters centered around:

Health Never Takes a Holiday

You can find links to these below.

When talking to your patients about their schedules, be understanding and empathetic. Hear their story. Then, be bold about your interest and concern that they maintain their care schedule through the holidays – and get them scheduled until next year.

And it is OK to use bribes.. Spicy warm apple cider gives off a very cozy smell and tastes great.. and is healthy, and free screenings/exams for patient’s holiday guests.

Links to posters:

Poster for Nov/Dec
Poster for any holiday

Snow Days and Chiropractic Care

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In this short article you will learn a new disease and how to prevent it, how to not lose money, and a special offer for a free drink in Las Vegas.

I love snow days.

As a kid, if you lived in the Northern climates, or mountains, or parts of the world where you can get a ton of snow dropped on you every now and then, you know what I mean. No school. Sleeping in, snow men, sledding, or just cuddling up with a game and watching the snow blow around.

But when you are in the business of providing chiropractic care, snow days can cause the opposite reaction. Snow days aren’t fun, they cost. Sometimes a few thousand dollars in one day and momentum can be lost for a week.

Have you ever known anyone who got really agitated and complained when they were delayed in their travels by a traffic jam?  I always wondered about this. WHY? Why complain? Do something constructive about it, and if you can’t,  then shut up. Why be negative?

Same with snow days. Or any natural work stoppage.  Snow days are a great time to “Sharpen the Saw.” It is a time to work on important things that are not urgent, as Dr. Covey talks about.

Jimmy Parker, D.C.,  always talked about turning your lemons into lemonade, another way of saying the same thing. (Speaking of Parker, come to Las Vegas and hang with us on January 15 & 16. Free drinks for all. Oops. Wait, I got carried away. First 10 that respond to this! See you there.)
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Case Management in a Chiropractic Office

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Chiropractic Case Manager Job Description Summary

In many chiropractic offices the majority of the attention on patient care is on the first 5 to 12 visits. In some offices, it is only on the first 5 visits, or less. It can get so bad that the primary concern is only on getting more and more new patient first visits.

An old maxim in dental consulting is that the biggest cost to the dentist is the incomplete dental program. A patient who discontinues care after the first $1,000 of a total program of $10,000 just cost the dental office $9,000. This also applies to the chiropractic office.

Actually, many chiropractors are producing incomplete cases. This is not in the best interest of the patient’s health or in the viability of the office. Imagine a hygienist that only cleaned the upper teeth, or a baker that only baked his bread half way through. Yet, many offices are only getting their patients partially through their treatment programs.

The job of your clinic is to get your patients to complete their entire treatment program and on to a Wellness Program. During the course of a patient’s care, the doctor and staff may concentrate only on their specific duties with the patient, such as scheduling, treating (adjusting), collection, etc.  Usually no one has the job of overseeing the patient’s progress along the entire treatment pathway, through all the adjustments, scheduling, therapy, education, payments, until they finally “graduate” and go on to a Wellness Program.

Yet a full Wellness Program takes some of the pressure off of the need for a constant stream of new patients and makes for a smooth running office.

To help ensure that patients get complete and comprehensive care, the position of Case Manager should be held by someone in the office.

Who should be the case manager: It can be fulfilled by the doctor, or the therapy or back office assistant, or the front desk or even the billing and collections staff member.

Time spent as a case manager: It should take no more than one hour per week.

Mission: The mission of the Case Manager is to ensure that all patients move through the various departments of a health care clinic smoothly and quickly, ensuring that they get excellent service such that they complete their treatment program as quickly as possible.

Duties and Responsibilities

1.  Coordination. Once a week, or daily before treating hours, the case manager should get the doctor and essential staff together for a Case Management Meeting. A great time to do this is 20 minutes before the first patient for the day, or weekly for one hour. During this time, the appointment book or a list of active patients should be reviewed.

    This is the most important tool the case manager (or case coordinator) has. During these meetings, the following points, among others, can be reviewed on each active patient:

    • Patient’s Progress
    • Patient’s Satisfaction
    • Re-exam (last/next)
    • Re-x-ray, or other diagnostics
    • Re-x-ray, or other diagnostics
    • Re-reports (progress report of findings)
    • Supplements
    • Exercises, nutritional or other recommendations
    • Financial conclusion (Initial, subsequent, and transitional to Wellness.)
    • Education programs, such as spinal care class, special lectures, pamphlets, etc.
    • Awards, compliments, thank you for referrals, good attendance, etc.
    • Family and friends referrals
    • Transition or adherence to a Wellness Program.

    2.  Outcome and Statistics. Keep a statistic of “Completed Treatment Programs”. Once a patient reaches a maximum level of improvement they are ready to go on to Wellness Care. One way to keep this statistic is to track the number of patients beginning a wellness care program.

      3.    Patient Progress Card. Make up a general treatment plan for every patient in the form of a simple checklist. This would include all service procedures, therapy, diagnostic, as well as educational actions. The last steps would include transitional consultations onto a wellness care program. This could be called a Patient Progress Card, and placed in the patient’s folder.

      4.    Day 1 & 2 Procedures. Ensure that day one and day two procedures are well documented and kept up to date with current procedures, and a simple flow chart outlined.

      5.    Regular Visit Procedures. Ensure that regular patient procedures are documented, and a simple flow chart outlined.

      6.    Staff Training. Staff walk-throughs for day one and day two procedures, and other flow procedures rehearsed at least on a quarterly basis. The best offices practice monthly.

      7.    Financial Consultations. Financial consultations done on all patients as often as is needed.

      8.    New Patient Orientation. New Patient Orientation done on each patient.

      9.    Patient Satisfaction. Ensured patients are very happy with service.

      10.    Pathways. Pathways for different types of cases documented and reviewed by all.

      11.    Flow Charts. Flow charts for first three day procedures outlined and rehearsed.

      12.    Conversion. All patients completing services are converted to wellness or other programs.

      Outcomes. The major outcome of the position of Case Manager is “Completed Treatment Programs.” That is, patients who have completed any acute or chronic treatment programs prescribed by the doctor and have reached maximum improvement. This definition could be extended to include: a patient who has completed their active care program and is educated so that they will continue onto a wellness program.”

      Performance Monitors

      • Number of Completed Treatment Programs
      • Number of Patients Beginning Wellness Care Programs
      • Number of Wellness Program Visits

      It is easy to drop out important but not urgent actions with patients during their care. Ultimately, this leads to poor quality and a deterioration of results. With a Patient Progress Card, and the Case Manager System in place, quality and patient results will improve, and your volume will increase. Often it is not what we see that hurts us, but what we don’t see. It is the gradual omissions that eventually add up to an empty office. Ensure each patient completes all of the steps of their treatment programs.

      For better patient retention, increased referrals, improved treatment compliance, and more revenue, implement the Case Management System!

      How Do You Start Your Day?

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      How do you start your day?

      The fact is, the way you start your day will determine, largely, how you end your day.

      Start it right and you’ll end it right.

      Start late, flustered, groggy, moody, cranky, and your day will be longer, harder, and less productive.

      Time and time again, when we work with doctors and their teams on starting their day off correctly, we notice that the patients become happier, the appointment book fills up,  and the doctor feels more in control of her patients.  Just last month, as a matter of fact, one doctor implemented this procedure and hit her highest new patients – ever.

      Another doctor gets to the office before his staff and associate doctors and reviews the day’s schedule.  Before the patients come in, he reviews each patient, as needed, and makes sure all patients are set up for the right procedures that day. In spite of the fact that he has several clinics, and a handful of associate partners, it is no wonder he still averages over 1200 visits per month. So can you.

      You can start your day any dang way you want, the choice is yours. Actually, you have two choices as diagrammed below.

      Some offices call this their morning “huddle”, or “case management” meeting. Whatever you call it, here are some successful procedures to start your day:

      1.    Discipline. Make sure that it starts on time. Only have it 2-3 times per week to start with. Keep it simple, FAST, and fun. This will be the biggest hurdle. But, just schedule it and make it happen.

      2.    Humor. A staff member should start off with a good joke. For example, the front desk has the first Monday, the doctor on Wednesday, the Accounts CA has to bring a joke for Friday, and so on. It goes on a rotational basis. If this is hard to do, then that is all the more reason to do bring a joke. If you are bad at jokes, again, all the more reason to bring a joke. 🙂  Need a joke? We have a few over here.

      3.    Patients. Then, go over each patient that is coming in that day and decide, as needed, what extra should be done with him or her.  For example, does Patient A need a progress exam, need to be scheduled for the care class, another financial consultation, or be seen to schedule her family for no charge “check-ups?”  If your office is seeing over 800 patients that day, probably best to just check over some of the patients — no need to cover each one. Just see if any of the doctors or staff have any input on anyone.[We have seen an 800 visit day. Lots of fun!]

      4.    Office. Then, review how the office is progressing towards its goals for the month.

      5.    Goals/Visualization. Then, set realistic daily goals, and look at and even visualize not only achieving them, but achieving the weekly and monthly goals as well.

      6.    Miscellaneous. No more than two quick minutes for a miscellaneous announcement, if needed.

      7.    Motivation. Finally, the clinic director should end off with a patient success story, or something inspirational and motivational. A quote, a story, etc.  We have lots of quotes in the Marketing Manger System computer program. You can also take one Chiropractic Principle each day, discuss it with the staff, and work out ways to apply it that day.

      The whole meeting should be done BEFORE patients are seen, and last no more than 15 minutes.  Use it in your group, and use it on your self, and watch your practice grow.