Accountability Can Create a Goal Driven Chiropractic and Healthcare Practice

Practice owner overseeing a goal driven chiropractic business

From Personality-Driven to Goal-Driven

I don’t recall a single doctor — chiropractor, dentist, or podiatrist — telling me they wanted to be chained to their practice so they could never leave it.

Nearly every doctor I’ve worked with wanted a business that was not entirely dependent upon their daily production or constant supervision.

Michael Gerber (The E-Myth) wrote about the system-driven business. Others talk about team-driven practice. I talk about a Goal Driven Practice.

In every case, the objective is the same:

The business should not depend on the personality of the owner.

I make a clear distinction between a Personality-Driven Practice and a Goal-Driven Practice:

An essential difference is accountability.

HOW ACCOUNTABILITY TRANSFORMS A PRACTICE

In a Personality-Driven Practice, results rise and fall with the owner’s energy and oversight. They are the driver of everything.

But a structured accountability system changes this.

A Goal-Driven Practice operates like a team sport. There’s a scoreboard. There are defined positions. Everyone knows their role, and everyone can see the score.

The numbers provide objective feedback. Roles clarify ownership. Goals define what winning means. Regular review keeps the team aligned and improving.

There is a great deal of science, actually, on how accountability improves performance. (See below)

THREE DRIVERS OF A GOAL DRIVEN CHIROPRACTIC PRACTICE

1. Clear Ownership of Outcomes

Every role should have one or two numbers that answer: “What results am I responsible for?”

These are the practical goals that need to be achieved each month.

2. Regular Review and Supportive Feedback

Numbers must be:

  • Reviewed consistently (Monthly, weekly)
  • Shown in trends, not just totals
  • Discussed openly, without blame
  • Action plans and coaching for improvement

We don’t always face, as Jim Collins says in his book, Good to Great, the “Brutal Facts.” Just facing up to them each month is a step forward.

For example, you can look at your bank account at the end of each month. Is the trend going up, or down? Discuss this with your spouse and consider what actions to take to improve what you see. Do this regularly!

3. Clear Purpose

Numbers without purpose become mechanical and soulless.

It is what the numbers represent that counts. When people understand why their role matters and how their outcomes serve patients, performance becomes meaningful.

The purpose is the higher level goal that gives you the reason for everything you do.

A SIMPLE EXAMPLE of CREATING A GOAL DRIVEN CHIROPRACTIC PRACTICE

At a monthly team meeting, each team member reports on their key numbers.

“Cheryl, how did we do at the front desk this month?”

“We beat our goal — 91% kept appointments, up from 88% last month. Visits increased from 1150 to 1204.”

The doctor acknowledges the wins and may ask what was done to improve performance. Then, the next team member gives their report. After everyone is through, the doctor asks each person about their goals for the new month.

Lastly, the chiropractor-CEO discusses some version of the purpose of the clinic. Perhaps with a story or testimonial and ends the meeting.

This process done over and over can help create a goal driven chiropractic practice.

I think the funny thing is… that we are all on scoreboards, we just don’t know it! (Lol) Maybe we look at our numbers now and then, but not on a regular basis! Or get our teams to do the same.

Read this newsletter/article again and put it to work. You’ll see your numbers improve!

And, as always, stay …Goal Driven,

Ed

P.S. If you have questions or would like some help transforming your practice into a Goal Driven business, please contact me. (Ed at goaldriven dot com.)

**References

Goal-Setting and Feedback
Locke, E. A., & Latham, G. P. (2002).
Building a practically useful theory of goal setting and task motivation.
American Psychologist.

Key finding:
Specific goals combined with feedback produce significantly higher performance than vague goals or no feedback.

Feedback Loops Improve Performance
Kluger, A. N., & DeNisi, A. (1996).
The effects of feedback interventions on performance.

Key finding:
Performance improves when feedback is frequent, task-focused, and tied to clear standards. Poorly designed feedback harms performance; structured accountability improves it.

. Scorecards and Visibility
Kaplan, R. S., & Norton, D. P. (1996).
The Balanced Scorecard.

Key contribution:
Organizations that use visible performance metrics aligned to strategy outperform those that rely on financial results alone.

Thoughts on The Goal Driven Business

I WISH I WOULD’VE HAD THIS BOOK 30 YEARS AGO!

Mr. Ed Petty takes his reader on an entrepreneurial safari, complete with a roadmap for success. This is a relatable, actionable business or practice guide for conquering the challenges that come along with business ownership or private practice. I have personally worked with Mr. Petty for years as he has helped me to convert my extremely personality-driven practice to a goal-driven practice. I am so grateful our paths crossed when they did. I wish I would’ve had this book 30 years ago! What an amazing compilation of the process of building a solid, goal-driven business. The author takes you through literally every “phase” of business practice and “chunks” it up into actionable steps. If you own a business, you need to read “The Goal Driven Business.”!!

Ann Metzler, D.C. Group Practice Owner ( 2 offices, 5 doctors) [LINK]

What is Special about L.L. Bean and How Does it Compare to Your Chiropractic or Healthcare Practice?

“Originally published on Goal Driven.com – republished with permission.”

LL bean womens boot
The Key to Building a Chiropractic and Healthcare Practice that Lasts

L.L. Bean. You’ve probably heard of them.

I just received a Christmas shopping catalogue from them (hard copy!). They are a clothing company out of Maine. Founded in 1912 by Leon Leonwood Bean. I probably bought something from them years ago, and I am on their Christmas list.

We also receive a catalogue from Patagonia each year. It is another clothing company. It was founded more recently, in 1973 by a rock climber, Yvon Chouinard.

I like both companies and I will tell you why – in a minute.

= = =

Recently, I saw an ad of a young man (chiropractor) coming off a stage saying that he just sold his practice for “seven figures.” It was a bit of brag and sounded like he wanted to help other doctors reach that level. He said he was able to grow his business quickly and sell it thanks to his marketing.

I’m all for marketing, and I truly hope he can help with other chiropractic practices.

But it made me think: aren’t there significant financial advantages to owning a business in the long term that compound?

When you own a practice for 10-20 years, you’re not just collecting a salary — you’re able to take advantage of tax benefits that can add $30-50K annually to your real compensation! These can include vehicle expenses, health insurance, retirement contributions, continuing education, and equipment depreciation. These can all reduce your tax burden.

Over 20-25 years, these ownership benefits can add $500K-$1M in value that disappears the moment you sell.

And beyond tax advantages, long-term ownership allows your business equity to compound alongside your income. A practice worth $500K in year 5 might grow to $2M by year 10 or $5 -10M by year 25 – or more — IF you have good management, create a strong reputation, and even bring on other providers, or add other locations. And all the while — taking profit distributions, building retirement accounts, and enjoying the flexibility that ownership provides.

The doctor who sells early gets one payday; the doctor who builds strategically gets decades of tax-optimized income plus a potentially much larger exit.

Back to L.L. Bean and Patagonia

Now, back to those Christmas catalogues! Both show how patient, long-term ownership and excellent management, products, and services can build generational wealth over decades of brand-building and customer loyalty.

L.L. Bean, a billion-dollar empire, is still family-owned. Patagonia, now worth billions, wasn’t sold at all. Chouinard transferred ownership to the Patagonia Purpose Trust to ensure profits protect the planet in perpetuity.

Both companies show how owners who focus on purpose-driven growth and lasting customer relationships can build enduring companies that dwarf what any early buyer would have paid.

Purpose and Values of Your Healthcare and Chiropractic Practice

But here is what does not show up in the spreadsheets of these two companies: their values and purposes.

And, their discipline to stick to them!

Selling your business earlier rather than later can be a valid choice. However, if you ensure it remains focused on its purpose and values, you’ll enhance its profitability and make it more valuable for whoever takes ownership next.

L.L. Bean built its reputation on an unconditional guarantee and commitment to customer satisfaction. “At L.L.Bean, we design products that make it easier for families of all kinds to spend time outside together.”

Patagonia’s environmental purpose became so central that Yvon Chouinard ultimately gave away his $3 billion company. “We’re in business to save our home planet.”

The lesson is that a business rooted in purpose beyond profit attracts loyal customers and dedicated employees and creates a brand that competitors can’t copy.

Your purpose — and the discipline to stay creatively and positively true to your goals — pays off.

So…

Stay Goal Driven!

Ed

P.S. And have fun doing so – maybe fishing, camping, or just outside and enjoy the fall. (Or spring, if you’re Down Under.)

Why Clear Roles Build a Stronger Chiropractic & Healthcare Practice

team players wearing staff hats front desk billing promotion marketing

Better teamwork, smoother operations, and improved patient care all start with clarity.

Years ago, I visited a chiropractic office where the doctor was frustrated: patients weren’t keeping appointments, and he blamed his front desk staff, “Sue.” The problem wasn’t effort—Sue was polite and friendly—but she had no clear job description, no checklist, and no real understanding of her responsibilities.

Once we clarified her role, outlined simple procedures, and scheduled regular reviews, the practice quickly improved. Patients kept their appointments, and both the doctor and Sue felt more confident and motivated.

This is a common issue: when roles are vague, results suffer. But when roles are clear, teams thrive.

The Three Elements of Every Role

According to the Goal Driven System, each role should include:

  1. Purpose – Why the role exists.
  2. Outcome – The measurable result it should achieve.
  3. Procedures – The specific actions to reach the outcome.

Example – Front Desk Role:

  • Purpose: Help patients achieve health goals by ensuring they stay on schedule.
  • Outcome: Patients consistently keeping appointments.
  • Procedures:
    • Greet every patient with a smile.
    • Answer the phone warmly.
    • Confirm each patient leaves with their next appointment scheduled.

 Action Steps for Your Practice

  1. Have every team member list their roles.
  2. Define the purpose, outcome, and 5–10 key procedures for each.
  3. Add measurable indicators (e.g., % kept appointments, total visits).
  4. Review and rehearse roles regularly, just like a winning sports team practices.

Clear roles create accountability, boost morale, and drive better patient care. Keep it simple, keep it consistent, and keep it fun.

Stay Goal Driven,

Ed

Hobby, Practice, Business. Which is it for You as a Chiropractic Doctor?

The 3 Phases of Practice Evolution

Is your work as a doctor a hobby, a practice, a business—or simply a job? Let’s explore.

1. HOBBY

Every practice begins as a hobby—or at least, it should. Early in your career, you’re driven by fascination with the science, philosophy, art, and technique of chiropractic. Your passion keeps you going, while business operations take a back seat.

2. PROFESSIONAL PRACTICE

The next phase is building a true professional practice. This stage is entrepreneurial and personality-driven, fueled by your presence and commitment. You create strong patient relationships and build loyalty through consistent care and connection.

3. PROFESSIONAL SERVICE BUSINESS

Finally comes the service business stage. Here, your practice is structured, systematized, and able to operate independently of your constant management. You may step into a CEO role or scale back to part-time patient care, but either way, the business runs on clear goals and proven systems. This is what people call “scaling.”

DIFFERENT PATHS, DIFFERENT GOALS

Not every doctor wants to build a business. I once knew a chiropractor who loved nothing more than adjusting patients. He wasn’t concerned with scaling or management systems. His secretary kept the office running, his patients were happy, and so was he. That was enough.

Most doctors, though, do want to grow—to serve more people, expand their caseloads, and run a strong practice while still enjoying their profession.

Then there are the entrepreneurial doctors who aim to scale beyond themselves. By setting goals and creating reliable systems, they can expand without adding more hours or overwhelming overhead.

But many who try to scale fall into what I call the Practice Roller Coaster. The excitement of practice gets buried under stress, inconsistency, and management struggles. What once felt like a calling begins to feel like just another job.

BREAKING THE ROLLER COASTER CYCLE

There are exceptions—many doctors do successfully build thriving service businesses. I’ve helped dozens achieve exactly that.

Five years ago, I wrote The Goal Driven Business after observing this cycle of burnout. In the book, I explain the hidden barriers to growth and outline the step-by-step process for building a scalable, independent practice.

If you find yourself on the Roller Coaster, here’s how to reset:

  1. Hobby – Fall back in love with chiropractic. Make practicing fun again.
  2. Professional Practice – Build and enjoy your patient community while earning a solid living.
  3. Professional Service Business – If you’re ready to scale:
    • Read The Goal Driven Business for a complete roadmap.
    • Or, reach out to me directly through our Goal Driven Consulting program for hands-on help building a profitable, self-sustaining business.

Take back your future. Build a business that runs without depending on your daily management.

Stay Goal Driven,

Ed

 

Preventing Procedural Atrophy in Your Practice

eroded asphalt highway

In any business, routines and procedures can slowly be shortened, skipped, or abandoned. When this happens, quality slips, and the practice begins to decline. I call this Procedural Atrophy, a key concept from The Goal Driven Business.

When results falter, doctors often try new approaches. These may work temporarily, but without consistent systems, the same decline sets in again. This creates the Practice Roller Coaster—a cycle driven more by personality than by clear goals and structure.

Think back to what you did when your practice was thriving. Did you call new patients after their first visit? Hold morning team huddles? Run patient education classes, progress exams, or referral drives? Chances are, when numbers dip, it’s because those proven actions have slipped away. The solution is often simple: return to what worked before.

 Solution 1: Set the Standard – Quality

Stand out in a noisy world by being consistent and excellent. Define exactly what a successful patient outcome looks like—for example, a patient who pays, stays, refers, feels healthier, understands their care, and is happy with their results.

Then, create brief checklists that outline the essential procedures needed to achieve this. Examples include:

  • Day 1, Day 2, and ongoing patient steps
  • Collections
  • Internal and external marketing
  • Team communication and coordination
  • Leadership and management

These checklists keep your practice systematic, repeatable, and reliable.

 Solution 2: Accountability Reviews

Consistency requires feedback. Use monthly statistics, chart trends, and review them with your team or a coach. This ensures everyone stays focused and motivated. Just like in life, accountability keeps us on track.

Bottom line: What you provide for your patients, team, and community is valuable. Don’t let your practice erode through neglect of the basics. Stay consistent, keep improving, and remain Goal Driven.

Ed

Scripts are Secondary in Your Chiropractic and Healthcare Practice

female chiropractor discussing care plan with patient

Why Scripting Can Fail—and How to Make It Work

A script is a prepared set of phrases, questions, or responses designed to guide staff or doctors in patient interactions. Whether word-for-word or just an outline, scripts help keep communication consistent, especially for new team members. But even the best script can flop if it’s missing one thing—authentic human connection.

Connection Comes Before Words

Think of connection like a radio signal. A carrier wave must exist before any music or voice can be transmitted. Without it, nothing gets through. In patient care, that “carrier wave” is trust and genuine interest. If it’s missing, your words—no matter how polished—won’t land.

I once had a doctor greet me after a minor surgery with a cheerful, “I can’t tell you even had it done!” It was a nice line, but it felt canned. The delivery lacked authenticity, so the message didn’t connect.

How to Create the “Carrier Wave”

  • Be authentic – Avoid sounding rehearsed.
  • Be curious – Take a few extra seconds to ask a follow-up question.
  • Recognize the person – Make patients feel valued and respected.

When you connect first, your scripted lines gain power and meaning. Without it, patients may feel unheard, leading to fewer new-patient conversions, lower follow-through, and less word-of-mouth.

Using Scripts Effectively

  • Review and practice scripts every couple of months.
  • Role-play different delivery styles (bored, overexcited, glum) to sharpen awareness.
  • Use scripts to keep patient conversations moving forward, not to replace genuine interest.

Bottom line: Scripts are useful tools—but they only work if you first connect with the human being in front of you.

For more helpful business tips visit our Goal Driver Blog [LINK]

Ed

Coaching Your Chiropractic and Healthcare Patients

Consider adding this to your Report of Findings

 

“Mrs. Jones, it will take 3 things to get better.”

Many, many years ago, I heard this from an extraordinarily successful chiropractic doctor. He invited me to observe him discuss this in a report of findings with one of his patients.

I sat on the side, next to his knee-chest table, and with the patient’s permission, observed, paid attention.

The first part of the report was typical: a review of the findings, an explanation of the condition, a treatment plan, and a description of the potential consequences of not treating the condition.

Pretty standard, even now.

Then, he told the patient: “Mrs. Jones, it will take 3 things to get better: Time. Repetition. Effort.”

He then went over each point. For example, it is obvious that it takes time to improve anything. It also requires repeated applications, such as painting a house, cleaning out a garage, or watering a garden.

But the last element he emphasized: Effort.

Any improvement takes work, he said, and gave examples. These included activities such as performing home exercises to improve their condition, attending a class on spinal fitness, and simply making it to the office to maintain their schedule.

He was an athletic doctor, and I believe this influenced his approach. He was coaching his patient, much like an athletic coach would motivate a player.

Yes, you are a well-educated, skilled, and caring doctor. But consider your role as a coach as well. You want to get your patient, as a “player,” to improve, and you know what it takes. You want them to win. So – you tell them!

They have a responsibility, just as you do. Seek your patient’s agreement on these three ingredients for a successful course of treatment, and remind them at approximately every 6 visits.

I have seen this work. It also applies to all aspects of our lives whenever we want to improve something.

In fact, I remind the offices we work with that these are the 3 factors needed to improve their business.

Educate your patients. But coach your chiropractic and healthcare patients on what it takes to get better, and that is:

  • Time
  • Repetition, and
  • Effort.

Keep caring, coaching, and stay Goal Driven.

Ed

What Do You Stand For In Your Chiropractic and Healthcare Practice?”

grandfather and grandmother reading a book to a toddler and coddling another

In your chiropractic and health practice, it’s not what you do, it’s why you do it.

In chiropractic and healthcare practices, defining your brand hinges on your “Why”—the core purpose or passion driving your work, as emphasized by Simon Sinek’s Golden Circle concept.

While most can explain what they do and some how they do it, articulating why you do it sets you apart and inspires others.

Your “Why” stems from deep motivations like justice, love, or curiosity, not just analytics. To build a strong brand, identify what makes your practice unique compared to competitors, as Roy Spence suggests in It’s Not What You Sell, It’s What You Stand For.

Know your patients, yourself, and your competition to highlight what you offer that others can’t. Stay connected to your purpose to avoid burnout, as Jon Gordon notes, and boldly define and discuss your unique qualities with your team regularly to maintain a distinctive, meaningful brand.

Jump here to read the Goal Driven Newsletter in it’s entirety.  [LINK]

Ed

References:

* Virgil, a Roman poet, 19 B.C.
Simon Sinek – Golden Circle

The Value Driven Chiropractic and Healthcare Practice

Many chiropractors and doctors, despite years of hard work, find their practices stuck in a cycle of growth and decline, unable to reach their full potential consistently. This is often due to operating in a “Personality-Driven Practice”, where the business relies heavily on the doctor filling multiple roles—clinic director, manager, marketer, and more.

While this model can launch a practice, it traps the doctor in a cycle of overwork, limiting growth and personal freedom.

The solution is transitioning to a “Goal Driven Business”, where systems and a motivated team, aligned by shared values, drive success with less direct effort from the doctor. To achieve this:

1. Define Your Philosophy and Values: Write a statement about your business philosophy and distill it into 5-8 heartfelt values (e.g., “Seek to understand, then be understood”).
2. Engage Your Team: Share your philosophy, have team members propose related values, and collaboratively agree on a shared purpose and goals for the business.
3. Systematize Operations: Build a business that runs efficiently, like a flywheel, requiring minimal effort to maintain momentum.

Benefits: Research from Gallup (2023) shows that organizations with clear, employee-embraced values experience 73% higher engagement, 23% higher profitability, 66% lower turnover, and 31% lower absenteeism.

By shifting to a Goal Driven Business, chiropractors can achieve sustainable growth, enjoy more freedom, and continue delivering impactful healthcare, supported by a team united by shared values.

Seize the Future

Ed

Read the full article here: [LINK]

PS: Get on our waiting list for our next MBA program if you are interested. I will be sending you special information about practice management, leadership, and marketing. Sign Up Now for Fall 2025 Wait-list

If you have any questions about creating a Goal Driven Business, just schedule a call or reply to this email. Book a Session Today

How Steve Jobs’ Vision Can Transform Your Chiropractic Practice Learning from Visionary Success

steve jobs

Apple, founded by Steve Jobs in 1976, is now the world’s most valuable company, with a market capitalization of $2.9 trillion and $54 billion in cash reserves. But in 1997, Apple was on the brink of bankruptcy. Jobs’ strategic overhaul turned it around, offering lessons for chiropractic and healthcare practices.

In a 1997 interview, Jobs shared a key insight: “If you do the right things on the top line, the bottom line will follow.” He emphasized that a clear strategy, passionate people, and a strong culture drive quality products, marketing, and operations—ultimately boosting profitability. For chiropractors, this means focusing on vision and values to achieve sustainable success.

The Top Line: Your Practice’s Foundation

Your “top line” is your practice’s vision, values, purpose, and the team that embraces them. When these are aligned, marketing, procedures, patient outcomes, and profits follow naturally.

Top-to-Bottom Framework:

  • Top Line: Vision, values, purpose, mission
  • Almost Top Line: A team aligned with these principles
  • Middle Line: Policies and procedures
  • Almost Bottom Line: Patient outcomes
  • Bottom Line: Net income

Focusing on the top line creates a “vision-driven” practice, much like Jobs’ approach at Apple.

Insights from a Chiropractic Leader

A seasoned chiropractor recently shared a video on social media, responding to a colleague concerned about high practice expenses. He identified the biggest cost: an “under-trained” team. His solution? Hiring passionate individuals and training them not just in chiropractic techniques but in the practice’s “why”—its purpose, mission, and vision. Team members who didn’t fully align were let go. The result? A thriving practice.

When I commented that his success stemmed from his own clear “why,” he agreed: “It all starts from the inside out. If the doctor has a big WHY and can teach it, the team will follow.”

Sustaining Your Vision

Keeping your practice’s values alive requires ongoing effort. It begins with your example as the leader and continues through consistent team coaching. In our MBA program, we explore proven strategies to maintain this focus, from vision to execution.

Apple’s Core Value and Your Practice

In 1997, Jobs defined Apple’s core value: “We believe people with passion can change the world for the better.” This resonates with top healthcare practices, where passion for patient care drives impact.

Does your practice reflect this passion? A clear vision, a dedicated team, and consistent coaching can transform your chiropractic business, just as Jobs transformed Apple.

Stay Goal Driven.

Ed

Momentum Magic: How the Flywheel Effect Boosts Your Chiropractic Practice and Service Business

flywheel effect

What separates good businesses from great ones?

It’s momentum—created by doing what works consistently and improving it over time. In business, especially in healthcare services like chiropractic, success often comes not from radical change but from steady, thoughtful progress.

Avoid the Trap of Constant Change

Healthcare entrepreneurs often seek out the next big thing—new therapies, machines, or procedures. While innovation can be beneficial, abrupt changes to proven systems can disrupt staff and confuse patients. A smarter approach is to test new ideas first, and only implement them if they complement what’s already working.

“If something works—fix it, refine it, but don’t toss it.”

The Flywheel Analogy

Jim Collins, in Good to Great, uses the image of a massive flywheel to illustrate how lasting success is built. At first, it takes immense effort to turn. But with consistent effort in the same direction, the wheel picks up speed and begins to turn on its own—powered by its own momentum.

The key lesson: there’s no single breakthrough moment—just consistent, focused effort over time.

How This Applies to Your Practice

  • Identify what’s working—and keep doing it.
  • Make small, strategic improvements over time.
  • Adapt to market changes gradually and intentionally.
  • Build systems that generate results with less effort over time.

By steadily turning your business flywheel, you’ll transform your practice from good to great—creating a self-sustaining engine of growth.

Keep building. Keep refining. Momentum will do the rest.

Ed

How Do You Start Your Day in Your Chiropractic Healthcare Practice?

bright yellow sunrise with a green grassy field

Morning Case Management Meetings

Does your day get off on the right foot, each and every day?

Are you and your team fully prepared when the patients start coming through the door?

Importance of Discipline

Arriving early and conducting Case Management meetings demonstrates discipline, which is crucial for business success. As Jim Collins states, “Greatness is not a function of circumstance. Greatness, it turns out, is largely a matter of conscious choice and discipline”.

Starting your day in a chiropractic healthcare practice with a morning case management meeting can significantly improve patient care, increase efficiency, and foster team cohesion. Here’s a summary of how to implement this practice:

Morning Case Management Meeting

The meeting should be brief, lasting about 10 minutes, and involve the entire team. Key components include:

1. Assign a Case Manager: Usually the Front Desk Coordinator, responsible for organizing and leading the meeting.

2. Review Appointments: Distribute the day’s appointment sheet to all team members.

3. Discuss Patient Goals: Go through selected patients, addressing:

– New injuries or concerns
– Scheduled progress exams or x-rays
– Patients transitioning to maintenance/wellness care
– Upcoming events like Patient Appreciation Day

4. Optional Office Review: Briefly discuss monthly numbers, marketing plans, and set goals.

5. Team Check-in: Ensure everyone is prepared for the day and maintain a positive atmosphere.

Benefits of Morning Meetings

– Enhances patient care quality
– Increases patient volume and referrals
– Improves organization and communication
– Sets a positive tone for the day

By implementing this morning routine, chiropractic practices can ensure they’re prepared to provide world-class care and maintain a goal-driven approach to their practice.

Stay Goal Driven

Ed

To read the full article and download the Sample Checklist go [HERE]

Create Something New Every Day in Your Chiropractic Healthcare Practice

viktor frankl, woman sitting on a rock waiting for a ship to come in the night

It’s a unique aspect of human nature that we thrive when looking toward the future. (Victor Frankl)

No one—neither you, nor I, nor the people we work with—is holding us back from shaping a better tomorrow. We are the authors of our next chapter: 2025.

In the coming months, we have the freedom and opportunity to craft a renewed and enhanced version of our chiropractic practices and our lives.

Creativity is not only fun, but it’s also deeply meaningful and rewarding. It aligns with our natural drive to improve, to take something good and make it better, then share that improvement with the world.

As the New Year approaches, take some time to envision what 2025 could look like for you. Collaborate with your team and others—it’s a reminder that we all need each other.

This is your chance to innovate. Whether it’s rearranging your desk, adding new wall art, offering care classes, trying a new activity like line dancing, stepping up your fitness routine, or simply listening more attentively to others—don’t take things too seriously!

The key is to treat each day as a fresh start. This ties into the concept of Present Time Consciousness (P.T.C.), something I remember Dr. Jimmy Parker teaching us. When you’re truly present—living in the now—you open yourself up to creativity.

On the other hand, if you fall into autopilot mode, your days blur together, and each patient becomes just another routine. The monotony can be draining—and when you slip into this, it’s likely your team will too.

This is where a strong support system can make all the difference. No one can do it alone, so lean on your teammates, coaches, and colleagues to help you stay grounded and hold you accountable.

In 2025, commit to making every day new—treat each patient visit like it’s the very first. Avoid slipping into automatic mode. Step outside the algorithmic world, and embrace your humanity, spirituality, and Innate wisdom.

CREATE!

Let’s make 2025 your best year yet.

Seize the Future.
(Carpe Futurum)

Warmly,
Ed

Download a tent poster here: [LINK]

Multiple Appointment Scheduling Calendars -2025

Multiple Appointment Scheduling Calendars are helpful for increasing your patient retention.  We take the work out of them by creating two different easy to use fully customizable forms.

Feel free to download them here.

Scheduling Calendars

Personal-Appointment-Calendar 2024(Customizable WORD Doc) (Portrait)

Appointment – Calendar 2024 (Customizable WORD Doc) (Landscape)

Personal-Appointment-Calendar 2025(Customizable WORD Doc) (Portrait)

Appointment – Calendar 2025(Customizable WORD Doc) (Landscape)

Use the Learning Pyramid for a Better ROI in Your Chiropractic Healthcare Practice

three generations of women cooking in a white kitchen

Don’t complain. Just train

“Over the long run, superior performance depends on superior learning.”
— Peter Senge

As the Clinic Director of your chiropractic and healthcare practice, you instinctively know that if you are not continually improving the service to your patients and potential patients, they will go to practices that are.

In fact, if you do not provide the BEST outcomes and service in your area, patients and potential patients will look for other practices that are the best, or at least better than you.

The BEST health care practice wins in the long run.

So, how do you get to be the best?

By constant improvement!

This was the concept the Japanese pushed in the 1970’s with their cars. They called it Kaizen.

Speaking of Japan, there was a study that showed how many hours employees trained over a 6-month period. Japan spent an average of 364 hours, Europe averaged 178, and the U.S. a paltry 42.* I discuss this more in my book, The Goal Driven Business. (pg 156)

The formula for improvement is simple: study and train.

The purpose and goal of training is improvement. This is why professional athletes and musicians constantly train. They do this for improvement and, ultimately, to bring about a good return on their investment.

Improvement has a definite ROI! A study by the Associate for Talent Development found that companies offering comprehensive training programs have 218% higher income per employee compared to those without formalized training.*

But what are the best methods for training — reading, listening, podcasts, seminars?

USING THE LEARNING PYRAMID TO TRAIN YOUR CHIROPRACTIC TEAM

The Learning Pyramid* illustrates the percentage of knowledge retained through various learning methods. Here are the typical percentages associated with each method:

  1. Lecture: 5%
  2. Reading: 10%
  3. Audio-Visual: 20%
  4. Demonstration: 30%
  5. Discussion: 50%
  6. Practice by Doing: 75%
  7. Teaching Others: 90%

This model emphasizes active participation in the learning process. Teaching others or practicing by doing, leads to higher knowledge retention rates compared to passive methods like listening to lectures or reading.

If you take your team to a seminar, do it for camaraderie and the sense of being part of something bigger. It can be motivational. But then, ensure that they take notes from one of the presentations and then teach it to the rest of the team at the next staff meeting.

Another angle is to have team members select a chapter from a book you all are reading (from your Lending Library!) and then have them teach it to the rest of the team a month later.

Train on your procedures every month. For example, you could demonstrate how you would like a patient to be positioned on a therapy table. (Get it recorded for future reference!) Then, have a staff member demonstrate the procedure back to you. You can also pair people and role-play the procedure. Do this for any of your office procedures. For those of you in group practices, doctors can practice their procedures.

BALANCING INFORMATION WITH PRACTICAL APPLICATION

The idea is that there are two sides to the learning coin: the information side and the practical application side. You can’t learn how to throw a fastball from reading a book. You must find a baseball and someone brave enough to catch your pitches and practice throwing hundreds of times. However, a book may have useful information on improving your throwing technique from those who have done it more than you.

It is best to go over the idea of training and improvement with your team first so they understand what you are doing and why.

Keep training fun. Your manager should ensure that training occurs every month.

And like Clarence Gonstead said:

“Practice. Practice. Practice. Never stop.”
“Our future will be our results.”

Keep training,

Ed

P.S. Who was Clarence Gonstead, D.C.

References:

ROI on training. An Evidence-Based Look at the ROI of Investing in Training (mentorgroup.us)

Clarence Gonstead https://www.gonstead.com/

The Learning Pyramid the learning pyramid – various percentages of retention. (thepeakperformancecenter.com)

========================

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

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

the goal driven business by edward petty

The Goal Driven Business
By Edward Petty

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Are All Things Created Twice?

goal driven young girl holding up a house design dreaming of what it will look likeMidyear Checkup for Chiropractic Healthcare Practices

It’s Halftime.

2024 is half over.

How’s it going? Are you closer or farther away from your goals?

Here’s a fast tip:

Stephen Covey says:

“All things are created twice. There’s a mental or first creation and a physical or second creation of all things.”

If you are behind in achieving your goals for 2024 in the real world, you may need to recreate them mentally.

Great performers and coaches encourage us to visit our goals and vision often.

Lou Holtz was a college football coach. Per statistics, possibly the best college football coach ever. He was the only college football coach to lead six different programs to bowl games and the only coach to guide four different programs to the final top 15 rankings. *

Mr. Holtz said a book by Dave Schwartz called The Magic of Think Big was his favorite book. The following is from Schwartz’s book:

“Look at things not as they are, but as they can be. Visualization adds value to everything. A big thinker always visualizes what can be done in the future. He isn’t stuck with the present”

“Belief, strong belief, triggers the mind to figure ways and means and how-to.”

I don’t think it ever stops – the importance of staying connected to your vision, your meaningful goals as well as the practical ones.

But what the heck? Go for it! And even if you don’t achieve all your goals, you will have at least played the game and had an adventure!

As Eckhart Tolle says:

“Life is an adventure, it’s not a package tour.”

Happy summer and happy times with your team, helping others achieve their goals!

Ed

P.S. Our Practice MBA is just 60 days away.

Think BIG! Our Practice MBA is back, and it’s updated and tailored for your practice manager and Big Thinkers like you.

Here’s what you need to know:

** Start Date: September 9th

** Registration ends August 30th or when the class is full

**Duration: 12 weekly classes

**Waiting List: Sign up now for exclusive program details!

Already on our list? Stay tuned—I’ll send more specifics soon. I’ll also set up times to chat with you and answer all your questions.

Our last Practice MBA was a big success. The new managers in chiropractic and other practices have effectively improved their practices and the stats show it. Our latest version is even better, and I can’t wait to get it started with you!

Ed

References:

Steven Covey: The Seven Habits of Highly Effective People

Eckhard Tolle — www.brainyquote.com

David Schwartz – The Magic of Thinking Big

Lou Holtz – Wikipedia

=============================

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

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

goal driven business www.goaldriven.com
The Goal Driven Business
By Edward Petty
goal driven business buy now button

Call Your Mom

mom with little boy and girl eating breakfast

Women, in general, see healthcare providers including chiropractors, more than men do. (The ratio is about 60% women and 40% men.)*

This week, hand each person in your office a flower and ask them to give it to their mom, or a mom. And if they are a mother, give them two. You could make a deal with your local florist and in return, post a sign on the flower vase stating where the flowers came from. Always try to create alliances with local businesses!

And, call your mom. I know, not all of us can. So, thank the moms you do know.

They take care of us and our future.

Here’s to moms!

Ed

*https://www.nccih.nih.gov/health/complementary-alternative-or-integrative-health-whats-in-a-name

Another post on moms! https://www.goaldriven.com/post/call-your-mom

Unexpected Successes in Practice

smiling woman with a stack of binders and books

Why Your Chiropractic Patients and Practice Can Improve in Multiple Ways

If you continue to work on improvement, you will see results. That’s just physics — a reduction of Newton’s laws, which state that causes create effects.

And if you keep improving what you are doing to make the improvements, the results will be even better. That, too, is physics. (See pages 47 and 256 of the Goal Driven Business!)

However, the results may not always be what you expect, at least not at first.

For example, you start adjusting your patient for their lower back pain. When they started with you, they also had a limp. After several visits, they stopped limping, but their back pain, while better, was still annoying. In time, their back pain was relieved as they continued with their care.

But what about the fact that their limp is gone, their gate is excellent, and they can walk and even run more easily? Didn’t anyone notice?

I mentioned this to someone who coaches people on weight loss. She understood immediately what I said. She referred to it as Non-Scale Victories. NSV’s, she called it!

THE CAUSE OF NONLINEAR POSITIVE RESULTS IN PRACTICE

I have been following the graduates of our first Practice MBA program carefully. I am delighted with the results, but they were not entirely what I expected. I had expected and hoped that practice numbers would increase! Well, this has been happening, in fact, in some cases, Best Evers in years.

But other pleasant surprises have been showing up. For example, chiropractic doctors mention how their offices are calmer and friendlier than before. Another acupuncture office is successfully bringing on a second associate, and another is expanding its marketing reach in entirely new and innovative ways. Even old system problems that have been buried for years are arising and getting resolved.

These and other practice improvements were not directly addressed in our training. I have been consulting for over 30 years and have never seen results like this.

I was at first puzzled by what was happening. I think I finally figured it out. Here are three reasons:

  • The Hidden Ripple Effect. Imagine a pebble dropped into a calm pond. The initial splash is visible, but the ripples extend far beyond the point of impact.
  • Holistic Growth. Improvement is rarely isolated. Improving one component in a system improves other elements.
  • Consistent Weekly Improvement. This is the biggest reason. The function of management and leadership in a practice is powerful, even if only worked on for a few hours per week. This is what we did for over 3 months, both doctor, manager and the team.

Imagine what would happen if you stuck to your exercise program consistently for a year! Yes, you might lose weight, build muscle, and improve your agility. But can you imagine how it might also affect other areas of your life?

But, like exercise, practice improvement gets put off too often. We focus on urgent practice issues, but because improvement, while important, is NOT urgent, we can tend to put it off.

UNSEEN BENEFITS: THERE ARE MORE SUCCESSES IN PRACTICE THAN WE ACKNOWLEDGE

We also aren’t inclined to notice nonlinear beneficial outcomes.

  • Our Instinct is to Look for the Negative. The sympathetic nervous system that governs our fight or flight response has evolved over the millennium as a survival mechanism. We are looking for poisonous snakes on the road and other possible threats.
  • We Also Have Tunnel Vision. We tend to focus on just our specific goals. This is essential but limits our perspective. We miss peripheral benefits.

So, one of the lessons I have learned from our Practice MBA program is that if we continue to work ON improving our practice and ourselves, if we just keep at it, successes will occur – often in multiple areas. When they do, they should be recognized and appreciated.

Keep improving – your office, your patients, and yourself!

That’s our goal!

Ed

Do You Have a Chiropractic Practice or a Chiropractic Business

jet breaking through the clouds

Break through the barriers and have both.

You have a practice if you are a doctor or a provider of any service.

Sooner or later, many of you must also create and run a business that supports your practice. This is where practice owners struggle.

It seems simple enough, but there is a wide gulf between a practice and a business that supports a practice.

Difference Between a Chiropractic and Healthcare Practice and a Chiropractic and Healthcare Business.

Let’s look at some key differences:

Goals:

  • The goal of a practice is to provide professional services and deliver outcomes of that profession.
  • The goal of a business is profit.

Structure:

  • A practice is structured around and dependent upon the owner/provider.
  • A business is structured around and dependent upon systems, including goals, policies, and procedures.

Scalability:

  • Practices are generally harder to scale because they depend on the limited time and expertise of the providers.
  • Businesses can be scaled more easily by replicating systems and hiring added staff to meet growing demand.

Succession and Sale:

  • A practice’s value is closely tied to its owner and reputation, making it challenging to sell or pass on.
  • A business, if well-structured, can run independently of its founder and can be sold or transferred more readily.

I spent 8 years researching the chasm between the practice and business models. I discuss this in my book, The Goal Driven Business.

You need to have a practice, of course. I define a practice as: “A network of relationships that are developed and sustained through communication and service.”

And so long as you are operating at 60% or less of your full capacity as a provider, your business concerns are manageable. You have the time to adjust and treat your patients, chat with them, and go to Costco for supplies. You are essentially a part-time provider.

To operate at full capacity, you need to create a business structure.

Organizational Barrier to Practice Growth

But doing so is like going from propeller airplanes in the 1940s to jets that go faster than 767 miles per hour, which is the speed of sound. The conventional airplane’s dynamics falter and control is lost as the speed increases. Many pilots lost their lives as their planes crashed in an attempt to break the Sound Barrier.

Similarly, there is a structural barrier, an Organizational Barrier, that causes growing practices to hit and likewise crash or stall.

The ideal is to continue nurturing your practice while gradually building a business infrastructure that allows you to operate at full speed, increase your profit, and still provide excellent service and outcomes. And at some point, pass it on profitably.

Despite the onslaught of advertisers that brag about million-dollar business owners in health care, real money is made by building an enduring practice supported by a solid business structure.

Love your patients and team, and improve your service. Strengthen relationships. Then, if you want to grow, schedule time to work on implementing the structural components for a business vehicle that will take you to your goals.

Want help in doing this? Contact me any time. Link

And read The Goal Driven Business.

Seize your future,

Ed

>

Do You Have a New Patient Log in Your Chiropractic or Healthcare Practice?

two women sitting at a desk discussing new patientsLaying the foundation for an enduring patient relationship

FIRST IMPRESSIONS COUNT!

I had advised a chiropractic office we had been working with for over a year to implement a new patient onboarding checklist. For one reason or another, this procedure just couldn’t be applied.

The chiropractic doctor wisely took our Goal Driven Practice MBA program with his practice manager last fall. They completed the program in December, and since then, I have been keeping track of their results. In almost all aspects, including key performance indicators, the practice has improved: collections, visits, new patients, and harmony!

The office seems to have come alive calmly and professionally.

While the practice has improved for many reasons, it has also put in place, finally, a new patient onboarding checklist I have been encouraging them to use. (I think I am happier about this than I am about all the other wonderful outcomes they are achieving!)

THE CHIROPRACTIC NEW PATIENT LOG

There are many reasons to improve the quality of the first 3-5 days of your patient’s care. Some studies prove it, but you don’t need studies (see references below.) You have your own experiences that verify the importance of first impressions. Any time you go to a new restaurant or retail business, how you feel about your visit will determine how quickly you return – if you ever do.

You know this, and so does your staff. But, like with any set of procedures, they will erode! I call this Procedural Atrophy. I cover this in my book, The Goal Driven Business (Page 159).

Procedural atrophy starts without notice. It’s not deliberate, but little actions start dropping out here and there. You substitute rote and automatic responses that replace thoughtful and lively communication. After a while, you wonder why your patient retention is low (patient visits per new patient).

A strong solution is to create a New Patient Log. (Email me, and I will send you a sample.) The first column has the patient’s name. Subsequent columns are for specific actions to take on each NP over the first 1-6 days.

The front desk can keep the log up to date. The doctors review it at the weekly meeting or even at the morning meetings. This is a form of case management to ensure all new patients (and returning patients) are receiving the care they need. I recommend the log be kept on a hard copy sheet, even on a clipboard. Digital is OK, as long as it is kept up to date and reviewed regularly in a group.

Here are some items that can be put on the New Patient Log:

Check and date when each of the following are done.

  1. Provide a warm welcome.
  2. Report of Findings.
  3. Treatment plan.
  4. Patient financial consultation and orientation.
  5. Multiple appointment card.
  6. Scheduled to Progress Exam. (Or longer)
  7. Take home reference pack: written report of findings, family care coupon, a treat!
  8. First adjustment call.
  9. If referred by patient, who the patient was. (This is so you can thank the patient with a card or gift.)
  10. Additional testing. (E.G., on Day 5 orthotics scan)
  11. Scheduled for patient orientation class. (Remember those!)
  12. Follow-up education emails.

Of course, ensuring these actions are done is just the first step. The next step is to see that they are done skillfully and with a friendly and engaged attitude. Rehearsing the steps on the New Patient Log every two or three months can help keep the onboarding system in tune and groovy!

Keep it fun — and help your patients achieve their goals,

Ed

Email me for a sample New Patient Log ed @ pmaworks.com

Cool References:

A study by Abrahamsson et al. (2017) found that patients who received clear information and education about their treatment plan had higher levels of adherence and satisfaction with their care. https://doi.org/10.1046/j.1471-6712.2002.00083.x

Deyo et al. (2018) demonstrated that patients who received follow-up communication after their initial appointment were more likely to adhere to their treatment plan and report better outcomes. https://doi.org/10.2522/ptj.2015.95.2.e1

A systematic review by Ganguli et al. (2016) highlighted the importance of addressing patients’ concerns and questions in improving treatment plan adherence and overall patient satisfaction. https://doi.org/10.1377/hlthaff.2017.1130

Spikmans et al. (2003) found that patients who received take-home materials and regular communication from their healthcare provider had higher levels of treatment plan adherence compared to those who did not. https://doi.org/10.1046/j.1365-277X.2003.00435.x

Consequences of poor onboarding practices:

A study by DiMatteo (2004) found that patients who did not receive adequate education or support from their healthcare provider had lower levels of treatment plan adherence, leading to poorer health outcomes. https://doi.org/10.1097/01.mlr.0000114908.90348.f9

Lacy et al. (2004) reported that patients who experienced poor communication or a lack of warmth from their healthcare provider were more likely to miss appointments and not follow through with their care. https://doi.org/10.1370/afm.123

A review by Martin et al. (2005) concluded that patients who did not feel engaged or supported by their healthcare provider had higher rates of treatment plan non-adherence and were more likely to seek care elsewhere. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1661624/

Schectman et al. (2005) found that patients who did not receive clear information about the costs and financial options associated with their treatment plan were more likely to delay or forgo necessary care. https://doi.org/10.1007/s11606-008-0747-1

—————————————————-

If your practice building efforts aren’t taking you to your goals,
there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

the goal driven business by edward petty

 

 

The Goal Driven Business
By Edward Petty

order now button