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

Have You Mapped Your Patient’s Health Journey?

woman mapping out patient flow for chiropractic office

Improving Your Chiropractic Patient’s Experience

Advertising has peaked. We are awash in ads coming at us from every possible source. We are hit with anywhere from 4000 to 10,000 ads per day.* With AI and ultra-sophisticated forms of targeting, it’s almost totalitarian.

The new marketing is customer service or Service Marketing.

Advertising has its place, of course, if it is to the right market, with the right message, and the right offer. But with all ads, the low-hanging fruit gets picked quickly, and new ones are needed.

There are other avenues of marketing your chiropractic services, but the importance of world-class service and outcomes is more vital than ever.

You’ve seen the stats:

  • 40% of customers began purchasing from a competitive brand because of its reputation for good customer service.
  • 55% are willing to recommend a company due to outstanding service, more so than price.
  • 85% would pay up to 25 percent more to ensure a superior customer service experience.*

Nothing is radically new about these numbers, but it helps to see them again.

And Service Marketing is not really new. But I believe it is and will be the dominant feature that distinguishes you from comparable providers. This is because content marketing has flooded the market. Therefore, call it service marketing or relationship marketing, turning each of your patients into raving fans who become salespeople for you is an intelligent marketing strategy.

But you must deliver the WOW!

CUSTOMER AND PATIENT JOURNEY MAPPING

Customer Journey Mapping is a relatively new term that has been hatched over the last 10 or 15 years in marketing. While the term is new, the concept is not.

Customer Journey Mapping is a procedure used to visualize and analyze customers’ end-to-end experience as they interact with, in this case, your practice.

It is essentially a flow chart.

It starts with a prospective patient’s first call to make an appointment. What do they see when they drive up to your office, walk through the door, and are greeted? It involves mapping out every encounter and even the likely emotion your patient experiences through Day 1, Day 2, Day 12, and so on.

And how far do you take your patient? Is it 8 visits and done? Do you take them through Acute Care, Corrective and Strengthening, to Supportive and Wellness? Do you have a map for your patients and do they know it? What are the milestones along the way? Are your patients excited about reaching them?

IMPROVING YOUR CHIROPRACTIC AND HEALTHCARE SERVICE

One of the exercises I covered in my book The Goal Driven Business, which has always been useful, is a complete Day 1 and Day 2 walk-through. It is rehearsing your flow chart or patient map.

Everyone watches while someone acts as a patient. I have often done this and acted as a patient. I will notice things that everyone has taken for granted — the old poster from 1989 still on the wall with the Muppets, a dead plant in the corner, a dead smile on the front desk, no explanation when I am dumped off on a therapy unit. Staff start noticing things as well. Redundancies show up, so do poor handoffs between the front desk and the doctor or from the doctor to patient accounts.

Zeroing in on how the phone is answered, an exam is done, or a report of findings is presented, you can find many small improvements that make a big difference on how your patients experience your office.

(Want me to set this up for you? Schedule a time and give me a call.)

Creating your patient’s experience is your most important marketing activity. Mapping it and practicing will help you create raving fans — that will generate even more fans.

Keep improving,

Ed

*The average American encounters around 6,000 to 10,000 ads or brand exposures per day. Source: “MIT Technology Review” article by Michael Schrage (Aug 7, 2017)

*Customer service stats. X: The Experience When Business Meets Design, by Brian Solis

—————————————————-

If your practice building efforts aren’t taking you to your goals,

there are reasons — many of which are hidden from you.

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

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

The Goal Driven Business, By Edward Petty

Goal driven order now button

He Fired the Office Manager in His Chiropractic Office

Goal Driven to learn practice management. ww.goaldriven.com

Should have been educated and not terminated.

This newsletter is a reprint of an article I wrote a few years ago. I was reminded of it as I am working with a number of offices on a Practice MBA program – which is going very well, by the way!

= = =

A few months ago, an chiropractic office manager called me. She said that her doctor had fired her.

Her primary role was Billing and Collections Coordinator, but she was also the office manager part-time. I had worked with the office for a few months and knew the doctor and Dorothy (not necessarily her real name.) I had gone over the role of the office manager with her and the doctor. They both felt they understood the situation and would let me know if they needed any help. I was pretty sure they didn’t know what their roles were or how to execute them. I suggested working with them longer, but their minds were made up.

Months went by, and then late one Monday morning, I got a call from Dorothy. She told me she had been fired. I asked her why. (Knowing her and the doctor, I had a pretty good idea.) She told me that new patients had been dropping for some months and that the doctor was not happy about this.

She said that she couldn’t believe it! “He fired me for that? I am not even in charge of new patients?” She was upset and went on about how new patients weren’t her responsibility.

What do you think? Was she right? Or was the doctor right?

Let’s look at it: the chiropractic doctor is ultimately the marketing director. As the Chief Executive Officer for the business, marketing is a key component of their job. But since he is also so busy as a doctor, he must delegate most of the marketing activities. But to whom?

  1. First, to all of the staff. It is each team member’s responsibility to sell health.
  2. Then, a staff member could help coordinate all the marketing activities as a marketing coordinator or marketing manager.
  3. You might also delegate different marketing activities to other staff: someone for external events and screenings, someone for the internet, etc.

But behind it all, it is the office manager’s role to ensure everything runs smoothly.

No one should have been fired.

Instead, they all should have been trained on marketing and management.

= = =

In your practice, marketing is your job.

And yours. And yours. It’s also yours! In fact, the marketing department is the entire office. Peter Drucker, considered the forefather of management theory, said (my italics):

“Marketing is so basic that it cannot be considered a separate function within the business, on a par with others such as manufacturing or personnel. Marketing requires separate work, and a distinct group of activities. But it is, first, a central dimension of the entire business. It is the whole business seen from the point of view of its final result, that is, from the customer’s point of view. Concern and responsibility for marketing must, therefore, permeate all areas of the enterprise. Management:Tasks, Responsibilities, Practices (p68)

One of the tenets we are discussing in our management training is the idea of ownership. That is, everyone on the team is a stakeholder, and at no point is anyone not directly connected to all outcomes of the office.

We are training managers to be Goal Driven, and how to create Goal Driven teams that take ownership of the outcomes. And along the way, we are also training the doctors as clinic directors! (That’s the hard part! Lol)

So, no one is getting fired on our watch.

Educate.
Don’t Terminate.

And seize your goals.

Ed

P.S Our next management, leadership, and marketing training starts in February 2024. Limited enrollment. Let me know if you are interested and or want to get on the waiting list.

What gets measured gets done

 

Your Goal Driven Analytics Scoreboard

Sometimes you can’t see the forest for the trees.

Sometimes you think things are worse than they are.

But then again, sometimes you think things are going better than they are. And then, BANG! Poop hits the fan!

What is the best way to determine how your business is doing?

Your Scoreboard

Your numbers are the best indicator of your Key Performance Indicators. They are your dashboard. Your Google maps. Your altimeter, as you take your business off the runway and up towards your goals.

In our consulting work, too often we see major management changes based on a minor error, hearsay, or emotions. This can have long-term devastating results.

On the other hand, improvements that show up on the stats can be ignored if no one is watching them.

One office we worked with continued to see an increase in new patients referred from a local gym. But amidst the busyness of the daily patient care, they hadn’t noticed. Since we closely monitored their numbers, I saw this increase in new patients from a local business on their New Patient Tracker. After discussing this with the doctor and manager, they finally took action to strengthen this valuable relationship. Last I heard, they are continuing to get referrals from this location.

You can miss the good things — as well as the coming crash. Numbers help you predict what needs fixing before things get ugly and what needs reinforcement to keep the good times going.

Ultimately, statistics tell you if you are moving towards your goals or away from them.

Unfortunately, most offices do not keep clear and consistent track of their numbers.

As a result, business owners do not get the information they need to manage their business properly. Software can spit out reports which can help, but they are not enough. And usually only partly used, if at all.

Here are some fast tips for your stat analysis scoreboard:

  • Key numbers. Monitor numbers week-to-date and month-to-date, especially new patients, visits, charges, and collections.
  • Individual providers. If you have multiple providers, find some way to measure their production. This can help both of you manage performance.
  • Percentages. Use percentages, such as visits divided by new patients, to give you an idea of how long your patients are staying with you.
  • This year to last year. You should be able to compare this year-to-date with last year-to-date.
  • Line charts. We use line graphs plotted over a couple of years. These clearly show what is trending — up or down.
  • New patients. Track the sources of your new patients as well as the types of new patients.
  • Weekly reports. Have someone in your office give you a daily, or at least a weekly and monthly statistical report.

Keeping statistical analysis in place has proven so valuable for offices that many clients have asked us to keep providing their stat analysis for them years after completing an intensive service with us.

While this is not a major service we offer, we realize how useful it is in our Goal Driven System of management.

Therefore, we have decided to start offering our Goal Driven Analytics program as a service to more offices.

We are only taking 5 new clients on this program for now, first come, first serve.   It is moderately priced and, as most of our clients can verify, managing by the numbers is invaluable. To learn more about the program, we’ve posted some more info, with the link below. If interested, just reply to this email, and we can set up a time go over the details.

But whether we provide you with your statistical analysis or you set it up yourself, I can’t recommend a more valuable management tool for managing your business profitably. Not only is it effective, but it is fast!

Your analytics scoreboard will help you smoothly navigate to your goals.

To your greater prosperity,

Ed

More info on the Goal Driven Analytics Scoreboard.

Health Never Takes a Holiday

fitness santas

Let the parties begin!

It’s beginning to look a lot like that special time of year. That very busy time of year with parties, food, traveling, shopping, cooking, and extra tasks.

A wonderful time of year. BUT…, please remind your patients that

Health Never Takes a Holiday!

They shouldn’t stop brushing their teeth, taking showers, or taking a pause from their yoga classes! These are all health activities that are just as important as their health program with you.

Yes, it’s OK to have an extra slice of pumpkin pie, stay up a bit later wrapping presents, or have a few drinks with an old acquittance, but encourage your patients to stick with THEIR health program.

Stopping and then starting again is tough. You lose your gains and momentum… so it is easier to just keep the ball rolling.

You can make a poster to help you remind your patients to keep working on their health. It also reminds you and your staff to keep your patients on track. Add something to your newsletter or a whiteboard with your Table Talk.

And in the spirit of the Season, you can click below to download free customizable sample posters for your patients. (We have many posters and patient scripts for our clients.)

Keep your patients Goal Driven to improve their health for a happier future!

Then, keep calm and party on!

Ed

Link to Posters- Health Never Takes a Holiday

Improving Patient Follow Through: The new patient log and checklist

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

In Praise of Geekiness


Are you a chiropractic geek?

Are you a health geek?

Here is Merriam Webster: Geek: “…a person with a high level of knowledge or skill in a field…” “an enthusiast or expert especially in a technological field… [The word geek has] seen increasing use with positive connotations, showing membership in a specialized group (film geek, beer geek) rather than social awkwardness.”

I like the word geek because it indicates someone who specializes in a field and is so engaged that they are not especially concerned with keeping up with what is accepted conventionally. In other words, they are a bit of a rebel.

Steve Jobs, for example, was a geek. A core value of Apple was a “power to the people” idea, that anyone could have a personal computer, not just the big corporations.

Wouldn’t Clarence Gonstead have been a geek? It would be difficult to find many chiropractors who were, or are, as engaged in chiropractic as he was or worked as hard.

I remember years ago when talking with a chiropractor over lunch and all he could talk about was the X,Y,Z axis, something about Euclidean geometry, and bilateral symmetrical function. I was trying to keep up! But there he was, in practice for over twenty years, talking excitedly about the last few patients he had seen. He was a chiropractic geek, for sure.

He also had a million-dollar practice with a very strong practice manager.

Great athletes are geeks in their field, studying and training harder than most. Same with musicians or chefs.

But it is easy to get distracted from your game. Collections, bills, staffing, procedures, marketing, insurance, taxes, and everything that goes along with running a business can cut into your productivity and dilute your concentration on your services.

Don’t let it.

Only the offices that give the highest quality services and deliver the best outcomes will survive, let alone thrive. Organize your administration such that it does not dampen your eagerness to engage with each patient, and continue to study and enhance every detail of your clinical skill.

And as a plug, this is why I wrote the Goal Driven Business – to help doctors be doctors, unfettered by administration, and free to express their skills and interests in their profession.

Organize your office so that you can focus on the science, art, and philosophy of your profession. Do so that you can look at chiropractic and its results newly each day, as if you just discovered its powerful potential to help people become healthier. Go deep on every level and rediscover your profession again, for the first time.

Be a geek.

Goal Driven to seize the future,

Ed

Case Management for Better Service and Retention

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

Are You Ready For Flu Season?

Are ready for flu season?

Big Pharma is.

If you haven’t seen the ads yet, you will soon. And so will your patients and potential patients.

It’s just business. “The global influenza vaccine market size was valued at USD 7.02 billion in 2021. The market is projected to grow from USD 7.54 billion in 2022 to USD 13.58 billion by 2029.” (Market Research Report, Fortune Business Insights, Sept 2022)

So, what does this have to do with practice and business development?

Your Unique Selling Proposition

In a practical sense, you are the uncola of the cola healthcare world.

You are health doctors – not disease doctors or drug doctors. However you want to frame it, you can define what you do as different than the pharmaceutical alternatives in such a way that you stand out from the crowd.

Remember, it is not necessarily what you do that counts. It’s what you stand for.

You stand for natural health. As Simon Sinek reminds us, “People don’t buy what you do; they buy why you do it. And what you do simply proves what you believe.”

Better Service and Better Health

In my book, the Goal Driven Business, I reference how consumers want more information about their services and products. Especially in this age of abundant and ready information. Patient education is not a chore, it is a service that, if it is well presented, patients appreciate.

But even more, you know about the immune system and what improves it. But natural approaches to boosting the immune system are not emphasized by the medical “information” that is promoted and posted. But you know better: adjustments, exercise, vitamin D, C, and all the rest. Acupuncture too!

It does take a little more time to educate your patients and community. But think of it as a clinical service that makes you unique and special. Think of it also as a marketing expense.

Pride and Purpose

There might be another reason to educate your community on natural approaches to viruses, one that is more personal.

You might feel that your patients and neighbors are being misled and that vital information is being kept from them. You may want to right this wrong!

And lest anyone tries to reframe you as unscientific, the leading cause of death is errors in medicine.(2)

So… the Flu Season is on its way. Go for it!

Enter the race and position yourself and your team as the good guys, the Natural Health Clinic that gets results. And by the way, don’t overlook that you all need to practice what you preach!

There is a very large portion of the population that is seeking a more natural lifestyle. Google search terms show strong interest in natural remedies. You will appeal to them — they are just looking for a health-oriented team to help them maintain and improve their healthy lifestyle.

Seize Your Future,

Ed

Links to the above references and others on the blog, here:

Learn how to create a Goal Driven practice that is more profitable and fun – get The Goal Driven Business

Brutal Economics: A hidden expense.

You have more expenses than you’ve probably considered.
 
Your biggest expense, like that old poster you have had in your reception room since 2012, has become invisible.
 
What is this big expense?
 
Well, one of the goals we work with in the Goal Driven System is the Full Capacity Goal.
 
This goal can be easily overlooked as we are focused on patient care, reimbursements, staffing schedules, vacations, and a thousand other tasks that require our attention.
 
The reason the use of goals is so effective in practice management is that they help you see the Vital Few from the Useful Many. (These terms are often used in reference to the Pareto Principle of 80/20.) The Vital Few are those factors (20% or less) that produce 80% (or more) of the results.
 
If you are not operating at close to full capacity, you are wasting money.
 
For example, if you could see, 160 patients in a week, given your schedule and good support, at $65 per visit, that would equal $10,400 per week. On a monthly basis, this would work out to be 640 visits and about $41,600 in revenue. This would be 100% Full Capacity.
 
You know from experience that your expenses are a lot higher than most realize. First, there are fixed expenses that you must pay out regardless of the performance of your business. And after everything and everyone is paid, after all accounts are settled, what is left over is yours.
 
At 70% capacity, that is not much. At 50% capacity, that is nothing.
 
Of course, you don’t focus on stats and money when you deal with patients as a doctor and as care givers.
 
But as a business owner, you must.
 
Numbers, analytics, Key Performance Indicators –– these make up your scoreboard and give you the best feedback to help you manage the performance of your business.
 
We carefully analyze our clients’ numbers each month and encourage they do the same. We also plot them on graphs and charts to notice trends. These are our x-rays.
 
Lately, we have realized that there is one number that gets overlooked in the hustle and bustle of business management. That is to what degree the office is operating at its full capacity.
 
In Goal Driven Analytics, we have been testing a “business capacitometer.” It displays, much like a speedometer or tachometer, the percentage of full capacity that the business is operating.
 
But you can easily do the same. Here is how:
 
  1. Weekly Visits. Determine the maximum number of visits you could see comfortably each week if you were reasonably supported with software and staff. ______
  2. Full Capacity Goal. Multiple this by 4 (I know, 4.3 is more exact): ___ This is your Full Capacity Goal.
  3. Percent of Full Capacity. At the end of the month, divide the number of visits you saw by your full Capacity Goal and you will get the percentage that shows you how the efficiency of your practice. E.G. You FCG is 800 and you saw 600 = 600/800 = 75%
Work towards maintaining 90% or above. Find the capacity constraints and remove them.
 
This is also very helpful if you have multiple providers – other associate chiropractors, massage therapists, other services, even your rehab or therapy departments. After agreeing on what volume would be full capacity, each month they can see their level of performance.
 
Last note: It is not about the statistics. While stats are your best indicator, remember … it is not the stat that is important — it is what they represent. A helped person!
 
Seize the Future,
 
Ed

 

Where Everybody Knows Your Name: Creating a Chiropractic Community

Used to be a popular TV program called Cheers back in the 80’s. It was modeled after a bar in Boston with the same name. As a situational comedy, Cheers presented a familiar group of customers who came to the bar to have a drink, but also to relax, socialize, and have good cheer.

 

Patients come into your office to improve their health and find relief from discomfort. But they are also looking for something more.

 

Remember that a practice is a network of relationships created and sustained through communication and service. That’s my definition. There are other definitions, I’m sure, but at the foundation, communication is critical.

 

It can be a lonely world where there seems little time for real communication – or friendship.

 

You are more than a doctor, and your staff are more than just support professionals. You and your entire team are part of a caring family, a community of like-minded people who are committed to health and helping each other achieve it.

 

Creating a community is a big deal in businesses now. For good reason… Belongingness has been identified as an intrinsic motivation we all have, according to Self-Determination Theory. But it can be contrived and gimmicky if it is not genuine.

 

In the best offices I have visited, staff and doctors formed a work family… genuinely caring for each other as well as for their patients. The patients were also included in the family. Sometimes, I would see them spending too much time gabbing at the front desk or bringing fresh produce for the doctor from their garden. I would even see patients just stop by the reception area to chat amongst themselves, catching up on shared concerns and local news.

 

Yes, the best practices have policies and procedures. These are the systems that help ensure fast and efficient service in high quantity with high quality.

 

But procedures cannot take the place of a real person interested in and caring for another person.

 

In very lay terms, the spine is the structure that supports and protects the function of the spinal cord. It is the function that counts, that comes first.

 

Many offices have their function impeded by tangled up, omitted, or unfollowed procedures and policies. You definitely need a strong infrastructure to have a prosperous low stress business. But the reason, the goal for good systems includes having good communication with your patients and each other.

 

There are many troubling issues we all face. Make your office a place where people want to go for better health and better friendship.

 

A place where everyone is glad you came and where everybody knows your name.

 

Ed

 

Theme from the sitcom Cheers
“…Making your way in the world today takes everything you’ve got.
Taking a break from all your worries, sure would help a lot.

 

Wouldn’t you like to get away?

 

Sometimes you want to go

 

Where everybody knows your name,
and they’re always glad you came.
You wanna be where you can see, our troubles are all the same
You wanna be where everybody knows
Your name.”

 

Carpe Posterum (Sieze the Future)

 

Ed

The Missing Role in Your Practice

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Three Functions of the CEO

The role of CEO includes these functions:

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

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

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

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

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

Ed Petty

March 14, 2022

Everything Else: Why The Goal Driven Practice is More Profitable and More Fun

What gets in the way of you growing your business?

What holds you back from your growth? From increased services and profits?

What keeps you from providing better services and improving your marketing results?

The government? Your childhood? Your neighbor’s cat?

One thing that is NOT holding you back is chiropractic or whatever services and skills you provide.

It is everything else.

When you are first growing your business, and let’s say you are barely at 40% of your full capacity, your practice may be performing well. You may have an assistant, but for the most part, you can see patients and generally oversee the operation of your practice. Life is good, and the future is … wide open.

But almost imperceptibly, as you start seeing more and more patients, the tide of administrative demands starts rising.

Eventually, you can look around your desk and see “undones” and “half-dones” and a hundred or so “to-dos” littering your office, smartphone, computer, and brain. You try to keep up, but there seems to be just too much to do.

So, what do you do? There seems to be only one solution – you settle. You settle into a comfort zone just to a point where you can earn enough to pay your bills.

Growth becomes a trap, and after many attempts to reach your goals, you finally settle.

Is there a way out?

Yes. But it has been hidden. And booby-trapped.

But you should know, after years of observation and analysis, what is holding you back is not your lack of effort. It is not chiropractic or your professional services.

The fact is, you can’t really get to where you want to go from where you are now. You can’t get there from here.

You need to make some major Big Shifts. 

To get to your goals, you have to start from a different place and build a newer version of your business. This is your next stage. Stage One is survival and entrepreneurial growth. It is a Personality practice.

Your next version is a fast, more advanced business that will take you to your goals and beyond.

The new version is called a Goal Driven Practice.

To achieve this requires making some significant changes or Big Shifts.

MANAGER OR ADMINISTRATIVE ASSISTANT (BIG SHIFT #7)

One of the solutions to breaking out of the trap and moving closer to your goals is assigning someone on your team to help you with…Everything Else.

This could be a manager or an administrative assistant. In either case, the role would probably only require 5-8 hours per week – at least at first.

One of their goals would be to remove everything from your desk, all your to-dos, all administrative traffic, sort it for you, and then work out with you what should be done with each item.

You would delegate, delay or dump each item.

This would help free you to increase your services as a doctor and give you time to expand the business as the CEO.

You can produce $500 to $1000 in services per hour as a provider if you are unfettered. As the CEO, you can direct your business to produce much more than this per hour. So, why are you spending time drowning in trying to do $20 or even $30 an hour jobs?

Everything Else gums up the works. It slows you down, confuses the staff, and the patients feel the confusion and notice the neglect, however slight.

This is why I came up with the Goal Driven System. It unmucks the gears of your business so that you can freely provide services and not be haunted by the looming demands of hundreds of to-dos.

This is covered in the book, The Goal Driven Business. If you can do this, you will be more productive and have more fun.

This is so valuable that I will be scheduling upcoming Zoominars on this subject for you and your manager. And stay tuned for upcoming programs on manager training, and training and even coaching on the Goal Driven System.

And just, just for fun, (I am smiling) don’t miss this future article:

The 2 Management Consultants from Petaluma California.

Seize the future

Ed

For more information on The Goal Driven System visit Goal Driven

Are Your “Engines” Driving Your Practice?

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

Five engines drive your business to its goals.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A great new February to you all,

Ed

Why Goals Work and How to Harness Their Power for Greater Prosperity

Goals are the 20%of efforts thatWhy do goals work?

We all know the obvious: they help keep you focused, and as Yogi Berra, the baseball catcher, said, “If you don’t know where you are going, you might wind up somewhere else.”

We have all heard about their importance.  But we may not have heard or understood WHY.

What is the underlying principle behind goals, and why do they work?  What gives them their power? And can you harness it improve your business and its bottom line?

Stick with me and find out…

==   ==   ==   ==   ==

It was one of those September days in the Midwest when the leaves were turning orange, and the wind was blowing.  I was in Chicago – the Windy City – where I attended a seminar downtown at one of its plush hotels.

The program was kind of out of my league – at least then.  The fee for three days was $7,000.  I was only attending the first day, which was $1,000 – still a lot of money.  But I was drawn to the subject, and I was familiar with the person who was putting it on.

There were aggressive young MBA types flying in from around the country and the world.  On the night before, at the hotel where the seminar was to be held, I saw several small groups in lively discussion around laptops – as if they were in the middle of inventing the next Big Thing.  I remember talking to one young man from Singapore and learning about the high-energy atmosphere of entrepreneurship there.

The seminar focused on building, buying, or overhauling a business.  The speaker was a self-made billionaire, a former management consultant, so his teaching fees did not come cheap.  This was not a seminar for dabblers!

The subjects discussed on the first day and, as I learned, on the other two days, were surprisingly uncomplicated.  They discussed the key ingredients to look for when deciding what business to build, buy, or grow.  These few key factors were introduced on the first day of the seminar and then expanded upon the other two days.

But it all started around one principle: the PARETO PRINCIPLE.

Many of you know the Pareto Principle and the Rule of 80/20.  This Principle has been used over the last 50 years by major manufacturing companies to improve the quality of their products.  The concept is easy to state but often difficult for entrepreneurs to apply.  It predicts that roughly 80% of valuable results come from just 20% of efforts.  In some cases, the ratio can even be more extreme so that 10% or even 5% produces 90% or 95% of the results.

Not all efforts are equal: there are the “vital few” efforts and the “useful many” efforts.  Workaholic entrepreneurs can struggle to put this concept into practical use.  We find that delegating a $20 an hour task is risky, so we will spend time organizing a bookshelf or driving to get office supplies ourselves instead of taking care of a potential $1,000 an hour task, or even a $10,000 an hour task.

As a non-business example of the 80/20 Rule, consider all the clothes in your closet.  I bet you wear just 20%, or less, 80% of the time.  Then, consider how you get to work – out of all the choices of roads to take, you use just a few of them.

Look at a winning athletic team.  Just a few players are responsible for 80% of its success.  This does not mean that the other players are not important – just not THAT important.

All efforts are just not equal or average.

How might this apply to your business?  Well, for example, 80% or more of customer dissatisfaction comes from 20% or less of your patients.  On the other hand, 20% or less of your patients account for 80% of your patient referrals.

As the CEO of your business, what are the vital few actions you can take that will produce the most results?  I suggest that defining the business’s goals, ensuring that your team understands them, and keeping these goals alive each week is key.

As Stephen Covey advises: “Begin with the end in mind.”  Goals are simply the end you have in mind.  On the higher end, they would include your mission, vision, and reason for them – your WHY.  They would also include the values you hold as standards of behavior and performance.

These greater goals would be manifested as products or outcomes.  For example, if your mission included helping people have healthy teeth, then a practical manifestation of this goal would be “Jim,” a patient, having his teeth cleaned today.  If your vision were a healthy and pain-free community, the practical outcomes would be 100 patients adjusted today.

As a doctor, what would be the 20% of your actions that account for 80% of your results?  I suggest letting the patient know that you understand their goals and work to help them achieve those goals at each encounter.

As the manager of your business, ensuring each team member knows the goals of their roles and helping them achieve these goals, with good coaching and communication, will produce 80% of their successful efforts.

It all goes back to goals.  

They are the leverage points that direct and amplify all your efforts.

But here is the truth you must understand:

A small amount of time consistently spent defining the goals of, and within, your business — and working out how to achieve them — are the vital few actions that produce most of your excellent outcomes.

Know before you go.

If you and your team routinely define and redefine your goals, both the higher ones and the practical ones, and work out how to better achieve them, you will have a more prosperous and stress-free business.

Get the goals right each day, and all else will follow in your favor.

Working towards a better future,

Ed

If you don’t have it yet, get my book to learn more about how to use goals in your practice. The Goal Driven Business.

***New Training Program***

Also, stay tuned for a new training program we will be offering on the Goal Driven System. It will be limited to just 10 offices and last for 6 months. Its goal is to train the business owner and manager/senior staff member on the Goal Driven System to transform their practice into a Goal Driven Business. A Goal Driven Business is a team of Goal Drivers. That is what this program will teach you to create. (What is a Goal Driven Business? )
If you are interested in taking the training program on the Goal Driven System, for you and 1 team member, please go here to schedule a time to learn more about it. Schedule a meeting with me.

Goal Driven.com
Petty Michel & Associates

The Problem With Seminars

the problem with seminars

I am all for seminars. Been to many myself. I know I have gotten useful information and, no doubt, have benefited from them.

But, their usefulness is often wasted.

I just talked to a business owner that came back from a seminar he and his doctors and staff attended. He told me that they have started hitting their best-ever weekly numbers. His office manager told me that everyone is excited.

For now.

I have seen it time and time again… go to a seminar, get stoked, come back, numbers go up for a month or so, and then everything returns to how it always was. In essence, the seminar was only a short-term, “acute care” fix that addressed symptoms. Nothing was really improved or corrected.

There is a solution on how to benefit the most from seminars. I discuss it in my book, The Goal Driven Business, from which most of this article is quoted from. The following is a story related to me from a chiropractic staff member a few years back:

“Our office was really slowing down last year. So, the owner decided to take everyone out of town to a weekend business seminar. The speakers discussed new and efficient methods for doing our work. It was entertaining and informative. Plus, we also gained some great marketing ideas. It was a fun seminar, so we were all excited when we returned to work after the weekend.

“On Monday, we agreed to get together at lunch to discuss how to implement what we learned. Some staff members had to take care of urgent matters first, so our lunch meeting started 30 minutes late. Once we finally got together in the break room and started eating, we began a good meeting, but then customers begin arriving for their afternoon appointments. We had to call the meeting to an end without getting through very much of our agenda, but we agreed to continue the meeting the following week. Turns out, we never did meet again about the seminar.

“But we were still pretty motivated from the out of town trip to the seminar and, as I recall, we had one of our best months ever. It’s my job to clean the break room and, after a few months, I noticed that the binders of information we received at the seminar were never opened; so I stored them for future reference. Now it is almost a year later, and everything is pretty much back to the way it was before we went to the seminar. Some of us are a little burned out and I don’t think we ever did implement anything from that seminar.”

Sound familiar?

I bet it does. I have seen it play out almost exactly the same way countless times. Starting, and not following through. No management and marketing system is set up, and no time scheduled to ensure the system is followed, and no lasting improvement is realized.

And I am sure, for most of us, this phenomenon applies to our personal lives as well. For instance, how is your exercise program coming along? Hmm? You’ve set goals to work out more often and eat better, right? To work ON your body, not just in it. Yet, my guess is it’s been pretty hit and miss.

We want to improve, we make improvement goals, but what happens? Why can’t we achieve them? Consistently. Is it that we’re all too busy? Too lazy? There seems to be no solution, so we accept our condition and do our best.

Yet, there IS a solution, and it’ll seem like science fiction—but, it’s actually a science fact.

The Goal Driven System of Business Development covers 20 Big Shifts, or actual office adjustments, that need to be made to reach your goals — and stay there. It takes you out of the Practice Roller Coaster that forces you to finally “settle” and accept a lower level of success because the stress of the ups and downs becomes too much.

Here’s how to get the most out of seminars from The Goal Driven Business.

goals lab goaldriven.comBIG SHIFT #1: Introducing the Goals Lab
You can’t improve your car while you’re speeding down the freeway. You must take it to a mechanic at a garage. Athletes and musicians alike spend time away from their audience to practice their game skills or their music, always improving their performance. Businesses need to do this as well. But where? And when?

 

The answer is you need to create a Goals Lab where you go to work on your business.

Your Goals Lab is a special place, a laboratory, an oasis for change. Here, you can think, study, learn, practice, become inspired, and have conversations. Here is where you go to reset your thinking and improve your actions—and the actions of others in your office as well.

I call it the Goals Lab, but you can give it another title, if you wish. Whatever you call it, this is the first Big Shift you’ll take on your journey to achieving your new goals.

Goals Lab to engineer your best route to your goals, Goalddriven.com

Why do you need a Goals Lab? Because you simply cannot focus on the other Big Shifts when you are in your office, juggling customers, staff, bills, phone calls, emails, vendors, and everything else that consumes your energy and brainpower.

Management companies and consultants may have advised you to work on your business, not just in it. While the idea of working on your business, as opposed to in it, is a clever and useful concept, I have rarely seen it applied consistently or comprehensively. Why? Because real business improvement can be more demanding than meets the eye. It is a separate activity that requires its own distinct time and place, and it has its own rules which must be followed to be effective.

I use the term Goals Lab because it is a virtual location that you visit to improve business performance. As an example, you spend most of your time with your car driving it. But you also take time to take your car to a special place where you let a mechanic work on it.

Not knowing about this place, this Goals Lab, its rules, and how it operates, is a fundamental reason why all your management books, marketing manuals, and practice improvement notes from seminars rarely get implemented.

Your Goals Lab has been mostly hidden from you. It almost has a fourth-dimensional location, which is outside the time and space continuum.”

Why don’t we spend more time on improving the business, not just working in it?

This is the real question, and it is answered in the book, The Goal Driven Business. You can read about it now, or wait for my next article where I explain WHY business improvement is so difficult and what to do about it.

Meanwhile, keep improving.

Ed

Learn more about book and get it here: https://www.GoalDriven.com

the goal driven business by edward petty

The Goal Driven Business: A New Book by Edward Petty

July 2021

 I went and wrote a book!Edward Petty displaying his new book, The Goal Driven Business

Took me more than 5 years.

Here it is:

It is called:

The Goal Driven Business
A New Business-Building Methodology That Is Simpler, Faster, More Profitable,
and More Fun Than Whatever You Are Doing Now

What the Book is About
The Goal Driven Business is a distillation of my 35 years of in-the-field work with business owners, doctors, and their teams from across the country. It also includes what we learned when we owned, with other providers, 22 practices here in Wisconsin and had to overcome significant financial, organizational, and clinical challenges – in which we ultimately profited.
Carefully reviewing what worked and what didn’t and correlating my observations with the results of other researchers, I was able to uncover certain universal practice principles I had not seen before. I was also able to isolate the hidden barriers that kept most hardworking doctors from achieving their full potential.

With this information, I put together a step-by-step map that any business owner could follow that, with good effort, could help them achieve their full potential. This a totally unique system of business development which I call the Goal Driven System. It is all covered in my new book, the Goal Driven Business.

What Others Say About the Goal Driven Business
The book has been receiving great reviews. You can read them at GoalDriven.com. Here are a few:

  • “A must read for doctors in private practice — read it and reread it, it is that valuable.” J. Peter Heffernan D.C. DPhCS.
  • “I wish I had this book 30 years ago!” Ann Metzler, D.C.
  • “The goal driven business is a “must have” for every business owner – the book is fantastic!” Cindy Munson, D.C.
  • “Mr. Petty, I have just finished reading your recent book “the goal driven business”. It is a masterpiece.” Maxwell Synsvoll, D.C.
  • “This book is more than just thorough. It’s the truth!” Tom Potisk, DC

Why I wrote the Goal Driven Business

  • Based on principals and Goal Driven. Too many offices are Personality Driven. In a Personality Driven practice, everything is dependent upon the owner. As the business grows, the burden on the owner can become too much. Stress increases, and production quantity and quality can suffer. So does income. Using the principles I observed, I worked out the natural system of business development that unfolds regardless of the owner’s personality. Knowing and applying this system in a Goal Driven Business, success is no longer dependent solely on the owner and their personality – stress decreases, and service and revenue easily increase.
  • The complete picture. As a consultant, I did not have the time to pass on all the information I had about business development in consulting sessions. As a result, clients would not get the complete picture. I also noticed that many key components to business success were avoided by other practice management consultants, books, and seminars. There are real barriers to success – and many are hidden. I reveal everything in the book — no stone was left unturned! I have charted a complete path and show you how to bypass the barriers and make the shifts necessary to reach your goals.
  • Only the best will survive. Market forces are eliminating individual businesses as monopolies continue to expand. We see more providers working for hospitals or competing with lesser skilled technicians. Large companies can dominate their markets through price, convenience, advertising, as well as “lobbying.” To survive, you need to provide world-class service and outcomes. Only the strongest practices that give the best service will survive and thrive in this decade. The Goal Driven Business shows you how to provide extraordinary service that creates extremely happy customers!
  • Your success is vital for our communities. It has become evident to me that many solutions offered by corporate entities are not always the best for the consumer. This puts the health of our communities and children at risk. Now more than ever, your patients – your neighbors – are better served by independent professionals like you whose help is not dictated or biased by titanic industry interests.

You must not overlook the grassroots power of goodwill when your patients receive excellent and genuine care. Like a stone dropped into a pond, there is a positive ripple effect that goes far beyond your office. This is why I suggest that one of the most effective methods in dealing with our challenging environment is to simply — help more people. Why not help 5 times more people? Why not help them become healthier and teach them about health? And why not earn much more? You certainly deserve it!

My book will show you how to help more people, earn more, and yet have more free time to pursue personal and professional goals. And in the bargain, you will have more fun.

And you will also help safeguard the health of your community for generations to come.

I have my book on sale for a limited time.
Usually $18, from
July 4th – Independence Day — to July 11th,
you can buy it for just $8.
Go straight to Amazon or through our website at www.GoalDriven.com

Get the book NOW!

Carpe Diem,

– Ed

P.S. A portion of all income from this book, and future training on the Goal Driven System, will go as a donation to the Children’s Health Defense (ChildrensHealthDefense.org).

Get the book! If you like the book, please post a review on Amazon. Buy more and give them to your colleagues.

What is an Adjustment

B.J. Palmer

What is an Adjustment by B.J. Palmer

An adjustment (“setment”) is one if not THE most exact in operation in the world; greater by far than ripping out an appendix, etc. It requires that “intuitive” sense of direction, proportion, distance, and ability to deliver just that and all that, and nothing more; a sense of fitness to do this one thing, which few seem to possess, which can be acquired if one is willing to pay the price in thought, study, development of mind and body.

I have spent 40 years to do what I can do today. The “follow thru” of an adjustment IS IMPORTANT, but not nearly as important as “the approach.” If the “approach” is natural, easy, perfectly timed and distanced, then follow-thru is The sportsmanship of adjusting subluxations is no different than the perfection in tennis football, baseball, or any sport where ONE gets this top, MANY drag behind, and MANY are way down at the tail of human endeavor.

The MIND thinks all action. As the MIND understands, the muscles deliver. I will spend no less than ONE HOUR studying a DISlocation before I adjust it. WHY? The mind THINKS all action, and the MUSCLES deliver. The more the MIND knows, the better will be the delivery of MUSCLES. I had a child-like that recently — 6 months old — a DISlocation to correct. It was done in a split fraction of a second. When your muscles come through, THEN they haven’t time to think action. Action must be formed IN THE MIND ahead of time.

(Page 844, Up From Below the Bottom, B. J. Palmer, 1950)

PDF Version for downloading: What is an adjustment by B. J. Palmer

The Future Belongs to the Best

Time spent on business improvement projects in your "Goals Lab," or during down time. From GoalDriven.com (c)2021

A few years ago, a staff member at an I office visited confided in me and told me the following story:

Our office was really slowing down last year. So, the doctor decided to take everyone out of town to a weekend practice management seminar. The speakers discussed really cool methods for doing our work. It was fun and we learned a lot. Plus, we also went over some great marketing ideas. We were all pretty excited when we returned to work after the weekend.

On Monday, we agreed to get together at lunch to discuss how to implement what we learned. Some staff members were still dealing with patients, so our lunch meeting started 30 minutes late. Once we finally got together in the break room and started eating, we began a good meeting. We were interrupted with a few phone calls, and some patients started arriving early for their afternoon appointments. We had to cut the meeting short and didn’t get to discuss much of topics of the seminar, but we agreed to continue the meeting the following week.

As it turned out, something always came up each week and… we never did meet again about the seminar.

But we were still pretty pumped from the seminar and we had one of our best months ever. It was my job to clean the break room and, after a few months, I noticed that the binders of information we received at the seminar were still on the break room table, never opened. I stored them away for future reference.

“Now it is almost a year later, and everything is pretty much back to the way it was before we went to the seminar. The numbers are back down, some of us are a little burned out, and I don’t think we ever did implement anything from that seminar.”

Sound familiar?

I bet it does. I have seen it play out almost the same way countless times.

We are in the improvement business. We help people improve their health. We should be able to do the same for our business and for each other. In fact, if you are not constantly improving, your patients will seek practices that are.

In this new decade, apart from the many new events and changing tides of culture, technology, and mega-corporate influence, your future success is up to you. And it will be primarily based on the quality of your service and your outcomes – the experience your customers receive.

A report from a survey by Microsoft underlines this:

“As customer expectations continue to climb, it becomes more challenging for brands to set themselves apart from the competition. Markets are increasingly crowded, and both price and product are being steadily overtaken by customer experience as the number one brand differentiator” (Microsoft 2018, State of Global Customer Service Report).

More than any other short-term marketing tactics you may be using, only the best offices will thrive in the long run. And those will be the offices that are working on consistent improvement. Mediocrity could get you by in the past. But now, the future belongs only to the best.

But I have noticed that most offices just do not spend enough time consistently on improving their performance. After studying this for some time, I have observed a number of obvious and even hidden barriers that prevent us from working on improvement. I will explain what these are in a later article, but the following steps can help you ensure that you work ON your business to improve it, not just work IN it.

Your Improvement Clinic – Your Goals Lab

  1. Time spent on improvement doesn’t cost. It pays! Some business owners are concerned that time spent on improving the business or staff is too costly. It can be if the training or planning is poorly done. But remember that:
    a. Better team efficiency generates better revenue.
    b. Better trained and focused team members generate better revenue.
    c. Better outcomes generate better revenue.
  2. Head Coach. As the owner and CEO, you are also the Head Coach. How your team does – the business – is in large part based upon your coaching.
  3. Give it a name. In my new book, The Goal Driven Business (to be launched on July 4th of this year), I use the term Goals Lab as it is a location where you can go to work on getting to your goals faster. It could be your breakroom, a restaurant, a park, the reception area – anywhere really. You can call it your Practice Field, Improvement Dojo, or Mystic Garden! Just consider it a place and time that is separate from your time with patients.
  4. What gets done.
    a. Team meetings for communication, review, coordination, and planning.
    b. Team training and practice.
    c. One-on-one training and practice.
    d. Personal training, study, meditation.
  5. Schedule these routinely – weekly, monthly, quarterly, and as needed.
  6. No interruptions, no calls, 100% attention present.
  7. Be challenging. You don’t get better unless you question what you have been doing to see how it could be better.
  8. Go over this with your team. Let them know that they, too, are coaches. And players as well. So, improvement is a team activity, one that requires responsibility and professional discipline.

Your car mechanic can’t work on your car when you are driving it down the freeway. You can’t see patients while they are driving their forklift at work or cooking dinner for their kids at home. You need a separate time and place dedicated to work on improvement.

Your goal is to create an expert office that generates expert results and gives your patients the best experience they can receive from any other comparable health care business.

Imagine your business being so good that patients not only drive in from across town, or even across the state, but fly in from all across the country to receive your services. Imagine that there is such a demand for your care that you even build a motel next to your facility to accommodate the out-of-towners.

Well, there was a Doctor of Chiropractic who was just that good. His name was Clarence Gonstead. His advice?

“Practice. Practice. Practice. Never stop.”

Ed

Ed Petty - author

Keep putting your business THERE

A tree withstands storms but continues with its systems.

Just a note here about procedures:

Keep the structure of your business – its policies and procedures — in place. As much as you can, stick to your usual routines.

Certainly, you want to integrate needed changes to prevent the spreading of the virus. And obviously, for many of you, patient volume has changed, so you may have to adjust your work hours and staff hours.

You do need to be flexible. Improvise — where needed, adapt, and overcome! (Paraphrase of Marine slogan!)

But do not let the virus be the tail that wags the dog!

Keep the recalls going. Keep the billing going. Hold staff meetings, if only by Zoom. Rally the team! Review numbers and SET GOALS. Give staff study assignments. If anything, increase your patient communication 5 times – or more.

Strengthen your network.

I bring this up as I have seen a few offices start to slack off on their procedures, and while this is understandable in many situations, it can be a slippery slope. This can set a precedent for neglecting other procedures. This is what leads to office anarchy and what I call “Procedural Atrophy.”

Procedural Atrophy is the gradual dropping out of procedures. For example, you used to call every new patient after their first adjustment and send out birthday cards. Then, you became so busy that you “didn’t have time” to do the calls or to makes sure the staff sent out birthday cards. Two years later, you wonder what happened to all your patients.

We are NOT victims. We will respond positively and use this opportunity to strengthen our resolve and our health network.

Hold true to time tested procedures during unusual conditions.

Stability breeds confidence. Your patients are looking to you to be the rock that they can count on.

Management’s job is to hold the structure of the organization in place. (And then improve upon it.) It may have to be abbreviated, economy of time, effort and money come into play, but … do the usual. Set your goals and stick to your successful procedures to reach them.

Do this, and after this storm passes — your business will be busier than ever.

Working now for the future,

Ed