Pilot of the Wheelchair: The Girl and Her Passenger

This short story may not seem at first to pertain to your chiropractic office, but it does.

In the hot afternoon Sunday traffic, in the right lane waiting to turn right, our lane had stop moving.

Crossing the busy six lane intersection heading toward us was a man in a motorized wheelchair.  His face was full but motionless and looked worn. I couldn’t be sure, but he had that straight-ahead look of someone who was blind. He was maybe upper thirties or mid forties with short hair, perhaps a wounded veteran who paid no mind to the antsy cars that waited for him and his wheelchair.

Sitting on his lap was a thin little girl. Maybe eight years old.  She was curled up, cuddled with one of her shoulders against one of his. As they were crossing the last three lanes, she stretched out her arm with an open hand as if to say “halt, please let us cross.”

She had the look of a girl who had not had an easy life but was happy to be with this person whose immobile legs she rested on.

Once they made it to the other side our lane started to move. The pair moved closer as I moved forward. It appeared as if she was acting as the man’s eyes and told him when to go. I had the sense that he was a family member, perhaps her father, by the bond they seemed to share.

As I passed them in my nice air conditioned car, I looked closely at the girl and waved to her and smiled. She looked at me directly as I drove by. She gave me a wave and beamed a big smile as if to say “Thanks. We just made it across a busy road and me and my pa are having a Sunday outing.”

In my mind, her face reminded me of pictures of Anne Frank, the girl in Amsterdam that kept a diary before being taken by the Nazis to her death in 1945.

I would have liked to stop and help her in some way. Or say “hi” to the man in the wheelchair who looked so stoic. Maybe there was something I could do for them.

But the fact is – they did something for me.

They set an example – of courage, caring and love. They had heart: For each other, for their goals, and seemingly for their adventure.

Not everything can be put into a mission statement or measured by statistics.  No “boot camp” can teach this, and even if all your policies and procedures were followed perfectly, you could still miss it.

Heart.

One office I know has so MUCH heart the whole town loves the office and the office loves the town. The fact that there is a 2-3 week waiting list of new patients is the biggest challenge the office has.

By training and professional experience, I have a bias towards procedures, organizational structure and production.  No doubt, without these, offices would experience anarchy or insolvency. But I have also learned that heart is more important.

We can all become discouraged at times. Emotions and confusions can affect your patients as they do you and this can put a barrier around our capacity to care.  This may be affecting you or your office now.

But this is only temporary and not the real you.

This is what the little girl gave me. Her wave to me was a “thank you for stopping to let us cross the road”, but also, “we are all in this together.”

That is the lesson I am left with.

There is heroism all around us. Simple and quiet examples of selfless caring and love pass us by daily if we were to notice.  People want to help others and want help as well. Why? Because we are all in this together. Because we care. Because we have heart.

Training on procedures such as the report of findings is fine, but your patients aren’t adversaries and neither is your community. They want to get better and they want to help others to get better.   Really care for them, really love them, be honest with them, and have the courage to always do this, and they will never leave you.

Whatever your office mission statement says, if you have one, it should say what is in your heart. And if you follow that, I am sure you can successfully pilot your team on its adventure.

#  #  #

Ed Petty

Upcoming Medicare and Reimbursement Changes: To Survive and Thrive – You Need to Study and Train

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.”  Alvin Toffler

 

I don’t see this discussed much – at least not enough.

It’s called: STUDY.  Study is similar to training, which includes practice, and both require real personal effort and engagement to be effective.

You may want to study more but just don’t feel like you have the time to do so.  It does take time away from other activities. It can be confusing, tedious, and even seem belittling – sitting down and grinding over information, trying to figure out how something works. Practicing and roll playing can seem even worse.

But the return on your investment is worth it.   And nowadays, you have to constantly study just to stay up to date, let alone get ahead.    For example, for those of you in the insurance departments – patient accounts – you have probably had to learn many new things lately. You may have had to upgrade your computer programs for electronic health records. You have had to learn about “meaningful use” and other new terms.

But wait, there’s more!
INSURANCE
I checked in with our resident billing expert, Mr. Dave Michel, and he informs me you have the following headed your way:
  • June: new CMS 1500 claim form
  • July: PQRS implementation
  • Sept 7: WPS to NGS (Medicare administrator change in several Midwest states.)
  • Oct: new ICD 10
  • January major provisions of the PPACA and required EFT and ERA

For those of you in charge of patient reimbursement, you will have to learn about these new programs, train and then get them correctly implemented.  You have many resources from which to learn, including: association seminars and webinars, the CMS website, Chirocode.com, NGS web site for those of you in the Midwest, the PM&A Members website and Facebook page.  There are other resources as well, but the point is that you will have to study, learn, and work it out and get it implemented.

FRONT DESK AND OTHER CLINIC DEPARTMENTS
This also applies to every other job in your office. Each team member should be able to write a book about their department and job within five years and be capable of presenting a full day seminar on what they do to other chiropractic staff.

The front desk should be experts in customer service, sales for scheduling, and excellent in many other skills.  Therapy and rehab staff should know the physiological affect their machines and protocols produce for their patients. They too need to be exceptional at patient education, customer service, and as compassionate as the patient’s mother.

YOU ARE PROFESSIONALS
These are high standards, but you are professionals. You don’t work on an assembly line at the Ford plant. We now live in a networked economy. We have long since passed the Industrial Age, even though most of our management techniques still seem tied back to when “Father Knows Best.”

There is no getting around it, this is a new age. Alvin Toffler, quoted above, wrote about post the Industrial age for business in his book, The Third Wave. The second wave was the Industrial Age – and the third was and is the Information Age.

It is 2013 and your patients are smarter than patients have ever been and expect more.  They know about you before they call you and report on you after they see you so the whole world knows how you treated them.

You have to be better.  You have to study, learn, train.  In a tough economy, patients will go to the best and  bypass the rest. You have to be the best.

A NOTE TO DOCTORS
This apples to you doubly. Beyond the continuing education credits, I suggest you consider challenging yourself to constantly work on improving any and every aspect of your clinical craft like a true artisan. Like a scientist. And like a philosopher.

But you are also a CEO, which includes an entirely different set of skills. As the owner and manager of your business, you need to perfect your skills as a leader, manager, and marketer.  This is so horribly omitted (or perverted) in many programs as to be either laughable or criminal.   Once you do learn these subjects, you can delegate most of them and we can show you how, but you need to learn them nevertheless.

ONE HOUR PER WEEK
Stephen Covey talks about how you have to “sharpen the saw.”  You can cut a tree much faster if the saw is sharp and that sharpening is called training and study.  According to the American Society for Training and Development, since 1991, annual training budgets in the U.S. have grown from $43.2 billion in 1991 to $156 billion in 2011. Obviously, business sees an ever increasing need for training.

Encourage your team to take at least one hour each week to study some aspect relating to their job.   Encourage them to attend seminars and webinars and tele-classes, and have them give a presentation for the entire team at the next team meeting about what they learned.  You can give them a bonus if they give a book report about a book they read in the Lending Library.

YOUR PATIENTS
Lastly, this also applies to your patients. One of the primary functions of your office should be the training and education of your patients.  They need to take responsibility for their own health and in order to do this – they need to know what you know.  Regular care classes, a “lending library” and of course, warm “table talk” by doctor and staff help.

***SPECIAL TEAM TRAINING TELECLASS WITH PHYLLIS FRASE AND DANA PITTNER TUESDAY, MAY 21, 

12:30pm – 1:30pm CDT – “Dialogues and Dilemmas

Take time this Tuesday to listen to these dynamic ladies discuss solutions to the 10 most common conversations staff often gets stuck on with patients.

Learn how your staff can share and educate your patients on the chiropractic lifestyle.  What you can say at the front desk, in therapy, financials, etc.

There is no charge for this teleclass. For active PM&A members, you will find it on you Members site in a few days just in case you missed it.

26 Chiropractic Training Webinars presented by Petty, Michel & Associates

The following is a list of 26 training webinars put on by Petty, Michel & Associates. These were recorded live  for doctors who wanted to improve their skills as a CEO, for the office managers, and for marketing managers. The links provided take you to the recorded webinars on PM&A’s members site.

Over the years, we have learned a seemingly obvious fact: Any difficulties you are having in practice or in business usually do not stem from clinical issues, but from administrative ones.

Why are CEO’s paid so much?

One reason is that they can make such profitable difference in the business that boards of directors and accountants see that rewarding them is a good investment. Likewise, good managers and good marketers can be worth their weight in gold.

In chiropractic business training, however, there has been little adequate training or support for these roles.  Yet the comparison to high paid executives and managers in other businesses also apply your office.  The more effective you are as a practice CEO and leader,  the more your office will be prosperous. And the better your office manager is, or your marketing coordinator, the more solvent your business will also be.

CEO Webinars

 1. How to Be an Effective Practice CEO  Video
If you are struggling with the ups and downs of a stressful practice, or have finally “settled” into a comfort zone producing much lower than you know you are capable of, this program is for you.

 2. Capacity Constraints : 33 minutes – Summary and Video
Do you work hard but you just don’t get as far as you should? The reason may be that you are running into unseen bottlenecks that are choking off your production and suffocating your growth. This is the subject of Capacity Constraints.

3. Management by the Numbers: 44 minutes – Summary and Video
Management is a subject that has techniques to help you go from where you are to where you want to be.

Management By the Numbers (MBN)  can be faster and more accurate than other forms of management, and help build staff morale and make it more self directed.

 4. Creating your Dream Team Summary and VideoA virtual “live” interview with the doctor and staff of a true chiropractic dream team. Find out what they do to achieve high numbers, profit, and fun.

 5. The Fast Flow Practice CEO  -55 minutes webinar video and summary.
One of the biggest challenges in running and growing your business is the time it takes you away from seeing patients and from your family.  We have solved this with what we call the Fast Flow Practice CEO System.   A new system derived from old principles.

Chiropractic Office Manager Training Webinars

1. Chiropractic Office Manager Training Webinar- Part I – Fundamentals of Practice Management [Summary, Video]
Part I covers the fundamentals of Practice Management (55 minutes)

2. Chiropractic Office Manager Training Webinar- Part IITips and Tricks to make the office more efficient [Summary, Video]
Part II reveals tips and tricks of what an office manager can actually do in the office on a day to day basis to make things run smoother and  significantly improve the volume and quality of services. (55 minutes)

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 3. Chiropractic Office Manager Training Webinar – It’s All About the Patient, the Doctor and the MISSION  [Summary, Video and Study Guide]
There are procedures to help the patients and procedures that help the doctor help the patient and then there is Everything Else.  Tips on how to deal with Everything Else. (30 minutes)

4. Chiropractic Office Manager Training Webinar How to Hire the Right Team Member   Summary, Video and Study Guide.
This webinar  covers eight principles for hiring the right team member from knowing when to hire, who to hire and how to hire.

5. Chiropractic Office Manager Training Webinar–  How to Best to Train Your Staff  Summary, Video and Study Guide
This webinar covers eight tips  to improve the performance of your team.  Training plays a big part in team building.

6. Chiropractic Office Manager Training Webinar –  The Office Manager Job Description  Summary, Video and Study Guide.
This class covers 17 essential duties of the office manager. Both the doctor and the office manager should watch and discuss these duties.

7. Chiropractic Office Manager Training Webinar – Team Meetings   Summary, Video and Study Guide.
This is an overview of 8 essential actions to help you improve your meetings and make them faster, more fun, and more effective. Plus, different types of short meetings that your team can grow.

8. Chiropractic Office Manager Training Webinar – Motivating Your StaffVideo  Ms. Phyllis Frase shares 5 secrets to keeping yourself and your staff motivated.

9. Chiropractic Office Manager Training Webinar – Reviews    Video
Employee reviews are often neglected, or are dreaded by employee and doctor. This webinar covers the basic steps to make them effective and positive for both doctor and employee.  Approx 37 minutes.

10. Chiropractic Office Manager Training Webinar – Roles and Goals  Summary, Video and Study Guide
What Are The Key Roles In Your Office? A hidden barrier in many offices has to do with confusing roles and job duties. Clear these up and see how much smoother patients and paper flow, and happier the team becomes.  Small office or big health business, clarify these 8 roles and the numbers will go up.

Chiropractic Marketing Manager Training Webinars

 1. Marketing Management – Session ISummary and Video The Why, What and How of Marketing. Getting your Marketing off the Ground. (55 minutes)

  2. Marketing Management – Session IISummary and Video  Specific Marketing Manager Duties – Your Job Description.  General Overview of the Most Effective Marketing Procedures in Each of the 11 Marketing Categories (55 minutes)

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 3. Marketing Tips for Chiropractic Marketing Managers Summary and Video   This is a short version of marketing management and some tips for the upcoming months. What are the three levels of marketing?  What part does communication have in your marketing?  How to engage your patients in your marketing efforts.  Upcoming special promotions. (30 minutes)

 4. Marketing Tips for the Chiropractic Marketing ManagerSummary and Video This webinar covers: Powerful internal marketing script, Report of findings referral procedure,  upcoming spring promotions, with special attention to utilizing Earth Day as an opportunity to promote your services.

 5. Scheduling Chiropractic Screenings and other External Events Summary and Video .  How to Schedule External Events And Create External Referral Sources.  Types of events, Outcomes, Purpose. How to plan the events and get them scheduled.(30 minutes) 

 6. The Art of Chiropractic Spinal Screenings.Summary and Video . Spinal Screenings – The Queen of External Marketing.  Everyone has done at least a few  spinal screenings. You have probably had some success with them. But how much better could you do if you knew the fundamentals of this time tested external marketing activity?  This is a three part series on spinal screenings. This session we will review the most fundamental principles of screenings. Get these, and all else will follow.(45 minutes)

7. Chiropractic  Infomercials.Summary and Video .
Whatever happened to Infomercials? They’re still around and they still work. And you can do them very inexpensively. You just need to know how.

This webinar will give you practical examples and include forms for you to use in producing your own amateur and informational marketing that can help you create more new patients and keep the ones you have.

8. Chiropractic Patient EducationSummary and Video (45 min)
We go over 7 basic strategies that cover the entire horizon of patient education and explain why it is so necessary to educate your patients if you want them to be healthier.

9. Chiropractic  Patient RetentionSummary and Video
If you understand the underlying basics of patient retention your appointment book should always be full.  Covered in this webinar is: Patient retention should be based on Principles – not gimmicks. Where are we you taking your patients? Why they quit?  The cost of not getting them there.

 10. Chiropractic Special Promotions  (55 minutes) – Webinar plus Summary.
This webinar covers different promotions by month. You will learn 2-4 different practical promotions for each month of the year. More importantly, you will learn how to organize them so that they are time effective and productive.

11.   Innate Marketing  (55 minutes) – Webinar plus Summary.
There are stories that float around every now and then about how some offices can simply “think”  “New Patients” and they come in.
Are these stories an urban legend? A myth, or a fact? Can staff or doctors “concept” new patients in the door. Is this true? If so, how can you do this?  10 steps to help you generate more patient visits through “concepting.”

Monthly Goal Setting for the Chiropractic Team

Chiropractic Team Goal Setting

At the beginning of each month you want to see that your team sets new TEAM GOALS.  You can also set individual goals privately at a different time, but TEAM goals are most immediate and important.

Each goal setting session always begins with a REVIEW of the past month. This gives the opportunity for the group (or individual in individual goal setting) to explain how they did and how they did it. And it gives you the opportunity to listen and then give some feedback. The feedback could be praise, or otherwise.

After the review, set the goals.   Group goals should be simple, usually just Office Visits and New Patients, though Collections can also be included. IMPORTANT: Let the group set the goals. You should negotiate the goals, but it has to be theirs.  Once these goals are set, ask the group (or individual) how they/we plan to achieve these goals? Get at least 3 action steps.

The last goal should include a “greater purpose” goal or two. This could be a party at your house next Thursday night, Betty, the Front Desk Coordinator will give a book report on one of the books in the Lending Library at next month’s Team Goal Setting meeting, and a check to see who is going to volunteer for working at the food bank next Saturday evening.

Why? You should also spend some time discussing why you have these goals. This takes you back to your MISSION.  Numbers for numbers sake is a soulless and goalless pursuit.

 In sum:

  1. Review last month’s numbers. Were they up or down from the prior month?  Ask.
  2. Then, ask why? Get the team to figure it out. Let it be a brainstorming session if possible.
  3. Let them tell you and you listen and question as needed.
  4. Acknowledge. Praise or show disapproval, as appropriate.
  5. Then ask for action steps to achieve goals.
  6. Then, get a few “greater purpose” goals.
  7. Then, continue with the rest of the staff meeting, such as announcing upcoming events, miscellaneous, etc. Include some discussion about WHY these goals are important.
  8. Do the same for individual team member’s right after the Team Goal Setting, or soon after.

 For more information on how this procedure is done, refer to the webinar called the Fast Flow CEO.

Chiropractic Practice Management, Marketing, and Leadership Recorded Training Webinars

This is a list of our practice development recorded webinars.

Each is a recording of a slide show driven lecture, each filled with an abundance of practice information derived from in the field work – and plenty of slides!

Currently, you have to be active on a PM&A program. By this summer, these will be available on and individual basis for a small fee.

 Chiropractic CEO Webinars

 Creating your Dream Team Summary and VideoA virtual “live” interview with the doctor and staff of a true chiropractic dream team. Find out what they do to achieve high numbers, profit, and fun.

 The Fast Flow Practice CEO  -55 minutes webinar video and summary.
One of the biggest challenges in running and growing your business is the time it takes you away from seeing patients and from your family.  We have solved this with what we call the Fast Flow Practice CEO System.   A new system derived from old principles.
Management by the Numbers: 44 minutes – Summary and Video
Management is a subject that has techniques to help you go from where you are to where you want to be.  Management By the Numbers (MBN)  can be faster and more accurate than other forms of management, and help build staff morale and make it more self directed.

Capacity Constraints : 33 minutes – Summary and Video
Do you work hard but you just don’t get as far as you should? The reason may be that you are running into unseen bottlenecks that are choking off your production and suffocating your growth. This is the subject of Capacity Constraints.

How to Be an Effective Practice CEO  Video
If you are struggling with the ups and downs of a stressful practice, or have finally “settled” into a comfort zone producing much lower than you know you are capable of, this program is for you.

~~

Chiropractic Office Manager Webinars

 Chiropractic Manager Webinar – Roles and Goals  Summary, Video and Study Guide
What Are The Key Roles In Your Office? A hidden barrier in many offices has to do with confusing roles and job duties. Clear these up and see how much smoother patients and paper flow, and happier the team becomes.  Small office or big health business, clarify these 8 roles and the numbers will go up.
 

Chiropractic Manager WebinarJob and Performance Reviews    Video
Employee reviews are often neglected, or are dreaded by employee and doctor. This webinar covers the basic steps to make them effective and positive for both doctor and employee.  Approx 37 minutes.

Chiropractic Manager Webinar – Motivating Your StaffVideo  Ms. Phyllis Frase shares 5 secrets to keeping yourself and your staff motivated.

 Chiropractic Manager WebinarTeam Meetings   Summary, Video and Study Guide. This is an overview of 8 essential actions to help you improve your meetings and make them faster, more fun, and more effective. Plus, different types of short meetings that your team can grow.

 Chiropractic Manager Webinar –  The Office Manager Job Description  Summary, Video and Study Guide. This class covers 17 essential duties of the office manager. Both the doctor and the office manager should watch and discuss these duties.
 

Chiropractic Manager Webinar-  How to Best to Train Your Staff  Summary, Video and Study Guide This webinar covers eight tips  to improve the performance of your team.  Training plays a big part in team building.
 

Chiropractic Manager WebinarHow to Hire the Right Team Member   Summary, Video and Study Guide.
This webinar  covers eight priniciples for hiring the right team member from knowing when to hire, who to hire and how to hire.
 

Office Manager Webinar – It’s All About the Patient, the Doctor and the MISSION [Summary, Video and Study Guide]
There are procedures to help the patients and procedures that help the doctor help the patient and then there is Everything Else.  Tips on how to deal with Everything Else. (30 minutes)

Office Manager Webinar- Part IITips and Tricks to make the office more efficient[Summary, Video]
Part II reveals tips and tricks of what an office manager can actually do in the office on a day to day basis to make things run smoother and  significantly improve the volume and quality of services. (55 minutes)

 Office Manager Webinar- Part I – Fundamentals of Practice Management [Summary, Video]
Part I covers the fundamentals of Practice Management (55 minutes)

 

Chiropractic Marketing Webinars

Innate Marketing  (55 minutes) – Webinar plus Summary.
There are stories that float around every now and then about how some offices can simply “think”  “New Patients” and they come in.
Are these stories an urban legend? A myth, or a fact? Can staff or doctors “concept” new patients in the door. Is this true? If so, how can you do this?  10 steps to help you generate more patient visits through “concepting.”

Chiropractic Special Promotions  (55 minutes) – Webinar plus Summary.
This webinar covers different promotions by month. You will learn 2-4 different practical promotions for each month of the year. More importantly, you will learn how to organize them so that they are time effective and productive.

Patient RetentionSummary and Video
If you understand the underlying basics of patient retention your appointment book should always be full.  Covered in this webinar is: Patient retention should be based on Principles – not gimmicks. Where are we you taking your patients? Why they quit?  The cost of not getting them there.

 Chiropractic Patient EducationSummary and Video (45 min)
We go over 7 basic strategies that cover the entire horizon of patient education and explain why it is so necessary to educate your patients if you want them to be healthier.

 Infomercials.Summary and Video .
Whatever happened to Infomercials? They’re still around and they still work. And you can do them very inexpensively. You just need to know how. This webinar will give you practical examples and include forms for you to use in producing your own amateur and informational marketing that can help you create more new patients and keep the ones you have.

 Internet Marketing and Social Media. – Summary and Video . This webinar covers some fundamentals regarding social media, Facebook, and general Internet marketing. (35 minutes) (not yet posted)

 The Art of Spinal Screenings.Summary and Video . Spinal Screenings – The Queen of External Marketing.  Everyone has done at least a few  spinal screenings. You have probably had some success with them. But how much better could you do if you knew the fundamentals of this time tested external marketing activity?  This is a three part series on spinal screenings. This session we will review the most fundamental principles of screenings. Get these, and all else will follow.(45 minutes)

 Scheduling Screenings and other External Events Summary and Video .  How to Schedule External Events And Create External Referral Sources.  Types of events, Outcomes, Purpose. How to plan the events and get them scheduled.(30 minutes)

Marketing Tips: Earth Day, Spring Promotions, and other TipsSummary and Video This webinar covers: Powerful internal marketing script, Report of findings referral procedure,  upcoming spring promotions, with special attention to utilizing Earth Day as an opportunity to promote your services.

Short Overview of Chiropractic Marketing Management with Some Marketing Tips Summary and Video   This is a short version of marketing management and some tips for the upcoming months. What are the three levels of marketing?  What part does communication have in your marketing?  How to engage your patients in your marketing efforts.  Upcoming special promotions. (30 minutes)

Marketing Management, Part I and Part II – This is the longer version of how to manage your marketing, and why.

Chiropractic Marketing Management – Session ISummary and Video The Why, What and How of Marketing. Getting your Marketing off the Ground. (55 minutes)

Chiropractic Marketing Management – Session IISummary and Video  Specific Marketing Manager Duties – Your Job Description.  General Overview of the Most Effective Marketing Procedures in Each of the 11 Marketing Categories (55 minutes)

 

Faster To Tomorrow

Road to Your Chiropractic Goals in 2013

It comes at you fast. 

The New Year. Like a fast train, you know it’s coming, and suddenly, it is already whizzing past you.

Actually, each year it comes by faster.  You may not have yet fully had a chance to finish all of last year’s work, or set your chiropractic goals for the New Year.  But nothing slows down the advance of this New Year – and before you know it, it will be spring.

And come summer and fall, what will you have changed in your practice? Probably not as much you would have hoped for.  Why? Because change is coming at you so fast it’s almost too much to keep up.

And it’s not just you that is experiencing change – our whole world is changing. Faster and faster.  The political noise and tumult we hear constantly are just the symptoms of the conventions of the old grating up against the realities of the new.

Ray Kurzweil, whose predictions have been mostly correct over the last 20 years or so, predicts that by 2045 we will have computers that will be able to teach themselves so fast that the speed in which they learn will reach infinity.  This is a very rough description of the Singularity he describes in his book. (The Singularity Is Near: When Humans Transcend Biology)

           “An analysis of the history of technology shows that technological change is exponential…  There’s even exponential growth in the rate of exponential growth…  The twenty-first century will see almost a thousand times greater technological change than its predecessor…”     – Ray KurzweilSingularity

In other words, change is changing exponentially.

This New Year of change is faster than ever before.  But if we move way out beyond all the hue and cry of chiropractic philosophy, “evidence based” chiropractic, “injectables”, politics in and out of the profession, the rah-rah and rock and roll, there is a quiet universe waiting of healing and success which we may only get glimpses of.

In my opinion (IMHO) … it is a world which you, the chiropractor, have always been in. It is not a matter of reaching your goal as a healer. You are already there. Science in fact is catching up to what  D.D. Palmer talked about as the 19th Century rolled naively into the 20th.  Bruce Lipton, a professor in biology who once taught medical students at a medical school here in Wisconsin, after his research and similar epiphany, now teaches chiropractors at a chiropractic college.  He gave a wonderful presentation at Life West Presentation in San Francisco in 2012. I was there and heard him. (Spontaneous Evolution by Bruce Lipton)

Bruce Lipton

Bruce Lipton with Ed Petty
Ed Petty and Bruce Lipton

But the truth is, you, as a chiropractor, are already there. You have already ridden the wave and, to some degree, are on the other side of the Singularly.  You may not  fully realize this, the full power and truth of your profession, and I certainly don’t pretend to.  Well, maybe you do since you are reading this, but probably most doc’s don’t fully appreciate what they have with chiropractic.   But the Innate power defined and used by chiropractors is there. How else do you think it has been able to survive and persist over these 120 years through the teeth of vested interests and vicious and covert attacks – that still persist? (see Doctored, the Movie.) It is certainly not because of the great skill and effectiveness of your national or state organizations (not to discount the good work they have done here and there.)

 And this brings me to the point of this article: you have got to upgrade the architecture and skills of the management of your office.  So, while the healing aspect of your profession is, and has been, way ahead of the times, in many cases your management is not.  Military control of your staff, robotic scripts, referral gimmicks and other relics from the 60’s and 80’s have no place in the future.  Dr. Noope left the building a long time ago.  (Who remembers him?)

For you to succeed, your management and marketing has to be way ahead of the curve. The world is changing so fast that if you are not keeping up, patients will look for chiropractic offices that are.  It is that simple: lead from the future, or perish as an amalgamation of P.T., massage, and G.N.C.

It is now 2013 and by now you may have, or should have set some chiropractic goals for 2013.   The challenge now is getting there. This is also our challenge as Petty Michel & Associates consultants and coaches as well.

This year, our goal is to get you to your goals FASTER.

Faster to the future and faster to your goals. It is a challenge, but we have been developing newer and faster approaches that can help you (and your team) get more done quicker.

We want to help you get to tomorrow’s goals – faster and once there, help you stay there and enjoy the ride.  “Get There Faster and Stay There Happier.”  Yep, them’s our goals!

As the world speeds up and changes faster each day, we can whine about how we are being left behind, stoically assert our principles and pretend everything is just the same, or embrace the changes and in fact drive them forward ourselves.

On February 1st we will be announcing new management technologies to get you to your goals  faster and funner.  Or Funnier.

In either case, please stay tuned.

From the Wave, the Mountains, to Your Chiropractic Office

Dr. Bruce Lipton discussing how the environment determines behavior more than genes.

Just returned from a long winding motorcycle trip in the Sierra’s and Coastal ranges of CA. We will be posting some photos of these on the Chiromotorcycleriders.com web page and Facebook pages soon.

Also attended the Wave in San Francisco put on by Life West. The best seminar program I have seen in a long time. Philosophy is needed, but the science presented by Bruce Lipton, PhD., and others, was amazing. I can’t recommend Dr. Lipton’s books enough.

For those of you who know Dr. Lipton, he is a biologist and taught cellular biology to medical students at the UW Medical School in Madison, WI.  In doing pioneering work in cellular biology a few years ago, he realized some basic flaws in the allopathic model of health. He gave up teaching MD’s and now teaches chiropractic students at chiropractic colleges.  He says that the profession of chiropractic, and the works of its founder, D.D. Palmer, was way ahead of its time and are fundamentally correct based upon his and other’s research.

Dan Murphy, D.C; Joe Mercola, D.O.; Gary Null, PhD.; and Malik Slosberg. D.C. were some of the other speakers I caught on Friday. Oh, and of course, Dr. Sigafoose. I couldn’t stay for Saturday.

Chiropractic is fairly unique in that it does have a “philosophy.”  This gives it a soul and a purpose where other professions, unfortunately, have none.

But the nuts and bolts of studies and research that was presented demonstrated that there is abundant evidence supporting the effectiveness and progressiveness of chiropractic.

Scientific evidence is reaffirming and enlightening. At the same time, the “evidence” you need has always been there in the successes of your patient.

A while ago an office wanted me to help them with their marketing. I was happy to meet with them and they said that they had been receiving help from an “evidenced based” consultant. They said they were trying to establish relationships with MDs. I replied that was great – but I also mentioned that they did not need another license to practice chiropractic. If they were seeking permission from MDs and trying to justify their profession with “evidence” when they already had all the proof they needed with their patients, it was no wonder their practice was slowing down.

I might have been a little too direct as I have never heard from them again.

Will be posting some video clips from the Wave soon and will let you know when they are up.

Best regards,

Ed

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This Month’s Webinars – August

 

Office Manager Webinar Roles And Goals: What Are The Key Roles In Your Office? – Thursday, August 16th – 12:30 to 1:30pm CDT
A hidden barrier in many offices has to do with confusing roles and job duties. Clear these up and see how much smoother patients and paper flow, and happier the team becomes.  Small office or big health business, clarify these 7 roles and the numbers will go up.

We will also provide you with a fast test for you to grade your office on how each of these roles is performing.

Register Now: https://www1.gotomeeting.com/register/322088520

Marketing Manager Webinar: Patient Retention: 8 Practical Procedures – Thursday, August 23rd – 12:30 to 1:30pm CDT
Do your patients see you as often as they should? Do they follow through and complete their programs? If not, this webinar will cover eight basic procedures that any office can use to ensure their patients get the care they need.

By now, you probably have heard more than a few different approaches to patient retention.  It certainly isn’t rocket science. However many procedures taught at seminars are just a bit gimmicky, and in the end, don’t work. Find out, or be reminded, of what does work.

Register Now: https://www1.gotomeeting.com/register/311709721

The Theory of Constraints: How Bottlenecks Can Suffocate The Growth Of Your Chiropractic Practice And What To Do About Them

Do you work hard but you just don’t get as far as you should?  The reason may be that you are running into unseen bottlenecks that are choking off your production and suffocating your growth.

Here is an example: One doctor we worked with a few years back had a small office of about 1000 square feet. He was seeing about 140 visits week but wanted to see more. He felt the problem was not enough promotions generating more new patients.

We visited his office and noticed that he already had a decent amount of marketing underway and he was getting external new patients. While his marketing could have been more effective, it wasn’t that bad.

We noticed that the reception area was tiny and mentioned this to the doctor and suggested he move to a larger office. He had his mind made up.  He did not want to get a larger office because he had heard of doctors seeing 300 O.V.’s per week in 1000 square feet with very low overhead and he wanted to do the same.

So we set up a special focus group and personally interviewed his patients. The primary complaint was that the reception area was too small. The patients interviewed said that during peak hours there was no room for them to sit. They said that they felt that he must be too busy and therefore they would not come in to see him because he was full, and that they referred their friends to other offices.

Well, with this information, the doctor finally decided to move into a new office with a larger reception room.  Shortly thereafter, his office visits shot up to an average of 225 per week.

There are a number of lessons to learn from this story. One being not having a fixed opinion of how things should be based upon hearsay, or what may work for one doctor may not work for you. But the biggest lesson has to do with capacity. And, there are many examples of capacity restraints that we often uncover in our consulting and coaching work over the years.

Bottlenecks can occur at the front desk, in the therapy area, and in the insurance department. They can occur with the patient flow, with paperwork or in doctor time.

The theory of capacity management, as expounded by Eli Goldratt and explained in his books, including the best selling The Goal, discusses the theory of capacity constraints as applied to a manufacturing environment.  The same principle applies to a health care facility.

According to Goldratt:“Capacity is the available time for production.” A bottleneck is:  “what happens if capacity is less than demand placed on resource.”

 

SOME CHIROPRACTIC EXAMPLES:

  • Peak Periods. Between the 4-6 pm slot, where there is extra traffic, additional staff or increased capacity is not always provided. If staff feel that patients are waiting too long, or that they are not able to handle all the traffic, they may unconsciously hope the phone does not ring or another patient walks in. In turn, should someone new call or walk in, the quality of service may be poor.
  • Paperwork.  Older forms may not meet the current needs, be redundant or even hard to read.
  • Poor scheduling of patients: (not cluster booked, not booking for NP or paperwork)
  • Doctors waiting for therapy patients. (No therapy staff or therapy after adjustment)
  • Front Desk doing insurance and scheduling at each visit (no multiple appointment plan or Prepayment plan)
  • Not enough exam rooms
  • Clutter in front desk/insurance area
  • Quitting time. After a long day, all staff and doctors are looking forward to leaving and really don’t want extra patients to call or come in.
  • Backlogs. Undone reports from two summers ago, partially completed projects, cluttered desks or office space, all discourage an increase in production. You only have so much mental capacity, and if it gets frittered away on projects that are not completed, you will have “too many irons in the fire” to add any more
  • Doctor talking too much. “Table talk” should be about chiropractic, the patient’s need for care, their progress, and referrals.  Now and then, a few questions about the patient’s personal life to demonstrate your genuine interest is good. Aside from that, there is no need to justify your services with lots of talking. Keep it moving.
  • “Difficult people”. Some staff, or patients, will seem to drain you of your energy, or consume too much of your time trying to keep them happy. This can “clog” up your day.
  • Doctor too busy doing administrative tasks and micro managing. This distracts him from the work that he needs to do.
  • Doctor’s mind “filled up” with lots of experience and no longer curious or interested in practice.

 

SIX CATEGORIES OF CAPACITY IN A CHIROPRACTIC OFFICE:   We can break practice capacity constraints into 6 categories.

  1. Physical. (For example, not enough rooms, rooms too small, or just too cluttered.)Doctor. (For example, doctor doing billing, answering phones, and micro managing. )
  2. Procedural. (E.G. making 4 copies of each EOB rather than making an electronic back up)
  3. Equipment. (For example, using hand feed copier rather than an automatic feeder.)
  4. Personnel. (Not enough staff, poorly trained staff, barely competent staff preventing you from hiring superior staff, and negative staff, etc.)
  5. Doctor. (For example, doctor doing billing, answering phones,  micro managing, head “filled” with “krap!” )

 

REMOVING PRACTICE CONSTRAINTS

Here are some steps to take to remove bottlenecks.

First, start by determining what is the maximum number of patients that could be seen by the doctor if all he or she did was adjust or treat them.  What is the doctor’s capacity in terms of visits? E.G. 250 visits per week – if all she did was adjust, do SOAPs, exams, and report of findings, with 6 New Patients and 5 returning or re-injured patients.

Then, look at what eats up the doctor’s time.  Then, consider the flow of patients, of paper, and anything that slows it down or gets in its way. Consider patients waiting, paperwork waiting, and any times of the day or days during the week where there is a slowdown or backlog.  Honestly check each category below.

Once you do this, have a staff meeting, explain the concept, and get responses from the staff.

  1. Doctor’s time: What does he do other than adjust patients? Can it be delegated? Can scheduling be improved so that the doctor never waits? Does she have any redundant tasks that can be made into a routine template?
  2. Procedures: Are there redundancies? Is something being done that could be done faster?
  3. Personnel: More training needed, more staff needed, better attitudes needed?
  4. Physical space: Do you need more space? Could things be arranged differently for greater efficiency?
  5. Equipment: Could a new piece of equipment speed things up? Does anything need fixing?

Once you have done this, give yourself 30 days to fix the biggest capacity constraint. Then, reassess. If the constraint is fixed and the flow is improved in that one area, it may have migrated to another area.

For example, a doctor was doing all of the x-rays which took extra time and she was also waiting for patients because they were not “cluster” booked. Solution: staff did all the x-ray work and the doctor just came in, checked, and “pushed the button.” The front desk booked the patients tightly so that the doctor did not have gaps in her schedule. Visits increased by 40 per week, from 160 to 200 for the week because now there was more “room.”

However, now that this was fixed, the bottle neck may “migrated” to another part of the office.  Now, the insurance department can’t keep up with the extra work and a backlog starts to build up in this area.   If this does not get fixed, then the insurance department’s traffic will slow down,  like a traffic jam,  and the office visits will eventually go back down to 160 per week.

 

When your business is not expanding like you feel it should, you may have bottlenecks or hidden logjams choking and stunting your growth. Fixing these and opening up the flow, even at extra cost, will usually greatly increase production and income and be worth it.

If it doesn’t get fixed soon, give us a call.

Sometime

(copyright Petty Michel & Associates 8/27, 2007. Revised 2012. CHMS, Inc.)

A Short History of How Everything Else Has Cost You Hundreds of Thousands of Dollars and (nearly) Killed Your Dreams as a Chiropractor

When you started your chiropractic practice, you took on 2 roles: “Doctor” and “Everything Else.” As your practice grew, you became busier in your role of doctor. That is what you wanted. That was good.

But as your practice grew, your role of “Everything Else” also got busier. This was a distraction from your role of doctor, so you delegated front desk, billing and therapy duties. You still kept the role of “Everything Else.”

As your practice continued to grow with more staff – your role of “Everything Else” expanded geometrically.  This concerned you.

You didn’t think about it much because you enjoyed being a chiropractor and loved your patients, but when you were very busy, you made more money. You could take a vacation with your family, put money aside for your kid’s education, and pay off debts.  Sometimes, you could see yourself producing even more, helping more people, and being even more prosperous.

These dreams didn’t last long. Your role of “Everything Else” became more demanding.  There were more “everything else’s” crying for attention.  There was too much to do and soon you saw your patient volume dropping. Patients were dropping out of care and new patients became scarce. You had lost control.

Other doctors who were experiencing lowered income blamed insurance companies. Or the economy. Or the modern culture.  All you knew was that it wasn’t fun anymore and there was just too much work to do. Work that wasn’t chiropractic.

The fact is, you were never too sure of this role of “Everything Else” and never really liked it all that much. You didn’t have any training in it like you did as a doctor.  And when all of the “everything else’s” starting coming at you, you felt like things were getting beyond your command.

You experienced some staff turnover and now with patient volume down, you didn’t need as many staff. Gradually there was less to do in your role of “Everything Else.”

This cycle may have occurred to you a few times: numbers up, then more stress, then back down. A roller coaster.

  MONTHLY OFFICE VISITS And here is where you may be now.

If you were to add up the amount of revenue you could have made had you stayed at your highest level, or been able to go even higher were it not for your role of “Everything Else”, you might be surprised how much this “Everything Else” role cost you. Hundreds of thousands of dollars.

= = = = = =  =

If this is your story so far, don’t go away. The last chapter hasn’t been written. In fact, your next one might be completely different. Here is an introduction to it:

You read about the chiropractic Executive Freedom Package and started it.

You discover that the “Everything Else” role is really the role of the business executive. It is the role of the CEO.

You realize that all major businesses have an executive and that there are certain skills and tools as a CEO to be learned. These skills have to do with leadership, management, and marketing.

So you learn these skills and get coached on them.  In time, you get better and better at applying them.

You find a staff member and give her the role of chiropractic office manager. You get her continuously trained and give her lots of your less important CEO duties. As she gets better, you give her more.

You get someone to help you coordinate all the marketing. You give him continuous training.

You have staff meetings and get the team on board with managing the office.

All the “everything else’s” are organized into systematized procedures and delegated to your team.

Numbers go up. Your team continues to improve. They are happy about this as they are sharing in the management of the office and its success. Now that all the “everything elses” are packaged up into nice neat systems, you have time to focus more on patient care, future planning,  personal studies, and other pursuits.

You are now a better leader, better manager, and a better marketer, and your business continues to grow. Your team is happier, more people are getting served, and you make more money.

If someone had only told you about the role “Everything Else” and what it really was all about years ago you would have avoided losing so much money and wasted time.

On the other hand, now that you know what the secret is, you are on your way out of the rut you have been in and on your way to greater freedom.

You can learn more about the “Everything Else” role and how to create the business structure that puts you in command with our new chiropractic business Freedom Package here.

 

Your Chiropractic Brand

A brand is the representation of you in the marketplace. Well defined, it can cut through the thousands of health messages people hear each day so that your message is heard distinct from all others.

We have said this over and over, but you have the opportunity to make and improve your own brand.  And the way you principally do this is through an active and continuous conversation that you have with each of your patients, vendors, staff, and local businesses.

You start your conversation usually on your patient’s first visit. Then you continue it on the second and on successive visits thereafter. Also through newsletters.  Also while doing a community event, letters, or even while shopping: “Hi Bob. How did your wife do at the 5K run?”

The conversation has to be two way.  You have to listen as well as communicate.  Facebook fits right into this, but you have to post more than what you copy and paste  from the American Chiropractic Association or from Mercola. Pictures of babies, puppies, recipes from a patient with photos, and anything you feel genuinely passionate about.  Anything endearing: “Aw, look at the cute baby.” Even a bulletin board with local stories of your patients let’s others know that you are paying attention.

Your brand is based upon how you converse with your select community, your own tribe.

Here is a great quote from Seth Godin’s book, Small is the New Big.

“Markets engage in conversations, but marketing often doesn’t. The reality is that most brands are actually monologues, not dialogues.  A conversation might create a better, more robust, more useful brand but, alas, most organizations can’t handle that truth. So they do their best to do it the old way.

Big brands are dying. Little brands are doing great.”

Improving Team Performance and Developing Community Services for a Chiropractic Office

This month we cover a couple of import topics, both of which can bring you more income if managed correctly: Chiropractic Staff Performance and Community Relations Marketing.

TEAM PERFORMANCE

How well does your staff perform their duties?

Studies show that there are 3 primary methods to improve performance:

  • Deliberate Practice
  • Expert Coaching
  • Family and social support.

Natural talent is a factor, but is never enough by itself and is often overrated.

So, how well does each member of your team perform?  Are they experts? Are they ready to teach their own seminars?

And how about your how team? How well do all of you work as a team? Will they go to the Super Bowl or World Series this year?

Your office responds to training like any athletic team or musical group. If the scoreboard shows that the numbers aren’t where they should be, then individual performance or team performance is a likely reason why.

What is the fast and economical solution? Training. Coaching.  This is something you and your office manager, and each team member can learn.

Team training is not done by just one person; it is done by the team. One member helps the other member, and back and forth until both improve.

Our webinar this week covers just this topic.

 10 Tips on How to Be An Effective Team Trainer

Tools and Tips for Fast Team Training That Pay Off

Thursday, March 8th, 12:30 CT

Don’t miss it. Excellent for Clinic Owners (CEO’s) and Office Managers.

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 COMMUNITY SERVICES: External Marketing

We all live in caves.

We live in a cave house. Then we get into our cave car and drive to our cave office and stay in our cave rooms.

Meanwhile, there is a whole world out there with thousands of people that need your care, but don’t know it.  And the main thing you have to do is to just … SHOW UP and do something.

What’s so hard about that?

You all have done screenings and you all have done some kind of external events: workshops, school presentations, visiting medical offices. The hard part is not the presentation. The most difficult (and it is not difficult) is getting these events scheduled.

Ideally, you should have your community services calendar scheduled with a few external events of one kind or another every month.

This is the subject of our next marketing webinar.

 Scheduling Effective External Events and Generating External Referrals

Learn how to schedule effective events in this short webinar.

Thursday, March 15th, 12:30 Central Time.

 

How to Register

For guests, you may register for all  of these webinars, plus full access to our extensive practice building library for one low introductory fee of $250/mo for all classes.

Guest Registration Form

For all active PMA clients register immediately for these classes at: Active Client Registration.  (Register for each webinar separately. You will automatically receive your special log-in access number where you can participate via computer, or by telephone only.)

If you’d like more information visit our website HERE, or contact Linda via email at Linda@pmaworks.com, or call her at: 888-762-8808

You can also download a calendar for upcoming webinars: LINK

Freedom Package Webinars for 2012

INTRODUCTION

For 2012, we will be offering an ongoing program of training and support for chiropractic marketing managers, office managers, and chiropractic doctors as CEO’s.

We are calling this the Practice Freedom Package. Its purpose is to help free the office from financial concerns, day to day managements worries, and give it the freedom to follow its greater purposes.

Over the years we have observed that the key barriers to achieving practice success are organizational.  The barriers do not lie with chiropractic. It is not a matter of chiropractic failing the office, but the office failing chiropractic.

These failings occur as a practice grows beyond its ability to effectively manage itself.  The capacity restraint ultimately stems from the doctor who is too busy doctoring to run her growing business.

This package of webinars and services is designed to help the doctor and the office overcome these organizational limits.   More information about how and why this program works can be found on by following the link below.

FREEDOM PACKAGE WEBINARS: COURSE DESCRIPTIONS

Chiropractic Practice Marketing Webinar

When. The 3rd Thursday of each month at 12:30 Central Time.

Description. You will learn principles and accompanying action steps which will help you generate new patients from other patients, from external sources, as well as reactivate former patients and better retain the ones you have.

Each webinar will cover at least 4 practical marketing procedures that are effective in generating more patients.

Who should attend. Designed particularly for chiropractic marketing coordinators and managers, doctors and office managers.

Chiropractic Practice Management  Webinar

When. The 2nd Thursday of each month, 12:30 Central Time.

Description. You will learn fundamental principles of management with specific applications to managing a chiropractic practice and business.

Each webinar will cover at least 3 practical action steps to improve individual and group performance, efficiency, and productivity. Also, tips on working with your doctor and how to provide more support for her or him as a doctor and as the CEO.

Who should attend. Designed for office managers, practice managers, and doctor owners

♦  Executive Management Webinar
The Doctor as a CEO

When. Starting in February, the 4th Thursday of every other month, 12:30 Central Time.

Description. Using actual case studies for examples, we will see what worked and what didn’t for doctors and their teams.  We will uncover the basic principles of effective leadership and management in case and see how to translate this to your business.

This is training on how to be a prosperous CEO.

Who should attend. This is only for doctors who own their own business.

Discussion Group/Share Session

After the presentation is over, we will open up the group for those who want to stay to ask questions and also to offer their experiences and advice to share with others.

This is often the most popular part of the program as other professionals really want to hear your stories and ideas. So, hang around and share and get to know your fellow teammates from other areas of the country. (Must be ready to contribute and share a successful procedure.)

Follow Up Materials

After the presentation is over, you will receive an email with a link to a private vault of marketing materials referred to in the most recent webinar.  There will also be a short summary of our discussion. Additionally, attendees will have access to our private Practice Marketing and Management Library of information and customizable tools for practice building which you can use in your practice.

Calendar of Classes [Link]

More information about how and why the Chiropractic Practice Freedom Package (Lots more info here, though not complete.) . Link

Chiropractic Promotions for the New Year

Seems like every office we talk to or visit these days is busy – crazy busy – with patients and computers and Christmas.

But the New Year is approaching – fast. 2012 only has 12 months and the first one starts in just about two weeks. And then, before you know it, it’s February and you are wondering what you should be doing for marketing and getting the word out about your services.

 

So as not to be left behind, you should begin the New Year with a strong marketing strategy.

 

Below are some fast tips to help get you started:

 

But first… PROJECT X-3. We are finishing adding the final components into our new 2012 program, temporarily called the Project X-3. This is just the working title and we will be announcing the new program soon with all the details. It is designed to help lift you and your practice onto and into a whole new level of prosperity and fulfillment in the New Year.

 

**Schedule Patients Now. Health Never Takes a Holiday. Poster. If you are active with PM&A, you can also find a customizable version on our Members site, along with other promotions under “monthly promotions.”

 

**External Referral Sources and Event Locations. Make a list of every location where you participated in a promotional type of event. Include any business or professional that sent you a referral or helped you in some way. Then, make sure you send each a card or a gift, or just stop by and wish them well and that you look forward to continued relationship with them in the New Year.

 

**Marketing Meeting. Schedule a thorough marketing meeting soon, maybe right after Christmas. Spend a couple of hours making a list of what has worked and what you want to do and then schedule these things over the next several months. One example we recommend is:

 

**Be an Authority and Educate. People want health care information.  This is proven by the fact that 80% of Internet users search for health information on line, according to PEW Research.  8 out of every 10 people at some time are looking for health information when they go to the Internet. That is significant.

…2 ways to do this is to schedule workshops and health “awareness weeks” for the New Year. People want to know the latest. This gives you an opportunity to teach. Yes, you do have to do your homework and it takes time. But it is time well spent because as you study and prepare, you will find that you will become motivated about your subject. Besides, at least 1/3 of your presentation can be your spinal care class, so this saves you time. These types of community education programs or services not only help you generate direct new patients, but give you an excuse to promote your office and services. Sample Poster Clients can find many more customizable posters and fliers on the Members site under: Marketing Materials/ Community Education.

You can find more ideas about upcoming promotions to start your New Year here. Link

 

Best wishes for a high volume 2012!

 

Ed

Zucchini’s and Chiropractic Businesses

Home grown zucchini's

It has been a good summer.  The crops are coming in.

Growing a practice and developing a business is much like farming. It takes nurturing, care, and just the right about of help at the right time.  A plant can seem to be dormant while underground its roots are growing and getting strong.  Sometimes practice improvement seems to occur slowly even though we may be working hard.  It could be that that you are just developing the “root” system before your practice is more productive.

Your practice follows natural laws – it has its own innate life force.

Just like a zucchini does.

You have to trust in your own goodness as you do in the power that made you and gave life to your patients. That Power — it also runs through your office and eavesdrops on your thoughts and intentions.

You have to smile about the truly awesome benefits your patients and you receive with chiropractic, which we all too often overlook.

It’s not about insurance or money or policies and procedures or schedules or management or marketing or meetings – which we all can use at the right time to the right degree. In the end it’s about the help we provide and that help should not be separated from the love in which it is given or the joy that it produces.

There is truly a lot to celebrate.

It’s a good procedure to look for and have many celebrations with your patients and those you are close to. Don’t be shy about it.

Keep nurturing your practice and it will continue to produce happy patients.

Chiropractic Practice Bottlenecks: How to Increase Capacity by Removing Hidden Barriers

The theory of capacity management, as developed by Eli Goldratt and explained in his books, including the best selling The Goal, discusses the theory of constraints as applied to a manufacturing environment.

The same principle applies to chiropractor’s business. According to Goldratt, “Capacity is the available time for production.” A bottleneck is: “what happens if capacity is less than demand placed on resource.”

Bottlenecks can be hide anywhere in an office.  For example:

  1.     Peak Periods. Between the 4-6 pm slot, where there is extra traffic, extra staff or increased capacity is not provided.
  2.     Paperwork. Old forms that are redundant.
  3.     Poor scheduling of patients: (not cluster booked, not booking for NP paperwork)
  4.     Doctors waiting for therapy patients. (No CT or therapy after adjustment)
  5.     Front Desk doing insurance and scheduling at each visit (no MAP and PIA)
  6.     Not enough exam rooms
  7.     Clutter in front desk/insurance area
  8.     Quitting time. After a long day, all staff and doctors are looking forward to leaving and really don’t want extra patients to call or come in. Patients are inadvertently discouraged to come in extra, bring in friends or family , or call in during the last hour.
  9.     Backlogs. Undone reports from the two summers ago, partially completed projects, cluttered desks or office space, all discourage more an increase in production. You only have so much mental capacity, and if it gets frittered away on projects that are not completed, you will have “too many irons in the fire” to add any more. Finish what you started, and make room for more.
  10.     “Difficult people“. Some staff, or patients, will seem to drain you of your energy, or consume too much of your time trying to keep them happy.

Warning: Too much capacity can also be a barrier.

A) Personnel. A staff that has to make up work can retard production. Happy staff are productive staff, and the opposite is also true. Unhappy staff will not make for happy patients. This will also suck up the doctors time to try to remedy his “staff problems.”

B) Space. Too large of a space can disconnect the staff from each other and the patients and minimize the synergy.

 

Exercise – Getting Rid of Capacity Restraints and Bottlenecks.

Make a list of any bottlenecks in your office. Start by considering the flow of patients, of paper, and anything that slows it down or gets in its way. Consider patients waiting, paperwork waiting, any times of the day or days during the week where there is a slow down or back log. You can organize it into four categories:

Physical space
Personnel
Procedures
Difficult people
Incomplete projects

Once you have listed these, give yourself 30 days to fix all these capacity restraints.

NOTE: Bottlenecks can sometimes be difficult to locate, and even more difficult to remove.  Need help: Give us a call. (414) 332-4511