The 5 Engines of Practice Development
Which component or practice engine is most important?
Find out in this week’s article [LINK]
It was at a large seminar. Maybe Parker, maybe a state convention, I don’t recall for sure. I was talking with some doctors I knew in the hallway when one of the sessions ended. The doors opened, and the doctors who attended the presentation began pouring out of the conference room. One of them joined us.
He eagerly discussed some new promotional projects he heard about in the session. He also said that he learned some new approaches to scheduling and billing. I was interested, so I asked him some questions. Once hearing about the ideas, I said that they sounded good.
But then I asked the WHO question: “Who is going to implement these new projects?”
He looked at me, suddenly changing his demeanor as if I had insulted him by asking him such an obvious and stupid question, and he walked away.
True story. But hey, that’s what we do at PM&A: ask the tough but obvious questions.
Time and time again, we have seen doctors and staff come back from seminars with useful information that never gets applied. And there is a reason for this.
THE MISSING “WHO”
The missing WHO is your manager.
Many practices do not have a functioning manager. And for those offices that do, their manager is usually not operating as fully as they could.
Every practice, whether large or small, has a set of departments or roles. Minimally, these include:
Beyond these, there is a boatload of other tasks that fall outside of the front desk, billing, and doctoring. Who does these? Who organizes these? Usually, the business owner, who is also the doctor, does.
Dealing with these tasks can take up valuable time and energy. And this is expensive. It costs more than most business owners realize. What is a clinical hour worth? $500, $1,000, $2,000. Having the doctor spend time on non-clinical or non-growth-oriented leadership projects is expensive!
There are so many benefits for a practice to have a manager that I have long considered why doctors and business owners don’t create and invest in this position. Even on a part-time basis, it makes practical sense.
I think these are some of the reasons:
And especially,
Because of these reasons, and a few more, we have launched our manager training program. I encourage all practice owners to create the manager position in their practice and then support it. If you are ready, I encourage you to consider our manager training program.
Our program starts the week after Labor Day and is filling up. Let us know if you are interested, and let’s talk soon.
Ed
“Based on our largest global study of the future of work, Gallup finds that the quality of managers and team leaders is the single biggest factor in your organization’s long-term success.”
It’s the Manager, by Jim Clifton and Jim Harter
If you continue to work on improvement, you will see results. That’s just physics — a reduction of Newton’s laws, which state that causes create effects.
And if you keep improving what you are doing to make the improvements, the results will be even better. That, too, is physics. (See pages 47 and 256 of the Goal Driven Business!)
However, the results may not always be what you expect, at least not at first.
For example, you start adjusting your patient for their lower back pain. When they started with you, they also had a limp. After several visits, they stopped limping, but their back pain, while better, was still annoying. In time, their back pain was relieved as they continued with their care.
But what about the fact that their limp is gone, their gate is excellent, and they can walk and even run more easily? Didn’t anyone notice?
I mentioned this to someone who coaches people on weight loss. She understood immediately what I said. She referred to it as Non-Scale Victories. NSV’s, she called it!
I have been following the graduates of our first Practice MBA program carefully. I am delighted with the results, but they were not entirely what I expected. I had expected and hoped that practice numbers would increase! Well, this has been happening, in fact, in some cases, Best Evers in years.
But other pleasant surprises have been showing up. For example, chiropractic doctors mention how their offices are calmer and friendlier than before. Another acupuncture office is successfully bringing on a second associate, and another is expanding its marketing reach in entirely new and innovative ways. Even old system problems that have been buried for years are arising and getting resolved.
These and other practice improvements were not directly addressed in our training. I have been consulting for over 30 years and have never seen results like this.
I was at first puzzled by what was happening. I think I finally figured it out. Here are three reasons:
Imagine what would happen if you stuck to your exercise program consistently for a year! Yes, you might lose weight, build muscle, and improve your agility. But can you imagine how it might also affect other areas of your life?
But, like exercise, practice improvement gets put off too often. We focus on urgent practice issues, but because improvement, while important, is NOT urgent, we can tend to put it off.
We also aren’t inclined to notice nonlinear beneficial outcomes.
So, one of the lessons I have learned from our Practice MBA program is that if we continue to work ON improving our practice and ourselves, if we just keep at it, successes will occur – often in multiple areas. When they do, they should be recognized and appreciated.
Keep improving – your office, your patients, and yourself!
That’s our goal!
Ed
Responsibility Scale – Ownership or Spectator?
A few years ago, I was teaching an exercise program to a group of underprivileged kids ranging from 8 to 13 years old.
The program was part of a larger volunteer program run out of an old, dilapidated church. The kids came from a very rough environment. Keeping them focused in class was challenging, and getting them to participate was even harder.
I would start the class by going over a virtue. This might include kindness, cleanliness, honesty, or discipline. When I asked the group questions, no one would usually answer.
Except for this one time.
I asked the children what the word “responsibility” meant. In the back row – I had them all standing in rows – one scruffy-looking boy, about 10, immediately raised his hand and said: “Ownership.”
“Ownership.” I was stunned. Not only did someone answer, and quickly, but what a perfect definition!
RESPONSIBILITY IS OWNERSHIP
Responsibility is taking ownership. It is saying “I caused that.” “That is mine.” It could also be saying, “I didn’t cause that.”
It is not deferring to excuses or outside forces. Sure, there are many things outside your zone of control for which you cannot take responsibility. But your job and the group you work with are within your limits. If the office is not doing well, don’t blame it on your childhood, Spring Break, or Taylor Swift.
As an employer, you should encourage your team to take responsibility. Their job, or department, is their sandbox, too. Encourage them to offer suggestions for the entire practice as well – and listen to them.
And on the other hand, all employees are stakeholders. They aren’t working for a large and well-funded corporation or government agency. How they perform each day determines how the entire office will perform.
And something else: a friend of mine says: “Everyone is on commission, but most just don’t know it.”
CHIROPRACTIC HEALTHCARE PRACTICE OWNERSHIP
We discussed the concept of responsibility and ownership in our Chiropractic Healthcare Practice MBA program by reviewing Jacko Willink’s book, Extreme Ownership.
Some managers played it for their team meetings. I recommend you do it as well. (The link is below.)
No doubt, we all take responsibility and ownership for our work. We are professionals. Sometimes, however, our determination can slip. When you notice yourself complaining about things, know that you are slipping! Complaining IS a form of responsibility, but just a very low form.
A scale of responsibility might look something like this:
SCALE OF RESPONSIBILITY
Extreme Ownership
Ownership
Spectator
Complainer
Blamer
Apathetic
Here is a quote from Jocko Willink, and I recommend watching a clip from his TED talk with your team.
“Implementing Extreme Ownership requires checking your ego and operating with a high degree of humility. Admitting mistakes, taking ownership, and developing a plan to overcome challenges are integral to any successful team.”
― Jocko Willink, Extreme Ownership: How U.S. Navy SEALs Lead and Win
Stay Goal Driven,
Ed
TED Talk. Jacko Willink. Extreme Ownership. ( 13 Minutes)
—————————————————-
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
You may delay, but time will not.
Benjamin Franklin
Time is your most precious resource.
How you use it makes all the difference in your progress toward your practice goals.
I still remember my father remarking on my 5th-grade report card. On the back of the card was a space for comments from the teacher. The comment was something about: “Edward would do better if he did less daydreaming.”
This “comment” has haunted me all my life. I daydream. I admit it. Sometimes, this is good – I learn something new. But the challenge is not wasting the time I need to complete projects.
Goal Driven time management procedures allow us to get more done during our day’s working hours. And even though we all are familiar with the principles and techniques of time management, it helps to review them occasionally.
Here are a few techniques I have learned from others that help me. Maybe they can help you too.
Breaks. Don’t feel guilty. We all need to take breaks — a short one every couple hours or so, longer ones every day, longer ones even still every week, and so on. Breaks are a physiological and mental requirement discussed in an insightful book called The Power of Full Engagement by Jim Loehr. Just schedule your breaks.
Scheduling blocks. As a chiropractor and health care provider, you naturally block off time periods to see patients. You can use the same concept for team meetings, individual conferences, and “paperwork.”
Goal Driven. Each time block should have a goal. The work you must do and the procedures you use should all focus on the desired outcomes.
No interruptions. As harsh as this may sound, unless there are emergencies, don’t allow yourself to be distracted during the block of time dedicated to doing your work. Schedule a brief period during the day to return to the unplanned issues.
Cluster booking. Schedule blocks of time for similar activities close together. The general idea is to keep you doing what you are doing until you are done. For example, seeing 3 patients and then waiting for 10 minutes before seeing 3 more slows you down and takes you out of the Flow. The idea of Flow is not new but recently refreshed by Mihaly Csikszentmihalyi in his book, FLOW. Flow is a mental experience when you are so lost in your work that nothing else matters – you are in the Zone. It is when you are “Lost in Service.”
Cluster booking can also be applied to other services: specific therapies or rehab, a Thursday morning for seniors, or a Mom’s Saturday morning with kids. Once you are in the Flow, you become more productive.
Prioritize: Take care of the Important and Urgent tasks as you must, of course. But do not neglect the Important but Not Urgent projects. This comes from Stephen Covey’s book, The 7 Habits of Highly Successful People, and Eisenhower before him. Covey notes that the more time spent on Important but Not Urgent projects, the less time needed for urgent matters.
Sort out the tasks – The 4 D’s. As you review your inbox or new tasks that come up, sort them along these guidelines:
Many of these points, and others, are covered in my book, The Goal Driven Business. We also worked these over in our Practice MBA program.
Yes, I still daydream. I recommend it. But now, I just schedule it!
Seize your future,
Ed
—————————————————-
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.
Strengthen Your Network in December
“Remember, George: no man is a failure who has friends.”*
Three weeks till Christmas!
Yikes! Let’s make the most out of this month before we get into the fast lane of the New Year.
Take this month to connect and reconnect: patients, referral sources, team members and stakeholders, family friends – those dear to us. Share some good tidings and joy. Here are some ideas:
1. Keep the show on the road. While ensuring that everyone has time off, try to keep the lights on, the tables warm, and the greetings friendly all month. Anytime you close for a period of time, you can lose momentum. If you are closed for a few days, PACK the days you are open with visits! Remember:
2. Thank You’s to referral sources. Plan to get out and thank all your external referral sources. Show your appreciation: cards, cookies, and guest passes for intro services! Keep your network active. Remember:
3. Thank You’s to your patients. Show extra appreciation to your patients. It takes some courage and effort to venture out to see you for care. They are taking responsibility for their health, even though they may not follow all your recommendations. Have an appreciation party, send out greeting cards, give away poinsettias to families, or offer eggnog and treats from a local independent store with the store’s promotional sign.
4. Your Team. Look at your Profit and Loss for the year. If you have any extra dough, privately reward individual team members with a bonus. If the cupboard is empty, let your team know, but give them something. And THANK THEM!
5. Your Family. Don’t forget your family! Heavens! They deserve something for putting up with you this year! (lol)
6. The Spirit! Lastly, be filled with the Spirit of the season. You can watch It’s a Wonderful Life with Jimmy Stewart. Again!
The New Year will come at us fast… so take this time to absorb all the merriment, comfort, and joy you can so you’ll start fresh and filled with renewed energy in January.
So consider the actions above and Don’t Be Forgotten!
Should old acquaintance be forgot – and never brought to mind?
Should old acquaintance be forgot – and old lang syne?
With friendship,
Ed and all of us at PM&A
*from the movie, It’s a Wonderful Life
** from the book, The Goal Driven Business
—————————————————-
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.
[scheduling tools below]
If so, you want to make sure that the momentum of your patient’s care does not slow down. You want to keep them on their healthcare programs these last few weeks of 2023 and into 2024.
It is a festive time of year for family, friends, and Auld Lang Syne.
But through it all, health does not take a holiday.
Your patients still brush their teeth, take showers, and sleep. They should also stick to their treatment program, their exercise program and stay on track to better health. You and your team can help them do this.
As a subscriber, I have two gifts for you that can assist you in helping your patients stick to their schedules. (Links to access them are below.)
A tent poster that says: Health Never Takes a Holiday. Download it and print copies for the front desk or other areas to remind patients that…Health Never Takes a Holiday.
A scheduling calendar for December. Linda designed a scheduling calendar for our clients.
She says:
“The goal is to keep your patients as close to their treatment plan as possible during the hustle and bustle of the holidays! I have used monthly calendars in the past and, believe me, they help with patients keeping their schedules.
“The link will take you to a sheet with 4 monthly calendars per sheet for December – a calendar for each patient to keep track of their schedules.
We all can use support and help to keep to our goals. As long as you are friendly and have the patient’s health in mind, they’ll appreciate your scheduling efforts.
In fact, it shows you care!
Enjoy the Season – encourage your patients to do the same. Just lock in everyone’s schedule and help them keep it.
Seize better health throughout the Season!
Ed
Downloads:
—————————————————-
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.
Based upon surveys, patients want the following from their doctors and health providers (References below):
What would happen to your chiropractic or healthcare practice if you and your team committed to a 12-month Patient Service Program to improve how your office meets these five Wants? You could give each category 20 points and have everyone give each one a grade from 1 to 20. The consensus might end up with a grade of 80 points, or 70, or 92 when all 5 are added together.
Then, over the next 12 months, everyone could work together each month on each category by refining the procedures and improving service skills. You could schedule in-office team training and individual training through seminars, webinars, and even books.
Guess what would happen to the patient referrals, patient retention, and goodwill as things improved? What would happen to staff morale as their competence increased each month and they saw that patients became happier by working on improving service?
Symptomatic management focuses, as it sometimes must, on the urgent necessitates that immediately increase income. But chasing symptoms, putting out one fire after another, is a trap we can all fall into. You stay busy. There are challenges that you overcome. So, it may seem that you are moving forward. But the months and then years go by, and you look around and are still doing what you were doing years ago. Nothing has changed.
Excellent management addresses urgent concerns but also carves out time to strengthen the skills and procedures of the service team. It builds for the future. And it does so by training, coaching, analyzing and steadily improving each of the 5 service categories, the 5 Wants. Over the long run, this gives patients what they want, and everyone wins.
Help your patients get what they want.
Carpe Futurum (Seize the Future!)
References: Patients’ preferences. PubMed , HCAHPS: Patients’ Perspectives of Care Survey
—————————————————-
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.
MARKETING is everything you do to promote your business, from the moment you conceive of it to the point at which customers buy your product or service and begin to patronize your business on a regular basis. The key words to remember are everything and regular basis. (Jay Levinson)
I remember when I bought the book Guerrilla Marketing by Jay Levinson.
I was familiar with the term Guerrilla Warfare, which was often used to describe the tactics used against the U.S. in the Vietnam War. The idea is that small groups of warriors (Guerra – war, illa – little) can oppose and successfully beat large groups of warriors.
When applied to marketing, especially chiropractic and health practices, the concept is that smaller and entrepreneurial businesses can use inexpensive tactics effectively to compete successfully in markets dominated by large corporations with big marketing budgets.
I embrace and enjoy the concept when used in healthcare marketing.
For example, showing up at a county fair and signing up 80 new patients that a hospital might have won over! For the WIN! (We’ve done that and more, by the way!!)
With a small budget, using Guerrilla Marketing, hundreds of inexpensive marketing approaches can work.
But Levinson makes a vital point in his book that I think is overlooked. And this results in poor marketing.
“Consistency equates with familiarity. Familiarity equates with confidence. And confidence equates with sales.
“Provided that your products or services are of sufficient quality, confidence in yourself and your offering will attract buyers more than any other attribute. More than quality. More than selection. More than price. More than service. Confidence will be your ally.
“And consistent marketing will breed confidence.”
Here is a secret to consistency: assign someone the responsibility of marketing coordinator. As a project manager, their goal is to ensure all the marketing procedures continue. That they are consistent.
This was a fundamental element to the Marketing Manager System I wrote in 2000.
I will be covering this, by the way, on our new Management, Marketing, and Leadership course starting next week. (We have a full class for now. Our next program begins in February 2024. Let us know if you want to be on the waiting list.)
But the details are also in my book, The Goal Driven Business.
Management is not as exciting as a new marketing method, or as thrilling as an energetic motivational seminar. But managing your marketing to continue consistently produces sustained results long after the “Killer Ad” wears out or the emotional high from last weekend’s seminar dims.
Here are 8 of the 10 marketing “truths” from Guerrilla marketing. Link to the full ten below.
1. The market is constantly changing. When you stop advertising, you miss evolving opportunities and stop being part of the process. You are not on the bus. You are not in the game.
2. People forget fast. Remember, they’re bombarded with tons of messages (an estimated 2700) daily.
3. Your competition isn’t quitting. People will spend money to make purchases, and if you don’t make them aware that you are selling something, they’ll spend their money elsewhere.
4. Marketing strengthens your identity. When you quit marketing, you shortchange your reputation, reliability, and the confidence people have in you. The bond of communication is too precious to break capriciously.
5. Marketing is essential to survival and growth. With very few exceptions, people won’t know you’re there if you don’t get the word out.
6. Marketing enables you to hold on to your old customers. Many enterprises survive on repeat and referral business. Old customers are the key to both. When old customers don’t hear from you or about you, they tend to forget you.
7. Marketing maintains morale. Your own morale is improved when you see your marketing at work, and especially when you see that it does, indeed, work. Your employees’ morale is similarly uplifted.
8. Marketing gives you an advantage over competitors who have ceased marketing.
Seize your goals by continuing marketing. Never stop.
Ed
Download the Ten Truths: Ten Truths Levinson Guerrilla Marketing
—————————————————-
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.
Happy September!
Well, here we are … the start of September and four more months left to the year.
Now what?
So just a suggestion: before we all get too caught up in this new month and the weeks get away from us with all the daily duties, I suggest you set some time aside, and you and your gang plan what you can do to end the year on your best note. Set some goals that are realistic with some fun rewards.
Key is marketing, of course. There are oodles of different approaches and procedures and actives that you can do that work.
Pick a few that have worked in the past. If they are recurring, put them on a list and ensure they are done routinely.
If they are special, done now and then, get them scheduled and post them on a calendar so that everyone can see them.
Your number 1 marketing activity will always be your vibe – and your Table Talk with your patients and with your team.
I hardily recommend newsletters as these help to keep the conversation and Table Talk going. You don’t own social media platforms, but you do your email.
Social media has worked now and then for short-term advertising. But if you have been in practice for a few years, you should have quite a base of patients from whom you can nurture and keep them coming in for care. They know you and trust you and should come back. They will if you keep informing them of all the extraordinary successes (and fun!) your other active patients are having. They also have family, friends, and work associates they can refer.
Motivation drives it all, so tap into the wisdom of your tribe. They know what works, and even if they don’t, let them run with an idea, and if they are enthused about it, it might work.
Lastly, plan to win, but don’t get too serious. You and your team are helping people – and how can that not be rewarding? Don’t let the minor fractures in communications that occur on a busy day get in the way of the joy of working with teammates to get others better.
Here is a list of special promotions that have worked for fall.
Ed
—————————————————-
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.
You would think that management, by now, as a subject, would be scientific. That corporations would employ skilled managers with their MBAs from prestigious universities that effectively applied administrative technology to nurture their companies.
Nah, it’s not like that.
A research study was conducted by Nicholas Bloom* and others aimed at determining how effectively management procedures were being used in U.S. companies. They found that only 15% of U.S. companies scored above a 4 on a 5-point scale. More than 30% scored a three or lower. Companies outside of the U.S. scored much worse.
Management is primarily personality driven – a little like politics and show business. And sometimes, the mafia. Some companies do well because there is a dynamic genius at the helm. Others do well because they were there at the right time. Others appear to do well because of the money they borrow, steal, or collude with government regulators.
I know some very successful chiropractors who are good managers. But they were good mostly because of their temperament and not because of their conscious use of management techniques.
Unfortunately, most management focuses on supervision. It is a form of spectator-ism and policing. Like watching robots on an assembly line and reprimanding errors and deviations.
Good management focuses on improvement. First, keep things working, then how can we all improve it? It is servant based.
In my book, Goal Driven Business, I cover this as part of the Goal Driven System.
For practical purposes, management has two different functions:
1. Keep doing what works.
2. Continually look at how the procedures and systems could be improved.
If it worked yesterday, you should do it today and also tomorrow.
Then, improve it – little by little.
If you want to make a big change, when the entrepreneurial spirit hits you, do a trial run first. Don’t disrupt the systems that are working.
A good number of practice problems occur for one reason:
You stopped doing what worked!
This applies to the front desk, patient accounts, new patient onboarding, team management, and marketing procedures.
If it worked once, it would probably work again. Just improve it if it is outdated – and if that doesn’t work, revert to what worked.
I know – your workdays can get boring and sometimes you want to go and chase the shiny things. Fine. But keep doing what works until something proves itself to be better.
I will be teaching a management course later this year. If you are interested, let us know and we’ll get you on the waiting list. It will be for you and your manager. Each class will be small to allow for more personalized instruction.
Good management underlies all your activities – managing your patients, your practice, and even your life. And especially your future!
Seize the future with good management!
* Harvard Business Review, November 2012 Nicholas Bloom
—————————————————-
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.
(This is part 2 following the last blog on the best known marketing secret.)
Networking is a marketing method that generates referrals from your direct efforts, from your patients, and from outside referral sources you have established. This is not only the most cost-effective form of marketing for new patients but helps to retain the ones you have.
YOUR PRACTICE IS A NETWORK
If you think about it, your practice itself is a network. A practice is a network of relationships created and sustained through communication and service. This is my definition, though yours could be similar.
Networking is simply creating a connection with another person in which you both share an interest in common and enjoy talking with each other.
Networking is getting to know people — who know people.
But I would also add – getting to know people you are interested in. Effective networking can’t be faked.
THE 4 COMPONENTS OF NETWORKING
I have seen 4 major components of effective networking:
Genuine interest in people. The best health networkers are interested in their active patients, inactive patients, and people in their community.
Genuine interest in the services they provide. The best networkers are excited about their services and what they can do for people.
Give in abundance. Effective networkers are givers. They provide excellent clinical service as well as free assistance, such as health tips, special events, referrals to other providers or services, a book, or a smile. And they educate others about the health subjects their services address.
Organization. A structured program needs to be in place to ensure net-working continues.
Venues for Networking
Table Talk. This is your private time with your patient. Be curious about them and how they are doing. Then, tell them about what is interesting to you about their health, about health subjects, and your services. Often, patients may see you for back pain but may not know that you also treat headaches and other issues.
Continue the Table Talk. Follow-up with your custom newsletters. I stress this routinely. You have hundreds, if not thousands, of people you have seen whose trust you have earned. You have started a relationship with them — why neglect it? This is why, for those offices on our new Mastery program (more about this soon!), we insist on sending out personal, customized emails for you monthly.
Social media is fine, but it is different. Posting a success story or an upcoming event is fast and easy. This helps with social proof and brand awareness. I have also seen it useful in short spurts for advertising, driving readers to a lead page, or making a phone call. But organically, few people will see your unboosted post. “If you have 2,000 Facebook fans usually only 2-5 people will see each post you publish” says Stuart Marler from Retriever Digital. (Mail Munch)*
Internal Events. In-house events from workshops on health to organic farming, barbecues, appreciation days, and yoga classes — the ideas are endless. And even if only 3 people show up, well promoted, you create the image that your office is an alive and vibrant health center.
External Events. There are the usual events: the Lions Club pancake breakfast, the local parade, the 5K Walk-Run, the art fair, the County Fair, and all the summer events that local communities host. These are great opportunities to meet new people.
Some doctors network with their church, or their local school affiliation as a high school coach, or with women’s groups like La Leche. Some doctors become involved with an ethnic group, and network with them. Se Habla Espanol? Often the connections are made via the patient.
You can also start creating your group. Visit the autobody shops and create a PI referral network. Or become the go-to source for local ballet, dance, and drama participants. Or, become THE motel chiropractor in town.
ORGANIZING YOUR NETWORKING
Organization. The biggest barrier to networking is a lack of internal structured organization supporting your marketing. I covered this years ago in the Marketing Manager System. Similar to the systems for your front desk and billing departments, you should have routine procedures, stats, and someone in charge of your marketing projects. And they need guaranteed time each week to work on the marketing.
Team. Each member of your team should be a trained and motivated networker – both in and out of the office.
The goal of networking. The goal of networking is the same as the mission of your practice: to help as many people as possible become healthier.
Stay interested and curious — give abundantly and educate.
Let’s do it!
Ed
Need some tips on how to improve your networking? Let’s talk.
* https://www.mailmunch.com/blog/email-marketing-vs-social-media
—————————————————-
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.
Mining the Underground Innate Knowledge of Your Team
You may not have run into this term before… maybe you have. It was new to me before I began putting together the notes for The Goal Driven Business.
In any case, it is a concept worth knowing and one you can use to improve your business. I’ll give you an example and then define it.
It was spring years ago, and I was meeting with a motivated practice owner who was already doing well. We were discussing marketing plans for the next several months, and some of our programs ended in June. We needed something that would work for July. So I said, “Why don’t we ask the staff for some ideas?”
We were scheduled for a team meeting anyway, which I attended. After the usual topics were covered, the doctor asked the staff for some ideas for marketing in July. Now, the doctor was relatively new to the community, and the team was long-time residents. Various ideas were thrown around, and one seemed to percolate and draw enthusiasm from the staff. A popular promotion that they had experienced as local consumers in their town was “Christmas in July.” Since their community was familiar with this promotion, they were sure it would work well if it were tied to a patient referral program.
Both the doctor and I thought it was a dumb idea. However, the staff was already in high gear planning the promotion by the end of the staff meeting. I suggested to the doctor that he let them run with it. He did, and as it turned out, it was a big hit. They had one of their best new patient and office visit months ever… in July.
At another office, some years later, I was helping the doctor work out her mission statement for the practice. She and her associate were hitting speed bumps trying to come up with a simple definition. I recommended putting it to the staff to see what they might come up with. At the next team meeting, the doctor discussed the idea of a global statement for the WHY of the office and its higher goals and asked them if they could work it out as an office mission by next week.
And that is what they did. The following week, the manager and staff presented the mission statement to the doctors. The doctor emailed it to me.
I didn’t really like it as it was long and too mushy, at least for me. But the doctor approved it and posted it in the reception area. The staff loved it. It fit their compassionate attitudes towards the patients and captured their existing relationship with them. They memorized it, and it was recited after every staff meeting. Their stats haven’t come down since. They are a happy and Goal Driven group!
In our consulting, we routinely encouraged the wisdom of veteran staff to be integrated into the management and marketing of the office. We didn’t have a definition for this knowledge, but it was effective nonetheless.
Here is the definition of Tribal Knowledge according to Leonard Bertain in his book, The Tribal Knowledge Paradox:
Tribal knowledge is the collective wisdom of the organization. It is the sum of the knowledge. It is the knowledge used to deliver, to support or to develop value for customers. But it is also knowledge that is wrong, imprecise and useless. It is knowledge of the informal power structure and process, or how things really work and how they ought to. … But more importantly, it is the untapped knowledge that remains unused or abused.
There is much more to this, of course. A valuable management and leadership skill is how to elicit tribal knowledge, decipher it, filter the practical from the impractical, and put it to use.
I try to keep these newsletters as short as possible. If you want to set up a time to discuss this subject more, just make an appointment (link below). No charge for subscribers to this newsletter.
Not everything can be put on job checklists. Job checklists are very useful, but there is a wealth of knowledge just under the surface with your team, even your spouse, that can be accessed and put to good use.
By creating a culture where it is safe to contribute learned experiences in team meetings, coaching sessions, and other opportunities, improvements in your practice can be made faster.
Seeking and honoring the tribal knowledge gained from the experience of your team respects them, whether the information is useful or not. This is the essence of creating a synergistic office – where team members help each other — to help more people become healthier.
Carpe Future (Seize the future)
Ed
Want to discuss how to uncover the Tribal Knowledge in your practice, schedule a short call with Ed here.
There could be a hidden barrier that jams your growth and holds you back.
MOST OFFICES WANT TO IMPROVE THEIR NEW PATIENT ACQUISITION. That is, attract more new patients.
At least, that is what many chiropractors and other doctors will say.
Oddly enough, that is not always exactly the truth.
Michel Killen, in his book Sell Futures, Not Features, says:
“Do you want more sales? The question should really be “do you really, really, REALLY want more sales?” This might sound insane and even obvious. Of course you want more sales, who doesn’t want more sales? However having taught and coached sales for a lot of people for a long time, this is often an underlying problem that has a tendency to sabotage our sales driving efforts. …I believe that people are creatures of goal pursuit, meaning they take actions which suit their goals. This means that if a business is struggling with sales, it’s usually because deep down a part of them doesn’t want more sales. This is extremely upsetting and even distressing to a lot of people, because of course they want more sales, everyone wants more sales!””
Well, I couldn’t agree more.
CONSCIOUSLY, you probably want more new patients as you know you can see more visits and, of course, you could use the increased revenue.
SUBCONSCIOUSLY, however, there is another story entirely. The devil’s advocate pipes up and says, “with more new patients, you will come home late, miss dinners with your family, your staff will make more errors, and your notes will start to backlog. You won’t have time to exercise, and your Worker’s Comp insurance will increase.”
But because you are a strong-willed entrepreneur and a bit of a rebel, you charge ahead and spend time and money on marketing. But after a while, you notice that your numbers don’t significantly increase.
Why?
There is a bottleneck somewhere in your office, a log jam, a Capacity Constraint.
The Theory of Constraints, originally discussed by Dr. Eliyahu Goldratt in his book, The Goal, has become a management science that implements a business improvement system. Simplified, it is a process that goes after the biggest constraint in any production process. Once that is fixed, management hunts for the next largest bottleneck, which continues as a never-ending process of improvement.
We adapted this, by the way, for practice management, in our Goal Driven System. The primary goal of the Theory of Constraints is profit. However, to achieve this, we need to look organizationally for the primary roadblock.
These constraints can be difficult to recognize sometimes. Partly because they are hidden and partly because of “damn-the-torpedoes” bias on the clinic director’s part.
For example, the front desk coordinator has been with the doctor for a few years and does a good job. The doctor returns from a new seminar, or someone new in the insurance department is hired, and things change. The doctor notices a moment when the front desk assistant is not busy and assigns them extra work. This happens a few times, and soon, the front desk has become a clerical department, filing insurance, ordering supplies, verifying insurance, and doesn’t have time to ensure all the patients are scheduled. When the phone rings, they kinda grimace and hope it’s not another new patient because they have more paperwork to do. Three months later, the doctor notices that the visits are down and spends more money on marketing.
But what is the real problem? The front desk is plugged up! Sure, some extra duties can be delegated to the front desk, but carefully, and ideally done at separate times when patients are not scheduled.
I have been able to increase patient volume and new patients by helping doctors locate the stuck points, the blockages in the office and open the flows. It could be a clinical assistant that is needed, a scribe, or replacing a staff member that really wants to work somewhere else. Maybe the staff needs better training, or intake forms massively simplified, or just a friendlier and less serious clinical director.
Constraints are like being stuck in a traffic jam. They wear your team down. And they affect your motivation and desire for growth.
Physical constraints result in mental constraints.
The real problem in marketing is not always with the marketing. It is often with the management. Being the entrepreneurial doctor you are, you know enough to make marketing work. You can make it work better once you fix the management of your practice and find the constraints and remove them.
Then, watch your volume pick up and your marketing really work.
Seize your future,
Ed
Want help removing all your constraints? Make an appointment for a quick all and I am sure I can help you uncover a probable bottleneck or two and give a you a couple simple solutions that could help.
The Need for Marketing Never Goes Away
Daylight Savings Time starts in two weeks here in the U.S. And across the northern part of our Planet, Spring begins in 4 weeks (March 20th). Guess that would be autumn for you all in the southern hemisphere.
What a great time to plan your spring and summer marketing.
The Need for Marketing Never Goes Away
No matter how full your practice is, the need for marketing never goes away.
Marketing is business and business is marketing.
Putting something valuable in the marketplace that other people want and will pay for – that is marketing. And that is your business.
The type of marketing you do varies depending on the condition and circumstances of your business. If you are just beginning a practice, you must spend a large percentage of your time and budget on marketing, especially direct response marketing. If you have built up your business, the focus of your marketing can be more on retaining your patients, creating alliances, and world-class customer service and outcomes.
Marketing covers a broad spectrum of activities, but all are, or should be, designed to generate new patients and keep the ones you have.
Trends for the future indicate that, in the end, the best and surest marketing will be customer services and outcomes. The communication channels are so packed and manufactured that your messages will get lost unless you have millions to spend. And now we have AI marketing – ads that robots put together.
Therefore, the best marketing will always be personal – relationship based. You and your people — authentic and interested in your patients and the individuals in your community – delivering extraordinary service and outcomes.
Marketing Plan
Practically speaking, it helps to plan your marketing.
Plan your work and then work your plan, right? So, I have attached a sample marketing plan (link below at the end of the blog article) to help you outline what to do. It is a sample and gives structure to managing your marketing. We’ve used one like this for years, and it works. Make your own and customize it to fit your needs.
And stay tuned for a new service we will offer to help you with your marketing.
But for now, Happy Spring, and Plan your Future
Ed
How to be happier and more prosperous
One of the unique characteristics of Petty, Michel & Associates is that we visit offices and provide on-site coaching based on what we see.
I remember one doctor whom we worked with for several years. When I visited his office, as soon as he saw me, and the minute he was free, he’d say, “Ed, come on over here, let me check you.”
He didn’t ask permission.
He saw many patients in the morning and the afternoon and always took time over lunch for a workout.
He was focused on adjusting anyone in his sight. Patient after a patient. And because he was so focused, he communicated with certainty and authority and earned the trust of his patients.
If you can strip away from your mind all the administrative tasks, worries, and challenges and just focus on seeing patients, you’ll be happier and see more people.
All the “other stuff” slows down doctors, the administrative tasks that seem to multiply exponentially. Your mind can be either dominated by business concerns — or by the joy of giving and serving.
You have the skill and ability to help others, which must be honored and given full reign to be expressed to its total capacity. It shouldn’t be withheld or hoarded.
A well-trained team and a practice manager are vital. They allow you, and the other providers, to practice your art while they care for everything else.
I have talked to many doctors who visit third-world countries and flat-out adjust 100-200 people in a day. No admin interruptions, just individual after individual, courageously providing service and practicing their craft without concern about reimbursement. They have told me that they would get into a “Zone,” or into a flow… and experience an intense kind of present-time consciousness that they don’t experience in their offices.
Dr. Sid Williams, who founded Life Chiropractic University in Georgia, promoted the idea of “Lasting Purpose,” which was defined as “to give, to love, to serve in abundance without expecting anything in return.”
Being generous doesn’t mean giving your services away. Generousness is a mindset of abundance. It is not withholding your gift and craft but practicing your art freely and abundantly.
To do so, train your staff to take care of everything else and delegate the admin tasks to them. We can help with this. But it first starts by committing to a value of service generosity. In our company, Petty, Michel, & Associates, one of our core values is delivering services in “Abbondanza,” Italian for abundance.
In physics, every action has a reaction. This is also expressed in ancient texts: the more you give, the more you receive. You’re persuaded each day to get lost in admin concerns. Don’t. Get “lost in service.” Admin details need to be tended to, but only during non-patient time, and most should be delegated to your team.
Be a Giver and be generous. Educate, care for, and help more people. Take on this attitude, and you’ll have more fun and be more prosperous.
Ed
*Sid Williams quote: https://lifewest.edu/dr-sid-williams-honored-in-life-wests-sid-square/
It is a peculiarity of man that he can only live by looking to the future.
(Viktor Frankl)
Traditionally, the first of any New Year is an excellent time to take stock of the prior year and make plans for the year to come.
Goals
In business, there are two (three, but for now, we will look at two) types of goals for your business:
Setting production goals for where you want to be 12 months from now is the easy part of goal setting. The hard part is working out the organizational support you will need to achieve your production and collections goals. It could be more than you think!
But keep this in mind:
chiropractic and your services are never the primary barriers to practice success.
It is always management. It is the administrative issues connected with organization, including marketing, that gum up the work, gets in the way, slows your business down and holds you back.
Motivation
Part of management is managing your motivation. Yep… motivation needs to be managed. Keeping your spirits high and your drive strong is necessary for an organization to flow.
And this takes us back to your goals.
Visualizing achieving your goals will stimulate your motivation – and your drive. If you can’t see any way to your goals, well, that can be depressing. But if you can… if you can envision accomplishing your future goals, you will be motivated.
Viktor Frankl
I reference Viktor Frankl in my book, The Goal Driven Business.
Speaking of his experience in a concentration camp, “As we said before, any attempt to restore a man’s inner strength in the camp had first to succeed in showing him some future goal…”
He also said, “Even when it is not fully attained, we become better by striving for a higher goal.”
For your goal setting for the New Year, I recommend you start with your higher goals, the 3rd type of goal, which are beyond production and organization. For example, what brings you bliss? What gives you meaning?
Begin with these goals – the higher, wilder, richer ones. Then, look at your production goals, then your organizational goals.
I encourage you to dream just a bit and look at next year as your playground. What higher, richer, and wilder adventures would you like to accomplish?
Have some fun considering these types of goals and all the ways you would like to achieve them. This will add zest and a special spirit to your production and organizational goals.
Help with Your Future
We want to help you with your future. Your work is important, and helping you achieve your goals has been a driving force and a higher goal within our company for over 30 years.
For 2023, we have a few openings for our Private Client status on our Goal Driven Program.
If you are interested in working with us, please reply to this email, and we will schedule a time to talk.
All of us at Petty Michel & Associates want to help you achieve your goals in 2023
Seize the Future! (Carpe Future)
Happy New Year
Ed
Reference. More information on this is covered in sections in The Goal Driven Business, starting at page 19 and page 116.
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
“People often say motivation doesn’t last.
Neither does bathing — that’s why we recommend it daily.”
(Attributed to Zig Ziglar)
I want to thank you for continuing to subscribe to this newsletter.
It has morphed into a kind of Tuesday’s Tips for Goal Drivers.
This newsletter has gained momentum over the last year from the publication of my book, The Goal Driven Business. It is written for that part of us that strives to achieve our goals.
The value of goals just can not be overstated. But “goals” cover a wide range of concepts and so can become confusing or even worse, boring.
But by frequently reconnecting with WHY you do WHAT you do, what you do becomes easier and more effective. And even more fun.
Why you do what you do is your motive — or your motivation.
Motivation to achieve your goals is senior to organizational procedures — but still needs organization to support its drive. When organization fails, as it often does, motivation is weakened. And organization is directly dependent on having the discipline of doing what needs to be done.
I don’t see the subject of discipline brought up too often in practice management conferences or discussions. It’s embarrassing, perhaps. Whether it is coming in late to see patients, not doing a thorough case review, or neglecting your support team, the little oversights can take a toll on our motivation.
Attending new seminars can give you a temporary buzz and momentarily motivate you. But unless you and your team have the discipline to stick to your values and procedures, the drive to your goals will lose its energy.
In his book Good to Great, Jim Collins talks about how successful businesses create a culture of discipline. He says, “It all starts with disciplined people…Next we have disciplined thought. You need the discipline to confront the brutal facts of reality, while retaining resolute faith that you can and will create a path to greatness.” “Finally, we have disciplined action.”
In a less academic way of saying the same thing, Mike Rowe said, “Work ethic is important because, unlike intelligence, athleticism, charisma, or any other natural attribute, it’s a choice.”
The way to stay motivated is to stay true to your mission, values, and procedures and to frequently take time to face the “brutal facts” of your performance and your WHY.
Like bathing, the process never ends… and keeps you clean!
Seize your future,
Ed