Category Archives: Goal Driven

Accountability Can Create a Goal Driven Chiropractic and Healthcare Practice

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Practice owner overseeing a goal driven chiropractic business

From Personality-Driven to Goal-Driven

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

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

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

In every case, the objective is the same:

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

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

An essential difference is accountability.

HOW ACCOUNTABILITY TRANSFORMS A PRACTICE

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

But a structured accountability system changes this.

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

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

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

THREE DRIVERS OF A GOAL DRIVEN CHIROPRACTIC PRACTICE

1. Clear Ownership of Outcomes

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

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

2. Regular Review and Supportive Feedback

Numbers must be:

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

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

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

3. Clear Purpose

Numbers without purpose become mechanical and soulless.

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

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

A SIMPLE EXAMPLE of CREATING A GOAL DRIVEN CHIROPRACTIC PRACTICE

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

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

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

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

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

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

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

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

And, as always, stay …Goal Driven,

Ed

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

**References

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

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

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

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

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

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

Thoughts on The Goal Driven Business

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

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

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

The Hidden Power of Patient Testimonials in Chiropractic and Healthcare that Go Beyond Marketing

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women healthier and pain free after chiropracticIn this newsletter I was going to show you some neat tricks to improve team accountability. Accountability is a powerful and positive trigger that drives excellent practice performance.

But something happened just before I started the article.

I received a patient success review from a doctor we work with.

It read it and…WOW! What a success! What a Win! (It is below!)

And I thought – boy, this is really good for marketing. But reviews like this also have other practical uses in your practice that may be overlooked.

Mostly, these are marketing tools—patients give reviews to let the community know what you do. They’re legit and one of the absolute best methods to sell your services. I’m sure when you buy products on Amazon, you look at the reviews. Right?

But patient reviews have 2 other very powerful benefits that may be overlooked.

Two Hidden Benefits of Reviews in Your Chiropractic Practice

First, they reinforce wins for your patients. A patient comes in barely able to move. You adjust them. They get better. And then—they start to forget how bad it was. It’s human nature. We adapt to our new normal fast. Or their wins come on so gradually they don’t even notice the change.

When patients write their reviews, they reconnect with where they were and recognize where they are now. That testimonial becomes their documented “why” — why they’re investing in care and why they’ll stick with their treatment plan.

Second, patient reviews keep the WHY in mind for you and your team.

The daily demands and deadlines that are required working in a practice, for the chiropractor and staff, can bury the reason you work in this profession: to help people heal.

Reading chiropractic patient testimonials reconnects you and your fellow team members to your purpose and the purpose of the office. When Mrs. Johnson writes about finally holding her grandson without pain, or the athlete describes returning to their sport—that’s not marketing copy. That’s meaning. That’s impact.

That is the essence of health care.

The Joy of Practice

If you can stay connected to the wins of your patients, I think you’ll find that practice stressors, or “onset burnout,” will start to melt away.

So,

Keep generating patient reviews. And if you aren’t, do so.

Get them posted so your community can see what you do: website, social media, Google Business profile, and your newsletters.

Read them. At weekly team meetings, staff and doctors can take turns reading one or two patient successes. I have seen patients how up at team meetings and at spinal care classes to talk about their wins!

Patient testimonials aren’t just marketing assets. They’re memory landmarks for patients who might take their wins for granted.

They’re purpose statements that remind the entire team what you all are really doing there. They’re the antidote to the sometimes-dreary aspects of practice management.

So yes, get the reviews for marketing. But also share them with each other. Let them be the thing that brings everyone back to why you all do this work.

And stay driven to enjoy the wins,

Ed

The public patient review I just read.:

Doctor Max is an absolute miracle worker. He is the best. I went to him a month ago basically as a last resort. I had tried everything else, and I mean everything. When I went to see him, I could barely walk. I had to use a cane. Getting in and out of vehicles was soooo very painful. I had sciatic pain, lower back and hip pain and could not bend my knee at all. Regular doctors told I would need a knee replacement. Nope..,not doing that. Doctor Max took X-rays of back, neck, hip and knee. Immediately he had a course of treatment. Now, after 1 month of treatments, 3 times a week, the change is a true miracle. I feel like a new woman (and that is tough to do at 80 years old LOL). I’m still going in for treatments to continue healing to make sure my body stays in great condition. I am convinced, if I had not found Doctor Max I would be in terrible shape and facing a knee replacement I did not need to have. Not only is Doctor Max great, but his staff is wonderful.” Cindy B

Leaders Like You – in Chiropractic and Healthcare Practices

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Doctors and team members of Excel Chiropractic, Lake Geneva, WI

Empowering Others in Chiropractic Healthcare Practice

You are a leader.

You may not consider yourself a leader. But you are. So is everyone on your team.

Not only by the service you provide, but by the example you set.

What is leadership? Let’s take a look to see if you fit:

  • “Leadership is not about who you are or where you sit. It’s about what you do to make a difference in the lives of others.” — Jim Kouzes & Barry Posner, The Leadership Challenge
  • “Leadership is not about being in charge. It is about taking care of those in your charge.” — Simon Sinek
  • “Leaders become great, not because of their power, but because of their ability to empower others.” — John C. Maxwell

I think you’ll have to agree, both you and your team are leaders. Servant leaders in chiropractic and your healthcare practice.

But, as you know, leadership is tough. It isn’t easy.

But you did it in 2025.

You helped others in big ways and small, regardless of your role.

It is possible, quite likely in fact, that you may not have acknowledged the vital role you and your teammates played in the wellbeing of others last year.

Why not? Well (lol) … because of all the #@#% that occurs when trying to get things done. The list can go on and on… there is so much noise and changes that occur in practice that sometimes it is difficult to see the road we are on.

But, you made it through another year. And in your wake, people are better.

All of us at Petty, Michel and Associates are proud to work with you. We appreciate your struggles and celebrate your wins as independent health care leaders!

In this New Year, stay true to you purpose and your role as the servant leader that you are – and your path to your goals in 2026 will be straighter and more certain.

“We never know how far reaching something we may think,
say or do today will affect the lives of millions tomorrow.”
B.J. Palmer’s 1949 book The Bigness of the Fellow Within

Ed Petty

Keep Hope Alive in Chiropractic and Healthcare Offices

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Previously published at GoalDriven.com

two young teens visiting an older gentleman with thanksgiving dinner.

A Message from the “Head Office” ?

Early Thursday morning, I drove to a suburban high school with two of my grandkids. We were participating with others involved with a service organization called Community Projects for Seniors here in Milwaukee.

When we pulled into the expansive parking lot, we saw hundreds of cars and people driving through designated stations, receiving boxes of hot Thanksgiving dinners to deliver to seniors across Southeast Wisconsin.

The loading was well organized and ran smoothly, despite everyone being volunteers. Everyone looked to be having a good time, smiling and high-fiving in the early morning, freezing temperatures!

The two grandkids and I delivered 51 meals to residences in a low-income section of Milwaukee. It was a good experience for them, knocking on apartment doors, wishing seniors a happy Thanksgiving, and sometimes offering short expressions of care and interest or best wishes for the Packers (professional football team) later in the day.

As we were getting to the end of our route, a senior gentleman, must have been 6′ 4″ or more, after accepting the meal, looked dead at my grandkids and said, “Keep Hope Alive.”

Keep Hope Alive

“Keep Hope Alive” was a phrase Rev. Jesse Jackson often used when he ran for president in 1988. Jackson participated in the Selma marches in 1965 and became a close aide to Dr. Martin Luther King Jr.

The Selma marches included Bloody Sunday, when 600 unarmed peaceful civil rights protesters were violently attacked and beaten, some unconscious, by state troopers in March of 1965 in Selma. The Voting Rights Act of 1965 was signed into law by President Johnson, guaranteeing the right to vote for African-Americans, especially in the South.

But here we are in 2025. What did this resident mean when he said “Keep Hope Alive” as he accepted the Thanksgiving dinner? Why did he say it to two suburban kids this Thanksgiving?

Unlike most of the other people we handed dinners to, he was the most cheerful. Perhaps, for him, an elder and certainly not well-off, he had hopes for a better future.

A better future for himself — and maybe for others.

Keep Goals for Your Chiropractic and Healthcare Practice Alive

The word “hope” is defined as the feeling of trust that something wished for can or will happen. The derivation of the word “hope” traces back to Old English “hopian,” meaning to expect, or look forward with confidence in a positive outcome.

Hope is more than just wishing… it is expecting what you want will happen.

Kinda sounds like a goal, doesn’t it?

You know, you can receive messages that are meant for you – from others.

Someone I know calls these “Memo’s from the Head Office!”

I think that, for me, the “message” from the senior gentleman was that any hope, or goal, for a better future must be actively kept alive.

That means, your dreams and goals for the New Year, including your chiropractic and healthcare practice, can’t be made and then parked.

They need to be kept alive.

Maybe his message was meant — for you too!

😊

Keep Hope — and Your Goals — Alive.

Ed

How the Gratitude Attitude Helps Healing in Your Chiropractic and Healthcare Practice

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Previously published on Goal Driven

gratitude with attitude thanksgiving message from pmaworks

The Gratitude Attitude: Proven to Speed Healing and Grow Chiropractic and Healthcare Practices

I don’t know about you, but I just like saying…” Gratitude…Attitude.”

There are plenty of studies on this subject – how just being grateful can improve health outcomes.

Here are just a few highlights:

  • Fewer aches and overall better health – Grateful people report less pain and are more likely to take care of themselves (exercise, regular checkups, etc.) (Emmons & McCullough, 2003 – UC Davis. My old alma mater!)
  • Heart failure patients who kept a gratitude journal for 8 weeks showed reduced inflammation, better heart-rate variability, and improved sleep (UC San Diego, 2015)
  • Lower blood pressure in grateful individuals (Teixeira et al., 2024)
  • Reduced depression and anxiety (Seligman et al., 2005)
  • Better sleep quality (Wood et al., 2009)
  • Improved diabetes management (multiple studies, 2010s–2020s)
  • Stronger immune function (University of Utah & others, 2003–2021)

The list can go on and on.

Two Simple Ways To Use This In Your Practice Right Now

  1. With patients – At the end of a visit, ask your chiropractic and healthcare patients to name 3 things they’re grateful for today (family, a sunny day, the fact they can walk into your office, etc.). Studies show this tiny habit alone can accelerate their healing.
  2. With your team – End your next team meeting by going around the room: everyone shares one thing they’re grateful for in the practice. I have seen this done, and the practice has grown as a result!

The benefits of gratitude may seem obvious and something we already know, but they can be easily overlooked. We focus on our daily challenges and can take for granted the people who support us, and who have done so in the past.

Faced with patient and practice demands, we can under-appreciate the opportunity we have to live an extraordinary life helping others.

So it is good to take time – right now — to give thanks.

Best wishes to you this week, wherever you are.

All of us at Petty Michel & Associates are truly grateful for you – and all you do to make the world and your community a better place!

Sincerely,

Ed

P.S. (On the other hand, you have to be careful!- You know you’ve overdone the Gratitude Attitude when you stub your toe and automatically think, “I’m so grateful I have toes to stub! And a chair to stub them on! And nerve endings that let me feel pain! Pain is a gift. This is so much amazing!” Ha-Ha! A little humor for ya! 🙂

More P.S. Here’s an old-fashioned poem:

Thanksgiving (Edgar Guest 1881 – 1959)

Gettin’ together to smile an’ rejoice,
An’ eatin’ an’ laughin’ with folks of your choice;
An’ kissin’ the girls an’ declarin’ that they
Are growin’ more beautiful day after day;
Chattin’ an’ braggin’ a bit with the men,
Buildin’ the old family circle again;
Livin’ the wholesome an’ old-fashioned cheer,
Just for awhile at the end of the year.

Greetings fly fast as we crowd through the door
And under the old roof we gather once more
Just as we did when the youngsters were small;
Mother’s a little bit grayer, that’s all.
Father’s a little bit older, but still
Ready to romp an’ to laugh with a will.
Here we are back at the table again
Tellin’ our stories as women an’ men.

(The rest of the poem.)

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

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

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

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

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

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

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

= = =

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

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

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

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

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

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

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

Back to L.L. Bean and Patagonia

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

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

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

Purpose and Values of Your Healthcare and Chiropractic Practice

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

And, their discipline to stick to them!

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

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

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

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

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

So…

Stay Goal Driven!

Ed

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

Building a Practice Through Relationships

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a happy bus driver like a chiropractor with happy people on their bus

Advertising has always been important. When we grew our Wisconsin network to 25 offices, we invested heavily in newspapers, shared mailers, radio, and even TV. Today, the focus has shifted to social media, SEO, and now Artificial Intelligence — positioning your practice for AI discovery will soon be essential (more on that later!).

But advertising is expensive. What truly sustained our growth was relationship marketing — connecting authentically with patients, referral sources, and our own team.

What Is Relationship Marketing?

Relationship marketing involves creating trust-based relationships with patients and referral sources, generating loyalty and organic referrals through genuine care and ongoing connection.

Examples:

  • Host a community event like a holiday food drive — invite patients and their families to participate and offer consultations in exchange for donations.
  • Encourage patients to refer loved ones with a personal touch (“Let’s check your spouse before their next soccer game!”).
  • Build partnerships with local professionals — massage therapists, trainers, or nutritionists — and support each other through referrals or shared promotions.

Your Most Important Relationships

Don’t overlook your team. When doctors and staff work together with shared purpose and positive energy, patients notice. It’s almost magnetic — phones start ringing and old patients return.

As Stephen Covey reminds us in The 7 Habits of Highly Effective People, success comes from empathy, communication, and a win-win mindset that creates synergy — or, as some might say, Universal Intelligence at work.

GETTING AND KEEPING PEOPLE ON YOUR BUS

As a doctor and clinic director, you are like a bus driver. You aim to make sure you are on time and complete your shift according to schedule.

One day, you turn around to look at the back of your bus and wonder why there are so many empty seats. “Where is everyone?”

Well, maybe you missed some stops and the people never got on! Or, you didn’t take time to say “hi” when they boarded, so they all left at the next stop. Or, you were so busy driving, you didn’t ask about your assistant’s new workout routine.

Take time to connect with people.

More than anything, you are in the people business.

Enjoy the ride!

Ed

“What’s Wrong with a Chiropractic and Healthcare Personality Practice, He Asked?”

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a group of women sitting at a chiropractic vendor booth waiting for potential clients to stop by and visitJust wrapped up an outstanding chiropractic convention put on by the Wisconsin Chiropractic Society here, you guessed it, in Wisconsin!

We enjoyed catching up with old friends, some we’ve known for decades. And making new friends.

For more on the Convention, you can check out our Facebook site, link below.

Personality Practice

While I was out listening to a presentation, I was told that a doctor dropped by the booth and asked about my book, The Goal Driven Business. He was told that it was about how to improve profits and outcomes by shifting from a personality-driven practice to one that was goal-driven. He felt that the personality practice was better.

I am sorry I wasn’t there to explain more – and hopefully he is reading this email.

Let me explain: A Personality Driven practice is propelled by the doctor’s behavior – their feelings, attitudes, and habits. What they personally do.

When opening a new office, the new business owner, of course, builds their new business on their behavior. It is their ambitious determination that is driving the initial growth of the practice. So, yes, a Personality Driven practice works at the launch of a new endeavor. What else is there? A dream, and the raw desire to manifest it.

So, the Personality-Driven practice works — at first.

However, after the practice is up and running, it needs to transition into a Goal Driven and systematized business.

The concept of a systematized business was hugely popular in the 1980s, thanks to Michael Gerber’s book, The E-Myth. In it, he says:

“The system runs the business. The people run the system.”

B. J. Palmer said something similar, much earlier. And he built a school that many of you may have attended. In his book, Up From Below the Bottom, he says:

“The size of a chiropractor’s business depends upon:

1st – His ability to notify people who he is, what he is, and where.

2nd – His systematization to take care of it as it grows and increases in volume.”

Gerber comically explains what happens when you don’t have systems running your business.

“If your business depends on you, you don’t own a business—you have a job. And it’s the worst job in the world because you’re working for a lunatic!”

–Making the Shift from Personality Driven to Goal Driven–

Making the SHIFT from a Personality Practice to a Goal Driven business is not easy. This is because you have established survival habits that have shown you that the practice depends on you, your feelings, attitudes, and overall behavior. You are the doctor, after all. You see the practice as DOCTOR-CENTERED.

A better approach, I recommend, is to keep it GOAL-CENTERED.

There are two echelons of goals to consider:

  1. Higher goals, including your purpose and “why.” This is your North Star.
  2. Practical goals, or outcomes. For example, you could have front desk goals (percentage of appointments kept), Billing and Collections goals (percentage of collections), and marketing goals (new patients and returning patients), and patient goals (patient completing tx program with an excellent review.)

Get your team on board with these goals. If you do, they can now help you put together the best approach to achieve your goals. These are the systems.

So: Personality Practice – YES! When starting a new business.

But once it is running, NO. Gradually back out and put in place goals and systems. And train your people on these.

For more details, read The Goal Driven Business.

If you want help with this, contact me. I’d love to help. (Been doing this for a while, so lots of tips!)

Services@pmaworks.com

Stay Goal Driven. Stay Free!

Ed

Photos of us and our friends at the Chiropractic Society of Wisconsin Fall Experience

Why Clear Roles Build a Stronger Chiropractic & Healthcare Practice

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team players wearing staff hats front desk billing promotion marketing

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

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

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

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

—

The Three Elements of Every Role

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

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

Example – Front Desk Role:

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

—

 Action Steps for Your Practice

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

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

Stay Goal Driven,

Ed

Want More New Patients in Your Chiropractic or Healthcare Practice? Start Here.

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chiropractic team going over stats to improve care and service

Most doctors think the first step to getting more new patients is marketing. But that’s not always true.

Years ago, a large chiropractic office asked for help because their new patient numbers were slipping. After analyzing their situation, it was clear their promotions were weak—but the real problem went deeper.

The senior doctor, in practice for 20+ years, had become bored. Patient visits felt routine. Long-time staff were stuck in old habits. Meanwhile, the two younger doctors had enthusiasm but lacked confidence and experience.

We started by focusing on quality of care, not ads. The senior doctor began coaching the new doctors on cases and patient communication. Staff refreshed their service procedures and rehearsed ways to create a stronger patient experience.

The result? Without launching a single new promotion, new patients and visits went up. Only after that did we create a marketing calendar—because now they had something truly worth promoting.

The Lesson

Before you spend time and money on external promotions, make sure your practice delivers the kind of care that inspires patients to return and refer. Quality care and continuous improvement are the foundation of real growth.

As Stephen Covey said, “Sharpen the Saw”—renewal and improvement keep the drive alive.

Stay Goal Driven

Ed

Read the full article here: Goal Driven Blog

Improving Case Acceptance and Patient Follow-Through in Chiropractic Care

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chiropractor discussing patient finances and treatment plan with patient

Seven tips to help others achieve their health goals.

I often read promotions from other chiropractors emphasizing the importance of “Day 2.”

And I have no argument about this.

However, I have known chiropractors who did well with a 3-day onboarding process, as well as a 1-day process.

Everyone does what they feel comfortable with. You should, too. But you should always strive to improve. This will show up in your statistics;

  • First Visits to New Patient Percent
  • Patient Visit Average (Retention – Visits/New Patients)

We routinely monitor these with our clients and discuss them monthly in our management meetings where we set up monthly strategies for improvement.

There are many details involved in setting up the best practice for onboarding patients. Again, everyone has an individualized approach.

I want to highlight seven factors that are sometimes overlooked.

In Chiropractic, It Starts With Trust

 

  1. Day 1. Before working on your Day 2, review your Day 1.Your prospective patient wants to know that you know them. Seek to really understand them and their complaint. It’s OK to go off script – what are you curious about?The byproduct of this, aside from learning about their condition, is establishing trust. By reason of your genuine curiosity, you demonstrate that you care about them as an individual, not just as a “new patient.”
  2. Specific. After day 1, you know them, their subjective complaint(s), and have discovered the objective cause.In your Report of Findings, you want to be specific about what is causing their issue. “Right here, Mrs. Jones, you have a subluxation at L-4, irritating your low back and hip.”This may not be the words you use (or might not be clinically correct). But your patient wants to know definitely what is causing their issue. Be as specific and as objective as possible.
  3. Certainty and Confidence. Communicate clearly with confidence your ability to help them get better. This begins the healing.
  4. Patient Financial Consultation: Prepare chiropractic payment agreement forms in advance, using insurance or cash details. Ideally, staff should meet with patients before treatment to outline payment options, agree on the best form of payment, schedule appointments, review procedures, and provide information about available family discounts. *(Contact Lisa for tips on this procedure. She’s an expert!)
  5. Flow Chart. List all the key procedures on Day 1, Day 2, and each day thereafter that you and your team will do to start a patient on a care program and keep them coming back to complete their care plan. Review this list with your team every two months, or more as needed.
  6. Practice. How does every athlete or musician maintain their edge, let alone improve? They practice! Set aside your ego and practice with one of your doctors or a staff member. Let everyone participate in improving the procedures. Use the flow chart as a guide.
  7. Manager. Your practice manager should work with you regularly to ensure that these steps are in place. We cover this on our Practice MBA this October. Consider enrolling them in this program.

There are certainly more steps involved — but they all rest upon the foundation of the trust you built on Day 1. If you have low conversion or if patients are dropping out of care, look to Day 1 first and then work forward from there.

Help patients achieve their health goals and…

Keep them Goal Driven,

Ed

*Shout out to Dr. Brad Glowacki and his seminar that goes deeply into Day 1 and Day 2. [Link]

Preventing Procedural Atrophy in Your Practice

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eroded asphalt highway

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

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

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

 Solution 1: Set the Standard – Quality

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

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

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

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

 Solution 2: Accountability Reviews

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

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

Ed

Scripts are Secondary in Your Chiropractic and Healthcare Practice

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female chiropractor discussing care plan with patient

Why Scripting Can Fail—and How to Make It Work

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

Connection Comes Before Words

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

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

How to Create the “Carrier Wave”

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

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

Using Scripts Effectively

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

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

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

Ed

The Power of Intention in Your Chiropractic and Healthcare Practice

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In the daily routine of healthcare—especially chiropractic work—it’s easy to get lost in the mechanics: forms, schedules, insurance, and technology. But behind all that is something far more important: people.

You’re not just working on bones or adjusting spines; you’re working with *life*. Your mindset, intention, and emotional presence directly impact your patients’ healing. Research supports this: for example, a British study found **a 61% improvement in outcomes** when providers maintained a positive, optimistic attitude.

Some healing modalities—like certain chiropractic techniques and practices like Reiki—explicitly incorporate intention as a key part of their method. This isn’t just theory; there’s growing scientific evidence supporting it.

Practical Ways to Use Intention in Your Practice

1. Present Time Consciousness
Before seeing each patient, take a brief moment to focus. Set a clear intention for their healing. One doctor used a subtle button sound to remind himself to be fully present.

2. Reinforce With Positivity
After adjustments, reinforce the moment with confident, uplifting words like “That adjustment felt great,” or “This is going to help.”

3. Leverage Collective Intention
Studies, including those by author Lynn McTaggart, show that intention becomes more powerful when shared by a group. Apply this by:

  • Partnering with patients– Get their buy-in and visualize outcomes together.
  • Team meetings – Discuss and send focused intention toward helping specific patients improve.
  • Group classes – Encourage collective healing energy and goal-setting among your patient community.

Intention isn’t fluff—it’s a tool backed by experience and research. Use it deliberately, involve others, and watch your results shift.

Read the full article with references at:  Goal Driven.com

Ed

Coaching Your Chiropractic and Healthcare Patients

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Consider adding this to your Report of Findings

 

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

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

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

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

Pretty standard, even now.

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

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

But the last element he emphasized: Effort.

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

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

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

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

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

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

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

  • Time
  • Repetition, and
  • Effort.

Keep caring, coaching, and stay Goal Driven.

Ed

He walked away when I asked, “Who is going to do it?”

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distressed overwhelmed male business man When you are the bottleneck

Many years ago, I attended a large chiropractic conference. I was new to the profession and curious about how things worked.

One of the seminars at the conference was on how to generate new patients. There must have been several hundred in the room. The speaker was charismatic and had some sensible recommendations. The audience seemed enthused.

I was sitting in the back of the room. When the seminar was over, I was one of the first to leave and walk into the hallway where attendees began to cluster to discuss the presentation.

I remember one doctor in particular. He was tall and had his name tag with ribbons hanging down. I didn’t understand what the ribbons meant, but I figured he must have been important.

I asked him how he liked the seminar. He was deliberate, almost authoritative when he said that he liked it and was going to implement some marketing projects. I told him that I thought that was good.

But then, thinking about it, I asked him, “Who in your office is going to do it?”

I remember him looking down at me. He seemed perturbed, as if I had insulted him. He looked up and walked away. Didn’t say a word.

I’ll never forget it.

This was a long time ago, but it made an impression on me.

REMEMBER THE OLD MAXIM
“Do what you do best, and delegate all the rest.”

You can’t do it all.

In the beginning, when starting and growing your practice, yes, you pretty much had to do most everything.

But at some point, you must create other team members who are trained and motivated to share the load. I know practice owners know this, but it’s easier said than done.

This is why a manager is so vital to your practice. Your manager is the fulcrum point that helps you make a team. They are a servant to the team — as you are to your patients.

They help put in the systems that allow all your internal and external marketing procedures to be effective. And not just marketing. Standard procedures for patient retention, patient services, patient reimbursement, and so on.

They take the load off of you, so you are not the bottleneck!

We’ve found that most staff and managers are very willing and want to help their offices grow. But in most cases, they are not sure how, or how best to work with their team, or their doctor.

It is because of this we have developed our Practice MBA program.

Take time each week to train your team.

And for some of you, our manager training program is just what you need to answer the question,

“Who is going to do it?”

Stay Goal Driven,

Ed

P.S. Get on our Waitlist today to ensure you get a spot. First come first serve. Only 15 spots available this fall.  [LINK]

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

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

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

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

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

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

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

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

Ed

References:

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

Discipline Drives Chiropractic Practice Success

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The Role of Discipline in Practice Success

Success in chiropractic or healthcare practices often correlates with discipline, much like weightlifting. While not universal, many successful doctors embrace the discomfort and effort required to achieve their goals, similar to consistent training.

Why Discipline Matters

Discipline means doing what’s necessary, even when it’s tough, and avoiding distractions or shortcuts. Like weightlifting or enduring hard work (e.g., the author’s father throwing sawdust down his shirt to toughen up for a grueling job), disciplined professionals push through challenges to achieve lasting success.

Jim Collins’ Insights on Discipline

In Good to Great, Jim Collins identifies discipline as key to transforming good businesses into great ones, applicable to chiropractic practices:

Disciplined People:

  • Leadership: Great leaders prioritize the practice’s success over personal gain, showing diligence and humility.
  • Team: Hire self-disciplined staff who don’t need micromanaging.

Disciplined Thought:

  • Face tough realities with courage while maintaining faith in long-term success.
  • Focus on what the practice is passionate about, excels at, and can profit from (Hedgehog Concept), avoiding distractions.

Disciplined Action:

  • Success comes from persistent, incremental efforts, like pushing a flywheel, not one grand action.
  • Stay focused on long-term goals, as greatness stems from disciplined choices, not circumstances.

Apply Discipline in Your Practice

Knowing what to do isn’t enough—discipline is executing it consistently. Embrace challenges, stay focused, and build momentum for lasting success.

Seize the Future,

Ed