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
Midyear Checkup for Chiropractic Healthcare Practices
It’s Halftime.
2024 is half over.
How’s it going? Are you closer or farther away from your goals?
Here’s a fast tip:
Stephen Covey says:
“All things are created twice. There’s a mental or first creation and a physical or second creation of all things.”
If you are behind in achieving your goals for 2024 in the real world, you may need to recreate them mentally.
Great performers and coaches encourage us to visit our goals and vision often.
Lou Holtz was a college football coach. Per statistics, possibly the best college football coach ever. He was the only college football coach to lead six different programs to bowl games and the only coach to guide four different programs to the final top 15 rankings. *
Mr. Holtz said a book by Dave Schwartz called The Magic of Think Big was his favorite book. The following is from Schwartz’s book:
“Look at things not as they are, but as they can be. Visualization adds value to everything. A big thinker always visualizes what can be done in the future. He isn’t stuck with the present”
“Belief, strong belief, triggers the mind to figure ways and means and how-to.”
I don’t think it ever stops – the importance of staying connected to your vision, your meaningful goals as well as the practical ones.
But what the heck? Go for it! And even if you don’t achieve all your goals, you will have at least played the game and had an adventure!
As Eckhart Tolle says:
“Life is an adventure, it’s not a package tour.”
Happy summer and happy times with your team, helping others achieve their goals!
Ed
P.S. Our Practice MBA is just 60 days away.
Think BIG! Our Practice MBA is back, and it’s updated and tailored for your practice manager and Big Thinkers like you.
Here’s what you need to know:
** Start Date: September 9th
** Registration ends August 30th or when the class is full
**Duration: 12 weekly classes
**Waiting List: Sign up now for exclusive program details!
Already on our list? Stay tuned—I’ll send more specifics soon. I’ll also set up times to chat with you and answer all your questions.
Our last Practice MBA was a big success. The new managers in chiropractic and other practices have effectively improved their practices and the stats show it. Our latest version is even better, and I can’t wait to get it started with you!
Ed
References:
Steven Covey: The Seven Habits of Highly Effective People
Eckhard Tolle — www.brainyquote.com
David Schwartz – The Magic of Thinking Big
Lou Holtz – Wikipedia
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If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.
Find out what they are and how to sail to your next level by getting and implementing my book, The Goal Driven Business.
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)
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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
Looking to the future
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
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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.
Patients come second.
As a doctor, you work for your patients.
As a business owner, you work for the business end of the practice.
Both of these roles have different outcomes. As the doctor, your outcome is healthy and very happy patients. As a business owner, you want to see a profit.
When you begin your practice, you do so as a business owner and doctor. Any management or leadership you do is done from these roles. I call this an Entrepreneurial or Personality-Driven Practice. This is workable until you reach about 50% of your full capacity as a provider.
Beyond about 50% capacity, the practice needs focused leadership and management. It is time for you as the owner to step into the role of Clinic Director if you want your enterprise to continue to grow.
The outcome of the Clinic Director is not the same as that of doctor or business owner. In simple terms, the outcome is a well-run organization that provides excellent service at a profit.
So, who does the Clinic Director work for?
The staff! The employees. This is called servant leadership and management.
This is a major shift in mindset for most highly driven entrepreneurial business owners. But it can be done, and if done correctly, there is no limit to practice growth, prosperity, and independence.
Year after year, Southwest Airlines ranks at the top for customer service and profitability over other airlines. And for good reason. They are excellently managed and led!
Their goals, purpose, and values are well-defined. They are a Goal Driven Business.
In their book about Southwest, authors Keven and Jackie Freiberg reveal that Southwest believes that the love and support they show their employees will be passed on to their customers. Servant leadership is a central theme.
Chapter 18 of their book caught my attention: Customers Come Second — But Still Get Great Service. In it, they say at Southwest, “Treat your employees with care and concern if that is the way you want them to treat each other and your customers.”
I use Southwest as an example, but there are many others.
In a smaller service company like a chiropractic or dental business, the doctor doesn’t have much time to be the Clinic Director or senior manager, isn’t paid (at least directly) for being one, and isn’t trained in management. Also, more than likely, doesn’t want to be a manager or leader. But what if there was a simple method to be an effective Clinic Director?
Well, there is. It is covered in my book, the Goal Driven Business, and is gone over in detail in our Practice MBA training program. In 2024, I will post more information on this subject and the Fast Flow CEO Method, as I am 100% certain that this is the stumbling block behind all stumbling blocks that keep practices from achieving greatness.
You can do this now:
If you put your team first, they will put the patient first.
This is, when all is said and done, the Golden Rule.
Or perhaps… we could also call it the Goal Driven Rule!
Seize the Future,
Ed
*Nuts – Southwest Airlines, Keven and Jackie Freiberg
—————————————————-
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.
I asked the office manager if I could review some of the staff’s job checklists.
I had observed a staff member training another on how to use a therapy device on patients. Their attention was on the equipment, how to position the patient and where to place the electrodes.
So, I looked with interest at the job description and checklists about placing patients on therapy. The therapy checklist listed all the procedures – what wire went where, what position the patient was to sit in, etc. But something was missing.
The goal, the outcome, of the checklist was not defined.
There was no mention anywhere about the purpose of the therapy, what it does, why to use it. And worse, there was nothing about the patient as a person. The checklist did not say how to introduce the patient to the procedures – and how to educate them on what it does. It might as well have been instructions on how to hook up jumper cables, wire a sump pump, or fill out tax forms.
I went over this with the practice manager and later was told that the staff were now spending more time with the patients explaining therapy procedures.
There’s a deeper principle here. Steven Covey has a great video on getting his son to take care of the lawn over the summer.
Rather than giving him procedures on what to do, he pointed to the neighbor’s lawn and had him notice that it was green and also clean. He then pointed to their lawn, which was becoming brown and littered. He told his son that all he had to do was keep their lawn Green and Clean. He didn’t care how he did it. He might want to use a hose and sprinkler or use buckets. The specific procedures were up to him. But the goal was –green and clean.
It is an entertaining story on video — the link is below on our blog. The son finally got the idea and worked out how best to take care of the lawn.
Checklists are useful for training, agreeing on who does what, and preventing key procedures from being overlooked. Please use them. We’ve used them for 30 years. (If you need help please contact us!)
But they should always begin with the goal, the outcome of the sum of the procedures. What do these series of procedures produce – and what is their mission?
If you just focus on procedures, you and your team might as well be algorithms, computerized, and repetitive functions that occur electronically. Like an Internet robot or bot! By omitting goals first, you may minimize the innate creativity and power of everyone, including yourself.
On the other hand, if you challenge yourself and your team to define the WHY for each major and even minor procedure:
…and more fun.
Seize the 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.
Find them, invest in them, and see your practice improve.
One of the aspects of practice development that you become familiar with after 30 or so years in the field is the concept of Leverage Points. Once you can spot them and work out methods to take advantage of them, your practice significantly improves.
According to Donella H. Meadows, Ph.D., leverage points “Are places within a complex system (a corporation, an economy, a living body, a city, an ecosystem) where a small shift in one thing can produce big changes in everything.” *
HIGHER LEVEL LEVERAGE POINTS IN YOUR PRACTICE
Ms. Meadows lists 12 levels of increasing effectiveness where leverage might be found. The top levels that can make the most significant changes are:
This is the Above Down Inside Out shift that can ignite the Innate power in a practice.
I have seen this when the clinic owner or team member becomes extraordinarily inspired and motivated, filled with a sense of mission. I also have noticed this in offices that shift from an entrepreneurial practice that is entirely dependent upon the owner to a systematized and goal-driven business.
TANGIBLE LEVERAGE POINTS
Adding a scribe or clinical assistant can be a practical example of utilizing a leverage point in a more tangible application. This might allow you to see an extra 10 patients a week and provide better service with less stress. In the end, you would have a positive Return on Investment for what you paid for the extra help.
Another example might be a situation where your front desk can’t keep up with check-ins, check-outs, call-ins, questions, data entry, cash collections, marketing reminders, and just being friendly. By adding the right person at the front desk, even a part-time during prime time in the afternoons, your volume might surge. (I have seen this.)
For a marketing example, you might be next door to a gym that sees hundreds of people each month. You could leverage your location with just a little effort to create a very beneficial relationship for their business and yours.
There are many examples of finding areas of your practice where the return will be positive when given more support.
LEVERAGING PRACTICE MANAGEMENT
In my experience, the number one leverage point is management.
As a practice grows, the admin tasks multiply exponentially. These start to fill up the doctor’s time, and eventually, growth hits a plateau.
By adding someone to take care of office administration or clarifying the duties of someone currently in that role, you can better concentrate on service, production, and leadership.
As a result, revenue increases and stress decreases. Proper training for the manager is essential and, unfortunately, usually absent.
As an aside, we are solving this now through our Practice MBA program. We are just a little more than ½ way through the training, and I am both impressed by their work and proud to be helping them become Goal Driven Managers.
But leverage points could be anywhere. Even between your ears! (haha!)
Look for where you might find a log jam or an untapped resource. Invest some time in supporting that area and see if that doesn’t make a big difference in practice.
You have untapped power in your business just waiting to be leveraged.
Ed
*Reference https://donellameadows.org/a-visual-approach-to-leverage-points/
—————————————————-
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.
Remember that time you were leaving for work in the morning and just as you were about to leave, you couldn’t find your keys? (It might have been your wallet, purse, or important papers.) As you tried to quell your rising panic, you thought – what if I am late? What about the patients? What if I have to call a cab, a Lyft or Uber? All the alternative scenarios and plans start weighing on you. Worried, distraught, you get ready to call the office when…there they are! Your keys, papers, the vital components to your daily life and you make a joyous reunion. And you are on your way.
That was a big win.
Five minutes later, you have forgotten the entire dramatic event. As if it never occurred.
Many patients who have had pains or discomforts for years, after finally experiencing relief thanks to your chiropractic care, take it almost for granted after a day or so. Even though it was a big win.
You, too, begin to experience the daily Miracles as Usual as commonplace. You and your team become accustomed to them.
And worse, we can let the “negative few outweigh the positive many.”
Our minds are wired, especially business owners, to be alert for dangers, threats, and failures. And because of this, we overlook the accomplishments, the successes, and the wins we all have.
They happen every day. We get work DONE… when we might have just let it slide. We take the extra time and make the extra effort, even as no one notices. We make it happen.
In an otherwise cold and frightening world, we help others through our actions — and even by our positive presence.
And the world reinforces the negative. Sensation drives all media. It “click baits” us, like emergency flagmen calling our attention to the as-yet-unseen car wrecks ahead of us.
But amidst the world’s chaos, the dramas of our patients, and the struggles of our own lives, we are here to help, and to whatever large or small degree we do, that is a win. We contributed something good into the world that day.
But our wins are easily overlooked. First, by ourselves, and second, by others.
So… don’t let this happen. You can change this! Change it in your practice and change it at home.
And if you do, you will create a more healing atmosphere in your practice and love in your life. Your day will end better, and your next new day will start fresh with greater cheer.
You are doing good work. You are helping people. So are others with whom you work and live.
Recognize and celebrate this, and at the end of each day, simply ask each person with whom you work to tell you and the others their win or wins and cheer for them. Let them do the same for you.
You deserve It – and so do they.
End on a win.
Ed
PS I was reminded of this at the recent Chiropractic Society of Wisconsin conference in Wisconsin. One very successful doctor with whom I had the privilege of talking to mentioned that at the end of the day, he would meet with his team and acknowledge a win each of them had. I too, years ago, had done this with a team I had worked with, but as the world turns, I’ve let this very successful procedure drop aside.
—————————————————-
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.
As farmers know, you must plan ahead and then work your plan. That is part of the Law of the Farm we discussed last week.
This is a short and fast reminder of some activities to consider as we enter into the last two months of the year:
Marketing – The front end of your practice. Keep it hopin’!
Business — The back end of your practice. Organize for the future.
With good scheduling and planning, there is no reason for disappointment in production for November and December. To help keep the atmosphere thankful, cheerful, and productive, here are a few promotional ideas:
Thanksgiving (U.S.A.) Turkey giveaways have been popular with many practices. The basic idea is to refer a friend and enter a drawing for a free turkey.
Thank-a-Veteran Day. Veterans Day – November 11. Special promotions, including free or discounted services or donations to local veterans’ organizations.
Donation Drives. Holiday time always brings an increased demand for helping those less fortunate. Within your office, you can set up a collection area for donation programs in your area.
Girl’s Night Out. This is a shopping/gift exchange that can take place in your office that builds community and helps generate referrals.
Poinsettia Give Away. Give away free poinsettias, one per family. Include cards with a gift certificate for family members or friends for your services.
Your External Referral Network. Deliver a fruit basket or other present personally during December with a card of thanks and mention how you are looking forward to another year working together for better health. Your External Referral Network would include any person or organization that referred a new patient to you, where you gave a lecture or screening, or in any way directly contributed to your office.
Patient Appreciation. Have a party. Your patients are part of your practice and health community. They are a select group of like-minded health seekers. Bring them together, recognize their efforts to improve their health in 2023 and 2024, and encourage them to help others do the same. Everyone gets Guest Passes to hand out to family and friends when they leave. (I still love the Flying Elvis’ coming in for a big patient appreciation party one office used to have!)
Once you get your marketing plan worked out and in gear, take time to review the business situation of your chiropractic or healthcare practice. These behind-the-scenes details are important but not always urgent! They are pretty obvious – this is just a reminder!
Accountant. You will want to meet with your accountant to review your financial statements, including your balance sheet and profit and loss. There have been changes to retirement laws, so check with them about how they may affect you. Review your tax situation and explore strategies to minimize it. Ensure that all tax-related documents and filings are up to date.
Legal and Licensing. Check the status of licenses and permits and renew them as needed. Consult with your attorney to review contracts and legal obligations.
Employee benefits. Consider benefit reviews as well as bonuses.
Payors. You’ll want to review your insurance contracts and dump any that don’t bring a good return.
Fees. Take a look at your fees and make any adjustments that are needed.
Compliance. This can be delegated, but ensure that you at least minimally meet basic HIPAA and OSHA standards. You can check with your local state association for recommendations for these and any other requirements.
Budget Planning. Work out a general budget for next year that incorporates all the findings from your financial review and business goals.
This is not a complete list, of course.
Preparation is working on your business, not just in it, but it is just as essential.
Let’s end the year prosperous and secure for the future.
Ed
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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.
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
Your patients’ goals are why we are here.
They are why your staff came to work today and why you went to your last licensing seminar.
Your patients’ goals are why you have a practice and are in business.
So, what are your patient’s goals? What do they want?
On the surface, it is usually to relieve discomfort or pain.
So, like you do, after your initial consult, exam, and imaging, you tell them the cause of their pain and present your treatment program. They nod in agreement, and you begin care.
But when the patient sees the staff member to work out their finances and scheduling, they may have a glazed look and not be too sure what you just told them. Something-something about submarines, or joints, or spondy low dices.
The next week you wonder where they are. Your front desk does recalls. You spend money on more marketing to get more new patients.
You may have experienced a version of this in the past.
And at home, the patient may even feel that they got what they wanted or thought that they wanted. Maybe they feel better. But did they really get what they wanted?
There is a quote questionably attributed to Henry Ford: “If I’d asked customers what they wanted, they would have told me, ‘A faster horse!'”
I get the point. But what people wanted, though they did know about a Model-T, was to travel faster with less horse poop.
You know that four adjustments, in most cases, won’t provide the health solution that the patient needs. But your patients don’t know what you know!
Was that why they didn’t come back for another visit, because you didn’t educate them enough? No.
Was it that you did not motivate them enough? No.
An excellent book on sales that I recommend is by Harry Browne, The Secret of Selling Anything. Brown points out that people are already motivated.
You don’t have to motivate your prospective patient when you initially see them. You just need to discover what is already motivating them.
This takes place in your initial consultation and history, which I feel is the most crucial part of the new patient onboarding process.
Brown offers these three steps.
These questions, and others, open the door to understanding what the other person wants. And if they know you understand them and are authentically interested, they will be more inclined to listen to you and trust you.
Now you both can agree on what they want.
This is a simple procedure that is genuine and caring. Not always easy to find these days, so you will stand out from others by using this method.
I would even spend time now and then rehearsing this. Even the pro’s practice.
Brown is not the only person who has offered this procedure as it is so fundamental. But we can never be reminded of the basics enough. He also said:
…the secret of success is:
Find out what people want and help them to get it.
Help your patients achieve their goals in 2023, and they will help you achieve yours.
Seize 2023!
Ed
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.
Using your brand to generate more patients, increase retention, and recruit top talent!
Promoting your brand has not been an important or even viable method of marketing for most chiropractors.
But that is no longer true.
Brand marketing needs to be part of your marketing mix. I will tell you why, but first, let’s define our terms:
Brand marketing is different from direct response marketing. Brand marketing focuses on generating awareness of your office, while direct response aims to generate new customers.
A smaller business with limited resources must focus on direct marketing rather than brand marketing. This is especially important when you begin.
Once your practice is maturing, your patients know you. You are the brand. You probably don’t plan on growing the business any further so there doesn’t seem to be any real need to promote your brand in the community.
But now there is.
Franchise health companies are stepping up their activities. For example, the Joint Chiropractic, which filed with the SEC for around $35 million 10 years ago, and is a public traded company, acquired an additional 7.5 million in funding just two years ago. Their website says they have more than 600 locations, and I have seen their marketing activities in Wisconsin.
Physical therapy franchises are spreading, such as FYZICAL. According to its website, it has grown to more than 448 locations in 7 years as of 2021. In addition, acupuncture franchises, massage franchises, and dental franchises are on the rise.
You can also see increased competition if you have been recruiting doctors, providers, or support personnel lately. Job seekers can acquire a startling amount of information about you and what it is like for employees to work with you. They are interested in your culture, benefits, and values – which are all part of your brand.
It could be said that your brand is: what makes you stand apart — and better – from all the comparable alternatives.
It is your Unique Selling Proposition.
A well-defined and promoted brand will help you:
Once again, it all goes back to goals. (Doesn’t everything?)
What is the mission of your office? What are its values? What are its valuable outcomes?
This Is a Distillation Of Your Story: why you are a doctor, why you are in business, and what brings you joy daily?
Answer this for yourself, and then ask your staff:
What makes us special?
Survey a few of your patients: what makes us special from other providers? Why did you choose us?
Your brand showcases all this into an identity that people can know, like, and trust.
It can be somewhat symbolized with a logo and tag line, like the Nike “shoosh,” and the tag line: “Just Do It.” It can be represented in your newsletters, your office decor and cleanliness, the appearance of you and your team, and in all aspects of your promotions on social media.
But primarily, it must be demonstrated each day by you and your team living up to your values, your commitment to your mission, and providing world-class service and outcomes.
The world is moving faster, and we all have to work to stay ahead. And if we do it right, not only will it be rewarding but also fun.
Carpe Posterum (Seize the Future)
Ed
Need help with your branding strategy? Schedule a call and let’s have look at the best strategic options
SCHEDULE NOW
Used to be a popular TV program called Cheers back in the 80’s. It was modeled after a bar in Boston with the same name. As a situational comedy, Cheers presented a familiar group of customers who came to the bar to have a drink, but also to relax, socialize, and have good cheer.
It all comes back to goals – helping patients achieve theirs.
Last week I discussed improving patient retention through excellent onboarding.
Onboarding is a 21st Century term meaning, in this case, those actions you take with a new patient to introduce and orient them to their new service. The analogy would be a new passenger coming “on board” a new boat. (The link to this article is below.)
The other activity I mentioned that can improve patient retention is also a 21st term: “Gamification.”
Merriam Webster says gamification is: “the process of adding games or gamelike elements to something (such as a task) so as to encourage participation.” The concept is not new, but it has become a science and is integrated into all video games. I cover this in detail in my book, The Goal Driven Business, which I recommend you purchase and use. (Link below.)
Games are native to our species. Even to puppies, as you see them rolling over each other. Kids love to play with their parents, and as they get older, with other kids, and then enjoy organized sports. The Olympic games began, according to one source, in 776 BCE. We love our games, and perhaps, we need them.
Awards
A game poses a challenge where you can overcome barriers and demonstrate your grit. If you win –hurray! Winning is the prize, but sometimes you also receive an award.
In ancient Greece, winners received an olive wreath as a crown. In modern Olympics, the winners receive bronze, silver, and gold medals. In some martial arts, as you advance in your skills, you are awarded different colored belts. When you graduate from college, you receive a nice certificate you can hang on your wall to impress your relatives! (sarcasm)
Your patient has accepted a challenge, along with you and the entire clinic team, to achieve certain health goals. So why not acknowledge or even reward the patient for completing specific benchmarks along the way?
Years ago, I recall some offices would have a special short ceremony for their patients once they completed their program of care. First, the staff would help the patient don a black robe used in graduation ceremonies and a graduation cap (mortarboard) and tassel. Then, they would take a polaroid snapshot (a brand of camera that produced instant hard copy photos) with the doctor and the patient in their graduation garb, give a copy to the patient and attach another to a bulletin board. I have even seen this in a hospital setting, just without the robe!
In Your Practice
Gamification can be applied in your office in many ways.
For example, after completing their 6th visit, the front desk could award patients a silver star sticker. After the 12th visit, they are awarded a gold star stuck to a coffee mug with the office name and logo. Finally, after completing their care program, the patient could receive a diamond star attached to an office t-shirt.
Gamification aims to keep everyone engaged in the “game” of achieving health goals.
One approach to bringing this about is to have a team meeting and go over this idea. Encourage unbridled creativity! Use the best ideas that make the most sense and run the program for three months on a trial basis. Set goals (and awards) for the team for percentages of patients completing their programs.
All these are examples of gamification. But even a “Glad you made it today Mrs. Jones. Good to see you and your daughter” is a kind of an award. Unfortunately, in life, we are rarely recognized for our accomplishments – and mostly for our errors.
So, compliment your patients for their courage to improve their health. It is a big deal and a major accomplishment that they even show up, let alone follow through with their care.
After all, games are fun. So, let the games begin!
Ed
Link to Onboarding Article
Link to The Goal Driven Business
Takes 5 minutes. This is an inspirational musical event. The link is below.
It is worthy of the best humans have to offer – and akin to what you provide innately to your patients – as doctors, providers, and support professionals.
Match this with all you do in April and you’ll have a great month!
-Ed
For more information on how to create a more profitable business that is more fun than what you are doing now, please purchase and then use the book, The Goal Driven Business.