Category Archives: Goal Driven Business

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

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

Fun and Effective Promotions for November and December

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food drive grocery cart for chiropractic and healthcare facilities

Spark Some Magic in Your Chiropractic Practice This Season!

Special Promotions for November and December 2025! These are loud and lively events that engage the entire team!

Why do them?

  • Increase new patients with great offers.
  • Energize less active patients and get them back.
  • Build greater team spirit for a shared purpose.
  • A reason to promote your office and let patients and your community know how active you are!
  • Increase your presence as the Health Hero’s in your community.

Even without an offer, just the fun of giving back will boost your visits and instill greater loyalty.

Read the full Goal Driver Newsletter at Goal Driven.com and checkout the fun, festive promotions that will spark magic in your office this holiday season!

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

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.

—

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]

Should You Scale Your Chiropractic or Healthcare Practice?

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chiropractic scaling graph

Scaling a chiropractic or healthcare practice involves more than just growth—it’s about achieving exponential progress through strategic systems. Unlike linear business growth, scaling leverages economies of scale, scope, learning, digitalization, and networking effects to accelerate success.

Key factors include reducing overhead, adding services carefully, improving skills through experience, and using efficient software.

However, scaling requires a solid leadership and management structure to avoid pitfalls like the “Practice Roller Coaster.” Whether aiming to expand one office, add doctors, or prepare for a sale, scaling can drive your goals. Specialized training on scaling will be part of an updated MBA program this fall.

Key Points:

  • Scaling vs. Growth: Scaling is geometric, not linear, leading to faster growth as you expand.
  • Critical Elements: Economies of scale, scope, learning, digital tools, and networking effects fuel scaling.
  • Foundation Needed: Agile leadership and management are essential to avoid instability.
  • Applications: Scaling suits single or multi-doctor offices and can prepare a business for sale.
  • Next Steps: Upcoming MBA training will cover scaling strategies.

Please let me know if you’re interested in this fascinating subject.

Meanwhile…

Help others achieve their goals!

Ed

For more details, contact Ed Petty, the author of the Goal Driven Business and founder of the Goal Driven MBA Program.

Read more about scaling here:  https://www.goaldriven.com/post/should-you-scale-your-chiropractic-healthcare-practice

How Steve Jobs’ Vision Can Transform Your Chiropractic Practice Learning from Visionary Success

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steve jobs

Apple, founded by Steve Jobs in 1976, is now the world’s most valuable company, with a market capitalization of $2.9 trillion and $54 billion in cash reserves. But in 1997, Apple was on the brink of bankruptcy. Jobs’ strategic overhaul turned it around, offering lessons for chiropractic and healthcare practices.

In a 1997 interview, Jobs shared a key insight: “If you do the right things on the top line, the bottom line will follow.” He emphasized that a clear strategy, passionate people, and a strong culture drive quality products, marketing, and operations—ultimately boosting profitability. For chiropractors, this means focusing on vision and values to achieve sustainable success.

The Top Line: Your Practice’s Foundation

Your “top line” is your practice’s vision, values, purpose, and the team that embraces them. When these are aligned, marketing, procedures, patient outcomes, and profits follow naturally.

Top-to-Bottom Framework:

  • Top Line: Vision, values, purpose, mission
  • Almost Top Line: A team aligned with these principles
  • Middle Line: Policies and procedures
  • Almost Bottom Line: Patient outcomes
  • Bottom Line: Net income

Focusing on the top line creates a “vision-driven” practice, much like Jobs’ approach at Apple.

Insights from a Chiropractic Leader

A seasoned chiropractor recently shared a video on social media, responding to a colleague concerned about high practice expenses. He identified the biggest cost: an “under-trained” team. His solution? Hiring passionate individuals and training them not just in chiropractic techniques but in the practice’s “why”—its purpose, mission, and vision. Team members who didn’t fully align were let go. The result? A thriving practice.

When I commented that his success stemmed from his own clear “why,” he agreed: “It all starts from the inside out. If the doctor has a big WHY and can teach it, the team will follow.”

Sustaining Your Vision

Keeping your practice’s values alive requires ongoing effort. It begins with your example as the leader and continues through consistent team coaching. In our MBA program, we explore proven strategies to maintain this focus, from vision to execution.

Apple’s Core Value and Your Practice

In 1997, Jobs defined Apple’s core value: “We believe people with passion can change the world for the better.” This resonates with top healthcare practices, where passion for patient care drives impact.

Does your practice reflect this passion? A clear vision, a dedicated team, and consistent coaching can transform your chiropractic business, just as Jobs transformed Apple.

Stay Goal Driven.

Ed

Improving Your Chiropractic Practice Team Meetings

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Team meetings can be very effective at improving the quality and quantity of your services.

At best, they bring everyone into alignment with the goals of the practice. They can release energy that results in sometimes almost magical results. I have seen it!

Here are some key tips for improving chiropractic practice team meetings:

1. Set Clear Goals and Structure

    • Hold weekly meetings, ideally on Mondays to start the week strong
    • Limit meetings to 1 hour maximum
    • Create a consistent agenda covering key areas like practice goals, statistics, department updates, etc

2. Encourage Participation

  • Require all staff to attend and come prepared to participate actively
  • Allow time for each team member to report on their department
  • Create an open forum for discussion and suggestions

3.  Focus on Improvement

  • Review practice statistics and track progress on goals
  • Discuss what’s working well and what needs improvement
  • Develop action plans to address any issues

4. Boost Motivation

  • Start with positive affirmations or recognizing accomplishments
  • Highlight exceptional work by staff members
  • Share patient success stories to reinforce the practice’s mission

5. Maintain Professionalism

  • Avoid criticizing individuals or changing policies during meetings
  • End on a positive, inspirational note
  • Follow up on action items and “to-do” lists from previous meetings

By implementing these strategies, you can transform your team meetings into productive, energizing sessions that align your staff and drive practice growth. Regular, well-run meetings are crucial for improving communication, motivation, and overall practice performance.

Read the full article here:  https://www.goaldriven.com/post/improving-your-chiropractic-practice-team-meetings

========================

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.

goal driven business www.goaldriven.com
 

The Goal Driven Business

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The Time I Asked a Doctor The “Who” Question?

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woman multitasking in a chiropractic office

What is the who question?

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:

  • front desk
  • billing and collections (patient accounts)
  • and the clinical services of the doctor or provider.

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:

  1. Reluctance to delegate: Starting a practice as an entrepreneur, many practice owners are accustomed to handling all aspects of their business themselves and may find it difficult to relinquish control over certain tasks and responsibilities.
  2. Lack of awareness: Some practice owners may not fully appreciate the potential benefits and return on investment that a skilled manager can bring to their practice.
  3. Misconceptions and uncertainties about the role: Is the manager our billing assistant, our accountant, or a glorified assistant? Can my spouse or daughter be the manager? What are their job duties?
  4. Overestimation of current efficiency: Business owners might believe their current operations are running smoothly enough without a trained manager.
  5. Concerns about team dynamics: when someone takes on the role of manager improperly, they can disrupt the team’s harmony.

And especially,

  1. Where can I train my staff member to be a skilled manager?

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

Are All Things Created Twice?

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goal driven young girl holding up a house design dreaming of what it will look likeMidyear 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

=============================

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.

goal driven business www.goaldriven.com
The Goal Driven Business
By Edward Petty
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How Responsible is Your Chiropractic Healthcare Office?

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take responsibility for what you care for

Responsibility Scale – Ownership or Spectator?

A few years ago, I was teaching an exercise program to a group of underprivileged kids ranging from 8 to 13 years old.

The program was part of a larger volunteer program run out of an old, dilapidated church. The kids came from a very rough environment. Keeping them focused in class was challenging, and getting them to participate was even harder.

I would start the class by going over a virtue. This might include kindness, cleanliness, honesty, or discipline. When I asked the group questions, no one would usually answer.

Except for this one time.

I asked the children what the word “responsibility” meant. In the back row – I had them all standing in rows – one scruffy-looking boy, about 10, immediately raised his hand and said: “Ownership.”

“Ownership.” I was stunned. Not only did someone answer, and quickly, but what a perfect definition!

RESPONSIBILITY IS OWNERSHIP

Responsibility is taking ownership. It is saying “I caused that.” “That is mine.” It could also be saying, “I didn’t cause that.”

It is not deferring to excuses or outside forces. Sure, there are many things outside your zone of control for which you cannot take responsibility. But your job and the group you work with are within your limits. If the office is not doing well, don’t blame it on your childhood, Spring Break, or Taylor Swift.

As an employer, you should encourage your team to take responsibility. Their job, or department, is their sandbox, too. Encourage them to offer suggestions for the entire practice as well – and listen to them.

And on the other hand, all employees are stakeholders. They aren’t working for a large and well-funded corporation or government agency. How they perform each day determines how the entire office will perform.

And something else: a friend of mine says: “Everyone is on commission, but most just don’t know it.”

CHIROPRACTIC HEALTHCARE PRACTICE OWNERSHIP

We discussed the concept of responsibility and ownership in our Chiropractic Healthcare Practice MBA program by reviewing Jacko Willink’s book, Extreme Ownership.

Some managers played it for their team meetings. I recommend you do it as well. (The link is below.)

No doubt, we all take responsibility and ownership for our work. We are professionals. Sometimes, however, our determination can slip. When you notice yourself complaining about things, know that you are slipping! Complaining IS a form of responsibility, but just a very low form.

A scale of responsibility might look something like this:

SCALE OF RESPONSIBILITY

Extreme Ownership
Ownership
Spectator
Complainer
Blamer
Apathetic

Here is a quote from Jocko Willink, and I recommend watching a clip from his TED talk with your team.

“Implementing Extreme Ownership requires checking your ego and operating with a high degree of humility. Admitting mistakes, taking ownership, and developing a plan to overcome challenges are integral to any successful team.”

― Jocko Willink, Extreme Ownership: How U.S. Navy SEALs Lead and Win

Stay Goal Driven,

Ed

TED Talk. Jacko Willink. Extreme Ownership. ( 13 Minutes)

—————————————————-

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

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

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

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

The Goal Driven Business, By Edward Petty

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