Category Archives: Goal Driven Business

The Hero’s Journey – Your Journey in Chiropractic and Healthcare

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heros journey chiropractic journey

Moving from One Stage to the Next

You are reading this because you are on a journey.

And you are also a hero.

You see things differently—you left the institutions and their mandates and took a different path. Like pioneers. Most of you reading this are involved with an alternative path of service – of helping people – chiropractic, nutrition, biological dentistry, acupuncture, midwifery, and more.

To us at PM&A, your goals are noble, and you are on a hero’s journey!

For nearly 40 years, our singular goal has been to help you, and others like you, succeed on that path.

A few years back, I wrote a book called The Goal Driven Business, where I laid out the methodology we’ve used to help doctors of all types, chiropractors, medical, dental… and business owners navigate that journey.

Your Progress as a Chiropractic and Healthcare Practice Owner Unfolds in Stages

The goal for any business practice or career is to operate at a level where you can do your most, at your best, comfortably. We call this Stage Full Capacity.

When you begin your career or practice, you may not have fully defined your end goal—just a general sense that you want to be successful.

Operationally though, the real goal is to deliver services at your highest comfortable capacity. That’s the most logical and economical level, since expenses like your building, equipment, and staff are mostly fixed — and you’ve already invested serious time and money developing your skills.

Getting to this goal means passing through other Stages first. Each one demands its own unique strategy. Apply the right strategy for the Stage you’re in, and you move to the next one. Fail to, and you stay stuck — or slide back down.

In our Goal Driven System, we’ve mapped the journey to Full Capacity into 5 major stages. For details, read the book The Goal Driven Business or contact me!

  1. Stage 1. Beginning – You’re just starting out. (Well, sometimes, we crash and burn and need to start over!) The strategy: actively getting out with the message: “Get to know me, and here’s what I can do for you! ” (The Goal Driven Business, Page 75)
  2. Stage 2. Goals and Roles. You’ve generated interest and delivered services — now it’s time to clarify goals and roles: who does what, when, and why. Like a growing organism, this is your cell-differentiation phase. Set your blueprint here, while you keep growing promotions and services. (Page 101)
  3. Stage 3. Stability Stage. Here is where you strengthen your people and procedures. Stage 1’s efforts are still firing, and your goals and roles are defined. The driver now is management — take care of your people, refine your procedures, and keep improving without any big change. (Page 141)
  4. Stage 4. Acceleration Stage. In time, with the earlier stages in place, you are going to hit your Best Ever! This is the most dangerous Stage — most practices never make it past this level. They hit it, crash, and try again — sometimes for years — until they settle. Key drivers: lean management, professional discipline, and extraordinary customer service. (Page 175)
  5. Stage 5. Full Capacity – Team Leadership. This is the goal: in business and in your career. All pistons firing at maximum — but at a sustainable RPM. (Page 211)

Whether or not you reach Full Capacity, we applaud your courage and purpose — your refusal to fit into a system that doesn’t always put health or people first.

You, and everyone you work with, are heroes in our eyes. And you might be surprised to learn: you’re heroes to the people you serve, too.

Carry on — and stay Goal Driven.

Ed

P.S. And reach out if you need some guidance along the way.

Does Your Chiropractic and Healthcare Practice Structure Determine Your Practice Function?

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comparison of two buildings one with poor structure resulting in poor function and the other strong structure, strong function. similar to a chiropractic businessHow a few adjustments can improve performance!

Over the years, I have worked with many talented, intelligent, and dedicated chiropractors and doctors—both men and women who were compassionate and effective with their patients.

However, not all of them were successful in business.

The reason was that they lacked organization—and organizational discipline.

That is to say, they lacked the business structure that would support a strong practice function.

What is Chiropractic Business Structure?

It is showing up on time.

It is the routine consultation, history, and exam procedures you do with all patients on their first visit.

It is the standard re-exam visit.

It is keeping up with patient notes.

It is also the regular team meeting that follows a routine procedure.

It is your monthly marketing programs.

It is effective financial management.

And especially, your weekly and monthly management review and planning meetings with your team and coach – if you have one.

Over and over and over – daily, weekly, monthly.

That is structure.

What is Chiropractic Business Function?

Ah… FUNCTION… this is the life of the practice!

It is getting to know your new patient as a unique person.

It is having a chuckle with one of your staff.

It is sincerely congratulating an established patient for a success in their life – and feeling happy for them.

It is cheerfully participating in an event promoting the good works of you and your team.

It is feeling pride at the end of the week with the care you and your team provided.

It is the structure of your business that allows the function of your practice to achieve its full potential.

Sound familiar!

How to Maintain Your Chiropractic Business Structure

THE HUMBLE CHECKLIST. I write about this almost quarterly. I don’t have to reiterate it here. There are some links below to earlier references.

But here’s the trick: you must put someone in charge of ensuring the checklists are getting done.

It’s a reminder role. And in all honesty, most of us need at least some reminding, nudging, even nagging…now and then, right? (How’s that exercise and workout program going for you…?)

Your practice manager should do this.

We went over this again and again in our MBA program.

So, there you have it.

A practice is like a body – its function depends on how well it is structured.

Make the adjustments as needed, and keep it aligned – and enjoy the full potential of your practice.

And stay – Goal Driven,

Ed

 

Why Are Group Practices – Chiropractic and Others — Growing?

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group of 4 chiropractors of a group practiceIs a Chiropractic Group Practice for You?

In 2014, roughly three out of four chiropractors owned their practice solo.

By 2024, that’s down to about half.

And the flip side of that decline is real growth: the share of chiropractors working in a multi-doctor or multidisciplinary setting has roughly doubled in ten years — from about 22% to about 48%.

Doubled. In ten years!

We’ve seen this happening in the field. But with better research tools, I was able to confirm it. Two separate industry surveys, from the National Board of Chiropractic Examiners and Chiropractic Economics, both show the same trend, year after year.

Why is this occurring

  1. Administrative demands keep piling up. Prior authorizations, OSHA compliance, personnel management, documentation requirements — it’s a full second job that doesn’t shrink just because your practice is small.
  2. Marketing has gotten harder and more expensive. With more providers, more provider types, and more channels to compete on — social media, review sites, paid search — its more than any solo doctor can keep up with alone.
  3. Overhead keeps climbing. Equipment, staff, and competitive wages all cost more than they used to, and they cost the same whether you’re splitting them one way or four.
  4. Third-party pay keeps shrinking. Medicare’s actual chiropractic payment rate has fallen roughly a third since 2001, adjusted for inflation. Commercial insurance pays better, but it comes with its own squeeze — visit caps, prior-authorization requirements, and tighter claim scrutiny every year.
  5. Succession has changed. Aging solo owners need someone to hand the practice to — retirement, sale, or simply relief. An associate who eventually buys in solves that. Staying solo to the finish line often doesn’t.

This is one of the reasons corporate chains like The Joint are growing — from about 309 clinics in 2016 to nearly 1,000 today. That’s roughly tripling in under a decade.

A group practice has many advantages:

  • Shared overhead — rent, equipment, and staff, split instead of carried alone.
  • Focused management to smoothly take on the increased administrative and marketing demands, and better support the doctors and staff.
  • Local market strength — a three-doctor practice out-competes both the franchise down the street and the lone operator across town.
  • Real vacation coverage — your practice doesn’t close when you do.
  • Camaraderie — a colleague to talk through hard cases and hard days.

But you don’t have to sell your name to get that. An independent group practice gets you the same advantages, minus the franchise fee, the corporate playbook, and institutionalization.

And the timing works in your favor: chiropractic use is climbing nationally, not shrinking. The demand is there. The only question is whether your practice is built to catch it.

Here’s what group practice owners already know — most independents don’t: none of this works without dedicated management. The practices that thrive as groups are built on a management structure that has a purpose.

That Shift — from a personality-based, one-doctor practice to a business built on goals and led by a team — is exactly what I cover in my book from 2001, The Goal Driven Business.

Ready to make the Shift? And if you already are part of a group practice — is it time to upgrade your management?

Read (and apply) The Goal Driven Business.

And stay Goal Driven,

Ed

Let me know you bought the book (email an image!), and I will send you another at no charge.

What Is Your Full Capacity in Your Chiropractic and Service Business?

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chiropractor adjusting a full capacity waiting roomWhy Running Below It Costs You More Than You Think

The idea of full capacity is so simple that it is easily overlooked.

WHAT IS FULL CAPACITY AND WHY IS IT IMPORTANT?

Full capacity is when you are serving as many people as possible, given the available space, equipment, and staff. In other words, what is the maximum number of people you can see in a day – comfortably – given full support?

This number will vary, of course, depending on how you practice.

Full capacity is a vital goal for financial survival. You are already paying full price for your space, equipment, and team. With lower production, your overhead rises and your profits decline. Overhead actually jumps. If you’re running at 50% of full capacity, you’re not paying “half the overhead” — you’re paying close to the same rent, staff wages, and equipment costs as if you were at 100%. That’s why practices at half capacity often feel like they’re working just as hard, if not harder, for a fraction of the profit.

WHAT GETS IN THE WAY OF FULL CAPACITY IN YOUR CHIROPRACTIC AND SERVICE BUSINESS

Let’s say you have a busy month. See lots of patients. Your front desk is busy scheduling and keeping the appointment book full.

One afternoon, during a momentary lull, you notice the front desk staff has a few moments, so you give them some insurance work to do. A week later, the chiropractic insurance department does the same.

The following month, everything seems the same… the front desk is busy.

But visits are down.

What happened? Can you guess?

Any system or flow pattern will accumulate unnecessary additions – extra checks, additional actions, or routings that start to slow the flow.

This gradual shift and increase in systems is called “Process Creep.”

PREVENTING PROCESS CREEP

Step back from your practice and ask the engineering question: given my space, staff, and equipment, how many visits can we see each week? What is our full capacity?

For practical purposes, use Visits as your metric.

That number is your Full Capacity Goal. Once you know that, you work backward: what’s standing between where you are now and that number?

You need to look for the capacity barriers in the way – and remove them! These are different types of bottlenecks. I discussed this in earlier articles and in my book, The Goal Driven Business*. Some barriers are in the systems, while others can be in the people.

It could be patient notes, patient scheduling, or even too many services available. Not enough new patients, interestingly, often goes back to a mindset.

Complexity occurs naturally — so you have to work to simplify the flow and eliminate unnecessary steps. This gives you more time to engage with your patient – your customer.

But it all starts with:

  • Determining your Full Capacity Goal – the real ceiling, not a guess
  • Removing the barriers standing between you and it

Contact me if you want to explore what might be holding you back from reaching your full potential!

And stay Goal Driven,

Ed

Email

*References

Communication: The Real Practice Builder in Your Chiropractic and Service Business

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chiropractor understanding patient

Seek to Understand First

Last week we reviewed the Japanese concept of Ichi-go Ichi-e – “One Time, One Meeting.”

The lesson was simple: Be present. Be interested.

But why is that so important?

Because communication creates relationships. And relationships create practices.

But you think you already know this, right? Well, yes and no.

Intellectually, perhaps you do. But in real life… a practice is busy, and life is full. So, communication often devolves into a text or is abbreviated.

Authentic human communication takes time — time that busy people don’t always make.

Communication with Your Chiropractic Patients

Doctors rightfully focus on adjusting and treating patients. Staff members believe their primary job is scheduling, collections, insurance, or even marketing.

The Clinic Director is looking at the bottom line.

But underneath it all — is communication.

Communication is the operating system that allows all the other “applications” in your practice to function.

Every patient who walks through your door is asking a question:

“Do you understand me?”

Not necessarily with words. But they are asking it, nonetheless.

Patients want competent care. They also want to be heard, understood, and valued.

When patients feel understood, trust grows. Trust is the foundation of every successful relationship.

And when trust grows, recommendations are accepted more readily, appointments are kept, referrals occur naturally, and relationships strengthen.

Communication Within the Chiropractic and Service Team

The same principle applies inside the practice.

Your practice is composed of people. Staff, chiropractic associate doctors, and providers often wonder why things are managed the way they are, why something was changed, or… whether their work is any good or appreciated.

Over the years, I have seen staff members leave practices not because of pay, benefits, hours, or workload.

They left because they didn’t feel understood. Their questions went unheard, and their accomplishments went unrecognized.

And people don’t always get up and just leave a relationship. They usually leave mentally first – months ahead of time.

I bet right now, you can think of how this applies to you and your situation.

This applies to any team. It applies to family and family members as well.

And it certainly applies to your patients.

__ __ __

Communication is more than talking. It is more than giving instructions. It is more than conducting meetings.

Communication requires being there — with attention and genuine interest. Then it needs understanding the other person’s point of view well enough that they know you understand.

It also requires time, but it is time well invested.

When the quality and quantity of communication in your practice improves, the practice numbers will go up!!!

As Stephen Covey says, in his 7 Habits of Highly Effective People, Habit #5 is:

Seek First to Understand, Then to Be Understood

Stay present. Stay interested. Listen to understand.

The results may surprise you.

People stay, and are happy and productive, where they feel understood.

Patients.

Staff.

Providers.

Family.

Keep driving – what you are doing is important!

Ed

P.S We work this concept strongly on our Practice MBA course this fall – with tough but fun exercises!

And remember,

A practice is a network of relationships – created and sustained through communication and service.

Maybe You Are Focusing On the Wrong Thing in Your Chiropractic Healthcare Practice

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chiropractors looking at chiropractic x-rays

Your best marketing tool may surprise you

I was asked to help an office a few years back with their marketing. It was a three-doctor office.

Did we work on discount ads, promotions, talks, and social media? No! I am all for these approaches, but I wanted to look at something else first.

== == ==

Marketing begins with what you are putting into the market — your product or your service outcome.

In this practice’s case, it was a “person who was healthier, relieved of pain, and had a great experience.” A person who had a “Wow!” experience.

THAT is what we worked on. We role-played, reviewed Days 1 and 2, and discussed different cases with the senior doctor. We trained on techniques and reviewed clinical procedures.

The focus was on the doctor’s services.

There was nothing really wrong with the quality of their service — they had been in business for many years. But after a while, I figured it would help to “sharpen the saw.”

Yes, we also worked with the staff and ran some promotions, but the primary effort was to refocus the doctors’ attention on their skills, training, and patient care.

And their numbers went up!

== == ==

I have seen this go both ways more than once.

Another example is a long-time client who has been using a new chiropractic technique for the last couple of years. He has told me how he finds this technique very effective and that he is getting the best results ever. His office has grown and stayed steady.

On the other hand, I see doctors too often become focused on scripts, office policies, or promotions. While these need to be addressed, they are not the purpose of the practice.

That is why I always stress the importance of getting one of your team members trained as a manager — even part-time. This allows you to delegate much of your management and marketing work so you can focus on providing superior service and generating extraordinary results.

If you focus on the quality of your care and get great results — if you get “Wow!”s from patients who exclaim about not only their outcome but the care they receive from you and your team — your numbers WILL go up.

== == ==

Take a few minutes to think about this. It is easy to get caught up in statistics and the latest management “operating system.” Fine — that is part of running a business.

But first and foremost, review the quality of your completed cases — not just “visits.” Then improve them.

== == ==
The Goal Driven System for Your Chiropractic, Healthcare, and Service Business

Our Goal Driven System includes a manager who supports the team, the doctors, and the patients — and the marketing! We cover this in our book, The Goal Driven Business, which you can grab on Amazon.

You don’t need a manager if you are at 50% capacity or less. But once you start hitting 60% or more, or have multiple doctors and providers, you should have someone to help with marketing and team support. It is not a bossy type of role, but someone who can pick up the odds and ends so you to keep your attention on patient results.

In the meantime, your best marketing is constantly improving the delivery of service to your patients.

That is your #1 goal.

Keep the “End in Mind,” as Dr. Stephen Covey said!

Ed

P.S. We are rolling out our new and updated Practice MBA program for practice managers and clinic directors this fall — stay tuned!

Why Things Don’t Get Done in Your Chiropractic and Healthcare Practice

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everybody, somebody, anybody, nobody taking responsibility in a chiropractic office

The Importance of Goal Driven Job Checklists

Why don’t things get done in a chiropractic practice – or any professional practice?

It’s rarely laziness. It’s usually just a lack of clarity.

Last week we discussed Accountability — and how it helps grow and sustain a practice.

There is real science behind this, but it is sort of obvious. People perform better when they have something, or someone, giving them feedback!

Like a coach! (Hi! Call me! 🖐️😁)

But in order to be accountable for something, you kinda need to know what it is that you are being accountable for.

That’s where the work activities break down.

We say we want accountability — but we haven’t clearly defined responsibility.

That is why job descriptions matter.

Most of these, the ones I have seen, are so confusing as to be impractical.

A good job description defines what it is that you are responsible for…and why. It defines the purpose of the job, its specific duties, and its outcomes.

And those outcomes…? You can measure them.

With a good job description, a person knows what they are responsible for and they have the stats that shows them how they are doing.

They can be their own manager!

Now the CEO/Clinic Director doesn’t have to police. They get to coach and that’s the culture we want.

Here are the 4 parts of a Goal Driven job description, or what I call a Job Checklists:

  1. Purpose of the job.
  2. Duties of the job.
  3. Outcomes of the job.
  4. Statistics (metrics, Key Performance Indicators) of the job.

Here’s a fast example:

= = =

Chiropractic Front Desk Coordinator

Purpose

  1. Ensure that patients complete their programs by keeping their appointments.
  2. Keep the appointment book full, rescheduled appointments to a minimum, and ensure patient flow is smooth and efficient.

Duties

  1. Always answered the phone with a smile.
  2. Greeted every patient personally when they entered the office with a smile, by their first/last name, as appropriate.
  3. Followed clinic and office policies as outlined in our office manual.
  4. Confirmed appointments as necessary for the next day’s schedule.
  5. Ensured that all patients had a treatment plan and set multiple schedules off them
  6. Ensured that the flow of patients never got jammed or “plugged up.” Got help when needed to “unplug” the flow.
  7. Never let patients wait more than 15 minutes.
  8. Asked for patient referrals each day.
  9. …

Outcomes

  1. All patients are scheduled for their appointments
  2. All patients keeping their appointments.

Performance Monitors

  1. Percentage of Kept Appointments
  2. Office Visits

This is a sample, but I am sure it comes close to what your front desk does… or should do.

= = =

Review your job checklist with your team monthly. Improve them and use them for training. You can co-coach each other!

But remember: responsibility comes before accountability.

Help others take responsibility for achieving their goals.

  • Define it.
  • Measure it.
  • Coach it.

And stay Goal Driven.

Ed

P.S.

Everybody, Somebody, Anybody, Nobody

“There was an important job to be done and Everybody was sure that Somebody would do it.

Anybody could have done it, but Nobody did it.

Somebody got angry about that because it was Everybody’s job.

Everybody thought that Anybody could do it, but Nobody realized that Everybody wouldn’t do it.

It ended up that Everybody blamed Somebody when Nobody did what Anybody could have done.”

– Charles R. Swindoll

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]