Bravery in Your Chiropractic Office

Posted on March 19, 2024 by Edward Petty

bravery but funny goal driven Bravery is one of the themes of our practice manager training program.

Brave, Not Perfect is the title of an excellent book by Reshma Saujani, and also from her TED talk with the same title. She states that our culture influences girls to be perfect while boys can be wilder, take risks, and make more mistakes. She encourages women to be braver.

I think this can apply to us all.

Practice Manager Success Story

But this newsletter is about a success story. A story of bravery and integrity. It is also to boast about one of our managers who recently graduated from our Goal Driven Practice MBA program for chiropractic and healthcare offices and demonstrated these values.

As the practice manager, she also does the billing in this office. The chiropractic doctor had treated a patient who had suffered a motor vehicle accident. She submitted the bill to a 3rd party, reducing the what was owed slightly as the doctor agreed to discount some of the services.

The 3rd party company came back and said they could only pay 70% of the bill.

This was the manager’s response:

“Good morning,

“Thank you for letting us know.

“We provided 100% of the care that our patient needed; therefore, we require 100% payment of our services we provided. The original discounted offer of $X,XXX is no longer valid.

“We have decided to pursue the full amount plus interest, along with any court/attorney fees if we haven’t received payment in the full amount of $Y,YYY by March 7th.”

“Thank you,

[Signature]

“Manager of Chiropractic Health Clinic”

She received the full amount before March 7th.

Be Brave — with Integrity and Humor

Be nice, be fair, but first, be brave.

This can apply to scheduling patients at the front desk. It applies to reporting on the patient’s condition and treatment plan options. It applies to promotions and advertising. It can apply to training and coaching for you and your team.

It takes courage to become a doctor, to start a business, and even to work as a professional in an independent healthcare clinic. It takes even more to succeed at doing so.

But hey, it can be fun. And it helps to have some humor.

Our manager made a copy of the correspondence with the claims company with a copy of the check. She gave it as a surprise to her clinic director, who sent me a text with the image of what she gave him. On the copy of the email, she included a handwritten quote from the classic comedy movie Princess Bride:

“NEVER GO AGAINST A SICILIAN WHEN DEATH IS ON THE LINE.”

Stay Brave and Goal Driven — and Have Fun.

P.S. Our next management and leadership training program begins this summer. We have been retooling it and upgrading it. Only 7 students will be accepted. If you are interested, please get on the Wait List, and I will contact you soon with more information. Click here for Wait List for our next Practice MBA

—————————————————-

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

Why Goals Work and How to Harness Their Power for Greater Prosperity

Posted on January 11, 2022 by Edward Petty

Why do goals work?

We all know the obvious: they help keep you focused, and as Yogi Berra, the baseball catcher, said, “If you don’t know where you are going, you might wind up somewhere else.”

We have all heard about their importance. But we may not have heard or understood WHY.

What is the underlying principle behind goals, and why do they work? What gives them their power? And can you harness it improve your business and its bottom line?

Stick with me and find out…

== == == == ==

It was one of those September days in the Midwest when the leaves were turning orange, and the wind was blowing. I was in Chicago – the Windy City – where I attended a seminar downtown at one of its plush hotels.

The program was kind of out of my league – at least then. The fee for three days was $7,000. I was only attending the first day, which was $1,000 – still a lot of money. But I was drawn to the subject, and I was familiar with the person who was putting it on.

There were aggressive young MBA types flying in from around the country and the world. On the night before, at the hotel where the seminar was to be held, I saw several small groups in lively discussion around laptops – as if they were in the middle of inventing the next Big Thing. I remember talking to one young man from Singapore and learning about the high-energy atmosphere of entrepreneurship there.

The seminar focused on building, buying, or overhauling a business. The speaker was a self-made billionaire, a former management consultant, so his teaching fees did not come cheap. This was not a seminar for dabblers!

The subjects discussed on the first day and, as I learned, on the other two days, were surprisingly uncomplicated. They discussed the key ingredients to look for when deciding what business to build, buy, or grow. These few key factors were introduced on the first day of the seminar and then expanded upon the other two days.

But it all started around one principle: the PARETO PRINCIPLE.

Many of you know the Pareto Principle and the Rule of 80/20. This Principle has been used over the last 50 years by major manufacturing companies to improve the quality of their products. The concept is easy to state but often difficult for entrepreneurs to apply. It predicts that roughly 80% of valuable results come from just 20% of efforts. In some cases, the ratio can even be more extreme so that 10% or even 5% produces 90% or 95% of the results.

Not all efforts are equal: there are the “vital few” efforts and the “useful many” efforts. Workaholic entrepreneurs can struggle to put this concept into practical use. We find that delegating a $20 an hour task is risky, so we will spend time organizing a bookshelf or driving to get office supplies ourselves instead of taking care of a potential $1,000 an hour task, or even a $10,000 an hour task.

As a non-business example of the 80/20 Rule, consider all the clothes in your closet. I bet you wear just 20%, or less, 80% of the time. Then, consider how you get to work – out of all the choices of roads to take, you use just a few of them.

Look at a winning athletic team. Just a few players are responsible for 80% of its success. This does not mean that the other players are not important – just not THAT important.

All efforts are just not equal or average.

How might this apply to your business? Well, for example, 80% or more of customer dissatisfaction comes from 20% or less of your patients. On the other hand, 20% or less of your patients account for 80% of your patient referrals.

As the CEO of your business, what are the vital few actions you can take that will produce the most results? I suggest that defining the business’s goals, ensuring that your team understands them, and keeping these goals alive each week is key.

As Stephen Covey advises: “Begin with the end in mind.” Goals are simply the end you have in mind. On the higher end, they would include your mission, vision, and reason for them – your WHY. They would also include the values you hold as standards of behavior and performance.

These greater goals would be manifested as products or outcomes. For example, if your mission included helping people have healthy teeth, then a practical manifestation of this goal would be “Jim,” a patient, having his teeth cleaned today. If your vision were a healthy and pain-free community, the practical outcomes would be 100 patients adjusted today.

As a doctor, what would be the 20% of your actions that account for 80% of your results? I suggest letting the patient know that you understand their goals and work to help them achieve those goals at each encounter.

As the manager of your business, ensuring each team member knows the goals of their roles and helping them achieve these goals, with good coaching and communication, will produce 80% of their successful efforts.

It all goes back to goals.

They are the leverage points that direct and amplify all your efforts.

But here is the truth you must understand:

A small amount of time consistently spent defining the goals of, and within, your business — and working out how to achieve them — are the vital few actions that produce most of your excellent outcomes.

Know before you go.

If you and your team routinely define and redefine your goals, both the higher ones and the practical ones, and work out how to better achieve them, you will have a more prosperous and stress-free business.

Get the goals right each day, and all else will follow in your favor.

Working towards a better future,

If you don’t have it yet, get my book to learn more about how to use goals in your practice. The Goal Driven Business.

***New Training Program***

Also, stay tuned for a new training program we will be offering on the Goal Driven System. It will be limited to just 10 offices and last for 6 months. Its goal is to train the business owner and manager/senior staff member on the Goal Driven System to transform their practice into a Goal Driven Business. A Goal Driven Business is a team of Goal Drivers. That is what this program will teach you to create. (What is a Goal Driven Business? )

Please contact me if you are interested.

If you are interested in taking the training program on the Goal Driven System, for you and 1 team member, please go here to schedule a time to learn more about it. Schedule a meeting with me.

Goal Driven.com
Petty Michel & Associates

The Five Engines Driving Your Business Towards Your Goals

Posted on August 4, 2021 by Edward Petty

Having goals is not enough.

Your business needs power, and lots of it, to propel it to its goals. There are five primary engines that you need to drive your business to its goals.

Customer Service and Outcomes
Marketing
Leadership
Management
Personal Power

Most businesses have a few of these engines already firing. However, in most cases, full power has not been realized. This means that you may not have enough propulsion to make it to your goals.

Let’s take a brief look at each one, and as we do so, consider how each one rates in your office: half on, fully on and functioning, or barely functioning?

Customer Service and Outcomes. As a doctor and provider, your primary focus is on providing the best service and outcomes possible. This is both in terms of the subjective satisfaction of your patients as well as the objective criteria expected in your results. But to achieve this, you need support, and this support is provided by the organization you put together as the CEO.

Marketing. As the CEO of your business, your organization must first generate customers. As a businessperson, marketing will always be your number one and primary focus. A business is dependent upon the customer. In fact, it could be said that a business is the customer. If you are not providing a service to people that pay you for your care, you do not have a business.

Leadership. An essential quality of the CEO is leadership. Leadership helps define the goals of the business and keeps the team inspired to reach them. It also insists that they are achieved.

Management. In most offices, I have seen attention placed on service, marketing, and leadership. Management, however, is often not given enough attention. Management works out how we achieve our goals. This can be a laborious and difficult process that most business owners just don’t have the time for. Plus, you are paid for your services, not for “managing.”

Personal Life Management. Lastly, often brushed aside, is how well your personal life is managed. Are you happy, and is your relationship with your family and friends healthy? Is your personal life in good order? Too often, because of the stresses of work, our personal lives can drift off in directions we later regret.

THE MANAGEMENT ENGINE

Using the Goal Driven System as explained in my book, The Goal Driven Business, you can learn how to get each engine fully firing so that you have abundant power to make it to your goals.

It has been my experience working with offices across the country that the weakest engine is always management. This isn’t true when the office is just beginning or stays at 40-50% capacity. But once the volume picks up, there are more details that need to be addressed. In addition to providing outstanding service, there is… everything else.

Management deals with “everything else.” And when it doesn’t or can’t, all these untended-to “Everything Else’s” start gumming up the works. Paperwork gets backlogged, phone calls and emails stack up, staff becomes disengaged, patient communications get cut short, and marketing gets put on the back burner. Soon, there is just too much work to do. This clogs up and limits your capacity to provide more and better service and adds more stress to you and the team.

The default solution, which occurs naturally, is a reduction of the volume of services to a more comfortable level. This is the Practice Roller Coaster, the syndrome that causes continuous stress and unfulfilled potential. Service volume goes up, it can’t be sustained comfortably, so the volume comes down.

But good management solves this. It takes you off the Practice Roller Coaster and allows your service volume to continue to increase, unimpeded. And with more services, with good management, there will be more profit.

Of course, if this was a simple solution, more offices would be seeing many more patients and doing much better. The fact is, it is not a simple fix as there are unseen barriers, booby traps, and dead ends that thwart your best efforts to streamline your management and procedures.

I cover this in my book, The Goal Driven Business. I shine the light on the hidden barriers and show you a path that, regardless of your personal skills and personality, you can follow and make it to your goals. The book covers a system of business development I call the Goal Driven System.

Of course, essential to effective management is having a manager! Oddly enough, there are no in-depth training programs for this role, and as far as I can recall, there never has been one. I cover the reasons for this in my book. Yet the ROI on an effective manager is 3 to 4 times, or more, than what you pay them

According to Gallup:
“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, Clifton and Harter)

In October, we will be launching our first training program on the Goal Driven System that will include in-depth training for practice managers – and their CEO’s.

If you are interested, contact me for more information about the Goal Driven System Program and how you can turn your team into Goal Drivers!

Meanwhile,

Seize the Day!

Have You Helped A Child Today?

Posted on October 9, 2019 by Linda

It’s a beautiful fall day here in Southeastern Wisconsin. Clear blue skies, the leaves are changing, and the temps are comfortably cool.

I wanted to take a few minutes of your time to introduce myself and let you know about an upcoming opportunity for you to make a difference in a child’s life both locally and globally.

My name is Linda Skiles, some of you already know me and some may not. I have been involved in chiropractic for the past 34 years in some way or another and a patient for most of my life. I began as a chiropractic assistant, graduating to an office manager, and now serve as the client services coordinator for Petty, Michel, and Associates, working with offices across the nation to promote PMA’s 3 Goals(sm)of methodology:

Greater Profit
Better Service
Higher Purpose

I am passionate about chiropractic and passionate about making our world a better place. Each and every day, I strive to find a way to live with a Higher Purpose. With that said, I’d like to invite you to help support my most recent mission.

Ed Petty and Dave Michel along with the Chiropractic Society of Wisconsin(CSW) have graciously given me the opportunity to collaborate with Wisconsin United for Freedom and Chiro Kid’s Day to host a “Kid’s Korner” at the CSW’s Fall Summit, October 18th-20th at the Wilderness Canyon Lodge Convention Center in the Wisconsin Dells.

The whole idea was born when I made the commitment to sell 600+ ornaments for the Khutsala Artisans of Project Canaan. A large task but achievable with your help.

Project Canaan is Heart for Africa’s 2,500-acre large-scale land development project being used to bring HOPE to the tiny Kingdom of Eswatini (formerly Swaziland) by focusing on four key areas: Hunger, Orphans, Poverty, and Education. It will provide training and employment, while supporting orphans and vulnerable children on the property and across the nation.

In 2013 my twenty-nine year old son, searching for a higher purpose in life, found Project Canaan and served as a volunteer missionary for one year as the bulldozer operator. I had the opportunity to visit while he was there and joined the Swazis in making jewelry. I continue to support their efforts through selling their beautiful beaded ornaments. 60% of the sales support the Khutsala Artisans’ daily living needs and 40% is donated to a local charity of my choice. Proceeds from the sales at the CSW Fall Summit will go to Oklahaven Children’s Chiropractic Center in Oklahoma City, OK.

In addition, I recently published my third book entitled, Nettie’s Fountain Pen – Another’s Days Writings. $5.00 from the sale of each of these books will go to Chiro Kid’s Day and Wisconsin United for Freedom.

Promoting the wellness of our children locally and globally is the theme of our booth. We will have informational material and resources available that focuses on the health of our children here in the US. I hope you will stop by, see what we all have to offer, and support our efforts.

Our children are our future! Can you help a child today?

If you are unable to attend the CSW Fall Summit but would like to purchase ornaments or books, please email me at linda@pmaworks.com

Sincerely,

Linda Skiles
262-749-0221

Links:
Follow my Journey at Project Canaan – Oct 17th 2013 – Nov 1st, 2013
Oklahaven Children’s Chiropractic Center
Heart for Africa – Project Canaan
Wisconsin United for Freedom
Chiro Kid’s Day
Children’s Health Defense

The Merry-Go-Round: Planning for a Prosperous Practice in 2018

Posted on December 15, 2017 by Edward Petty

Progress in practice is made by steady persistence and passion.

In Angela Duckworth’s new book, she calls this “Grit.”

Think of evolution, think of growing crops… think of growing children! Whether it is child development or practice development, growth is achieved through steady and unrelenting nurturing and adjusting according to circumstances.

I recommend you take some time to do some planning before the New Year gets in high gear. January and February are good months to do this. Do it by yourself – and do it with your team. But…

Don’t reinvent the wheel… Just make it go faster with less effort.

The Vital Few

A few of our actions are always more productive than most of the other actions that we do. Unfortunately, we can get distracted and spend far too much time on activities that, in retrospect, just don’t give us that much of a return.

The “vital few” actions that have helped you the most will be camouflaged, even countered, by the “trivial (but useful) many.” This is a term used by Nathan Juran, famous for his approach to business and quality improvement and the Pareto Principle.

And, I would like you to consider this: In many respects, your business has succeeded in ways that – perhaps – you have not yet recognized. Therefore, I don’t recommend abandoning all you did last year and start chasing the newest “shiniest” procedures that seem appealing.

The key is to dust off all your actions from 2017 – review everything you did — and see the great things that worked and the victories you and your team achieved.

Then, just find better approaches to do more of this!

Diamonds in Your Office

The idea of having diamonds in our backyard, a story made famous by Russell Conwell (1843 – 1925) of the 1800s, applies. There are many variations, but it goes something like this: there once was a man who wanted more wealth, so he sold his house and left in search of diamonds. Years later, penniless, he happened back to his village where he roomed at a shelter for the poor. The shelter was supported by a grant from a local resident. In inquiring who the resident was, the diamond searcher discovered that it was the person to whom he had sold his house.

One day he paid a visit to his old house, now renovated into a beautiful estate. He talked to the new owner who told him that he had become rich. He said that when he bought the house, he needed to do some digging in the backyard where he discovered thousands of diamonds.

The moral of the story is obvious: you already are rich – you already have the diamonds. You just need to polish them.

Many of the components of your future success are already in your office. But we overlook them, or use them once and then forget about them, like teenagers looking for the next new article of clothing to make a fashion statement.

As entrepreneurs, creatively – we are all looking for that next dopamine high… and seek the next new “shiny” thing.

You have a show on the road. Just make it better. Make it fresh. Set a new standard, and make a new game to “level up!” Add a few new things here and there, but keep doing what is working.

Looking for Your Diamonds

Review what has been working for you. Reaffirm it and keep at it. Look at what hasn’t worked that well and fix it so that it does, or drop it like barbell that you have been holding over your head for too long.

By yourself, and later, with your team, here are some areas to look into:

____1. Review Your Mission Statement. Does it apply? How? Does it need to be customized? Beyond your mission, what is your WHY? Does the mission satisfy this?
____2. What Are Your Outcomes? For example: “People relieved of pain, healthier, educated so that they can and will continue to improve their health… and refer others?” You can also define Minimal Viable (Valuable) Outcomes, e.g., “A patient who accepts care.” Etc.
____3. How Is the Office Vibe? This is determined by your values and how everyone is living up to them. Are these values posted for all to see and check how they are “measuring up?” Are they defined? Do we need to add more, change some, delete some? Should we better define each value? Should we add:

• Trust. Are we worthy of trust with our patients and ourselves?
• Mission Oriented. Do we help each other cheerfully achieve our mission – each day?
• How well are we living up to these?
• How can we live up to these better?

____4. How Were the Numbers? Up, or down?

• When the numbers went up, what did, or didn’t we do? How can we improve upon this?
• When the numbers went down, what did, or didn’t we do? Should we improve or discontinue those actions?

____5. Individual. What can each one of us do professionally this next year to improve our ability to contribute to our team and its mission?

Some of this should be on simple, brief checklists and memo’s. Add it to your Practice Playbook. Document it so that it can be referred to for training and coaching in the future.

Merry-Go-Round

Imagine that your practice is a merry-go-round, the kind you find at children’s playgrounds.

It takes a lot of energy to push it and get it going. But… once it is moving, it takes less effort to gradually get it going faster. And faster! And faster…

Take some time to review how you are pushing your merry-go-round. What procedures worked better for pushing it faster? Focus on these… Makes these better.

Go faster… and push less.

And as you do, watch those, including yourself, hold on tighter and smile bigger.

Enjoy the ride!

With admiration,

–Ed

Kaizen: Constant Practice Improvement – From Wooden to Deming

Posted on November 17, 2015 by Edward Petty

What improvements do you need to make in your practice for 2016?

Managing your practice is similar to managing a sports team in many ways. There are goals, rules, plays (procedures,) skill development, strategies, winning and losing. There is also coaching and training.

The teams that win the most constantly work to improve. But the improvements often focus on just the refinement of the basics.

One chiropractor I worked with told me stories about his experiences with John Wooden. Coach Wooden was a very successful basketball coach who coached the UCLA basketball team to 10 national championships over a 12-year period.

Here is what Coach Wooden has said:

“When you improve a little each day, eventually big things occur…. Not tomorrow, not the next day, but eventually a big gain is made. Don’t look for the big, quick improvement.

Seek the small improvement one day at a time. That’s the only way it happens – and when it happens, it lasts.”

In Japan they have something called Kaizen. This means continuous improvement. Part of this was developed by another Midwesterner (Wooden was from Indiana), Edwards Deming (Iowa).

The Deming Cycle is a process of continuous improvement that helped grow the Japanese car industry in the 60’s to what it is today. For a long time, Detroit auto companies weren’t that interested in what Deming had to say – and, of course, we can see how that turned out for them!

Constant improvement takes discipline. Those of you who had to practice a musical instrument or an athletic skill in school remember the daily routine. Improving the little things can get boring and when a colleague calls with excitement about this new seminar or gadget or website, many doctors are off to the chase the “shiny things.”

Innovation needs to happen, certainly. But the real successful businesses and teams continually work to master what they already do.

Mastering the basics is always the key to success. Deliberate practice, study and good coaching. And this takes discipline and… a certain degree of humility to admit you can personally improve.

But since you are not a full time coach and mostly work IN the practice, you have to schedule specific times to work ON the practice. But what do you work on? ICD 11? (Yes… it IS on the horizon!) More E.H.R?

Well, maybe, but these are not the areas that will significantly improve your business over the long run and take it to the next level.

To help you uncover what should be improved, you can use our updated Practice Progress Grid. You can go over it with your team and plot where you were, where you are now… and then where you want to be next year! (Link is below.)

This can help reveal what organizational and engineering steps you need to build a better business machine for 2016.

In most cases, the improvements don’t have to be major. They just have to be continuously refined. But some areas that are holding you back from your goals can be hidden or overlooked.

If you want to dig deeper, we also have our Practice Development Assessment(PDA). It takes more time to complete but gives you a more complete analysis. (The link is below.)

The world is changing faster and faster. You have to constantly improve to keep up, let alone, to stay ahead. And if you don’t… well, your patients will be going to those offices that are.

From all of us at PM&A, we look forward to your continued improvements and to helping you get closer to your goals in the New Year.

Ed Petty

Link to Practice Progress Grid
Link to Practice Development Assessment (No charge for first 15 users, $25 thereafter.)

“Ichi-go Ichi-e:” The Springtime Secret to Improving Your Chiropractic Practice

Posted on March 23, 2015 by Edward Petty

The best chiropractic businesses excel at the basics. Too often we can take the fundamentals of practice excellence for granted and go off to chase the “shiny” things, forsaking the powerful potentials right in front of us.

So here is an organic reminder that you, and all of us, can immediately put to use to help us keep growing and groovin’.

Most of us enjoy spring…flowers blooming, birds singing. It is new. It is creative. It is a beginning.

Life goes in cycles – everything has a beginning, a progression, and an ending. Some cycles are longer – every twelve months the tulips come through the winter mud. Some are shorter – each day the sun comes up and we have a new cup of coffee. But nature endures through cycles.

Unfortunately, we don’t always follow nature in our offices.

If you are like most of us, you don’t really start your day. It sort of happens and you just go along. You walk into the office a see what the appointment book offers you. Based upon the urgencies of the morning, you make your way through to the afternoon until you can leave to go home in the evening. But do you really end your day or does it linger with you as you go home, or even stay with you till the next morning?

Most of us are stuck in the blur of stretched out cycles that are blended one moment to the next so that there is never any real beginning or never any real ending. One phone call in the middle of a busy afternoon is very similar to the one you had in the morning…everyday for the last three years. This adjustment to this patient is just too similar to the one you gave…3,000 times before. One moment blurs to the next.

Jim Parker, of Parker Seminars, used to talk about “PTC”, Present Time Consciousness, as a key element to practice success. A practice can suffer because, over time, our consciousness gets stuck in past moments, strung out so that we have less consciousness in the here and now. When you greet your patient, you are not as “here” or as conscious in the present as you might have been the first month you were in practice, or the first week you were on the job. And your patients know it, at least on a subliminal level. They can have a sense that you are disinterested in them and so end up leaving and looking for a doctor who is.

Each encounter with each patient should be new. It should be its own cycle. Each phone call, each adjustment should be unique, separate, as if it has never happened before.

The Japanese have a name for this: “Ichi-go Ichi-e.” Roughly, It means “one time, one meeting” — that this one time will never happen again. It is its own time. It is special.

What would happen to your practice if each day – today – was brand new? Like spring. If this week was the first week you were finally able to see patients after years of preparation?

First of all, you wouldn’t be bored. You wouldn’t be burned out, worried, or angry. Why? Because you are just starting and you have a chance to create the practice anyway you want.

So, what causes us to lose our “PTC” and fall into doldrums? How can we stay in the “now” and be creative each moment we are with our patients, each other, and our loved ones outside of practice?

First, watch out for the backlogs. They are energy dumps. Try to complete your work when you are doing it. Patient notes, insurance reports, filing…try to get it all done as soon as possible. You see, when you start to put your consciousness into a cycle you don’t really get all of it back until you complete that cycle. So, every pile of paperwork and partially completed job that is lying around the office will gradually draw your attention into the past.

Spend a weekend applying the 4 D’s: With each task: Get it DONE, or DELEGATE it, or DUMP it in the trash can. Not all jobs can be completed now, and so some can be DELAYED with a time noted to complete it.

Here are some other steps to make each moment new:

Early to Rise. Begin your day a little earlier… with a walk or a book, some music, meditation or prayer.
Morning Group Planning. Begin your day in the office with a case management meeting, reviewing who is coming in, what special actions need to be coordinated. Maybe add a joke to keep things from getting serious.
End Each Encounter. After each patient contact, end the meeting in your mind.
Interest. With each new patient contact, genuinely find something interesting and new about them – their appearance, their week, something about their story.
Business Coach. Meet with your business coach and review your business and make plans for the next month.
Get Away. Get away on a vacation with your spouse, or a sabbatical and seminar for yourself. ( I’m heading out to Cal Jam this week. Hope to see you there!)
Un-Serious. Do things in your office that are different, fresh, and new. One office has a “fruity Friday” and offers fruit to the patients. Avoid the deadly disease of “seriousness.” Tell a joke, be silly.
The Four D’s (again): Do it, Dump it, Delegate it, Delay it. Avoid backlogs.

Some of this takes discipline and creating rituals to help ensure these actions take place

But you are part of nature and spring is already in your heart. You just have to let it out, like a song that is ready to be sung or a jig ready to be danced. You already have the creative spark of newness inside you.

So just breathe.. and let your spring happen today and each day. And help others to do the same.

Carpe Diem and Happy Spring!

–Ed

10 Practice Development Strategies for Chiropractors in 2015

Posted on December 31, 2014 by Edward Petty

[If you think that you could make more money selling pharmaceuticals, injecting patients with vaccines and promoting flu shots in front of your office, these recommendations are not for you. For those matters, you might want to ask Palmer Chiropractic College or the Wisconsin Chiropractic Association for their opinions.]

What strategic moves should you be taking now to make sure that you have a better year in 2015 and in years to come?

After reviewing current literature and statistics, and based upon my observations and experience, I have put together a report which makes a number of recommendations that can be helpful to you. I have also included an extensive list of references for your further study.

The report contains a lot of information and so it is only for the serious practice executive. It will be a useful resource for you to refer to while you implement some of the suggestions I offer. Reading time is about 15 minutes. It offers new views on practice marketing, management, and leadership, with 25 specific recommendations. To go straight to the main course, go here:

Here is a shorter version:

Executive Summary – 10 Strategies to Prosper and Flourish in 2015 and Beyond

1. Know Your Environment. The Medical-Pharmaceutical industries are spending more to dominate the market place. Their efforts are becoming more pervasive in reach and more covert in manipulation. At the same time, wellness statistics continue to grow. More people are turning to organic foods and are focused on wellness.

2. Marketing Positioning. My recommendation is to embrace the popular movement towards natural health and own it. Be its champion. You are the Healthy Life Doctors. This is your niche.

3. Unique Selling Proposition. Stay committed to your core services, but articulate your Unique Selling Proposition to your specific market niche(s). Not everyone is your patient. Select certain markets that are already reaching for your type of services: people fed up with drugs, baby boomers who want to stay healthy, mothers who want to avoid drugs for their children, athletes, employers who want healthy employees, etc.

4. Get More For Less. Watch your economics but don’t get stuck in a scarcity mindset. Central to economics is a return on investment -ROI. Invest in yourself and especially in making your support team expert professionals. Learn and apply the Pareto Principle (how 80 percent of your results come from just 20% of your efforts).

5. Insurance or Cash? Yes! Take insurance but don’t kowtow to the Insurance Cartel. There are millions of people who want help and can pay for it and are just looking for a solution. You have to let them know that you have their solution.

6. Shift from Personality Driven Practice to Team Driven Business. The successful offices of the future will be team driven and systematized. Each team member has to be an expert as a specialist, as a team member, and as a marketer. And each should try to achieve this as well. The doctor will delegate most marketing and administrative details to others.

7. Shift from Solo Practice to Group Practice. For those of you who are ready, you should join forces with other doctors in a group practice. This has not had a lot of success in the chiropractic profession as it has in other professions, but the time is right now to band together synergistically as brothers and sisters. There are many good reasons to do this now. However, it has to be set up — and maintained — correctly.

8. New Role: CEO and Leader. Why do CEO’s get paid so much? Because they can make such a positive difference in the business. Up to now in your career you have taken on administrative and marketing projects mostly from the role of doctor, or perhaps owner. The CEO role probably has not been emphasized. Shifting to the role of CEO changes everything. Growing a business becomes easier, you have more time available, and you make more money.

9. Seek Out and Integrate Your Greater Purposes with Your Business. The power for your office, and you, comes from those things that mean the most. This would include your family and your spiritual pursuits. But our world is smaller and we live in a networked economy and culture. Your office, in its own right, has to be a leader in your community and environment and contribute in some way beyond its walls. This also includes having a voice in your professional organization. Your greater purposes also include your personal hobbies. Since you are not working on an assembly line, many of these purposes should be integrated into your work.

10. Get an Executive Coach. Why does corporate America spend over a billion dollars on executive coaching? Because the return of investment proves to be at least 7 times, and in some cases, 10-49 times cost. Executive coaching doesn’t cost – it pays.

An executive coach is different from a clinical coach. An executive coach will help you be a better CEO – a better leader, marketer and manager who builds a team driven business which allows you to delegate most non clinical duties. He or she will help you sort out what tasks will produce the greatest positive effects for your business, and help you get those tasks done. He or she will be your partner, counselor, confident, coach, teacher, drill instructor, and friend.

The future has never looked brighter, but the challenges are not slight. This makes your success all the more important – and sweeter.

Ed Petty

Giving Thanks – Appreciating Each Other

Posted on November 25, 2014 by Edward Petty

I know you are busy now.

We all are.

We fly through our days, adjust and treat patients, make our calls, do our paper work, and then rush out to our personal lives.

But often we are like bus drivers, driving so fast that we drive past of our bus stops where our passengers are waiting for us.

So this is just a short note to remind each of us to stop, now and then, and say thanks. (And I know you know this, but a gentle reminder never hurts.) Over here in the U.S., we are celebrating Thanksgiving Day, so it is a customary holiday for us. But we really need to give thanks daily.

Gratitude is a powerful attitude and a feeling that we can use and regularly adopt to make our lives better. But its practical application derives from the fact that it is a basic recognition of a deep truth that we probably too often overlook.

The truth is that we are given so much — and that there is so much goodness in the world that deserves our appreciation.

And so this is a note to also let you know that all of us at PM&A are truly thankful for the work each of you do.

We know how hard you work and we know how much you help your patients and your community and we sincerely honor it. In fact, it is the reason we do what we do.

Unlike other management companies, we have seen you in your offices, talked to your staff, and know your numbers. We know that you don’t really get the appreciation that you deserve, but thankfully, you are not waiting around to receive “thank you” cards! Each of you are too busy helping others.

You really are the leaders in health care. You haven’t sold out. You are strong in your principles and motivated in your mission. And so are we. How each of us arrived in this line of work — who knows? Perhaps it is part of a plan, or a calling… but here we are.

I think it is safe to say that each one of you also appreciates the good work of each other across this planet in helping others get better naturally – even though you haven’t all been introduced. We are all connected by our basic efforts to help others get healthier.

And when you think about what we are all doing to help others, there certainly is a lot to be grateful for. It can almost give hope that the world can be, and will be, a better place.

With much gratitude and best wishes,

Happy Thanksgiving to one and all.

Chiropractic Team Tryouts: Tips on Interviewing Potential New Team Members

Posted on January 23, 2014 by Edward Petty

Tryout: a test of someone’s ability to do something that is used to see if he or she should join a team, perform in a play, etc. (Merriam-Webster)

We routinely help our chiropractic teams with the hiring process.

Getting the right players can make all the difference in whether you are a winning team or just a mediocre one.

It is often difficult to find the right candidate for the job. The prospective employee is trained to be sweet at the interview and have an impressive resume and you are expected to ask her just the right questions that will evoke her true character. This is usually not adequate.

In addition to interviews, practical tests that challenge candidates for the job position can be included as part of the hiring process. Much like a “tryout” for any sport team, musical group, or an audition for a play, we want to see how the prospective new employee performs.

A good management motto is: “Look, don’t listen.” This definitely applies to hiring.

After the first interview, if you are still interested in the person, have them come in again for a practical interview. This is the “tryout” or audition. For the front desk position, present them with some challenging but common situations and have them demonstrate how they would handle each. Have them demonstrate as in role playing, not just tell you how they would do it.

In the examples below, the doctor can be in the role of the patient, or prospective patient, or have another team member in that role.

For the Front Desk position, you can have the candidate take on the following situations:

Appointment book is full. Patient calls in and wants to see the doctor.
Patient calls in and is in pain.
Calls but is skeptical of chiropractic
Calls, asks how much for an adjustment, and then says it costs too much
Patient is leaving after an adjustment, needs to be scheduled, and the phone is ringing.
Patient owes $37.67. Collect it.
Promoting upcoming talk, next Tuesday at 6:30 on “Spinal Fitness.”

Someone applying for Patient Accounts could role-play the following:

Perform a patient financial consultation on a new Medicare patient who also has a secondary.
Call for chiropractic benefits.
Receive a letter “not medically necessary.” What actions to take?
Promoting upcoming talk, next Tuesday at 6:30 on Spinal Fitness.

Other situations can be presented that are appropriate for your office, depending on the position, such as therapy, external marketing, etc. Be creative and keep it fun, but challenging.

You can give the candidate a few lines to help them, but tell them you want them to improvise to the best of their ability. It doesn’t have to be perfect and probably won’t be that smooth as they are new to your office.

What you are looking for is their ability to be genuinely interested in the patient. You want to see how much in command they are of the situation, their friendliness, compassion, and general quality of their communication.

If you want a winning team, when hiring, use “Tryouts.”

Monthly Goal Setting for the Chiropractic Team

Posted on January 31, 2013 by Edward Petty

Chiropractic Team Goal Setting

At the beginning of each month you want to see that your team sets new TEAM GOALS. You can also set individual goals privately at a different time, but TEAM goals are most immediate and important.

Each goal setting session always begins with a REVIEW of the past month. This gives the opportunity for the group (or individual in individual goal setting) to explain how they did and how they did it. And it gives you the opportunity to listen and then give some feedback. The feedback could be praise, or otherwise.

After the review, set the goals. Group goals should be simple, usually just Office Visits and New Patients, though Collections can also be included. IMPORTANT: Let the group set the goals. You should negotiate the goals, but it has to be theirs. Once these goals are set, ask the group (or individual) how they/we plan to achieve these goals? Get at least 3 action steps.

The last goal should include a “greater purpose” goal or two. This could be a party at your house next Thursday night, Betty, the Front Desk Coordinator will give a book report on one of the books in the Lending Library at next month’s Team Goal Setting meeting, and a check to see who is going to volunteer for working at the food bank next Saturday evening.

Why? You should also spend some time discussing why you have these goals. This takes you back to your MISSION. Numbers for numbers sake is a soulless and goalless pursuit.

In sum:

Review last month’s numbers. Were they up or down from the prior month? Ask.
Then, ask why? Get the team to figure it out. Let it be a brainstorming session if possible.
Let them tell you and you listen and question as needed.
Acknowledge. Praise or show disapproval, as appropriate.
Then ask for action steps to achieve goals.
Then, get a few “greater purpose” goals.
Then, continue with the rest of the staff meeting, such as announcing upcoming events, miscellaneous, etc. Include some discussion about WHY these goals are important.
Do the same for individual team member’s right after the Team Goal Setting, or soon after.

For more information on how this procedure is done, refer to the webinar called the Fast Flow CEO.

Chiropractic Practice Management, Marketing, and Leadership Recorded Training Webinars

Posted on January 31, 2013 by Edward Petty

This is a list of our practice development recorded webinars.

Each is a recording of a slide show driven lecture, each filled with an abundance of practice information derived from in the field work – and plenty of slides!

Currently, you have to be active on a PM&A program. By this summer, these will be available on and individual basis for a small fee.

Chiropractic CEO Webinars

Creating your Dream Team Summary and VideoA virtual “live” interview with the doctor and staff of a true chiropractic dream team. Find out what they do to achieve high numbers, profit, and fun.

The Fast Flow Practice CEO -55 minutes webinar video and summary.
One of the biggest challenges in running and growing your business is the time it takes you away from seeing patients and from your family. We have solved this with what we call the Fast Flow Practice CEO System. A new system derived from old principles.
Management by the Numbers: 44 minutes – Summary and Video
Management is a subject that has techniques to help you go from where you are to where you want to be. Management By the Numbers (MBN) can be faster and more accurate than other forms of management, and help build staff morale and make it more self directed.

Capacity Constraints : 33 minutes – Summary and Video
Do you work hard but you just don’t get as far as you should? The reason may be that you are running into unseen bottlenecks that are choking off your production and suffocating your growth. This is the subject of Capacity Constraints.

How to Be an Effective Practice CEO Video
If you are struggling with the ups and downs of a stressful practice, or have finally “settled” into a comfort zone producing much lower than you know you are capable of, this program is for you.

Chiropractic Office Manager Webinars

Chiropractic Manager Webinar – Roles and Goals Summary, Video and Study Guide
What Are The Key Roles In Your Office? A hidden barrier in many offices has to do with confusing roles and job duties. Clear these up and see how much smoother patients and paper flow, and happier the team becomes. Small office or big health business, clarify these 8 roles and the numbers will go up.

Chiropractic Manager Webinar – Job and Performance Reviews Video
Employee reviews are often neglected, or are dreaded by employee and doctor. This webinar covers the basic steps to make them effective and positive for both doctor and employee. Approx 37 minutes.

Chiropractic Manager Webinar – Motivating Your Staff – Video Ms. Phyllis Frase shares 5 secrets to keeping yourself and your staff motivated.

Chiropractic Manager Webinar – Team Meetings Summary, Video and Study Guide. This is an overview of 8 essential actions to help you improve your meetings and make them faster, more fun, and more effective. Plus, different types of short meetings that your team can grow.

Chiropractic Manager Webinar – The Office Manager Job Description Summary, Video and Study Guide. This class covers 17 essential duties of the office manager. Both the doctor and the office manager should watch and discuss these duties.

Chiropractic Manager Webinar- How to Best to Train Your Staff Summary, Video and Study Guide This webinar covers eight tips to improve the performance of your team. Training plays a big part in team building.

Chiropractic Manager Webinar– How to Hire the Right Team Member Summary, Video and Study Guide.
This webinar covers eight priniciples for hiring the right team member from knowing when to hire, who to hire and how to hire.

Office Manager Webinar – It’s All About the Patient, the Doctor and the MISSION [Summary, Video and Study Guide]
There are procedures to help the patients and procedures that help the doctor help the patient and then there is Everything Else. Tips on how to deal with Everything Else. (30 minutes)

Office Manager Webinar- Part II – Tips and Tricks to make the office more efficient[Summary, Video]
Part II reveals tips and tricks of what an office manager can actually do in the office on a day to day basis to make things run smoother and significantly improve the volume and quality of services. (55 minutes)

Office Manager Webinar- Part I – Fundamentals of Practice Management [Summary, Video]
Part I covers the fundamentals of Practice Management (55 minutes)

Chiropractic Marketing Webinars

Innate Marketing (55 minutes) – Webinar plus Summary.
There are stories that float around every now and then about how some offices can simply “think” “New Patients” and they come in.
Are these stories an urban legend? A myth, or a fact? Can staff or doctors “concept” new patients in the door. Is this true? If so, how can you do this? 10 steps to help you generate more patient visits through “concepting.”

Chiropractic Special Promotions (55 minutes) – Webinar plus Summary.
This webinar covers different promotions by month. You will learn 2-4 different practical promotions for each month of the year. More importantly, you will learn how to organize them so that they are time effective and productive.

Patient Retention – Summary and Video
If you understand the underlying basics of patient retention your appointment book should always be full. Covered in this webinar is: Patient retention should be based on Principles – not gimmicks. Where are we you taking your patients? Why they quit? The cost of not getting them there.

Chiropractic Patient Education – Summary and Video (45 min)
We go over 7 basic strategies that cover the entire horizon of patient education and explain why it is so necessary to educate your patients if you want them to be healthier.

Infomercials. – Summary and Video .
Whatever happened to Infomercials? They’re still around and they still work. And you can do them very inexpensively. You just need to know how. This webinar will give you practical examples and include forms for you to use in producing your own amateur and informational marketing that can help you create more new patients and keep the ones you have.

Internet Marketing and Social Media. – Summary and Video . This webinar covers some fundamentals regarding social media, Facebook, and general Internet marketing. (35 minutes) (not yet posted)

The Art of Spinal Screenings. – Summary and Video . Spinal Screenings – The Queen of External Marketing. Everyone has done at least a few spinal screenings. You have probably had some success with them. But how much better could you do if you knew the fundamentals of this time tested external marketing activity? This is a three part series on spinal screenings. This session we will review the most fundamental principles of screenings. Get these, and all else will follow.(45 minutes)

Scheduling Screenings and other External Events – Summary and Video . How to Schedule External Events And Create External Referral Sources. Types of events, Outcomes, Purpose. How to plan the events and get them scheduled.(30 minutes)

Marketing Tips: Earth Day, Spring Promotions, and other Tips – Summary and Video This webinar covers: Powerful internal marketing script, Report of findings referral procedure, upcoming spring promotions, with special attention to utilizing Earth Day as an opportunity to promote your services.

Short Overview of Chiropractic Marketing Management with Some Marketing Tips – Summary and Video This is a short version of marketing management and some tips for the upcoming months. What are the three levels of marketing? What part does communication have in your marketing? How to engage your patients in your marketing efforts. Upcoming special promotions. (30 minutes)

Marketing Management, Part I and Part II – This is the longer version of how to manage your marketing, and why.

Chiropractic Marketing Management – Session I – Summary and Video The Why, What and How of Marketing. Getting your Marketing off the Ground. (55 minutes)

Chiropractic Marketing Management – Session II – Summary and Video Specific Marketing Manager Duties – Your Job Description. General Overview of the Most Effective Marketing Procedures in Each of the 11 Marketing Categories (55 minutes)

Faster To Tomorrow

Posted on January 17, 2013 by Edward Petty

It comes at you fast.

The New Year. Like a fast train, you know it’s coming, and suddenly, it is already whizzing past you.

Actually, each year it comes by faster. You may not have yet fully had a chance to finish all of last year’s work, or set your chiropractic goals for the New Year. But nothing slows down the advance of this New Year – and before you know it, it will be spring.

And come summer and fall, what will you have changed in your practice? Probably not as much you would have hoped for. Why? Because change is coming at you so fast it’s almost too much to keep up.

And it’s not just you that is experiencing change – our whole world is changing. Faster and faster. The political noise and tumult we hear constantly are just the symptoms of the conventions of the old grating up against the realities of the new.

Ray Kurzweil, whose predictions have been mostly correct over the last 20 years or so, predicts that by 2045 we will have computers that will be able to teach themselves so fast that the speed in which they learn will reach infinity. This is a very rough description of the Singularity he describes in his book. (The Singularity Is Near: When Humans Transcend Biology)

“An analysis of the history of technology shows that technological change is exponential… There’s even exponential growth in the rate of exponential growth… The twenty-first century will see almost a thousand times greater technological change than its predecessor…” – Ray Kurzweil

In other words, change is changing exponentially.

This New Year of change is faster than ever before. But if we move way out beyond all the hue and cry of chiropractic philosophy, “evidence based” chiropractic, “injectables”, politics in and out of the profession, the rah-rah and rock and roll, there is a quiet universe waiting of healing and success which we may only get glimpses of.

In my opinion (IMHO) … it is a world which you, the chiropractor, have always been in. It is not a matter of reaching your goal as a healer. You are already there. Science in fact is catching up to what D.D. Palmer talked about as the 19th Century rolled naively into the 20th. Bruce Lipton, a professor in biology who once taught medical students at a medical school here in Wisconsin, after his research and similar epiphany, now teaches chiropractors at a chiropractic college. He gave a wonderful presentation at Life West Presentation in San Francisco in 2012. I was there and heard him. (Spontaneous Evolution by Bruce Lipton)

: Ed Petty and Bruce Lipton

But the truth is, you, as a chiropractor, are already there. You have already ridden the wave and, to some degree, are on the other side of the Singularly. You may not fully realize this, the full power and truth of your profession, and I certainly don’t pretend to. Well, maybe you do since you are reading this, but probably most doc’s don’t fully appreciate what they have with chiropractic. But the Innate power defined and used by chiropractors is there. How else do you think it has been able to survive and persist over these 120 years through the teeth of vested interests and vicious and covert attacks – that still persist? (see Doctored, the Movie.) It is certainly not because of the great skill and effectiveness of your national or state organizations (not to discount the good work they have done here and there.)

And this brings me to the point of this article: you have got to upgrade the architecture and skills of the management of your office. So, while the healing aspect of your profession is, and has been, way ahead of the times, in many cases your management is not. Military control of your staff, robotic scripts, referral gimmicks and other relics from the 60’s and 80’s have no place in the future. Dr. Noope left the building a long time ago. (Who remembers him?)

For you to succeed, your management and marketing has to be way ahead of the curve. The world is changing so fast that if you are not keeping up, patients will look for chiropractic offices that are. It is that simple: lead from the future, or perish as an amalgamation of P.T., massage, and G.N.C.

It is now 2013 and by now you may have, or should have set some chiropractic goals for 2013. The challenge now is getting there. This is also our challenge as Petty Michel & Associates consultants and coaches as well.

This year, our goal is to get you to your goals FASTER.

Faster to the future and faster to your goals. It is a challenge, but we have been developing newer and faster approaches that can help you (and your team) get more done quicker.

We want to help you get to tomorrow’s goals – faster and once there, help you stay there and enjoy the ride. “Get There Faster and Stay There Happier.” Yep, them’s our goals!

As the world speeds up and changes faster each day, we can whine about how we are being left behind, stoically assert our principles and pretend everything is just the same, or embrace the changes and in fact drive them forward ourselves.

On February 1st we will be announcing new management technologies to get you to your goals faster and funner. Or Funnier.

In either case, please stay tuned.

The Chiropractor Versus the Chiropractic CEO

Posted on October 15, 2012 by Edward Petty

There is a constant struggle in your office.

It is a battle between you as the doctor and you as the CEO.

As the CEO, you want to grow your business. You want it to be profitable, smooth running, and systematized. You want it to be efficient and providing excellent service.

As the doctor, you want to focus on each patient and their unique treatment program. You really could care less about administrative concerns as these are usually just distractions to your patient care.

Who wins this war between the doctor and the executive manager?

Unfortunately, in most cases, no one. Usually, the doctor’s duties blend in with the executive duties and the services get watered down and the growth of the office never reaches its full potential.

Without a doubt, the biggest dilemma in practice management is just this:

How can you be the best doctor you can be
and also run your office?
If you had the time (and perhaps the training, but that too just takes more time!) you could take your business to the next level. But there just isn’t the time. You are too busy as it is.

This was the theme of Gerber’s book, the E-Myth, wasn’t it?

You know you should “systematize” your office procedures, but that still takes time. And maybe this systematizing stuff hasn’t worked all that well for you.

It comes down to roles: how can you be a compassionate and dedicated doctor while at the same time being the CEO of a growing small business?

This Thursday, October 18, 12:30 pm Central to 1:20, we will show you how –

Learn how you can, in 5 hours or less each month:

* Drive your business to the next level
* Improve communication with team members
* Help each staff member be more goal oriented
* Help create a stronger team that is more goal oriented
* Have more fun in practice
* Achieve more of your clinic goals

As the doctor, you are taught patient management procedures. You need them and patients benefit from them.

But as a business owner, you also need practice management procedures. Done properly done, your business will benefit.

We will show you how to do it in just over 1 hour per week, on average.

You won’t find this anywhere else. (Hype alert.) This is a culmination of our Marketing Manager System (2001), 3 Goals Management System (2008), and three other management systems which we have incorporated into our consulting over the last 25 years.

Because we feel this process is so important for your practice, we are waiving the fee for this webinar.

That’s right, this is one is FREE. It should be three times the usual price but we want to get it out to you now and fast. We want to help you get a head start on 2013.

But you have to register, so go HERE to do so.

Best regards,
Ed

PS This webinar is for doctor owners only and the office manager or administrative/office coordinator.

5 Levels of Administrative Support in a Chiropractic Office

Posted on October 10, 2012 by Edward Petty

Someone in your office needs to be responsible for the administrative duties that fall outside of the usual functions in a chiropractic office of:

Front Desk
Patient Accounts
Hallway/Therapy.

This someone is usually the chiropractor – at least at first. But as the practice grows there is more administrative work to do. The doctor can do it, of course, but he or she should be spending time on adjusting patients and building the office.

The smart doctor knows this rule:

Do what you do best,
And delegate all the rest.

Some offices have a chiropractic assistant that is called an “office manager.” The role of the office manager is often vague and the duties are varied. Usually the “office manager” has had very little, if any, management training.

The growth of the business will eventually stall because of this.

Most chiropractic team members are bright and industrious and whoever is assigned the role of office manager usually does her best for the office. Unfortunately, this is not enough in most cases for the office to achieve its capacity and goals.

In 2013 we will be launching a number of new office manager training programs to help doctors and office managers achieve their full potential.

In the meantime, the chart below may help clarify the general range of duties of an office manager. It lists an approximate hierarchy of responsibility for someone delegated by the doctor to perform administrative functions.

A staff member who has another job in the office, for example, front desk, may take on a part time role of Administrative Assistant. As the office grows, she could take on more responsibilities as the Administrative Coordinator, and then finally as an Office Manager. She may have to delegate some of her front desk duties to give time for the extra admin work she now has.

The titles below are intended to demonstrate that there are different levels of administrative responsibility and are not exact. Your office might just need an admin assistant.

However all doctors need to delegate their management and administrative duties and more offices than not, suffer for lack of well trained and effective office managers.

5 Levels of Administrative Support

Administer = from Latin administrare, from ad- + ministrare to serve, from minister, servant

5. Practice Manager – Similar to a general manager. This role is for a larger office with 15 or more staff.

4. Office Manager – About 5 hours per week or more, but takes on a majority of the administrative duties and some of the management functions. Supports the staff and the doctor to give better service. Is accountable for office growth and performance.

3. Office Coordinator – Works 5 hours a week on administration. Helps the doctor with management duties, including human resources (hiring, training, etc.), marketing, coordinates with the staff on training, marketing, and other special projects.

2. Administrative Coordinator – Works about 3-5 hours a week on administration. Clerical duties, some important. Helps the doctor with management duties, including human resources, marketing, etc.

1. Administrative Assistant – Works about 3 hours a week on administration. Mostly clerical duties.

Chiropractic Staff ROI and Motivation

Posted on July 12, 2006 by Edward Petty

Staff Management: An Essential Component To Practice Success

A big reason for your chiropractic practice is doing well is because of your staff. And, a big reason your chiropractic practice is not doing well is because of your staff. Either way, your staff plays a major role in the success of your business.

How much can a good staff member contribute to the office? What is the Return On Investment for staff expenses? There does not seem to be any good research on this for chiropractic offices. (If you know of any, we would appreciate the references.) We have seen some studies and based upon these and our experience it would be safe to say that a staff member should contribute at least double what you pay them.

This means that if you pay a Chiropractic Assistant, for example, $2,500 (including taxes, FICA , etc.) a month, you should at least be able to generate $5,000 because of her. On the other hand, when a staff member is not performing well, their contributions can go to zero, or even lower. If they are alienated from the doctor and the practice, they can actually become a liability. An unhappy or defiant staff can turn away patient referrals, discourage patient phone appointments, create disharmony with other staff, and many other costly problems.

Staff Turnover
The cost of staff turnover can be very high, as much as three times their monthly pay. This would include recruiting cost, training cost, extra time on your part, lost patient and lost new patients. For example, if your senior front desk C.A. leaves and she is paid $2,500 per month, it could take a couple of months before you find another CA that has the qualifications you need, and at least a couple of more months before they are trained.

By the way, this is why it is so important to have your practice systematized with all of your procedures written up for fast training and evaluation. (This is what our PM&A Practice Development Programs help you with!)

Conversely, as mentioned above, you can save money by letting an under performer go.
Staff Motivation
Once you have personnel, you have to keep them motivated. Frankly, this can be a problem for many doctors. There is a basic reason for this which I will explain later on. First, let’s look at some interesting information on employee motivation.

A recent article from the Harvard Business School reports on a study that showed that most employees start out relatively motivated, but things change after about 6 months.

“The great majority of employees are quite enthusiastic when they start a new job. But in about 85 percent of companies, our research finds, employees’ morale sharply declines after their first six months—and continues to deteriorate for years afterward.”

One of the biggest causes for this goes straight to the relationship they have with their managers.

“Many companies treat employees as disposable. At the first sign of business difficulty, employees—who are usually routinely referred to as “our greatest asset”—become expendable.

“Employees generally receive inadequate recognition and reward: About half of the workers in our surveys report receiving little or no credit, and almost two-thirds say management is much more likely to criticize them for poor performance than praise them for good work.

“Management inadvertently makes it difficult for employees to do their jobs. Excessive levels of required approvals, endless paperwork, insufficient training, failure to communicate, infrequent delegation of authority, and a lack of a credible vision contribute to employees’ frustration.” (You can read the entire article here.)

We have seen versions of these problems in every office. Even our own!! It happens. One of the most common habits of doctors that can impede staff performance and motivation is micro managing. For example, fretting over the office volume, doctors can hover around the front desk causing the staff to be more concerned about the doctor’s constant evaluation than engaging with the patients.

To solve these de-motivation factors, the authors suggest the following:

1. Instill an inspiring purpose.
2. Provide recognition.
3. Be an expediter for your employees.
4. Coach your employees for improvement.
5. Communicate fully.
6. Face up to poor performance.
7. Promote teamwork.
8. Listen and involve.

We would add two more factors. First:

9. Clear policies and procedures consistently applied. You need to coach your team on the same procedures today that you applied yesterday, and will use tomorrow. These procedures should be written down in some form for easy reference. This gives an objective reference for staff coaching (#4) and regular staff evaluations (#6).

And the most important, and most overlooked in a doctor’ office:

10. Separate your roles of doctor and clinic director so that you can be a part time manager.

The Most Common De-motivator
Most chiropractors are either too busy and/or too focused on doctoring to have much attention left for caring for staff. After all, the staff is there for the doctor and to help him or her with the patients. The doctor is not there for the staff. And, the staff is paid to do their job.

So, what’s the problem?

The problem is that employees are people and not machines. And, like all living things, they need a certain amount of nurturing. Growing a business is like growing an orchard. It needs tending. Doctors do not feel they should have to do this, and as doctors, they shouldn’t.

However, as the C.E.O. their business, they have too. Larger offices have office managers or practice administrators that can help do much of the staff management. We usually recommend that the doctor assign a staff member to take the role, if only for a few hours per week, of senior C.A., office coordinator, or office manager.

Most doctors can be managers and coach their staff, but don’t. The reason, and the solution are relatively simple: just separate the roles of doctor and clinic director. As the doctor, everyone works for you and the patient. As clinic director and a part of management, you work for everyone else.

With good business systems in place, a well organized office should require little time of the doctor to be a clinic director. And in the role of business owner and investor, the doctor should see a very good return on his efforts if his staff is motivated.

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Observations

observations from our travels in the world of chiropractic

Category Archives: Office manager