Category Archives: Practice Management

Why Practice Systems Aren’t Enough

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What you need to do

     “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.
– B.J. Palmer (1920, from Up From Below the Bottom)

B.J. Palmer, a pioneer in chiropractic, emphasized two keys to growing a practice: effective marketing to establish visibility and robust systems to manage growth. In the 1920s, he built a chiropractic college with 1,000 students, showcasing his ability to promote and systematize. Similarly, Michael Gerber’s The E-Myth (1980s) stresses that systems, not individual effort, drive business success. Quotes like “Systems run the business and people run the systems” highlight the need for structured processes.

However, many chiropractic offices struggle to implement systems effectively. The missing piece is clear leadership and accountability. Doctors and staff are often too busy to manage systems, and most practitioners lack the desire to oversee them. A dedicated manager and a goal-driven team are essential to bridge this gap.

Action Steps to Implement Systems:

  1. Lead as the Clinic Director: Dedicate a few hours monthly to strategic oversight, emulating Palmer’s leadership in driving innovation.
  2. Instill Purpose: Hold monthly team meetings (2 hours) to reinforce your practice’s philosophy and align the team.
  3. Appoint a Manager: Designate an administrative coordinator for 2-4 hours weekly to oversee systems.
  4. Define Roles: Have the manager collaborate with the team to create and maintain job duties, reviewed by you.
  5. Coach the Manager: Meet twice monthly (1-2 hours) to review the manager’s progress and provide guidance.
  6. Use Frameworks: Apply *The Goal Driven Business* to structure system implementation.

The Outcome:
A manager handles daily operations, freeing you to focus on growth. This shifts your practice from surviving to thriving.

Next Steps:
Read The Goal Driven Business for detailed guidance. Assign a manager now or book a consultation (May 2025). Stay goal-driven to build a scalable, successful practice.

And Stay Goal Driven,

Ed

Book a Consultation NOW!

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

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steve jobs

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

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

The Top Line: Your Practice’s Foundation

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

Top-to-Bottom Framework:

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

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

Insights from a Chiropractic Leader

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

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

Sustaining Your Vision

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

Apple’s Core Value and Your Practice

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

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

Stay Goal Driven.

Ed

Momentum Magic: How the Flywheel Effect Boosts Your Chiropractic Practice and Service Business

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flywheel effect

What separates good businesses from great ones?

It’s momentum—created by doing what works consistently and improving it over time. In business, especially in healthcare services like chiropractic, success often comes not from radical change but from steady, thoughtful progress.

Avoid the Trap of Constant Change

Healthcare entrepreneurs often seek out the next big thing—new therapies, machines, or procedures. While innovation can be beneficial, abrupt changes to proven systems can disrupt staff and confuse patients. A smarter approach is to test new ideas first, and only implement them if they complement what’s already working.

“If something works—fix it, refine it, but don’t toss it.”

The Flywheel Analogy

Jim Collins, in Good to Great, uses the image of a massive flywheel to illustrate how lasting success is built. At first, it takes immense effort to turn. But with consistent effort in the same direction, the wheel picks up speed and begins to turn on its own—powered by its own momentum.

The key lesson: there’s no single breakthrough moment—just consistent, focused effort over time.

How This Applies to Your Practice

  • Identify what’s working—and keep doing it.
  • Make small, strategic improvements over time.
  • Adapt to market changes gradually and intentionally.
  • Build systems that generate results with less effort over time.

By steadily turning your business flywheel, you’ll transform your practice from good to great—creating a self-sustaining engine of growth.

Keep building. Keep refining. Momentum will do the rest.

Ed

Boosting Service and Retention Through Daily Case Management in Chiropractic Practices

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planning for a winning dayStart the Day with Purpose

A quick, structured case management meeting each morning can significantly enhance patient retention, referrals, service quality, and team morale.

The Morning Case Management Routine

Spend 20 minutes before seeing patients to meet with your team. Review the day’s patient schedule—focusing on individual needs, progress, or concerns. You don’t have to cover every patient, especially on busy days, but focus on those needing special attention.

Key points to discuss:

  • What’s the goal of today’s visit?
  • Do they need therapy, rehab, or a progress exam?
  • Have they voiced any concerns?
  • Do they need educational materials or financial consultations?
  • Should a family member attend?

Also, go over new patients—who referred them, what to expect, and how to create a warm welcome.

Keep the Energy Up

Beyond planning, these meetings set a positive tone for the day. Encourage team bonding with short activities like stretches, planks, or even a daily “bad dad joke” to keep things light.

Set achievable goals for the day—such as new patient intakes or completed cases—and review a motivational quote or revisit your practice’s core mission.

Make It Routine, Make It Stick

Assign responsibility for leading the meeting, but ensure it has leadership support. These meetings only work if they happen consistently—don’t let them fade away.

Ultimately, the purpose is to better serve patients and help them reach their health goals—this is what great case management is all about.

Seize the future!

Ed

Master Your Craft First: The Key to Success in Chiropractic, Healthcare, and Service Businesses

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chef Jiro Ono, mastering the skill of making sushi

Marketing Starts with Service Quality

A chiropractic clinic once asked for help boosting patient numbers and improving their marketing. While we did touch on marketing strategies, the real game-changer was getting back to the basics—refining the way they practiced.

Each visit, we reviewed patient interactions, discussed specific cases, and role-played challenging scenarios. This hands-on, continuous learning approach helped the doctors improve their confidence and communication. The result? Within a few months, new patient numbers nearly doubled, and total visits increased by 50%, driven by better retention and reactivations.

When Business Slows Down, Go Back to the Fundamentals

If your numbers are dipping, the first step isn’t better marketing—it’s better service. Start with yourself and your team. Are you genuinely present with each patient? Do you “really” listen and connect?

One of the most successful doctors I worked with approached every patient with deep empathy and curiosity. She didn’t rush into treatment—she listened, observed, and connected both emotionally and physically. Her retention and referrals were outstanding.

On the other hand, her associate, while friendly, lacked that same depth of connection. As a result, her performance—and the clinic’s growth—suffered. Unfortunately, without proper training or mentorship, her skills never reached the necessary level.

Excellence Is Contagious

Great service isn’t just about the doctor. Every team member needs to be aligned in delivering exceptional care. It’s a group effort.

Consider sushi master “Jiro Ono”, whose small Tokyo restaurant had a waitlist over a year long. He dedicated his life to perfecting every element of sushi, constantly refining and improving. His commitment to excellence became his best marketing tool.

As Jiro said: “You must immerse yourself in your work. You have to fall in love with your work. That’s the secret of success.”

The Takeaway

Before pouring energy into marketing tactics, ask yourself: “Have I mastered my craft? Are my team and I truly delivering top-tier care?”

A good business, like a good restaurant, eventually fills itself up—because mastery, presence, and consistent quality attract people naturally.

Keep mastering your skill

Ed

Is Your Practice Lacking a Competent Office Manager?

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super woman goal driven office manager

Chiropractic practices with dedicated managers tend to offer better service and generate higher revenue. In my early experience working with a large chiropractic office, the practice included 28 adjusting rooms, multiple associate doctors, and saw over 2,000 visits weekly. The doctor was often away attending seminars or traveling, while the practice manager and the COO (the doctor’s wife) helped run the clinic. Similarly, I recently spoke with a manager in a practice with four doctors, where the owner planned to shift to part-time work, and the manager took on the responsibility of running the practice.

In larger practices, having a manager allowed the owner to focus on patient care, which boosted revenue. Studies confirm the benefits of having a manager. A 2005 study found that small firms with a second-in-command grow 15-25% faster, while a 2018 Harvard Business Review article highlighted that CEOs who delegate to managers increase strategic time, leading to higher revenue. Gallup’s research also shows that good managers increase profits, work quality, and retention, while reducing absenteeism.

Effective managers help doctors see more patients, improve care, and support the staff, all while taking ownership of the business. Some doctors prefer a smaller operation, but others, especially entrepreneurs, want to grow their practices and achieve financial independence. For those doctors, training a manager is key to success.

Our Practice MBA program offers practical, interactive training for managers, focusing on goal-driven leadership. The program includes group and individualized coaching, and it equips managers with the tools to help grow the business and support the team. Enrollment is limited, so don’t wait—sign up now to start growing your business with a trained manager.

Ed.

Goal Driven MBA3 Office Manager Training Information

 

The Next Generation of Chiropractic and Healthcare Practice Development: Growing Your Practice from the Inside Out

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it's the manager book cover by clifton and harter

To grow a successful chiropractic practice, there are four key principles that can help improve both your practice and business. These principles are based on years of experience working with doctors and staff in the field.

1. Practice Success Depends on Two Key Factors

  • Quality clinical outcomes: Delivering effective results for your patients.
  • Quality support: Ensuring your practice has the infrastructure and administrative help to maintain and grow.

While excellent results are critical, support is equally important. As your practice grows, administrative demands increase, and these are often overlooked. The key is balancing patient care with behind-the-scenes tasks like scheduling, billing, staff management, marketing, and more. Without proper support, your clinical focus can be distracted.

Remember: It’s not chiropractic that slows you down—it’s everything else!

2. Better Support Leads to More and Better Services, Resulting in Increased Revenue

The equation is simple:  Improving the support for your practice will enhance both the quality and quantity of services provided. With increased and improved services, your revenue will naturally rise. It’s a logical and proven cycle.

3. Better Management Leads to Stronger Practice Performance

Studies show that the most successful practices often have someone in a managerial role, even if they’re not fully trained. These offices tend to have higher and more stable production. The best business owners understand the importance of having a manager, even if they’re still training them.

4. Gallup’s Insight: Management is Key to Long-Term Success

Gallup, a global analytics company, confirms the importance of good management. In their book *It’s the Manager*, they state that **the quality of managers and team leaders is the single most important factor in long-term organizational success. This underscores how critical it is to invest in strong management.

Enter the Goal-Driven Practice MBA

Based on these insights, a new program was created to train chiropractic managers: the Goal-Driven Practice MBA. This program focuses on improving the support system within your practice to enhance both patient care and practice performance. If you’re interested in a personalized training program for your practice, the next session starts in April. Only 10 offices are accepted, ensuring a highly tailored experience.

If you’re interested, contact Linda, the program coordinator, to discuss whether it’s the right fit for your practice.

Seize the Future: Take action now to elevate your practice.

Ed

The “New Will of the World” Chiropractic and Natural Health Care.

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The “New Will of the World,” Chiropractic, and Natural Health Care: Embracing Purpose-Driven Change

Gallup, a global analytics company, has identified emerging trends in society through data analysis. One significant trend is the “New Will of the World,” which reflects a shift in social values, including a growing desire for meaningful, purpose-driven work. This trend is influencing both the workplace and health care, where people are seeking more than just a job or pain relief—they’re looking for purpose in their lives.

The “New Will of the World”

This shift involves a broad societal movement towards work and health practices that focus on meaning and personal fulfillment. People—whether in the workplace or as patients—are increasingly searching for deeper connections to their work and well-being.

“Make America Healthy Again” Movement

Coined by Robert F. Kennedy Jr. during his presidential campaign, the “Make America Healthy Again” (MAHA) movement has gained momentum, particularly in the context of promoting chiropractic and natural health care. Kennedy, an advocate for these approaches, has proposed several initiatives:

  • Nutrition and Food Policy: Kennedy focuses on improving nutrition, including revamping the FDA’s oversight of food labeling, limiting ultra-processed foods, and banning harmful additives.
  • Pesticide Reduction: He aims to enforce stricter limits on pesticide use and encourage sustainable farming practices.
  • Revised Dietary Guidelines: Kennedy’s plan is to prioritize whole foods, organic options, and regenerative farming over corporate interests.
  • Support for Small Producers: He pledges to revise regulations to support smaller farmers and create a more level playing field in agriculture.
  • Creating Meaningful Change in Your Practice

Chiropractic offices and health care providers have a unique opportunity to align with this broader movement by offering a work environment and services that reflect purpose and community well-being. You can inspire both your team and patients by adopting the “Make America Healthy Again” ethos. Consider creating local initiatives, such as a “Make [Your Town] Healthy Again” campaign, in collaboration with health food stores, gyms, and local farmers. Hosting workshops, talks, and podcasts can bring the community together while promoting your services.

Engaging Your Team and Community

Your team is seeking more meaningful work, and your patients are looking for more than just pain relief—they desire holistic well-being. By tying your practice to this larger, purpose-driven movement, you can foster a sense of fulfillment and connection with both your staff and the local community. Activities like health-themed workshops or collaborative events with professionals in the community can deepen this mission and benefit everyone involved.

In summary, embracing the “New Will of the World” allows you to create a practice with greater purpose, connecting people to a healthier, more meaningful lifestyle while supporting the growing trend of chiropractic and natural health care.

ED

References and Full Article at [LINK]

He Fired the Chiropractic Assistant When the Stats Went Up

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In the article *He Fired the Chiropractic Assistant When the Stats Went Up*, Ed Petty discusses how a positive attitude at the front desk can significantly impact the success of a chiropractic office. He compares busy and struggling offices, noting that busy offices often have a welcoming, “open” attitude, with a motto like “Always room for one more!” These offices focus on getting as many people as possible in for adjustments, creating an atmosphere of openness and enthusiasm. In contrast, less busy offices tend to have more rules and prioritize collections over patient care.

Petty shares a story of an office where the front desk assistant, despite being new to computers, became incredibly enthusiastic after attending a chiropractic seminar. Her attitude transformed, and visit numbers skyrocketed. However, due to computer issues and billing frustrations, the doctor fired her, which resulted in a decline in visits and the eventual loss of an associate. Petty argues that the doctor should have hired someone for data entry, allowing the front desk assistant to continue her work of promoting chiropractic care.

The article emphasizes that the front desk plays a crucial role in driving office volume and that a “high capacity” mindset is essential. Petty encourages chiropractic teams to ask their front desk if they can handle increased patient visits, and similarly, evaluate their own capacity for growth. He concludes with a call to adopt a “Big Capacity” attitude, referencing his book *The Goal Driven Business* and his upcoming Practice MBA program, to help chiropractic offices grow and succeed.

Read the full article here [LINK]

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What Gets Measured — Gets Managed in Your Chiropractic and Service Business

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bus driver with the dashboard in front of him guiding him where to go.

ED shares how chiropractic business owners can effectively manage their practice as it grows by using key performance statistics. Initially, managing both patient care and business operations is feasible when a practice is at 50-60% capacity. However, as the practice grows, the increasing demand for management and staff coordination can lead to stress and “growing pains.” To overcome this, the article introduces the Fast Flow CEO system, which helps doctors manage their businesses effectively by dedicating just a few hours a month to business operations.

Key to this system is the use of performance statistics, which help track progress and identify areas for improvement. The article outlines essential components for tracking performance, including:

  • Key statistics: New patients, paid visits, charges, and collections.
  • Time period comparisons: Weekly, monthly, and yearly comparisons.
  • Same-month comparisons: Analyzing ratios like Visits/New Patients or Charges/Collections.
  • New patient tracking: Monitoring where new patients come from, especially for practices investing in marketing.
  • Marketing expenses: Tracking cost per new patient to optimize marketing spending.
  • Visual tools: Graphs and charts to help visualize trends and results.

The article emphasizes that these numbers represent outcomes, not just data. The goal is to improve patient care and practice efficiency, not simply to increase the numbers. Displaying these metrics in team meetings and using them as a “dashboard” helps everyone stay aligned with the practice’s goals.

The overall message is that managing a growing chiropractic practice requires smart use of data to drive decisions, improve outcomes, and continue progressing toward long-term goals.

Read the full article here: https://www.goaldriven.com/post/what-gets-measured-gets-managed

 

Chiropractic End of Year Marketing and Business Checklist

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goal driven checklist to prepare for the New Year

This article provides a comprehensive checklist for chiropractors to prepare their practices for the end of the year and the upcoming new year. With 2025 just around the corner, the focus is on winding down advertising and shifting toward internal marketing strategies during November and December. Key ideas include:

  1. Holiday Promotions: Offer Thanksgiving turkey giveaways, special promotions for veterans, donation drives, and patient appreciation events like gift exchanges or holiday parties.
  2. Referral Programs: Encourage patient referrals with giveaways such as poinsettias and gift certificates, and express gratitude to external referral partners with thank-you gifts.
  3. Newsletters & Reminders: Send personalized practice updates and reminders to schedule appointments through the holidays.

Planning for the Future:

  • Spend time with your team reflecting on 2024’s achievements and brainstorming goals for 2025. Consider creating a unifying theme or project for the year ahead.

Business Essentials:

  • Financial Review: Meet with your accountant to assess finances and tax strategies.
  • Employee Benefits & Contracts: Review employee benefits, consider bonuses, and evaluate insurance contracts for profitability.
  • Compliance & Licensing: Ensure adherence to HIPAA and other regulations, and confirm that all licenses and malpractice insurance are in place for the coming year.
  • Budget Planning: Set a budget aligned with your practice goals.

Start with a clear vision and remain focused on both immediate tasks and long-term objectives for continued success in the new year.

Where Is Your Chiropractic Marketing Department?

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Excellent Service in Your Chiropractic Practice is Marketing

Here is a little exercise that can boost your new patients and improve the quality of your patient care. And create a little more excitement in the practice in the bargain.

First, let’s review a couple of wise words about marketing:

1. Jay Levinson, from his book Guerrilla Marketing.

Marketing is everything you do to promote your business, from the moment you conceive of it to the point at which customers buy your product or service and begin to patronize your business on a regular basis. The key words to remember are everything and regular basis.

2. Peter Drucker, Management: Tasks, Responsibilities, Practices (p68)

Marketing is so basic that it cannot be considered a separate function (i.e.,a separate skill or work) within the business, on a par with others such as manufacturing or personnel. Marketing requires separate work, and a distinct group of activities. But it is, first, a central dimension of the entire business. … Concern and responsibility for marketing must, therefore, permeate all areas of the enterprise.

What Levinson says is that marketing is EVERYTHING you do consistently.

Drucker says that while there are specific marketing activities, marketing is too fundamental to have its own department. It is a “central dimension of the entire business.”

Yes, there are specific marketing activities to help your chiropractic and healthcare practice, some of which you delegate to advertisers, such as Internet marketers. Larger offices hire field representatives. I have hired and trained practice marketers who effectively generated new patients from external activities.

However, most of your practice marketing comes from the actions you and each team member take in the office. This is true in ANY business, but especially in chiropractic or smaller independent healthcare offices.

A common misconception is that some vague or distant marketing department or advertising company takes care of marketing and is not a “central dimension” to each person’s job.

Every position in your office has a marketing component. It comes with the role of a team member. Doctor, front desk, billing and patient accounts, therapy, rehab, and anyone who is on the team, is a marketer.

So, where is the marketing department? It’s your entire office! Here are a few marketing activities each team member can do:

  • Be genuinely interested in each patient.
  • Honestly care for how each patient is doing.
  • Do your very best with each patient with Present Time Consciousness.
  • When and if appropriate, invite your patient to bring in a family member or friend for a scheduled consultation or event.
  • Congratulate patients for any success.

Then, there is a list of specific marketing activities you can do: newsy newsletters, internal and external events to the office. You can find many of these suggestions on our blogs.

HEALTHCARE TEAM MEMBER MARKETING EXERCISE

In your team meeting, have each team member present at least two types of marketing actions they can do from their position every day.

Help them with this. If you have time, have your team practice their marketing procedure with each other.

As an added emphasis, consider that now that we are in the world of AI, real-life human interest and live communication is more valuable than ever. Believe it or not, one of your key marketing “niches” is just your plain ol’ non-hyped interest in the other person. Never fake that. In our ever-increasing sterile and digital world that is becoming more robotic, less human, and less spiritual each day, genuine human communication is more valuable than ever.

Don’t ask for where the marketing department is,

For it resides within thee!

Always selling health,

Ed

P.S. By the way, I left out telling jokes as a marketing action! One office up “nort” here in Wisconsin, I swear, generates new patients with the doctor’s Ole and Lena jokes! This may not be appropriate for your office though! (lol)

OLE AND LENA (A favorite!)

Ole and Lena got married.
After a beautiful ceremony and a fun but modest reception, they got in Ole’s car and headed out on their honeymoon.
When they reached Saint Paul, Ole put his hand on Lena’s knee.
Lena said, “Ole, we’re married now. You can go farder den dat.”
So Ole drove to Duluth.

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

If your practice-building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

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

the goal driven business by edward petty

The Goal Driven Business
By Edward Petty

order now button

Use the Learning Pyramid for a Better ROI in Your Chiropractic Healthcare Practice

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Don’t complain. Just train

“Over the long run, superior performance depends on superior learning.”
— Peter Senge

As the Clinic Director of your chiropractic and healthcare practice, you instinctively know that if you are not continually improving the service to your patients and potential patients, they will go to practices that are.

In fact, if you do not provide the BEST outcomes and service in your area, patients and potential patients will look for other practices that are the best, or at least better than you.

The BEST health care practice wins in the long run.

So, how do you get to be the best?

By constant improvement!

This was the concept the Japanese pushed in the 1970’s with their cars. They called it Kaizen.

Speaking of Japan, there was a study that showed how many hours employees trained over a 6-month period. Japan spent an average of 364 hours, Europe averaged 178, and the U.S. a paltry 42.* I discuss this more in my book, The Goal Driven Business. (pg 156)

The formula for improvement is simple: study and train.

The purpose and goal of training is improvement. This is why professional athletes and musicians constantly train. They do this for improvement and, ultimately, to bring about a good return on their investment.

Improvement has a definite ROI! A study by the Associate for Talent Development found that companies offering comprehensive training programs have 218% higher income per employee compared to those without formalized training.*

But what are the best methods for training — reading, listening, podcasts, seminars?

USING THE LEARNING PYRAMID TO TRAIN YOUR CHIROPRACTIC TEAM

The Learning Pyramid* illustrates the percentage of knowledge retained through various learning methods. Here are the typical percentages associated with each method:

  1. Lecture: 5%
  2. Reading: 10%
  3. Audio-Visual: 20%
  4. Demonstration: 30%
  5. Discussion: 50%
  6. Practice by Doing: 75%
  7. Teaching Others: 90%

This model emphasizes active participation in the learning process. Teaching others or practicing by doing, leads to higher knowledge retention rates compared to passive methods like listening to lectures or reading.

If you take your team to a seminar, do it for camaraderie and the sense of being part of something bigger. It can be motivational. But then, ensure that they take notes from one of the presentations and then teach it to the rest of the team at the next staff meeting.

Another angle is to have team members select a chapter from a book you all are reading (from your Lending Library!) and then have them teach it to the rest of the team a month later.

Train on your procedures every month. For example, you could demonstrate how you would like a patient to be positioned on a therapy table. (Get it recorded for future reference!) Then, have a staff member demonstrate the procedure back to you. You can also pair people and role-play the procedure. Do this for any of your office procedures. For those of you in group practices, doctors can practice their procedures.

BALANCING INFORMATION WITH PRACTICAL APPLICATION

The idea is that there are two sides to the learning coin: the information side and the practical application side. You can’t learn how to throw a fastball from reading a book. You must find a baseball and someone brave enough to catch your pitches and practice throwing hundreds of times. However, a book may have useful information on improving your throwing technique from those who have done it more than you.

It is best to go over the idea of training and improvement with your team first so they understand what you are doing and why.

Keep training fun. Your manager should ensure that training occurs every month.

And like Clarence Gonstead said:

“Practice. Practice. Practice. Never stop.”
“Our future will be our results.”

Keep training,

Ed

P.S. Who was Clarence Gonstead, D.C.

References:

ROI on training. An Evidence-Based Look at the ROI of Investing in Training (mentorgroup.us)

Clarence Gonstead https://www.gonstead.com/

The Learning Pyramid the learning pyramid – various percentages of retention. (thepeakperformancecenter.com)

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

If your practice-building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

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

the goal driven business by edward petty

The Goal Driven Business
By Edward Petty

order now button

Why You Should Have a Turnkey Chiropractic and Healthcare Practice

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keys in a door of a goal driven turnkey chiropractic office

The Practice Development Scale

If you were going to buy a practice, wouldn’t you prefer it to be “turnkey?”

If you were to work as a chiropractic doctor or provider in another clinic, you’d want it to be “turnkey,” right?

Or, as a support professional and assistant, I bet working in a turnkey office would be your preference.

WHAT IS A TURNKEY PRACTICE?

The term “turnkey” implies that the necessary operational elements of a practice are in place so that all the owner or practitioner has to do is “turn the key,” and the practice just goes!

A turnkey practice is so well organized that the stress level is low, the revenue is high, and the service outcomes are excellent.

Consider a scale of 1-5, where 5 is a turnkey practice, and 0 is an insolvent practice.

SCALE OF PRACTICE DEVELOPMENT

___5: Turnkey Practice

  • The practice is fully equipped and operates at close to full capacity. It is ready to be sold, to bring on additional providers, or just happily and profitably cruise.

  • There is a strong, established patient base ensuring regular revenue.

  • Administrative, billing, scheduling, and management systems are highly efficient.

  • The practice is financially robust, accumulating income over expenses each month.

  • The practice has a trained and established manager who ensures the seamless operation and continuity of all systems and procedures.

  • Staff are highly skilled, well-trained, and capable of independently managing the practice. Morale is high.

  • The business owner spends just a few hours each month on administration.

___4: Well-Established Practice

  • The practice is well-established and runs well.

  • There is a large, loyal client or patient base.

  • Administrative systems are efficient.

  • The practice is financially stable.

  • Staff members are trained and experienced.

  • The owner spends a few hours each week on administration.

__3: Growing practice

  • The practice is showing signs of growth.

  • The client or patient base is stable and increasing.

  • Administrative systems are more organized.

  • Financial health is improving.

  • Staffing is more stable, with ongoing training.

  • Owner works hard each week

___2: Basic Operational Practice

  • The practice has the basic elements required for operation.

  • There is a modest, gradually growing client or patient base.

  • Basic administrative systems are in place but may be inefficient.

  • Financial stability is tenuous but improving.

  • Staff are present but may lack competence or numbers.

  • Daily admin operations are dependent on the owner

___1: Struggling practice

  • The practice is operational but faces significant challenges.

  • There is a small, inconsistent client or patient base.

  • Administrative systems are inefficient or nonexistent.

  • Financial difficulties are prevalent, with cash flow issues and potential debt.

  • Staff may be minimal, overworked, or inadequately trained.

  • Owner stressed by dealing with administrative tasks

___0: No Practice / Insolvent

SELL, CLONE, OR CRUISE

Once you have achieved turnkey practice, you can sell it for the highest price.

Or, you now have the option to add another provider profitably. There is no limit – if you develop each provider to a turnkey level before adding more.

But the third option is just to cruise and have fun seeing patients with a great team supporting you and the practice. This option allows you to continue helping your patients while integrating your personal life with your practice life.

In a subsequent article, I will list the key roadblocks, some of them hidden, that can get in your way from creating a turnkey practice. I will also show you how to get to a turnkey practice faster.

But just knowing this scale will give you a map to better chart your course to success.

Keeping the end in mind,

Ed

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

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

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

goal driven business www.goaldriven.com
The Goal Driven Business
By Edward Petty
goal driven business buy now button

An Inexpensive Method to Improve Chiropractic and Healthcare Patient Engagement

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gray haired woman reading letter from chiropractor

How to Keep Table Talk Going

The new staff member said she could help with marketing by posting photos on Instagram and Facebook. The doctor said great!

I noticed a photo of a patient or the doctor with a short comment for a few weeks.

I usually had to search for the image. It often had a few likes or hearts. Maybe 5 at most. Then it stopped. The staff member had taken on other duties.

I had been asking the doctor to send regular email newsletters to his patients. He didn’t seem that interested, but we said we would help him put them together which would cost less than $100 per month.

He got us the content, and we put the newsletter together and sent it out. On the 1st day, over 500 people opened and looked at his newsletter. These weren’t strangers. These were patients who knew him, liked him, and trusted him. Most of them just hadn’t been in to see him for a while.

Linda, our manager and service coordinator, just conducted a quick survey with some of our clients. She found that the offices that consistently send out personal email newsletters have all had a positive impact on their practices. They have improved patient referrals, reactivations, and patient engagement.

Some of the responses included: “Increases volume.” “Patients refer.” “They love the recipes.” “[Patients] come into the office and comment that they saw a particular condition talked about in the newsletter that the office was not aware the doctor could help them with.” “Great response when promoting [a new service].”

Social media platforms are entertaining. They have to be because they are in the advertising business.

But unless you pay them for ads, your posts are shown at the whim of the platform. You have no control. Your readers are entertainment seekers and, even if they see your post, are often distracted by other posts and ads.

I have seen ad agencies use social media effectively to generate leads that become new patients. It can be pricey but worth it if done correctly. Done now and then, expert advertising on social media for a special offer for a limited time can work.

But if you do not regularly send personal newsletters to your patient base, you are wasting some of the goodwill you have generated over the years.

A CHIROPRACTIC AND HEALTHCARE PRACTICE IS A NETWORK OF RELATIONSHIPS

A practice is grown and sustained through communication and service to your network. The quality and quantity of your network, and how engaged it is with you, is your practice goodwill.

We are now in the age of Artificial Intelligence. Communications are manufactured. In other words, more and more communication is just plain fake.

But you are not fake, and neither is the easy dialogue you have with your patients. More than ever, people want authentic communication and relationships. Social media posts and ads just can’t compete with your short personal newsletters.

Here’s some tips on how to get your personal newsletter done fast:

SETUP

  1. Email Coordinator. Assign a team member to help you with the newsletter. Give them 1 hour per week to do so.
  2. Email service. Use an email service like Mail Chimp, Constant Contact, or others. They will assist with the setup. Have the assistant complete the setup and update it monthly.

CONTENT

  1. Table talk. Think of a patient that you often see in your office. Imagine talking to them about a subject that you are currently thinking about. It could be headaches, low back pain, nutrition, posture, or really anything you’re feeling passionate about.

    Now, write about 2-3 paragraphs as if you were writing a letter to them about your thoughts. (Link below.)

  2. Recipe. People love these. Always introduce a recipe and personalize it. “This was my grandmother’s favorite rabbit stew.”
  3. Success story. Introduce it: “Mildred did great.”
  4. Promotion. Every few months include a special promotion.

You can certainly add other elements. But the most essential component is your original message. It is YOUR VOICE that keeps the conversation going.

Effective newsletters will improve patient retention and patient referrals and reactivate inactive patients.

Nurture and sustain the relationships in your practice.

And seize your future!

=====

Sample message from the doctor for the newsletter

“You know, when I was driving to work this morning I saw this fellow bent over with a walker walking down the sidewalk. I bet if I had seen him 10 to 20 years ago, he wouldn’t be in that condition.

It’s the whole idea of a hinge. If it isn’t used much, it will rust and get stuck. Your vertebrae are like hinges. You gotta keep them moving otherwise they will get stuck.

Exercise helps. So does stretching.

But now and then your hinges (vertebrae) can get stuck, and that’s when you wanna come on and see us.

Keep moving and stay unstuck, and have a great June.

Dr. Bob Marley”

Related articles for chiropractors and independent healthcare practices:

https://www.goaldriven.com/post/sample-patient-group-activities

https://www.goaldriven.com/post/part-2-of-the-best-known-marketing-secret

 

Unexpected Successes in Practice

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smiling woman with a stack of binders and books

Why Your Chiropractic Patients and Practice Can Improve in Multiple Ways

If you continue to work on improvement, you will see results. That’s just physics — a reduction of Newton’s laws, which state that causes create effects.

And if you keep improving what you are doing to make the improvements, the results will be even better. That, too, is physics. (See pages 47 and 256 of the Goal Driven Business!)

However, the results may not always be what you expect, at least not at first.

For example, you start adjusting your patient for their lower back pain. When they started with you, they also had a limp. After several visits, they stopped limping, but their back pain, while better, was still annoying. In time, their back pain was relieved as they continued with their care.

But what about the fact that their limp is gone, their gate is excellent, and they can walk and even run more easily? Didn’t anyone notice?

I mentioned this to someone who coaches people on weight loss. She understood immediately what I said. She referred to it as Non-Scale Victories. NSV’s, she called it!

THE CAUSE OF NONLINEAR POSITIVE RESULTS IN PRACTICE

I have been following the graduates of our first Practice MBA program carefully. I am delighted with the results, but they were not entirely what I expected. I had expected and hoped that practice numbers would increase! Well, this has been happening, in fact, in some cases, Best Evers in years.

But other pleasant surprises have been showing up. For example, chiropractic doctors mention how their offices are calmer and friendlier than before. Another acupuncture office is successfully bringing on a second associate, and another is expanding its marketing reach in entirely new and innovative ways. Even old system problems that have been buried for years are arising and getting resolved.

These and other practice improvements were not directly addressed in our training. I have been consulting for over 30 years and have never seen results like this.

I was at first puzzled by what was happening. I think I finally figured it out. Here are three reasons:

  • The Hidden Ripple Effect. Imagine a pebble dropped into a calm pond. The initial splash is visible, but the ripples extend far beyond the point of impact.
  • Holistic Growth. Improvement is rarely isolated. Improving one component in a system improves other elements.
  • Consistent Weekly Improvement. This is the biggest reason. The function of management and leadership in a practice is powerful, even if only worked on for a few hours per week. This is what we did for over 3 months, both doctor, manager and the team.

Imagine what would happen if you stuck to your exercise program consistently for a year! Yes, you might lose weight, build muscle, and improve your agility. But can you imagine how it might also affect other areas of your life?

But, like exercise, practice improvement gets put off too often. We focus on urgent practice issues, but because improvement, while important, is NOT urgent, we can tend to put it off.

UNSEEN BENEFITS: THERE ARE MORE SUCCESSES IN PRACTICE THAN WE ACKNOWLEDGE

We also aren’t inclined to notice nonlinear beneficial outcomes.

  • Our Instinct is to Look for the Negative. The sympathetic nervous system that governs our fight or flight response has evolved over the millennium as a survival mechanism. We are looking for poisonous snakes on the road and other possible threats.
  • We Also Have Tunnel Vision. We tend to focus on just our specific goals. This is essential but limits our perspective. We miss peripheral benefits.

So, one of the lessons I have learned from our Practice MBA program is that if we continue to work ON improving our practice and ourselves, if we just keep at it, successes will occur – often in multiple areas. When they do, they should be recognized and appreciated.

Keep improving – your office, your patients, and yourself!

That’s our goal!

Ed

Bravery in Your Chiropractic Office

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bravery but funny goal drivenBravery 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.

Ed

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

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Goal Driven Time Management Skills

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chiropractic or small business time management skills calendar

You may delay, but time will not.
Benjamin Franklin

Time is your most precious resource.

How you use it makes all the difference in your progress toward your practice goals.

I still remember my father remarking on my 5th-grade report card. On the back of the card was a space for comments from the teacher. The comment was something about: “Edward would do better if he did less daydreaming.”

This “comment” has haunted me all my life. I daydream. I admit it. Sometimes, this is good – I learn something new. But the challenge is not wasting the time I need to complete projects.

Goal Driven time management procedures allow us to get more done during our day’s working hours. And even though we all are familiar with the principles and techniques of time management, it helps to review them occasionally.

Here are a few techniques I have learned from others that help me. Maybe they can help you too.

GOAL DRIVEN TIME MANAGEMENT PROCEDURES IN YOUR
CHIROPRACTIC HEALTHCARE PRACTICE

Breaks. Don’t feel guilty. We all need to take breaks — a short one every couple hours or so, longer ones every day, longer ones even still every week, and so on. Breaks are a physiological and mental requirement discussed in an insightful book called The Power of Full Engagement by Jim Loehr. Just schedule your breaks.

Scheduling blocks. As a chiropractor and health care provider, you naturally block off time periods to see patients. You can use the same concept for team meetings, individual conferences, and “paperwork.”

Goal Driven. Each time block should have a goal. The work you must do and the procedures you use should all focus on the desired outcomes.

No interruptions. As harsh as this may sound, unless there are emergencies, don’t allow yourself to be distracted during the block of time dedicated to doing your work. Schedule a brief period during the day to return to the unplanned issues.

Cluster booking. Schedule blocks of time for similar activities close together. The general idea is to keep you doing what you are doing until you are done. For example, seeing 3 patients and then waiting for 10 minutes before seeing 3 more slows you down and takes you out of the Flow. The idea of Flow is not new but recently refreshed by Mihaly Csikszentmihalyi in his book, FLOW. Flow is a mental experience when you are so lost in your work that nothing else matters – you are in the Zone. It is when you are “Lost in Service.”

Cluster booking can also be applied to other services: specific therapies or rehab, a Thursday morning for seniors, or a Mom’s Saturday morning with kids. Once you are in the Flow, you become more productive.

Prioritize: Take care of the Important and Urgent tasks as you must, of course. But do not neglect the Important but Not Urgent projects. This comes from Stephen Covey’s book, The 7 Habits of Highly Successful People, and Eisenhower before him. Covey notes that the more time spent on Important but Not Urgent projects, the less time needed for urgent matters.

Sort out the tasks – The 4 D’s. As you review your inbox or new tasks that come up, sort them along these guidelines:

  • Do them now.
  • Delegate them.
  • Delay them.
  • Dump them.

Many of these points, and others, are covered in my book, The Goal Driven Business. We also worked these over in our Practice MBA program.

Yes, I still daydream. I recommend it. But now, I just schedule it!

Seize your future,

Ed

—————————————————-

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

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

goal driven business building methodology

The Goal Driven Business,  By Edward Petty

goal driven business buy now button

Ask Lisa – Introduction

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Lisa Barnett practice appraisals credentialing and

Lisa J. Barnett

HI!

I’m Lisa with Petty, Michel and Associates.

I’ve been with this wonderful company for nine years and have worked in the chiropractic profession for 17 years.

Do you need help with:

• credentialing new providers and/or your tax ID?
• debugging complex insurance issues?
• documentation/insurance audits?
• practice appraisal?

Would you like these projects completed without you or your team spending time doing it on your own?

Let me do it for you!

Contact me. Because some practice issues shouldn’t wait.

lisa@pmaworks.com

920-334-4561

Find out more about me here

== == ==

“I Give PMA Two Thumbs Up!
Lisa was incredibly helpful and created huge value and peace of mind when she came face to face to my clinic and looked over everything. There are core competencies when it comes to dealing with Medicare and Petty Michel and Associates knows the process and what Medicare will be looking for if you get a notes request or an audit request.

PMA proved to be a huge value and I am thrilled they were able to help my clinic become compliant, which makes seeing Medicare and Medicaid patients more enjoyable and less worrisome. I give PMA two thumbs up.
—
Matt Kingston D.C.
Madison Chiropractic Solutions