Category Archives: Practice Management

Capacity Constraints: Hidden Practice Barriers

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Fixing the weakest links.

Your practice should flow smooth, fast, and uninterrupted, like a clear mountain stream.

Most offices, unfortunately, have hidden dams that slow or even block the flows within their office. This limits growth and increases stress.

For example, I have often seen the front desk so clogged with paperwork that new and active patients were inadvertently discouraged from coming in.

Every department and function of your practice is vulnerable to innocuously seeming events that add friction that choke production. Interruptions in the billing department, poor note-keeping systems for doctors, too many therapies to choose from, insufficient space, staff unclear of their goals, staff driven into apathy by being micromanaged… there are many potential opportunities for roadblocks.

Generating more new patients to increase your patient volume is usually a good idea. But often, the increase in volume is short lived because the office had too many hidden log jams and wasn’t set up for the higher patient volume. Even the doctors, while saying they want more new patients, can become fatigued by the end of the day and privately look forward to lighter days.

There are several remedies for these clogged flows.

First, clear up the goals and outcomes of each department. For example, the goal of the front desk is not “completed paperwork.” (A “Fully Scheduled Day” would be better!)

Second, you can review and refine the flow of patients into, through, and out of your practice. Draw a patient flow chart. Start with your new patients. List the sequence of actions your new patient goes through on their first day at your office. Later, you can do this for their second and third day. You can later work out a flow chart for reactivated patients, re-injured patients, and different types of cases.

Then, you and your team can rehearse the entire sequence to see what is missing or what needs to be eliminated.

I cover this in The Goal Driven Business:

Broken flow patterns that remain invisible “clog up” the system and slow down everyone’s best efforts to produce valuable outcomes and excellent service. These are bottlenecks. Discovering and eradicating them is a significant function of the Goal Achievement Process.

In his 1984 book, The Goal, Eliyahu Goldratt introduced what has come to be known as the “Theory of Constraints.” By making a chart outlining the flow of your customers, for example, you’ll better identify “leaks” or constraints which lessen your ability to achieve high quality and quantity customer outcomes.

As Goldratt states, “Since the strength of the chain is determined by the weakest link, then the first step to improve an organization must be to identify the weakest link.”

Every three months or so, do a “walk-through” with your entire team, where someone takes on the role of customer. This rehearsal will bring to light many duplicated or omitted functions. You’d be surprised to discover that many of the tasks you assume are done for your customer are actually skipped or poorly linked in. Sometimes you find tasks from decades ago, that no longer apply, are still being done.

Be an engineer to your goals and discover the constraints holding your office back, and remove them.

Be…… A Goalineer!

Ed

PS For those of you who have purchased my book, The Goal Driven Business, you are welcome to schedule a no-charge consultation to see how you can remove your bottlenecks and achieve your goals. SCHEDULE NOW

If you haven’t purchased the book yet, please do so here.  BUY THE BOOK

Those Numbers: Do You Manage by Emotions or by Goals?

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scoreboard for statistics

It’s Monday morning. The staff is getting the office ready for the new day. And while doing so, they are wondering… “How is the boss’s mood going to be today?”

They are taking their cues on how the day will transpire based upon, at least in part, your emotional state.

Your team, as well, will often be tempted to manage their roles in the office emotionally, based on the circumstances in their personal lives.

There is nothing wrong with positive emotion. Emotion is a feeling “a mental reaction subjectively experienced” (Merriam-Webster). Some are more positive than others, such as joy, delight, cheerfulness, and others are more negative, such as anger, grief, and fear.

But emotion is reactive. Setting your sights and working for goals is proactive.

Your Scoreboard

Your practice numbers show you if you are headed towards your goals or away from them.

They can predict what needs to be done to improve your business and achieve your goals. They also keep everyone on your team informed on the status of the practice and included in its management.

There is a right and wrong way to use your numbers to help you achieve your goals.

There is, in fact, an entire methodology on how to use statistics to improve business performance.

Large companies use analytics to manage and improve their production in formal processes such as Kaizen, Six Sigma, and Total Quality Management.

In the Goal Driven System, we use a simplified version called GAP, the Goals Achievement Process, which works just fine.

At the beginning of each month:

  1. Review. Review your key numbers monthly at staff meetings. (This can also be done weekly to check on your progress.)
  2. Notice and support. Notice where the numbers went up. Then, plan a couple of action steps to support the areas that went up.
  3. Notice and fix. Notice where the numbers went down. Then, plan a few action steps to fix the areas that were down.

Remember that numbers by themselves are nothing. They are symptoms or representations of the quality and quantity of your outcomes. Don’t get so caught up with the “stats” that you lose sight of what the numbers represent. Expecting the numbers to improve without confronting and enhancing the factors causing the numbers is at best ineffective and, at worst, can be abusive.

But numbers can assist you and each team member to stay focused on the goals: your office mission, its values, and its outcomes.

In a Goal Driven office, your team takes its cues from the office scoreboard.
There is an art and a method to capture, display, read your statistics and apply what they tell you. This is not adequately taught to most doctors in business – or to employees. Yet managing by numbers is a fast and very effective method to keep your business improving.

We are creating a short training course to remedy this called Goal Driven Analytics for the Chiropractic Practice. Subscribers to this newsletter (you!) will be the first to hear about it.

In the meantime, stay true to your goals, and use your scoreboard to help you do so.

Seize the Future

Ed

Which is Better for You: Direct Marketing or Indirect Marketing?

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Last week I sent an email with a link to Ode to Joy.

Ode to Joy is from Beethoven’s 4th movement of his 9th symphony, considered one of the top three symphonies ever created.

It was a short 5-minute rendition. It is beautiful and evocative – listen to it again. (Link below.) Plus, its performance was a masterpiece.

But it was actually an ad.

It was a brilliant advertisement for a Spanish Bank. It was promoting Sabadell Bank’s 130th year anniversary in 2012. According to one website, it has had 90 million views since 2012, while another posted in 2015 has received over 18 million views.

That is a lot of exposure. But does it generate new business?

This type of advertising is called brand marketing, or what I call indirect marketing. It is the opposite of direct marketing. Direct marketing, also called direct response marketing, tries to generate an immediate response. Knowing the differences will help you manage your marketing and make it more effective for your particular situation.

Direct Marketing

The goal of direct response marketing is to generate qualified prospects that respond to an offer. When you receive a card in the mail that promotes a free dinner about retirement funds, the company that sent you that mailer hopes you reply and attend the dinner and accompanying talk. At the dinner, a speaker gives a presentation with the hope of scheduling you for a private consultation later that week. When you see an ad on Facebook for a free manual, the advertisers intend that you respond and order their manual. The distinguishing characteristic of direct marketing is numbers – you can quantify the results of your marketing efforts.

Indirect Marketing

The goal for indirect, or brand marketing, is for the name of your business to be well known and well thought of. When you volunteer at the local food bank, co-sponsor a kid’s little league team, or simply provide excellent customer service, these are all examples of indirect marketing. The results of indirect marketing are difficult to identify immediately.

Until you are in Stage 4 in the growth of your business (about 75% or more full capacity), most of your marketing efforts should be direct marketing. Indirect marketing supports direct marketing, but even if your entire town knew about your business and thought highly of it, there is no guarantee that anyone would come to see you as a customer.

Handing out your business card to someone would be an example of indirect, personal brand building. However, handing out your business card with a handwritten note on the back that said something like “N/C screening in May for Joe M. Dr. EP” might be an example of a direct response marketing.

Marketing Mix – Direct, Indirect, and Internal, External

Another factor to consider in managing your marketing is how much should be directed externally – to non-patients and customers and how much should be directed internally to your existing and former patients and customers.

It has been my experience that too few practices are industrious enough with marketing to and communicating with their existing and former patients.

Below is a chart that gives approximate percentages of how to balance your direct and indirect marketing for your practice. I have divided the development of a business arbitrarily into 5 Stages. Figure each Stage to be about 20% your full capacity.

Telling your story and the successes of your services should never end, regardless of how successful you are. Change your marketing strategies depending at what Stage of development your business is in — but keep marketing.

Carpe Posterum (Seize the Future),

Ed
GoalDriven.com

Ode To Joy

Make each day an Ode to Joy!

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“Music is … a higher revelation than all Wisdom & Philosophy”
― Ludwig van Beethoven

Takes 5 minutes. This is an inspirational musical event. The link is below.

It is worthy of the best humans have to offer – and akin to what you provide innately to your patients – as doctors, providers, and support professionals.

Match this with all you do in April and you’ll have a great month!

-Ed

 

For more information on how to create a more profitable business that is more fun than what you are doing now, please purchase and then use the book, The Goal Driven Business.

What You Must Do Before You Try to Improve Your Practice

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We are what we repeatedly do. Excellence, then, is not an act, but a habit.
Will Durant

Too often, we stop doing what worked and yet wonder why our business isn’t doing as well as it had in the past.

When I would visit an office that wanted to improve, I would initially ask them what they were doing when the office was performing better?

The staff and doctors would pause, think, and gradually, the answers would begin. “Well, we used to call the new patient after the first adjustment…” “We used to have a radio program…” “We used to send out birthday cards… “We used to ….”

After each answer, I would ask, “Well, are you doing that now? The answer was usually “no.”

If business is improving, if the scoreboard shows that you are having a winning season, why stop doing what is working?

Keep doing what works!

This may seem obvious. It is. But we all fail at this one time or another, so it bears repeating.

What keeps us from continuing to do those things that are most successful? Boredom, staff turnover, or a momentary crisis when many procedures get washed overboard.

All offices suffer from what I call Procedural Atrophy – a gradually wearing away of what works. The result is only the very minimal procedures that keep the doors open are performed. Progress exams are no longer done, and the front desk no longer smiles when answering the phone.

The Goals Achieve Process – Now You Can Improve

You want to improve your business – provide better service, increase revenue, decrease stress.

But first, ensure that you are still doing what you were doing when you were doing well. Keep applying your successful procedures!

THEN, make improvements.

Various organizational processes are used in large companies that entail a sophisticated method of improvement, sometimes called Kaizen, Six Sigma, and Lean. Kaizen is a Japanese process developed by an American, but you can earn a “Black Belt” in Six Sigma. (I know. Confusing! People get paid big bucks for this stuff!) We have a very simple improvement process called the Goals Achievement Process outlined below.

  1. Review your numbers for the last few years.
  2. Notice when you were doing better.
  3. Make a list of the procedures, projects, and policies that were successful then.
  4. Also, include the level of your motivation and your attitude, and what you were doing to keep you inspired during those times.
  5. Get the successful procedures on checklists for your team to implement and ensure they are done again.
  6. Assign your manager to ensure that these procedures stay in place.
  7. Do a version of this each month, over and over.
    1. Review what worked and what didn’t the prior month.
    2. Check what procedures weren’t done or done well, or need to be improved, or discontinued
    3. Make a 4-6 step plan for the new month to improve those areas that need improvement.
  8. Optional: Use a professional coach/consultant to help you keep everything on track and improving!
  9. Also, read The Goal Driven Business.

In an entrepreneurial practice (the Personality Driven Practice), the owner is good at using their creative energy to get things started. And while this burst of energy is essential to start a business, it usually doesn’t continue once the “newness” wears off. So, they go in search of a new “shiny thing” to implement or try in their Practice.

A Goal Driven and systematized business works both creatively and methodically to become expert at doing the same procedures over and over, each time as if it was the first time. There is a vast difference between the amateur or serial entrepreneur and the expert who is still training and working to improve.

As Clarence Gonstead said: “Practice. Practice. Practice. Never stop.”

Stay on the Rails

It helps to think of your business as a train. You gradually build up speed and momentum. Keep doing what is working and keep it on the rails. Then, improve it.

Have a great week!

Ed

A new review for the book The Goal Driven Business:

A MUST-READ FOR ANY BUSINESS OWNER!

Throughout the years of my Practice, Ed has helped coach our staff and change our thinking from “personality” driven to “goal” driven – allowing my office to stay open and profitable whether I am here or taking time off!

This book is so easy to understand and gives you real steps to take now in your business. I highly recommend this book to anyone who currently owns a business, is thinking about owning a business, or is a manger of a business!

Donna Brown, D.C.
Business Owner, Group Practice

The Missing Role in Your Practice

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The cause of almost all relationship difficulties is rooted in conflicting or ambiguous expectations around roles and goals. Stephen Covey

The reason many offices have a difficult time growing has to do with missing roles.

A role is the identity assumed to perform a series of tasks that produce a specified outcome.

In the hundreds of offices that we have visited over the years, the doctors take on essentially two roles: doctor and owner. This works in the beginning for a few years as the practice grows. In time, however, the practice begins to roller coaster. Numbers go up, then they go down, cycling up and down until everyone fatigues and just settles.

There are several causes for the Practice Roller Coaster. There are hidden barriers that hold an office back and sabotage its growth. These are covered in my book, The Goal Driven Business.

One of the barriers has to do with a missing role that most business owners overlook. Can you guess which one that is?

Let’s look at goals: What is the goal of a doctor? “A healthier person,” right?

What is the goal of a business owner? A secure and solvent business. Dividends from ownership.

What is missing? The doctor can achieve their goal by seeing 10 people a week. As a business owner, they can keep their overhead very low – perhaps working out of their home. But is that what you really want – to see 10 people a week out of your house? Overhead is low and you are getting good results. So, what is missing?

The CEO – the chief executive is the missing role. The goal of a CEO is a very profitable business that operates at full capacity providing world class service and delivering extraordinary results.

The CEO is the chief manager, leader, and marketer, which are the three functions that drive the business to its goals.

Sometimes we hear the doctor being referred to as the “boss,” but boss is not a well-defined role. “Boss” is generally recognized as the person who gives orders and makes decisions. However, it is an overlay of an existing role, as in a “bossy” doctor or “bossy” owner. The role of a CEO is much more than this.

Most providers are too busy providing services to do much managing – and besides, they are paid for their services, not their managing or leadership. Doctors are trained to manage patients, not businesses.

Still, this is a role that must be fulfilled as distinct and separate from the owner or provider roles if the business’s full capacity is to be achieved.

Three Functions of the CEO

The role of CEO includes these functions:

  • Leadership: Leadership is all about goals. It defines where you are going and why and helps everyone you work with embrace this knowledge with commitment. Leadership includes your mission, long-range plans, values, and … the insistence upon achieving them.
  • Management: Management deals with how to get to the goals. Management works to ensure that people and procedures are effectively working and improving.
  • Marketing. Marketing includes procedures and projects that help generate new patients/clients and retain them. Marketing is business, and business is marketing.

Once your practice is at least at 50% capacity, a couple of hours spent each week on effective leadership, management, or marketing activities as a CEO is worth 8 hours or more doing anything else. For example, time spent going to a seminar – perhaps 20 hours including the transportation, may increase your numbers for months afterward. A little can go a long way.

Because the role of practice CEO must be very part-time, we have developed the Fast Flow CEO System for the Goal Driven Business. This can take as little as 2 -3 hours per week, depending on the scale of your business. Here are five components of the Fast Flow CEO System:

  1. Get Out to Work On. Regularly take time to get out of the business so that you can work on your business.
  2. The CEO Works for the Business. The business does not work for the CEO. Sure, the business works for the doctors so that they can provide better service to the patients. But that is for the doctor. Sometimes called “servant leadership,” the CEO is the Chief Coach, helping others understand the goals and how to achieve them.
  3. Team Members. The CEO works to create team members who take on a portion of departmental management, marketing, and leadership.
  4. Manager. The CEO creates the role of manager and delegates a team member to assume this as a part-time role. The manager can take on much of the CEO’s daily and weekly duties.
  5. Study. The CEO studies leadership, management, and marketing to improve their skill as a CEO. Leaders are … readers!

Certainly, all this requires some skill and training – and coaching! But just clarifying the role of CEO and its expectations as distinct from the roles of owner and doctor (or “boss”) will significantly improve your chances of breaking out of the Practice Roller Coaster and achieving your goals.

Ed Petty

March 14, 2022

Motivation

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No matter how many goals you say you have or how you write them out, unless you have the motivation to achieve them – you won’t.

“Motivation is the driving force behind the energy required to complete a task… a person’s willingness to exert physical or mental effort in order to complete a goal or set aim. (Psychology Dictionary.org)

This is a key element in a Goal Driven Business.

You first need to define your goals – and they must be practical as well as meaningful. But you also need the drive to achieve them. Without the drive, the motivation to get to where you want to go, you are just a poser in the business world.

(Case #345) The doctor and I had discussed a plan to motivate his team and increase production. This was many years ago. Over lunch, we had a team meeting to announce the plan to his other two doctors and about 10 support staff. He announced that if certain goals were met over the next 7 months, everyone could get a trip to Hawaii.

Everyone was shocked. Including me! The doctor and I had discussed a two-month plan for rewards based upon a modest performance improvement – but not Hawaii and not the increase in production he wanted. He came up with this on the spot during our meeting.

But that afternoon, amazingly, the phones lit up. People were calling in for appointments. (Never mind that this was an example of Innate or Quantum Entanglement!) As I recall, they had their best month ever. But unfortunately, they soon realized that the goals were unrealistic, they had little support to achieve them, and the doctor saw that he couldn’t afford it even if they did reach their goals. The practice subsequently went into a long-term slump.

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

What is the lesson? Well, there are a few of them, but I want to focus on motivation.

While it may seem like people become motivated because of the “carrot,” or the reward, there are deeper reasons – or principles.

Edward Deci, along with others, put forth a new framework for motivation called Self-Determination Theory. Essentially, it states that we are all driven by intrinsic goals as part of our fundamental nature. Our reward comes from the satisfaction we feel from the achievement more than from any external prize.

These are the three intrinsic goals we all share:

AUTONOMY. We all want to play in our own sandbox! We need to feel in control of our own corner of the world. Just like we don’t like insurance companies intruding into our clinical decisions, staff does not like being micromanaged.

COMPETENCE. We all want to be superheroes! Deep down, the prospect of becoming more skilled, more masterful, and better able to be in control of our environment is a drive we all have.

CONNECTION. We all want to be part of something bigger than ourselves. This manifests in two ways: a) being part of and working with a supportive group or team, and b) working to help bring about something more significant than our paycheck or the accomplishment of our everyday tasks.

The office staff was excited to go to Hawaii, but this was not necessarily because they could lie in the sun. It was because it was a huge goal that gave them a very large sandbox to play in – together – to work for a very large result.

Self-Determination Theory is why games work. In Kevin Werbach book, For the Win, he discusses the subject of Gamification.

“For thousands of years, we’ve created things called games that tap the tremendous psychic power of fun. A well-designed game is a guided missile to the motivational heart of the human psyche. …monetary rewards aren’t even necessary because the game itself is the reward.”

Whether it is a sporting event, video game, or Sheepshead (a popular game of old-time Wisconsinites, so I’ve heard), we love our games. And I think we need them.

But it all goes back to the principles of Self-Determination Theory.

Remember when you started your business? The challenge that lay ahead? The new business card that identified you as the hero to conquer new plateaus?

Those drives are still there and can be rekindled, regardless of prior disappointments.

As Soon as You Make a Goal—You Have Created the Potential for a Game.

Win or lose, IF the principles of Self-Determination Theory are in place, you will be motivated and so will those with whom you work.

Apply these principles to yourself and your team – for the game, for the fun, and for the win!

Seize the Future,

Ed

For more information on how to apply self-Determination Theory, games, and motivating yourself and your team, please purchase the book,
The Goal Driven Business. [Link to sell page]

 

Everything Else: Why The Goal Driven Practice is More Profitable and More Fun

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What gets in the way of you growing your business?

What holds you back from your growth? From increased services and profits?

What keeps you from providing better services and improving your marketing results?

The government? Your childhood? Your neighbor’s cat?

One thing that is NOT holding you back is chiropractic or whatever services and skills you provide.

It is everything else.

When you are first growing your business, and let’s say you are barely at 40% of your full capacity, your practice may be performing well. You may have an assistant, but for the most part, you can see patients and generally oversee the operation of your practice. Life is good, and the future is … wide open.

But almost imperceptibly, as you start seeing more and more patients, the tide of administrative demands starts rising.

Eventually, you can look around your desk and see “undones” and “half-dones” and a hundred or so “to-dos” littering your office, smartphone, computer, and brain. You try to keep up, but there seems to be just too much to do.

So, what do you do? There seems to be only one solution – you settle. You settle into a comfort zone just to a point where you can earn enough to pay your bills.

Growth becomes a trap, and after many attempts to reach your goals, you finally settle.

Is there a way out?

Yes. But it has been hidden. And booby-trapped.

But you should know, after years of observation and analysis, what is holding you back is not your lack of effort. It is not chiropractic or your professional services.

The fact is, you can’t really get to where you want to go from where you are now. You can’t get there from here.

You need to make some major Big Shifts. 

To get to your goals, you have to start from a different place and build a newer version of your business. This is your next stage. Stage One is survival and entrepreneurial growth. It is a Personality practice.

Your next version is a fast, more advanced business that will take you to your goals and beyond.

The new version is called a Goal Driven Practice.

To achieve this requires making some significant changes or Big Shifts.

MANAGER OR ADMINISTRATIVE ASSISTANT (BIG SHIFT #7)

One of the solutions to breaking out of the trap and moving closer to your goals is assigning someone on your team to help you with…Everything Else.

This could be a manager or an administrative assistant. In either case, the role would probably only require 5-8 hours per week – at least at first.

One of their goals would be to remove everything from your desk, all your to-dos, all administrative traffic, sort it for you, and then work out with you what should be done with each item.

You would delegate, delay or dump each item.

This would help free you to increase your services as a doctor and give you time to expand the business as the CEO.

You can produce $500 to $1000 in services per hour as a provider if you are unfettered. As the CEO, you can direct your business to produce much more than this per hour. So, why are you spending time drowning in trying to do $20 or even $30 an hour jobs?

Everything Else gums up the works. It slows you down, confuses the staff, and the patients feel the confusion and notice the neglect, however slight.

This is why I came up with the Goal Driven System. It unmucks the gears of your business so that you can freely provide services and not be haunted by the looming demands of hundreds of to-dos.

This is covered in the book, The Goal Driven Business. If you can do this, you will be more productive and have more fun.

This is so valuable that I will be scheduling upcoming Zoominars on this subject for you and your manager. And stay tuned for upcoming programs on manager training, and training and even coaching on the Goal Driven System.

And just, just for fun, (I am smiling) don’t miss this future article:

The 2 Management Consultants from Petaluma California.

Seize the future

Ed

For more information on The Goal Driven System visit Goal Driven

Goal Driven Job Descriptions

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playbook goal chart

In a Goal Driven Practice, Goal Driven Job Descriptions are short, fast, and to the point.

And they are used!

They help improve the quality and quantity of services and are motivational.

So, how is this different from other job descriptions?

Most job descriptions are usually a hodge-podge and catchall of unrelated tasks. For example, the front desk job description may include getting supplies, taking x rays, calling attorneys, and scheduling patients. Billing may include marketing and equipment repair.

Staff will do the tasks assigned but end up zigzagging from one function to another, losing focus on what they are doing, and often disengaged in their activities.

In typical job descriptions, the goals are not clearly defined, measured, nor are the expectations stated. Further, employees don’t always see or get recognized for the results of the work detailed on their job descriptions.

Yet another failing of most job descriptions is obvious – they just aren’t used.

Let’s look at how to power up job descriptions so that they are Goal Driven.

Many job descriptions contain the duties of several different roles. A role is an assumed identity. For example, in a restaurant, there are the roles of a server, cashier, dishwasher, and chef, or cook. In a small restaurant, one person may take on a number of these roles, and all these roles would be their job description. Hence the idiom: “chief cook and bottle washer.”

But to be effective, each role needs to be separated, well defined, and organized with the other roles.

In a Goal Driven Practice, job descriptions are broken down into different roles and described in job checklists.

The job checklist begins by clarifying the goals. This includes the mission, the outcomes, what is used to measure performance, and the level of performance expected of that role.

For example, for the role of Patient Accounts, the mission might be something like: “To help the patient pay for all of the services they received in such a way that they will continue to receive services.” The outcome might be a zero balance or “no accounts receivable more than 30 days.” The statistics used to measure this role could be the “percent of collections to adjusted services.” And finally, the expectation might be something like: “All patients very happy with the encounters with Patient Accounts and continuing with their services, with a collections percent of at least 95% of adjusted services average.”

We now list the most important procedures to achieve this goal. The CEO of the office defines WHAT the goals should be – that is leadership. But the manager and those working in patient accounts would work out HOW the goals would be achieved.

Encouraging the team member to define the best procedures to achieve their goals empowers them and gives them autonomy and responsibility for their role. According to Self-Determination Theory, real motivation is intrinsic. It comes from one’s desires and needs rather than external rewards or threats. Edward Deci, in his book Why We Do What We Do, says people “strive for personal causation.” (This is more fully covered in my book, The Goal Driven Business)

If the cook understands that their goal is to make tasty meals that the customers enjoy and for which they will pay, they can be more responsible for how best to achieve that goal.

A team member may have five or more roles, each with a job checklist, as part of their job description. As the doctor and owner, you may have 25! (And if so, that could be a big capacity barrier right there!)

Once the goals are clearly defined … and kept in mind, the rest of the checklist can be easily worked out.

Once per month or more, you or the manager can meet with each team member and do what we call a Coaching Review. This is a fast review of employee performance: at what they are excelling and at what they need to improve. In addition, the job checklist can act as an assessment.

But it is all geared around the goals of their roles. You also ask them what could be added or changed to improve both the quantity and the quality of their outcomes. They can make the changes to the job checklist and make sure you have a copy.

None of this takes a long time to do each month.

Management of your office is not just about getting procedures done. It is about constant improvement in the quantity and quality of their goals.

You may have told your patients something like: “If you do not make time for your wellness, you will be forced to make time for your illness.”

The same applies to managing your business. “If you do not take time to improve your procedures and your people to achieve the goals in their roles, you will be forced to make time to rebuild your practice.”

Steven Covey, in his book The 7 Habits of Highly Effective People put it simply and best:

Begin with the end in mind.

 

Ed

The Goal Driven Front Desk

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A dynamic front desk can increase your visits by 20%, maybe more if you have the room. On the other hand, a dysfunctional front desk can constrict the flow of patients and hold your office back.
I have seen instances of both.
There is much more going on and at stake at the front desk than most doctors and staff appreciate.
Ordinarily, you would think that the billing department is the most demanding. There are hundreds of details that need to be learned and followed with excellent discipline. This position requires professionalism and expertise.
But this function is not on the front lines of the constant patient, phone, and doctor interactions and interruptions. Managing patient accounts can be regulated and organized to maintain a calm and comfortable workflow.
Therapy and adjunctive services are often undervalued, but the patient flow is usually smooth, and they are not faced with unexpected patients or phone calls.
It is interesting to note that the front desk has the highest turnover in most offices.
But properly set up and managed, this department can be an engine of growth and stability in your office.
Let’s look at some of the more important attributes of the front desk:
  1. It represents you and your services. It is your ambassador to the world outside your office. The front desk reflects what you stand for and the quality of your services.
  2. It is the first and the last contact – and impression –with anyone in the office.
  3. It can convert inquiries to new patient appointments.
  4. Rapport and relationships. The front desk can provide world-class service to patients, improving patient retention, reviews, and referrals. (The 5 Rs)
  5. Direct marketing. The front desk can directly promote clinic services to patients, hand out coupons, and promote upcoming events to generate patient referrals.
  6. Team member support. The front desk can support the insurance department and all team members to create a positive, upbeat day every day.
  7. Case Management. The front desk can contribute to case management by relaying any comments or observations relative to the patient’s care to the doctors.
  8. Fully Scheduled Day. The front desk fills the appointment book and keeps it full.
Let’s imagine an ideal front desk and put it at a “5” on a 5 Point Scale.

 

5. GOAL DRIVEN FRONT DESK. The appointment book is full. The front desk staff are cheerful, having fun doing their jobs, and genuinely interested in every patient and phone inquiry. They sincerely care for each patient and non-patient. They have a strong intent on helping patients complete their programs by keeping their appointments. They personally and professionally want to achieve the mission of the office and encourage patients to help them accomplish this mission by bringing in family and friends. They also help the rest of the office achieve the office’s mission. They are sending out positive “vibrations” to help more people. They are proactive and Goal Driven.

 

Below this level, we find the front desk that is struggling.

 

2.5 A COPING FRONT DESK– The appointment book is 50-70% full. The front desk is trying, but it is not keeping up, which creates a bottleneck to patient flow. (Subluxated) Even though the staff wants a full appointment book, subconsciously, they don’t want any more work until they catch up.

 

2. A SLOW FRONT DESK. The front desk operates at a “comfortable” 40-50% capacity. The staff is pacing themselves, keeping up with computer tasks, insurance, and following the scripts for phone and patient encounters. However, they are mostly disengaged from the front desk and office goals.

 

1-2. GIVEN UP and BORED. I only describe this because I have seen this condition. The staff is ignored or badgered. In either case, they feel relegated to a 4th class employee. They hide out and pretend to work, essentially having quit and just waiting until something better comes along.

 

You can create a Goal Driven Front Desk. It is not achieved overnight, but once it is established, you’ll be close to a dream practice and a Goal Driven Business. We will cover some tips on how to create a Goal Driven Front Desk in another newsletter.

 

In the meantime, stay Goal Driven,

 

Ed
“Your brain sends out vibrations all the time, and your thoughts affect your life and other people’s. They pick up these thoughts and get changed by them.”
– Bruce Lipton (Biology of Belief)

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

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Goals are the 20%of efforts thatWhy 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,

Ed

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? )
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

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A service business needs 5 different engines to become a Goal Driven Business

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.

  1. Customer Service and Outcomes
  2. Marketing
  3. Leadership
  4. Management
  5. 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!

Ed

Tempus Fugit (time flies)

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As the ancient Greek reminds us, Time Flies — and July comes at us fast.

We are halfway through the year – 2021!

While enjoying the summer, I suggest you take a Half-Time Break and reassess, readjust, and recommit where needed. That is, reassess your progress so far this year.  Make any adjustments to your yearly plans. Recommit to your higher goals.

This is a team exercise. You can discuss with each team member first, but I would focus on the four categories below:

                What are the goals for the rest of the year?

  1. Yourself as a professional?
  2. The office as a whole?
  3. The quality of service/outcomes of your patients?
  4. Yourself personally.

You can reprint this and send it out to your team as a memo next week. Then, meet as a group in the following weeks to discuss.   Here are some tips you can pass on to the staff and doctors:

  1. Goals for yourself as a professional. How are you going to improve your level of competence as a support professional or doctor? What subjects do you want to study, or skills you want to improve, in anatomy, customer service, chiropractic, chiropractic history, marketing, health care in society, etc.
  2. Goals for the entire office. Review the mission, core values, and outcomes of our office, and from these, consider what improvement goals we could set for the next six months.
  3. Goals for the services we provide our patients? Consider such things as faster service, more complete outcomes, more fun for the patients, and more engagement with our mission.
  4. Goals for yourself personally. This is personal and can be private. It can be discussed, but that is optional. This might include such things as more time with nature, family, exercise, prayer, recreational reading, a new hobby, and travel.

Enjoy your summer but be PROactive and meet with your team to plan out the rest of the year. Keep it fun. You can meet at the lake, in the park, by the mountains or near the sea. Integrate health and an unquarantined life into your work meeting.

But remember… TIME WAITS FOR NO ONE.

Carpe Diem,

 Ed

ALSO, if you haven’t yet — buy my book now while it is still only $8. The Goal Driven Business.   It will help you achieve your goals.

The Goal Driven Business: A New Book by Edward Petty

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July 2021

 I went and wrote a book!Edward Petty displaying his new book, The Goal Driven Business

Took me more than 5 years.

Here it is:

It is called:

The Goal Driven Business
A New Business-Building Methodology That Is Simpler, Faster, More Profitable,
and More Fun Than Whatever You Are Doing Now

What the Book is About
The Goal Driven Business is a distillation of my 35 years of in-the-field work with business owners, doctors, and their teams from across the country. It also includes what we learned when we owned, with other providers, 22 practices here in Wisconsin and had to overcome significant financial, organizational, and clinical challenges – in which we ultimately profited.
Carefully reviewing what worked and what didn’t and correlating my observations with the results of other researchers, I was able to uncover certain universal practice principles I had not seen before. I was also able to isolate the hidden barriers that kept most hardworking doctors from achieving their full potential.

With this information, I put together a step-by-step map that any business owner could follow that, with good effort, could help them achieve their full potential. This a totally unique system of business development which I call the Goal Driven System. It is all covered in my new book, the Goal Driven Business.

What Others Say About the Goal Driven Business
The book has been receiving great reviews. You can read them at GoalDriven.com. Here are a few:

  • “A must read for doctors in private practice — read it and reread it, it is that valuable.” J. Peter Heffernan D.C. DPhCS.
  • “I wish I had this book 30 years ago!” Ann Metzler, D.C.
  • “The goal driven business is a “must have” for every business owner – the book is fantastic!” Cindy Munson, D.C.
  • “Mr. Petty, I have just finished reading your recent book “the goal driven business”. It is a masterpiece.” Maxwell Synsvoll, D.C.
  • “This book is more than just thorough. It’s the truth!” Tom Potisk, DC

Why I wrote the Goal Driven Business

  • Based on principals and Goal Driven. Too many offices are Personality Driven. In a Personality Driven practice, everything is dependent upon the owner. As the business grows, the burden on the owner can become too much. Stress increases, and production quantity and quality can suffer. So does income. Using the principles I observed, I worked out the natural system of business development that unfolds regardless of the owner’s personality. Knowing and applying this system in a Goal Driven Business, success is no longer dependent solely on the owner and their personality – stress decreases, and service and revenue easily increase.
  • The complete picture. As a consultant, I did not have the time to pass on all the information I had about business development in consulting sessions. As a result, clients would not get the complete picture. I also noticed that many key components to business success were avoided by other practice management consultants, books, and seminars. There are real barriers to success – and many are hidden. I reveal everything in the book — no stone was left unturned! I have charted a complete path and show you how to bypass the barriers and make the shifts necessary to reach your goals.
  • Only the best will survive. Market forces are eliminating individual businesses as monopolies continue to expand. We see more providers working for hospitals or competing with lesser skilled technicians. Large companies can dominate their markets through price, convenience, advertising, as well as “lobbying.” To survive, you need to provide world-class service and outcomes. Only the strongest practices that give the best service will survive and thrive in this decade. The Goal Driven Business shows you how to provide extraordinary service that creates extremely happy customers!
  • Your success is vital for our communities. It has become evident to me that many solutions offered by corporate entities are not always the best for the consumer. This puts the health of our communities and children at risk. Now more than ever, your patients – your neighbors – are better served by independent professionals like you whose help is not dictated or biased by titanic industry interests.

You must not overlook the grassroots power of goodwill when your patients receive excellent and genuine care. Like a stone dropped into a pond, there is a positive ripple effect that goes far beyond your office. This is why I suggest that one of the most effective methods in dealing with our challenging environment is to simply — help more people. Why not help 5 times more people? Why not help them become healthier and teach them about health? And why not earn much more? You certainly deserve it!

My book will show you how to help more people, earn more, and yet have more free time to pursue personal and professional goals. And in the bargain, you will have more fun.

And you will also help safeguard the health of your community for generations to come.

I have my book on sale for a limited time.
Usually $18, from
July 4th – Independence Day — to July 11th,
you can buy it for just $8.
Go straight to Amazon or through our website at www.GoalDriven.com

Get the book NOW!

Carpe Diem,

– Ed

P.S. A portion of all income from this book, and future training on the Goal Driven System, will go as a donation to the Children’s Health Defense (ChildrensHealthDefense.org).

Get the book! If you like the book, please post a review on Amazon. Buy more and give them to your colleagues.

The Future Belongs to the Best

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Time spent on business improvement projects in your "Goals Lab," or during down time. From GoalDriven.com (c)2021

A few years ago, a staff member at an I office visited confided in me and told me the following story:

“Our office was really slowing down last year. So, the doctor decided to take everyone out of town to a weekend practice management seminar. The speakers discussed really cool methods for doing our work. It was fun and we learned a lot. Plus, we also went over some great marketing ideas. We were all pretty excited when we returned to work after the weekend.

“On Monday, we agreed to get together at lunch to discuss how to implement what we learned. Some staff members were still dealing with patients, so our lunch meeting started 30 minutes late. Once we finally got together in the break room and started eating, we began a good meeting. We were interrupted with a few phone calls, and some patients started arriving early for their afternoon appointments. We had to cut the meeting short and didn’t get to discuss much of topics of the seminar, but we agreed to continue the meeting the following week.

“As it turned out, something always came up each week and… we never did meet again about the seminar.

“But we were still pretty pumped from the seminar and we had one of our best months ever. It was my job to clean the break room and, after a few months, I noticed that the binders of information we received at the seminar were still on the break room table, never opened. I stored them away for future reference.

“Now it is almost a year later, and everything is pretty much back to the way it was before we went to the seminar. The numbers are back down, some of us are a little burned out, and I don’t think we ever did implement anything from that seminar.”

—

Sound familiar?

I bet it does. I have seen it play out almost the same way countless times.

We are in the improvement business. We help people improve their health. We should be able to do the same for our business and for each other. In fact, if you are not constantly improving, your patients will seek practices that are.

In this new decade, apart from the many new events and changing tides of culture, technology, and mega-corporate influence, your future success is up to you. And it will be primarily based on the quality of your service and your outcomes – the experience your customers receive.

A report from a survey by Microsoft underlines this:

“As customer expectations continue to climb, it becomes more challenging for brands to set themselves apart from the competition. Markets are increasingly crowded, and both price and product are being steadily overtaken by customer experience as the number one brand differentiator” (Microsoft 2018, State of Global Customer Service Report).

More than any other short-term marketing tactics you may be using, only the best offices will thrive in the long run. And those will be the offices that are working on consistent improvement. Mediocrity could get you by in the past. But now, the future belongs only to the best.

But I have noticed that most offices just do not spend enough time consistently on improving their performance. After studying this for some time, I have observed a number of obvious and even hidden barriers that prevent us from working on improvement. I will explain what these are in a later article, but the following steps can help you ensure that you work ON your business to improve it, not just work IN it.

Your Improvement Clinic – Your Goals Lab

  1. Time spent on improvement doesn’t cost. It pays! Some business owners are concerned that time spent on improving the business or staff is too costly. It can be if the training or planning is poorly done. But remember that:
    a. Better team efficiency generates better revenue.
    b. Better trained and focused team members generate better revenue.
    c. Better outcomes generate better revenue.
  2. Head Coach. As the owner and CEO, you are also the Head Coach. How your team does – the business – is in large part based upon your coaching.
  3. Give it a name. In my new book, The Goal Driven Business (to be launched on July 4th of this year), I use the term Goals Lab as it is a location where you can go to work on getting to your goals faster. It could be your breakroom, a restaurant, a park, the reception area – anywhere really. You can call it your Practice Field, Improvement Dojo, or Mystic Garden! Just consider it a place and time that is separate from your time with patients.
  4. What gets done.
    a. Team meetings for communication, review, coordination, and planning.
    b. Team training and practice.
    c. One-on-one training and practice.
    d. Personal training, study, meditation.
  5. Schedule these routinely – weekly, monthly, quarterly, and as needed.
  6. No interruptions, no calls, 100% attention present.
  7. Be challenging. You don’t get better unless you question what you have been doing to see how it could be better.
  8. Go over this with your team. Let them know that they, too, are coaches. And players as well. So, improvement is a team activity, one that requires responsibility and professional discipline.

Your car mechanic can’t work on your car when you are driving it down the freeway. You can’t see patients while they are driving their forklift at work or cooking dinner for their kids at home. You need a separate time and place dedicated to work on improvement.

Your goal is to create an expert office that generates expert results and gives your patients the best experience they can receive from any other comparable health care business.

Imagine your business being so good that patients not only drive in from across town, or even across the state, but fly in from all across the country to receive your services. Imagine that there is such a demand for your care that you even build a motel next to your facility to accommodate the out-of-towners.

Well, there was a Doctor of Chiropractic who was just that good. His name was Clarence Gonstead. His advice?

“Practice. Practice. Practice. Never stop.”

Ed

Ed Petty - author

The Morale Virus: What doctors say and how they are combating it

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Over the last few months, I have been noticing a particular phenomenon in offices that I don’t think I have seen before… maybe ever. It is like noticing a slight hand tremor that you never knew you had or a buzzing sound from outside that has become increasingly loud and annoying.

2020 was a long year, a stressful one. And you all have been in the thick of it. Daily, seeing more people in one day than most providers see in a week – or more.

My old football coach, Johnny Pappa from Davis, made a big impression on me as a young freshman when he said: “When the going gets tough, the tough get going.” In my then youthful life, I had never heard such profound words. They still apply – especially to you. You are tough!

But stoicism has its limits. The cognitive dissonance can finally get to you.

One doctor expressed to me extreme frustration about two young and very healthy patients, who exercised, got adjusted, ate well, took their vitamins, but decided to discontinue taking their outdoor walks for fear of COVID.

Another doctor, venting his dismay, told me that he couldn’t bear to watch the medical bureaucrats talk about masking and vaccinations as the only remedies to COVID when he knew of so many methods that have been demonstrated to ameliorate the virus. “People are frightened and told to stay at home, don’t socialize, wear a mask if you go out, and wait for the vaccine. That’s it? That’s all you got for people? This really shuts people down.”

One doctor I talked to who, after dealing with depressed and suicidal patients, many of them vets, has become depressed himself. Another wonders what the hell is happening to our chiropractic colleges – have they all been taken over by medical bureaucrats? Is chiropractic finally squashed?

Your good nature can become frayed, your patience worn thin, and regardless of your professional composure and your disciplined countenance, the stresses can have an affect. I mention this because most of you are tough as nails – you have successfully dealt with many types of stressful situations in the past, as a doctor, professional, and for many of you, a business owner.

Morale Virus

So if you are feeling a bit off, recognize that you might be affected by a contagious “Morale Virus.” The Morale Virus is what I call the social sickness that occurs as an emotional response to continual fear-baiting. Frightened, your patients are told they can’t do this and shouldn’t do that.

The Morale Virus is not caused by hardship itself. It is caused when you are pushed into a corner and given no way to fight back. You tend to give up. (Or go stark raving mad!) (Reminds me of the movie, One Flew over the Cuckoo’s Nest when the star, McMurphy (Jack Nicholson), says: “You guys complain how much you hate it here, and then don’t even have the guts to leave! You’re all crazy!”)

There has been a constant assault of bad news emanating from officials and authorities. Yes, and I know the media plays a part — it is mostly owned and controlled by just a few rich people and corporations who have their own agenda — namely, more money. But still – no one buys boring newspapers. Sensation sells the news, and we, the consumers, buy it. We listen and read the “news” that riles us up and confirms our bias. Social media does the same, times ten.

Dirty Laundry (Song by Don Henley) 

I make my living off the evening news
Just give me something, something I can use

People love it when you lose. They love dirty laundry
We got the bubble-headed bleach-blonde who comes on at five

She can tell you about the plane crash with a gleam in her eye
It’s interesting when people die, give us dirty laundry

Morale Virus Disinfectant

Here are some ideas on how you can fight back, disinfect your office from this disease, and better help your patients regain their spirit of hope, kindness, and free enterprise. And yours as well.

Good Vibe Year

One doctor we work with likes to anchor her practice around a yearly theme. For 2021, she is calling 2021 the year of Good Vibes and has events planned to support this philosophy. And just to reinforce the idea, she has T-Shirts made that say Good Vibes. (And by the way, she has a bustling two-doctor office.)

Study. Acquire More Knowledge. Teach

Fear is often a byproduct of lack of knowledge – so arm yourself with the facts.

For example: Roommate 1: “Oh my god! (A panic shout is heard.) The television isn’t working and the game is on. What will we do?” (Drama ensues.) Roommate 2:(Calmly) “Check the remote for new batteries.”  Roommate 1: “Ah, that fixed it, thanks.”

Study, use critical thinking, avoid bias – your own and others. Go to the sources – research studies and from people who are actually working on what you are studying. Then, please educate your patients and clients on how to be happier and healthier. And educate your team, help them increase their knowledge. Arm them as well. Doctor comes from the Latin to docere – “to show, teach, cause to know.”

Leverage Point

What area in your office, if changed, will produce the most significant effect?

Obviously, first and foremost is the doctor. Each day should be a trip to the playground, the ski slope, the baseball field, the dance floor. Ideally, each day is a fresh opportunity to accept the privilege of helping as many people from suffering as possible, to teach them, and have fun doing so.

In most offices, I would also say it is your front desk. The front desk’s power is so poorly recognized in most offices that at least 20% or more production is lost. A vibrant, aggressively friendly, caring, mission and goal-oriented front desk can and will boost your volume – this week. Front Desk team members may need more support and less admin (billing) duties. They may need a better understanding of the mission and how your office is helping people.

Entrepreneur Harder

During cultural upheavals and shifts, entrepreneur businesses remain and often thrive. New opportunities open up. More established and larger companies are weighed down by dogmatic rituals, have high overhead and many vice presidents, and vast networks of suppliers. Change is difficult. But not for the entrepreneur. Most entrepreneurs are all too “change-happy.” You can adapt, innovate, and overcome quicker than companies who are afraid to or can’t. So what if in-person care classes are out for now? Get everyone on a Zoom class, give them a secret word. Test them when they come in again and if they answer correctly, give them a gift – a bottle of Vitamin D or a lunch at another patient’s business.

Stay Out of the Weeds

One doctor told me that her solution was to “stay out of the weeds.” To stay in her lane and just keep helping people and not get caught up in the storms of controversy. I suggest that this is the best course of action. You want news? Sensational news…? Just listen to your patients and staff and community. But stay on the fairway and don’t get sidetracked, mentally or in real life.

Goals

Stay with your goals. Goals are agreements that you made with yourself, and usually others. If you stay true to them, they will lead you out of the den of the morale sickness. Staying true to your goals is a point of integrity. Your goals are not in the weeds – they are straight ahead. Figure out new and better ways to get there or resurrect old ways that worked. Fall down 7 times, get up 8. Each day and each week — begin with the end in mind.

Your goals are in three categories:

  1. Financial. This includes marketing and production.
  2. Service. Developing individual and team expertise with constant improvement..
  3. Purpose. Your higher purposes, those goals outside of work that are greater than this week and that are most meaningful need to be integrated into your work-life.

The Future is Bright and Roaring!

We have seen harsher times. The past is easily forgotten, and we think we are in the worst of times. Well, the 1918 flu was much worse than COVID. Plus, we were sending our young boys to suffer in horror and die in the trenches in Europe in the Great War. But society prevailed and soon ushered in the Roaring 20’s, a time of economic growth and cultural freedom.

Prepare to roar!

Carpe Deum (Seize the Day)

Ed

Ed Petty - author

This is such an important subject, I encourage you to share it with your team and colleagues:  To print out a hard copy

Wisconsin License Renewal Requirements – 2020

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REMINDER:  Wisconsin License Renewal Credentialing Requirements

*Please Note:  Due to the pandemic, usual and customary continuing education requirements are waived this biennium.   However, even if you did not complete your hours, you still need to renew your license.

A review of the usual requirements follow:

Doctors of Chiropractic (DCs):

  • Continuing Education: Forty (40) hours minimum of state board-approved courses; four (4) of the 40 in nutrition
  • Maintain Current CPR

Starting now and prior to December 14th, renew online: https://online.drl.wi.gov/UserLogin.aspx

Chiropractic Technicians (CTs):

  • Continuing Education: Six (6) hours minimum of state-board approved courses

Starting now and prior to December 14th, renew online:  https://dsps.wi.gov/Pages/Professions/ChiropracticTechnician/CE.aspx

Chiropractic Radiological Technicians (CRTs):

  • Continuing Education: Twelve (12) hours minimum of state-board approved courses

Starting now prior to December 14, renew online:  https://dsps.wi.gov/Pages/Professions/ChiropracticRadiologicalTechnician/CE.aspx

TIP:  Keep your transcripts and file them safely, in the event of a continuing education audit.

Approved course listings can be found here:
https://dsps.wi.gov/Pages/Professions/Chiropractor/CE.aspx

All licenses (DC, CT, CRT) expire on December 14, 2020, at midnight.

Questions?

Contact Lisa Barnett
PM&A Consultant
920-334-4561

How to Defeat COVID: Be A HEALTH OUTLAW!

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“I will sell Chiropractic, serve Chiropractic, and save Chiropractic if it will take me twenty lifetimes to do it. I will promote it within the law, without the law, in keeping with the law or against the law in order to get sick people well and keep the well from getting sick.” — B. J. Palmer

What is it with all the bad news ALL the time?

Well, here is some good news: across the boards, practices are returning to their pre-COVID days. We monitor our clients’ numbers closely, and we see offices meeting, and in some cases, exceeding what they did at the same time last year! A few others are even hiring more doctors and staff.

What? Isn’t the world coming to an end?

Hell no! And here is why: people like you, and your patients, are, and always have been, rebellious. Health rebels! You question authority. (How dare you!)

What we are witnessing, for chiropractors and other non-conventional health offices, is nothing new. The good news and benefits of real health care are never promoted, and in fact, are suppressed. Got pain? Here, take some opioids. Back problem? We’ll just do surgery. Too much weight? We’ll suck the fat out. (yuck) Arthritis? Here, have some Vioxx.

You know what real health care is – and isn’t. And you know what? So do your patients. You can’t fool everyone all the time. And I would say that much of the world is with you, despite the massive media slant towards drugs and population crisis control. People are aware of organic food, for example, and so organic products and food stores have had explosive growth in the last 20 years. And supplements! The supplement industry has also seen mega growth and is expected to grow over 12% this year, according to Nutritional Business Journal*.

People know what side you are on – their side. They know what you stand for – health. You are the health doctors, coaches, and teams — curious, caring, and independent. You aren’t beholding to hospitals, a bureaucracy, or drug companies. This is what Dr. Zelenko cited as a factor to help him, and his colleagues come up with an inexpensive antidote for COVID that is 80-90% effective – so effective in fact, other countries are adopting it. I strongly recommend his YouTube videos, especially the one with Del Bigtree. (Link below.)

Here are some suggestions to Fight COVID:
How to Fight COVID: Steps for Health Outlaws

  1.  Goal: Get more people healthier.
  2. Stay on the offense. Stay true to your goal. Think about how you can help three times more people.
  3. Don’t let the negative few outweigh the positive many. Keep in mind, only a small percentage of bad things cause the majority of the bad news. (Pareto Principle – 80/20)
  4. Don’t get distracted by politics, or “I am right — you are wrong.”
  5. Be nice. Understand people are confused and frightened. Don’t call people sheeple, cowards, or selfish killers.
  6. Protesting is fine. Just don’t get side-tracked. Stay GOAL DRIVEN.
  7. Keep studying what is working. Mercola.com, Highwire with Del Big Tree, ChildrensHeathDefense.org, and others.
  8. Use your voice and educate others.
    a. Use Table Talk, your most powerful weapon when combined with excellent service and outcomes.
    b. Use newsletters. Genuine communication keeps the relationship and conversation going with you, rather than with the media or distraught neighbors or family members.
    c. Post on social media.
    d. Zoom workshops.
    e. Podcasts.
  9. Stay Well in Winter campaign. Consider promoting a health and conditioning program, Stay Well in Winter, to strengthen people for the seasonal flu and possible “2nd Wave” of COVID.
  10. Join or create a Health “Rebel” Alliance. Network with other providers in your area and form a health “conspiracy.” Chiropractors, acupuncturists, Holistic MD’s, Naturopathic Doctors, Biological Dentists, Exercise Trainers, Organic Food Co-ops, to name a few. Lead the way.

The chiropractic profession has been the largest and most active professional group standing up for true health for over 120 years. Absolute American and homegrown, your profession has been genuine guardians of health, and has withstood every attack imaginable. So, all this pandemic stuff is pretty routine for you guys and gals. And if this has made you Health Outlaws, I know that sits just fine with you.

Loads of sincere respect and thanks for crisis medical teams, as always. But keeping people out of crisis, out of hospitals is your goal, and ours as well. We share this goal with you and stand with you to help more people become healthier.

Thank you for all you do.

Ed and all of us at PM&A

Del Bigtree and Dr. Vladimir Zelenko 45 minutes
Deal Big Tree “Crimes Against Humanity” – with Dr. Zelenko and others, full presentation. 2:16

Nutritional Business Journal.

Have You Helped A Child Today?

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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

Goals, Games, and Groundhog Day

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It is a New Year and already we are knee-deep in its work.

But it is a NEW YEAR and it is important that you take time out to make new plans and then review them often.

Life Works in Cycles

Each year in Wisconsin, the leaves fall and then the snow falls. But by July the strawberries are ready for the pickin’. Every month, we can see the full moon. Each day, we can see the sunrise – if it is not cloudy.

In human endeavors, we seem to follow this natural rhythm of following cycles. After we finish the 9th grade, we are ready to begin the 10th grade. We are excited to finish when we get out of school for the summer, and then again, eager to start the new grade when we begin again in the fall.

These are all cycles.

What would happen if you stayed in the 9th grade, year after year? How would you feel?

Yet, in our work life we fall into the trap of doing the same thing over and over and over. This is not the first unique and special patient you have ever seen…this patient is a customer just like all the others — just another case. Today is not the first day of the rest of your life, it is just like yesterday which is the same as a long line of days that go on and on. And on…

We get beaten down by the tedium, working endlessly for some forgotten purpose, as if the assembly line we were on never stopped and was always the same.

This is a major cause of stress.

Groundhog Day Syndrome

You can’t do one thing forever, like in the movie “Groundhog Day.” In it, the main character visits a town in Pennsylvania where everyone watches to see if a groundhog can see its shadow. This is traditionally on February 2 (This year, it is on a Saturday.) The only problem is, for this character, the day keeps repeating and repeating, the same each day. It drives the character to suicide, but even that doesn’t work. Finally, he falls in love and wins the girl and has a new life.

Anything in life that begins, it seems, must end. It can start again, but it must end so that a new iteration can be created. It is the cycle of life.

Goals and Games

This is an important factor in what is called Gamification. With the advent of computer games, design elements are added in to make the game fun, challenging, and motivational.

But games are nothing new. Baseball is a game. It has a season and games and innings. It has cycles. Games have been part of human behavior since the beginning. The Olympics started in 776 BCE.

One aspect of games that can be overlooked is the fact that they are just an activity for play. Play is something we do naturally as toddlers. As we grow older, this activity becomes structured into organized sports and games, but at the core is the desire to have fun. To play.

We can lose this sense of play when what we do has no end and no beginning. Persistence is a good quality, but it can lead to an enforced dullness that buries our enthusiasm.

It is important to keep in mind that in business, as in sports, keeping the perspective of play is more effective than bearing down on one’s duties with serious gravity. Practices that incorporate some of the components of a game into their operations are more productive and have a better time.

What are your goals for 2019? For the 1st Quarter? For this month… or for today? Higher numbers? New team members? Community wide outreach program? New training and greater knowledge?

As soon as you make a goal, you start a new cycle and begin a new game. Try to win. But you could lose. Either way, don’t get too serious about it and just be grateful to be able to be in the game.

Set new goals and play. Play — to win. Have fun. Smile a little more!