Category Archives: Practice Management

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

Goal driven order now button

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

He Fired the Office Manager in His Chiropractic Office

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Goal Driven to learn practice management. ww.goaldriven.com

Should have been educated and not terminated.

This newsletter is a reprint of an article I wrote a few years ago. I was reminded of it as I am working with a number of offices on a Practice MBA program – which is going very well, by the way!

= = =

A few months ago, an chiropractic office manager called me. She said that her doctor had fired her.

Her primary role was Billing and Collections Coordinator, but she was also the office manager part-time. I had worked with the office for a few months and knew the doctor and Dorothy (not necessarily her real name.) I had gone over the role of the office manager with her and the doctor. They both felt they understood the situation and would let me know if they needed any help. I was pretty sure they didn’t know what their roles were or how to execute them. I suggested working with them longer, but their minds were made up.

Months went by, and then late one Monday morning, I got a call from Dorothy. She told me she had been fired. I asked her why. (Knowing her and the doctor, I had a pretty good idea.) She told me that new patients had been dropping for some months and that the doctor was not happy about this.

She said that she couldn’t believe it! “He fired me for that? I am not even in charge of new patients?” She was upset and went on about how new patients weren’t her responsibility.

What do you think? Was she right? Or was the doctor right?

Let’s look at it: the chiropractic doctor is ultimately the marketing director. As the Chief Executive Officer for the business, marketing is a key component of their job. But since he is also so busy as a doctor, he must delegate most of the marketing activities. But to whom?

  1. First, to all of the staff. It is each team member’s responsibility to sell health.
  2. Then, a staff member could help coordinate all the marketing activities as a marketing coordinator or marketing manager.
  3. You might also delegate different marketing activities to other staff: someone for external events and screenings, someone for the internet, etc.

But behind it all, it is the office manager’s role to ensure everything runs smoothly.

No one should have been fired.

Instead, they all should have been trained on marketing and management.

= = =

In your practice, marketing is your job.

And yours. And yours. It’s also yours! In fact, the marketing department is the entire office. Peter Drucker, considered the forefather of management theory, said (my italics):

“Marketing is so basic that it cannot be considered a separate function 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. It is the whole business seen from the point of view of its final result, that is, from the customer’s point of view. Concern and responsibility for marketing must, therefore, permeate all areas of the enterprise. Management:Tasks, Responsibilities, Practices (p68)

One of the tenets we are discussing in our management training is the idea of ownership. That is, everyone on the team is a stakeholder, and at no point is anyone not directly connected to all outcomes of the office.

We are training managers to be Goal Driven, and how to create Goal Driven teams that take ownership of the outcomes. And along the way, we are also training the doctors as clinic directors! (That’s the hard part! Lol)

So, no one is getting fired on our watch.

Educate.
Don’t Terminate.

And seize your goals.

Ed

P.S Our next management, leadership, and marketing training starts in February 2024. Limited enrollment. Let me know if you are interested and or want to get on the waiting list.

Tribal Knowledge Can Improve Your Practice

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teams, management, chiropractic, knowledge

Mining the Underground Innate Knowledge of Your Team

You may not have run into this term before… maybe you have. It was new to me before I began putting together the notes for The Goal Driven Business.

In any case, it is a concept worth knowing and one you can use to improve your business. I’ll give you an example and then define it.

It was spring years ago, and I was meeting with a motivated practice owner who was already doing well. We were discussing marketing plans for the next several months, and some of our programs ended in June. We needed something that would work for July. So I said, “Why don’t we ask the staff for some ideas?”

We were scheduled for a team meeting anyway, which I attended. After the usual topics were covered, the doctor asked the staff for some ideas for marketing in July. Now, the doctor was relatively new to the community, and the team was long-time residents. Various ideas were thrown around, and one seemed to percolate and draw enthusiasm from the staff. A popular promotion that they had experienced as local consumers in their town was “Christmas in July.” Since their community was familiar with this promotion, they were sure it would work well if it were tied to a patient referral program.

Both the doctor and I thought it was a dumb idea. However, the staff was already in high gear planning the promotion by the end of the staff meeting. I suggested to the doctor that he let them run with it. He did, and as it turned out, it was a big hit. They had one of their best new patient and office visit months ever… in July.

At another office, some years later, I was helping the doctor work out her mission statement for the practice. She and her associate were hitting speed bumps trying to come up with a simple definition. I recommended putting it to the staff to see what they might come up with. At the next team meeting, the doctor discussed the idea of a global statement for the WHY of the office and its higher goals and asked them if they could work it out as an office mission by next week.

And that is what they did. The following week, the manager and staff presented the mission statement to the doctors. The doctor emailed it to me.

I didn’t really like it as it was long and too mushy, at least for me. But the doctor approved it and posted it in the reception area. The staff loved it. It fit their compassionate attitudes towards the patients and captured their existing relationship with them. They memorized it, and it was recited after every staff meeting. Their stats haven’t come down since. They are a happy and Goal Driven group!

In our consulting, we routinely encouraged the wisdom of veteran staff to be integrated into the management and marketing of the office. We didn’t have a definition for this knowledge, but it was effective nonetheless.

Here is the definition of Tribal Knowledge according to Leonard Bertain in his book, The Tribal Knowledge Paradox:

Tribal knowledge is the collective wisdom of the organization. It is the sum of the knowledge. It is the knowledge used to deliver, to support or to develop value for customers. But it is also knowledge that is wrong, imprecise and useless. It is knowledge of the informal power structure and process, or how things really work and how they ought to. … But more importantly, it is the untapped knowledge that remains unused or abused.

There is much more to this, of course. A valuable management and leadership skill is how to elicit tribal knowledge, decipher it, filter the practical from the impractical, and put it to use.

I try to keep these newsletters as short as possible. If you want to set up a time to discuss this subject more, just make an appointment (link below). No charge for subscribers to this newsletter.

Not everything can be put on job checklists. Job checklists are very useful, but there is a wealth of knowledge just under the surface with your team, even your spouse, that can be accessed and put to good use.

By creating a culture where it is safe to contribute learned experiences in team meetings, coaching sessions, and other opportunities, improvements in your practice can be made faster.

Seeking and honoring the tribal knowledge gained from the experience of your team respects them, whether the information is useful or not. This is the essence of creating a synergistic office – where team members help each other — to help more people become healthier.

Carpe Future (Seize the future)

Ed

Want to discuss how to uncover the Tribal Knowledge in your practice, schedule a short call with Ed here.

The Problem with Your Chiropractic and Health Care Marketing May Not Be What You Think

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There could be a hidden barrier that jams your growth and holds you back.

MOST OFFICES WANT TO IMPROVE THEIR NEW PATIENT ACQUISITION. That is, attract more new patients.

At least, that is what many chiropractors and other doctors will say.

Oddly enough, that is not always exactly the truth.

Michel Killen, in his book Sell Futures, Not Features, says:

“Do you want more sales? The question should really be “do you really, really, REALLY want more sales?” This might sound insane and even obvious. Of course you want more sales, who doesn’t want more sales? However having taught and coached sales for a lot of people for a long time, this is often an underlying problem that has a tendency to sabotage our sales driving efforts. …I believe that people are creatures of goal pursuit, meaning they take actions which suit their goals. This means that if a business is struggling with sales, it’s usually because deep down a part of them doesn’t want more sales. This is extremely upsetting and even distressing to a lot of people, because of course they want more sales, everyone wants more sales!””

Well, I couldn’t agree more.

CONSCIOUSLY, you probably want more new patients as you know you can see more visits and, of course, you could use the increased revenue.

SUBCONSCIOUSLY, however, there is another story entirely. The devil’s advocate pipes up and says, “with more new patients, you will come home late, miss dinners with your family, your staff will make more errors, and your notes will start to backlog. You won’t have time to exercise, and your Worker’s Comp insurance will increase.”

But because you are a strong-willed entrepreneur and a bit of a rebel, you charge ahead and spend time and money on marketing. But after a while, you notice that your numbers don’t significantly increase.

Why?

There is a bottleneck somewhere in your office, a log jam, a Capacity Constraint.

The Theory of Constraints, originally discussed by Dr. Eliyahu Goldratt in his book, The Goal, has become a management science that implements a business improvement system. Simplified, it is a process that goes after the biggest constraint in any production process. Once that is fixed, management hunts for the next largest bottleneck, which continues as a never-ending process of improvement.

We adapted this, by the way, for practice management, in our Goal Driven System. The primary goal of the Theory of Constraints is profit. However, to achieve this, we need to look organizationally for the primary roadblock.

These constraints can be difficult to recognize sometimes. Partly because they are hidden and partly because of “damn-the-torpedoes” bias on the clinic director’s part.

For example, the front desk coordinator has been with the doctor for a few years and does a good job. The doctor returns from a new seminar, or someone new in the insurance department is hired, and things change. The doctor notices a moment when the front desk assistant is not busy and assigns them extra work. This happens a few times, and soon, the front desk has become a clerical department, filing insurance, ordering supplies, verifying insurance, and doesn’t have time to ensure all the patients are scheduled. When the phone rings, they kinda grimace and hope it’s not another new patient because they have more paperwork to do. Three months later, the doctor notices that the visits are down and spends more money on marketing.

But what is the real problem? The front desk is plugged up! Sure, some extra duties can be delegated to the front desk, but carefully, and ideally done at separate times when patients are not scheduled.

I have been able to increase patient volume and new patients by helping doctors locate the stuck points, the blockages in the office and open the flows. It could be a clinical assistant that is needed, a scribe, or replacing a staff member that really wants to work somewhere else. Maybe the staff needs better training, or intake forms massively simplified, or just a friendlier and less serious clinical director.

Constraints are like being stuck in a traffic jam. They wear your team down. And they affect your motivation and desire for growth.

Physical constraints result in mental constraints.

The real problem in marketing is not always with the marketing. It is often with the management. Being the entrepreneurial doctor you are, you know enough to make marketing work. You can make it work better once you fix the management of your practice and find the constraints and remove them.

Then, watch your volume pick up and your marketing really work.

Seize your future,

Ed

Want help removing all your constraints? Make an appointment for a quick all and I am sure I can help you uncover a probable bottleneck or two and give a you a couple simple solutions that could help.

Does Goal Setting Really Improve Performance? Ask Science.

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young boy celebrating success
FOR THE WIN!
 
There you are, sitting at the team meeting at the beginning of the month.
 
What goals should you set for the new month?
 
And… does it really help? I mean, after so many months (and years) of goal setting, so many seminars, and books that say you should set goals — does it really matter if you set goals for this month?
 
And what kind of goals?
 
And, does your team really care?
 
And, do you? (lol)
 
Well, here’s the deal: YES, goals do matter.
 
Here’s some evidence from a study by Edwin Locke and Gary Latham, who summarized 35 years of empirical research on goal setting theory*. They found that setting specific and challenging goals led to significantly higher levels of task performance than easy goals or no goals at all. They found that goals:
  1. Direct activities towards goal-relevant activities and away from goal-irrelevant activities.
  2. Can be motivational or “energizing.”
  3. Affect persistence.
  4. Encourage people to use the knowledge they have acquired.
But goal setting is affected or moderated by many factors. For example, Locke and Latham found that feedback and commitment to goals were critical for goal attainment.
 
FEEDBACK
 
You and your team need to know how you did last month. You all need to know if you are heading toward your mission or away from it.
 
The clinic director or manager should individually meet with each team member and review how they did. This should be done in a friendly and collaborative manner, ideally each month.
 
The idea of employees being a TEAM also necessitates the concept of a COACH. So, the clinic director or manager must act as a coach and help individuals, and everyone achieve goals.
 
COMMITMENT
 
According to the Study, goal commitment is linked to the importance of the goal. In my experience, this is improved by:
 
  1. Examining the mission or why of the practice.
  2. Reviewing patient successes and outcomes.
  3. Allowing team members to participate in goal setting so that it is their goal, not management’s!
  4. An occasional group goal and game, with a deadline that may include a reward.
As part of the Goal Driven System, we emphasize 3 categories of goals:
  1. Production. These are usually monthly goals such as new patients, visits, kept appointment percentage, and case completions.
  2. Organization. These are important but not urgent goals, including training, catching up on backlogs, planning, and other activities. Because these are not always apparent, vital functions can become neglected. A checklist of duties helps with this, and then reviewing them monthly.
  3. Greater Goals: professional and personal. No one works just for production or organization, so setting goals for long-term achievements is essential. We aren’t just workers — we are dreamers and explorers. We like to adventure, and we like to play.
Goals are part of games, and games should be fun. We humans like games, from the Olympics to the most recent popular computer game. It is part of our nature.
 
My grandson just had his 7th birthday. He’s a big basketball fan. I gave him a couple of presents. The first one he opened and quickly tossed aside. The second present was a large book with photo’s of basketball players and their stories. As soon as the wrapping paper was off, he raised it over his head, cheering: “for the win.” And ran off with it like the wild boy he is!
 
So set goals and play the game.
 
Keep it fun and go FOR THE WIN!
 
Ed
 
 
*https://pubmed.ncbi.nlm.nih.gov/12237980/

Failure to Follow Through

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It is the ‘follow through’ that makes the great difference between ultimate success and failure, because it is so easy to stop. — Charles Kettering

Failure to Follow Through

If it worked once it probably will work again

There is a management disease that many businesses, including chiropractic and other health practices, can suffer from. It is called “Failure to Follow Through.”

I noticed this at one of the first offices I worked with in Northern California – years ago. Their numbers were down. When I visited their office on a hot summer day, the reception room was empty, and few patients were scheduled. I noticed they had a thick binder of photos of patients and staff on the lower shelf of a dusty bookcase. The photos showed happy staff, doctors, and patients. There were also patient success testimonials, several years old.

We all met together for a staff meeting. I asked the doctor and staff if they could name a few specific actions they did back then. I said, “let’s start with marketing.”

Well, it turned out that they ran advertisements for a bi-yearly promotion. So I asked if they had done this in the last few years. “No” was their answer.

“What else were you doing at the time,” I asked. They said they always discussed financial and scheduling arrangements away from the front desk. Are you doing that now? “No.”

What else were you doing during that time? “We used to call the new patient after the first adjustment.” They also did progress exams. “Doing it now?” “No.”

The list went on and on.

Being the brilliant practice management scientist that I am, I encouraged them to re-implement what they had been doing. They did, and a few months later, the office was filling up again.

Practice Management

If it worked once, it probably will work again. Make minor improvements as needed, but why change the system if it is working?

Well, you can get bored, right? Or a staff member who knew the system left and their duties were not replicated by someone else. Or, everyone gets bored, so you feel the need to change things to bring excitement back into the office, and key procedures quietly start disappearing.

Discontinuing your successful procedures can create a roller coaster ride for your practice, with numbers going up and then down. And this can cost you thousands, even tens of thousands of dollars.

A checklist of successful procedures is essential, but that is not enough. They need to be reviewed regularly.

That, too, is not enough. We need to keep the practice environment fresh and lively while still maintaining those activities that are helping us grow and develop. We are not on an assembly line, and we are not robots!

I cover this in my book, The Goal Driven Business. (See Goal Driven Principle #17, Goals, Games, Groundhog Day). This is part of the Goal Driven System of practice development and includes checklists, reviews and coaching, and other components, such as gamification.

Gamification is a new term for an old principle: we like to play games! As video games became more prevalent, businesses saw that they could adapt elements of gamification to help engage employees and customers. Nothing new, really.

To make your office feel new again, you can think of a new promotion for this summer or new colors to paint the office. Spend a morning reviewing your goals, mission, and policies, and then go to a spa for a reward! One office creates a health theme each year and makes t-shirts promoting the theme for staff and patients.

Keep it fun — but stick to your winning ways.

Patient Management

ALSO… like practice management, patient management can also be affected by failure to follow through. Your patients need help to adhere to their treatment plan to achieve their health goals.

Stick-to-itiveness is simply being true to our goals.

Make improvements along the way and keep it fun. But help each other and your patients follow through.

Your goals are waiting for you!

Ed

She Wanted to Teach Chiropractic Staff

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Greater Prosperity through Goals, Leadership, and Teaching.

woman teaching to a crowdEffective leaders are, first and foremost, good teachers.
We’re in the education business. — John Wooden

Greater Prosperity through Goals, Leadership, and Teaching

A highly productive and prosperous chiropractic clinic always has a goal driven team for support.

Motivation is directly linked to goals and leadership. When anyone pushes their way towards their goals, they are leaders. And one of the primary methods of leading is through teaching.

This is how you lead your patients to their health goals – you educate them at the initial report, the progress report, and each visit where you Table Talk!

In a Goal Driven Practice, eventually, everyone takes a leadership role. And leaders teach.

Teaching, in and of itself, is motivational.

She Wanted to Teach

I will never forget an outstanding example of this, though disappointing in some ways.

One of our clients hired a woman to be his office manager. She had big goals while working at another chiropractic office but was not encouraged to pursue them. So, she found an office, one that we worked with, where the doctor supported her mission.

She was a powerhouse on the front desk, but also worked with the staff and the doctor on improvement projects. She told him that she would work with him for one year, and if the numbers reached a certain level, she would replace herself, receive a substantial bonus, and move on. However, she had a bigger goal in mind. She wanted to begin a team training program for other chiropractic staff throughout the state.

We worked together on this plan for the entire year. The office was already busy and doing well. But after she started, we saw the volume increase significantly. She was a great team trainer, and after a year, she won her first game. The numbers increased on a sustained basis by over 20%. The owner was very pleased.

The disappointment occurred when she visited doctors around the state to encourage them to have their staff train with her. She also promoted her services to the state association. The reception in all cases was mild. She could not convince the doctors or the association of the advantages of having their staff on a professional training program.

She eventually took a high-paying position at a corporation in another state.

Teaching is Leading

As the chiropractor, and the Clinic Director, you are a leader – and a teacher.

In a Goal Driven Practice, you also want each team member to be a leader. The fact is, in their own way, they want to be leaders. Maybe not on the stage or in front of an orchestra, but leading by actively pushing their way to their goals and the office’s goals as well.

Each one of your team members has professional and personal goals. Just like you do. These goals should align with the goals of the office. You can help to unleash the power of these goals, for yourself, and for each team member, in the following ways:

1. Accept the fact that pursuing goals is leadership. And a function of leadership is teaching.

2. Do your own in-office seminars. Teach your team how to achieve the goals of the office, and especially, why.

3. Meet with each team member and help them write down their professional and, optionally, their personal goals. Then, help them achieve these goals.

4. Have them teach. For example:

a. At occasional staff meetings, one team member can give a presentation on some aspect of their job, a core value of the office, or a chapter in a book or a video.

b. In one year (or two) after they are hired, require all staff to help you give the first half of a lay lecture.

A Goal Driven Practice is not dependent upon the doctor. Instead, it is dependent upon goals and, as such, is more profitable, provides better service, and is more fun to work in.

Seize the future and your goals,

Ed

Contact us on the link below if you are interested in discussing how we can help you create a Goal Driven Practice.

Also, read my book! 😊

*https://www.expressionsofexcellence.com/ARTICLES/wooden_interview.html

Contact Us

Individual Team Development Plans

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Tips on Creating a Goal Driven Chiropractic Practice

A Goal Driven team member training to create a Goal Driven Practice by Petty Michel Associates and Edward Petty

Helping your employees pursue their professional goals will help them also pursue the clinic’s goals.

How?

Think of yourself. If you are working on learning a new technique professionally, you might feel more energized.

Why? According to Self Determination Theory, each of us has an innate or intrinsic drive to achieve mastery and competence. We want to improve our ability to control the outcomes we produce to better achieve our goals.

I would also add that helping your team members pursue their personal goals will increase their energy to do the same for the clinic’s goals. So again, think of yourself. Looking forward to that hunting trip, that vacation with your kids to Europe, or getting in shape at the gym can give you more optimism, hope, and zest for doing your best at work.

As Vitktor Frankl says:

It is a peculiarity of man that he can only live by looking to the future.

A Goal Driven clinic is systematized and motivated to achieve its goals. It achieves this partly because it takes into account different survival energies: the patients, the practice, and each employee.

At the first of every year, besides setting clinic goals, the clinic director can meet individually with each team member for a goal-setting meeting regarding their career and professional goals. (Download sample Individual Development Plan forms)

Staff members might be interested in different subjects, such as anatomy, human behavior, customer service, or marketing. Perhaps there are certification programs for staff. Meet with your doctors as well: what areas do each want to explore and study?

Work out the goals, then discuss different approaches to achieve these. Then, check back in 6 months on their progress. The practice manager can ensure that this happens.

You can also discuss the personal development goals of each team member. For example, perhaps they wanted to try a new sport, take a unique vacation with their family, or learn a new language.

This holistic approach to leadership and management is part of what we call the Goal Driven System.

Help your people achieve their professional and personal goals, and they be more energized to do the same for the clinic to achieve its goals.

 

PTC and the Subtle Art of Being There

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It was in the 80s at a Parker Seminar, which was in Reno that year, that I first heard the term.

In the opening session, Dr. Jimmy Parker talked about PTC. I was attending as a guest with a chiropractor who introduced me to chiropractic. What an introduction!

Dr. Parker explained that PTC stood for Present Time Consciousness. (Parker had quite a few of these abbreviations!) He explained that a doctor could deliver a much better adjustment if their attention on the patient were in the present time, not thinking about past issues or on future concerns.

I have come to learn that this is a vital but easily overlooked skill.

You can tell when someone is 100% paying attention to you, or maybe not quite, or maybe not at all. And this makes all the difference in the patient’s trust in you, how long they stay with you, and whether they refer others to you.

But maintaining PTC can be challenging in a high-volume chiropractic office or any health office. How many thousands of adjustments does it take until all patients start blending into to one?

A doctor who worked with Clarence Gonstead told me about one evening when he was shadowing Dr. Gonstead. It was around 9 p.m., and the reception/waiting room was full. The doctor said to me that he exclaimed to Dr. Gonstead that his waiting room was still filled with patients. He said that Dr. Gonstead turned to him in the hallway before they went in with the next patient and said, emphatically, “No. I only have one patient, and that is the one I am with now.”

That sounds like he was present with each patient, and perhaps that is at least one reason he was so successful as a chiropractor.

I have seen more than a few techniques, or hacks, that help keep doctors, and support staff, in the present with each patient. For example

  • Completing the visit.  Some doctors soundly end each visit, often confidently saying, “That was a good adjustment, and I am satisfied.” Ending one visit before starting the next visit creates a micro-break, a little space between visits.
  • Break up the day. Different approaches to breaking up the day seem effective. For example, busy offices usually have varied but ritualized lunch breaks. These might include such activities as weight training or exercise, marketing, team workshops, lunch with the spouse, guitar practice, you name it. Mid-morning and mid-afternoon 5-minute breaks can also be helpful. (Stay away from social media!)
  • Remove distractions. You want to remove distractions that can pull your attention to future challenges or past mix-ups.  Pre-shift and short weekly meetings can be helpful in this regard by sorting out administrative issues so that you are free to focus on patients – in the present.
  • Cricket clicker! I remember one doctor telling me that he used a steel clicker, a “cricket clicker.” He would click the clicker just before the next patient visit, which would help him mentally begin the next visit.  (Whatever works!)

I suspect that this is a high-level technique. One for the masters. It can’t be canned. Perhaps it is beyond technique. When accomplished, when you are totally present, the patient innately feels that you are there for them and them alone, and this perhaps speeds their recovery.

I would be interested to know how you maintain Present Time Consciousness. You can add your thoughts here on our blog.

Staying engaged in the present for a better future!

Ed

The power for creating a better future is contained in the present moment:
You create a good future by creating a good present. (Eckhart Tolle)

Goals, Motivation, and Discipline

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“People often say motivation doesn’t last.
Neither does bathing — that’s why we recommend it daily.”
(Attributed to Zig Ziglar)

I want to thank you for continuing to subscribe to this newsletter.

It has morphed into a kind of Tuesday’s Tips for Goal Drivers.

It includes weekly practice development tips, reminders, nudges, and even sometimes…insights. We include what we have seen that works, or doesn’t, in all types of chiropractic and other offices.

This newsletter has gained momentum over the last year from the publication of my book, The Goal Driven Business. It is written for that part of us that strives to achieve our goals.

The value of goals just can not be overstated. But “goals” cover a wide range of concepts and so can become confusing or even worse, boring.

But by frequently reconnecting with WHY you do WHAT you do, what you do becomes easier and more effective. And even more fun.

Why you do what you do is your motive — or your motivation.

Motivation to achieve your goals is senior to organizational procedures — but still needs organization to support its drive. When organization fails, as it often does, motivation is weakened. And organization is directly dependent on having the discipline of doing what needs to be done.

I don’t see the subject of discipline brought up too often in practice management conferences or discussions. It’s embarrassing, perhaps. Whether it is coming in late to see patients, not doing a thorough case review, or neglecting your support team, the little oversights can take a toll on our motivation.

Attending new seminars can give you a temporary buzz and momentarily motivate you. But unless you and your team have the discipline to stick to your values and procedures, the drive to your goals will lose its energy.

In his book Good to Great, Jim Collins talks about how successful businesses create a culture of discipline. He says, “It all starts with disciplined people…Next we have disciplined thought. You need the discipline to confront the brutal facts of reality, while retaining resolute faith that you can and will create a path to greatness.” “Finally, we have disciplined action.”

In a less academic way of saying the same thing, Mike Rowe said, “Work ethic is important because, unlike intelligence, athleticism, charisma, or any other natural attribute, it’s a choice.”

The way to stay motivated is to stay true to your mission, values, and procedures and to frequently take time to face the “brutal facts” of your performance and your WHY.

Like bathing, the process never ends… and keeps you clean!

Seize your future,

Ed

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