GOALS 2007: Part 1

You set goals for your chiropractic practice, right? Maybe you do it on a monthly basis. Some chiropractors even set weekly and daily goals. Almost everyone decides on a goal or two at the beginning of each New Year.

This is good, usually.

Goals help you to focus your energies towards outcomes that help you survive and succeed. Without goals, it is easier to become distracted. At the end of the day, month, or year, you can look back and realize that, even though you were very busy, you may not have gotten much done. And in business, what counts in the end is what you get done.

But there are dangers in setting goals too. I have seen staff meetings where goals were set and after an initial flurry of activity for a week or so, the office numbers crashed to the basement and stayed there for months afterward.

Setting your goals is a function of managing your business.  But just throwing out a number for a goal can be a lazy way to manage. It omits many key elements that have to be in place for goals to work.

Here is a list of seven critical factors that can help you achieve the goals you set for the New Year.

1. Set Time Aside to Plan Your Goals. Goal setting is working on your business. As a doctor, you spend most of your time working in your business. The ratio varies, depending on the condition of things, but it should never be less than 5% of your time, and can take as much as 30% of your time when you are just starting out, or rebuilding.
2. Outcome Goals First. Usually, goals are set for certain office statistics such as income, office visits, and new patients. These represent the results of excellent service and procedures. There are many other outcomes for which goals can also be set.

   These are simply numbers, of course, but they represent the outcomes of hard work excellently applied. We often look at these as “scores” that show how well our health care “team” played, doctor(s) included.  This puts it into a less serious but still highly focused frame of reference.

   The numbers are very important. They represent real outcomes that are not open to much interpretation.  The money comes in and you can pay your staff. If the money doesn’t come in, they are out of a job and you cant pay for your kid’s education.  Successful doctors watch the numbers daily. Doctors that are not successful seem to have distaste for monitoring their practice statistics.

   There is a downside to this: you can become so caught up in the numbers that what they represent gets forgotten. An office that becomes too focused on just the numbers can get overly stressed and fail.  The goals represent, ultimately, “helped people.”  To achieve your goals, you have to push sometimes. The key is to push on and care about what those numbers represent, and what makes those numbers go up, such as procedures.

3. Procedure Goals Second. Improve your procedures.  Set goals for improving certain organizational processes in your office, including chiropractic patient education, first day services, patient financial consultations, referral generation, and chiropractic marketing. (Our next article on goal setting focuses on this type of goal.)
4. People Goals. Your doctors and staff are going to be implementing the procedures. If you want better outcomes, and improved procedures, then you better also set a few goals to improve the skills of your staff. Regular monthly in-service trainings can go a long way to train staff. Videos, coaching, and an outside seminar every now and then also help. Keep working to upgrade the skills and motivation of your staff and set goals to do so. You can also set goals for hours of training each month.
5. Mission. This is the most important step of your goal setting.  Aside from your business mission, which is to generate profit, the mission you and your office are charged with as chiropractic doctors and staff should drive all that you do.  This actually is often worked out first before any goals are set.  However, working out your mission can sometimes become so visionary that you can lose track of what needs to be done in the next time period. To keep it real, work out your outcome goals first. Once you have worked out your mission, you then can go back to readjust any of your outcome goals.
6. Keep it Real. Aim higher, but not too high. Take a look at what you did at the same time last year and at the last time period (week, month, year, day).  Take into account any projects that may affect the goals. For example, if you are planning a vacation, lower the goals for that time period. Keep it real. Also, readjust your goal each month, week, or period. Don’t just keep it at the same level.
7. Systematized Review. A procedure we use in the Marketing Manager System(sm) (a marketing system for chiropractic offices) is very useful.  For each time period, we have worked out specific steps to accomplish three things:

Use these seven factors in setting up your goals and you will have a much better likelihood of achieving them and having more fun in the process.

Ed Petty

Always laugh when you can. It is cheap medicine.
Lord Byron

You probably don’t laugh enough.

And, just probably, there could be more humor in your clinic.

Sometimes offices can be downright grim. Stressed insurance staff, doctors working with an emergency case, patients running late… the list goes on and on. You may not notice it from the inside, but your patients do. Have you ever walked into a doctor’s office that seemed less than happy or friendly? How about a dentist’s office?  You don’t really want to return to an office that is stressful and tense.

Laughter is good medicine, or rather, good therapy. It is good for patients, employees, and doctors.  It helps make the work day go smoother, tasks seem easier, and goals more obtainable. And more fun to achieve.

Even if you are not good at telling jokes or making them up, you can work on it. And that can be funny too! At least for others!!

ACTION STEP

Start each staff meeting, or your morning case management meetings with a joke. Have your staff take turns.  (No mean or off-color jokes.)

Telling jokes can help you to take the gravity and stress out of your work. Successful practices, and people, tend to be lighter hearted than those that are worried and very very serious.

Sometimes when you start laughing you can find more things to laugh about. Try it sometime.  You can always check out our “Breakroom” for a joke or two. They may be a little corny, but that is funny too.

P.S. April is National Humor Month. Click here to learn more.

Change happens.  And you either are making the change happen and evolving your business, or the change will happen to you and to your practice. It is a matter of either being proactive or unresponsive.

Too many offices seem to be changing, but they are actually caught in a kind of neurosis: compulsively putting out fires, and like a dog chasing its own tail, never getting anywhere.

Other offices go to the seminars and read the books, and talk about improvements, but never really change. They stay stuck and hide in their comfort zones, doing business the way they did back last century.

You have to change. All you have to do is look at other business models for examples. We have a McDonalds a few miles from our office (who doesn’t?). It has been there for many years. A new Panera moved in near to it. It is a beautiful and convenient restaurant with all the things people want now: upgraded coffee, salads with chicken, and some no-fat bread. Oh yes, with Wi-Fi (wireless fidelity).  And it is very busy.  So what is McDonalds doing? About two weeks ago heavy equipment moved in and started demolishing the building. Today, it is completely destroyed and plans are underway for building a new McDonalds with a new design and improved features. I assume with Wi-Fi and fancy coffee.

Peter Drucker, one of the world’s foremost management consultants who recently passed away, said that “business has only two functions — marketing and innovation.”

You have to change, or to put it better, you have to innovate.  And you have to market.

We have recently talked about the process of Continuous Improvement. The Japanese call it Kaizen. We have begun implementing a process called Continuous Improvement Reviews (C.I.R.), which is an adaptation of some of our basic consulting procedures that have been so effective. The CIR looks to be a vital tool for improving practice innovation and marketing. We will be posting more information on how to do the process in the future.

A new month is coming and it is time for a change. Time to innovate and market and grow your practice.

A fill in chart of the Six Components To A Self-Reliant Chiropractic Clinic

[ Download/View File ]

You can use this worksheet to help you implement a process of continuous improvement in your clinic.

It is not enough just to have goals.

It is a good start, but there is more.  In fact, just setting goals does not work. You have a staff meeting and decide that in the New Year you are going to see 400 Visits per week average and 30 new patients average.  Then you go back to work. That’s great, but it’s just not enough.  Plus, you have probably done this before so it becomes boring at best, or at worst, brings to mind past failures.

Just setting goals is lazy management. Like General Motors.

You have heard of them. They make cars, like Chevrolet, Cadillac, Buick, Pontiac, and the Hummer, to name a few.  Each year they set production quotas and they once dominated the world.   Over the years their market share has been shrinking, their stock has been shriveling, and they continue to close plants and lay off workers.

Toyota, on the other hand has been growing for decades and  is now predicted to overtake General Motors  as the number one car manufacturer in the world.

Toyota sets goals and quota’s, sure.  But they do something more. They set improvement goals and implement a process to reach these goals.  They call this process KAIZEN. It translates roughly as continuous improvement.

As a business, you either continue to improve, or you eventually die.  It is not enough to improve once every five years. It has to be continuous. You are either improving your clinic this year, or your patients may be drawn to an office that is. That is the way the market works.  You should review the level of your efficiency, patient care and service, promotion and public relations, patient education, and staff training and see if there is room for improvement.

You don’t have to make big improvements, but you have to constantly work on it.  It has to be a process or system of improvement, with incremental tweaks here and  there,  working out the bugs as you continue to grow.

Real business improvement also requires that each team member work on improving themselves personally.  Better health, greater fitness, more education, new hobbies, better relationships, etc., all add up to an improved team and an improved office.

Chiropractic is the improvement profession. This is an added benefit for anyone working in chiropractic because it supports constant professional and personal improvement.

There are many benefits that come from a process of constant improvement. And the consequences of not setting and working improvement goals? Ask a recently unemployed GM worker or stock holder.

Make the 2006 your Year of Improvement.

ACTION STEP. Have a staff meeting and make a list of at least 5 areas in your clinic that you want to improve on over the next three months. You can download a worksheet to help you do this (click here) .  Discuss each area with your staff, and assign each one a grade on a scale of 1-10. Set a goal to improve this part of your clinic in the next three months. Next, have each staff member and doctor do the same for 5 areas of their lives. Have them grade each area, and set an improvement goal for the next three months. The last step of the meeting would be to set a date for the next meeting, three months later.

Repeat this drill every three months for a twelve month period.