Category Archives: Practice Manager

Unexpected Successes in Practice

Posted on by
Reply

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

Posted on by
Reply

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

Posted on by
Reply

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

What Is Effective Chiropractic Practice Management?

Posted on by
Reply

You would think that management, by now, as a subject, would be scientific. That corporations would employ skilled managers with their MBAs from prestigious universities that effectively applied administrative technology to nurture their companies.

Nah, it’s not like that.

A research study was conducted by Nicholas Bloom* and others aimed at determining how effectively management procedures were being used in U.S. companies. They found that only 15% of U.S. companies scored above a 4 on a 5-point scale. More than 30% scored a three or lower. Companies outside of the U.S. scored much worse.

Management is primarily personality driven – a little like politics and show business. And sometimes, the mafia. Some companies do well because there is a dynamic genius at the helm. Others do well because they were there at the right time. Others appear to do well because of the money they borrow, steal, or collude with government regulators.

I know some very successful chiropractors who are good managers. But they were good mostly because of their temperament and not because of their conscious use of management techniques.

Unfortunately, most management focuses on supervision. It is a form of spectator-ism and policing. Like watching robots on an assembly line and reprimanding errors and deviations.

Good management focuses on improvement. First, keep things working, then how can we all improve it? It is servant based.

In my book, Goal Driven Business, I cover this as part of the Goal Driven System.

For practical purposes, management has two different functions:

1. Keep doing what works.

2. Continually look at how the procedures and systems could be improved.

If it worked yesterday, you should do it today and also tomorrow.

Then, improve it – little by little.

If you want to make a big change, when the entrepreneurial spirit hits you, do a trial run first. Don’t disrupt the systems that are working.

A good number of practice problems occur for one reason:

You stopped doing what worked!

This applies to the front desk, patient accounts, new patient onboarding, team management, and marketing procedures.

If it worked once, it would probably work again. Just improve it if it is outdated – and if that doesn’t work, revert to what worked.

I know – your workdays can get boring and sometimes you want to go and chase the shiny things. Fine. But keep doing what works until something proves itself to be better.

I will be teaching a management course later this year. If you are interested, let us know and we’ll get you on the waiting list. It will be for you and your manager. Each class will be small to allow for more personalized instruction.

Good management underlies all your activities – managing your patients, your practice, and even your life. And especially your future!

Seize the future with good management!

* Harvard Business Review, November 2012 Nicholas Bloom

—————————————————-

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.

The Goal Driven Business By Edward Petty

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

Posted on by
Reply

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

The Five Engines Driving Your Business Towards Your Goals

Posted on by
Reply

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

Kaizen: Constant Practice Improvement – From Wooden to Deming

Posted on by
Reply

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

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

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

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

Here is what Coach Wooden has said:

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

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

 

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

Kaizen

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

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

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

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

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

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

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

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

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

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

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

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

Ed Petty

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

Was Darwin Wrong? Happy Valentine’s Day!

Posted on by
Reply

Was Darwin wrong? Let’s find out.

BUT FIRST CONSIDER THIS  WARNING:

You and your staff may have an uninspected cultural bias that is toxic to you and your office and is negatively affecting your best efforts.  This could be happening right now as you read this!

 How could this be?

Well, ingrained in our culture is the idea that to survive, we must compete and overcome others.  It is a win-lose world: either I win and you lose, or you win and I lose.

This idea had much support with the work of Charles Darwin.  Darwin’s perspective of evolution included the concept of survival of the fittest with a sort of “dog eat dog” theme.

However, recent studies suggest this is not entirely the case.

“When biologists look closely at nature they cannot help but notice cooperative partnerships that do not comfortably fit with the competitive struggle that is central to Darwinanin evolution.” (Darwin’s Blind Spot: Evolution Beyond Natural Selection, Frank Ryan)

This theory of cooperation in evolution was actually put forth 50 years before Darwin, by a Frenchman by the name of Jean-Baptiste de Lamarack (1744 – 1829), who established evolution as a scientific fact.

According to Bruce Lipton, “Not only did Lamarck present his theory fifty years before Darwin, he offered a much less harsh theory of the mechanisms of evolution. Lamarck’s theory suggested that evolution was based upon an “instructive,” cooperative interaction among organisms and their environment that enables life forms to survive and evolve in a dynamic world. (Biology of Belief, page 11)

But Lamarck’s ideas, which also included what is now called epigenetics, were cast aside and rejected until recently. So, instead of seeing that organisms in nature evolve symbiotically and cooperatively, Darwin saw that: “living organisms are perpetually embroiled in a struggle for existence. For Darwin, struggle and violence are not only a part of animal (human) nature but the principal “forces” behind evolution advancement.  Darwin wrote of an inevitable “struggle for life” and that evolution was driven by “the war of nature, from famine and death.” (Bruce Lipton, PhD, Biology of Belief) [my emphasis]

The idea of “survival of the fittest”, obviously, is not very cooperative. In an office, it can create brooding jealously, competitive back stabbing, fear and defensiveness, and make us objectify our patients as “cases” and statistics. It can create at a division between us and our patients — between each other.

I got to thinking about all of this as another Valentine’s Day approached. As it turns out, Valentine’s Day is observed all around the world and has been around for hundreds of years, even as early as 300 AD. And, it wasn’t always about romantic love. One legend has it that:

“… in order “to remind these men of their vows and God’s love, Saint Valentine is said to have cut hearts from parchment”, giving them to these soldiers and persecuted Christians, a possible origin of the widespread use of hearts on St. Valentine’s Day.” (From Wikipedia)

The Greeks had 4 different types of love:

  • Agape =Charity, or the love of Man for God or vice versa.
  • Eros = We all know this – romantic, intimate love.
  • Philia = Love between friends or family.
  • Storge = love of parents for children (Wikipedia)

Valentine’s Day is about love. Romantic love, sure but also about charity, generosity, compassion, caring – all kinds of love. And this takes us back to the notion that love, or a type of love, has been the basis for survival of all species on this planet – including mankind. Survival of life forms requires mutual support on some level – survival is cooperative and caring.

In many offices I have noticed a degree of an adversarial undercurrent. You can almost feel a sub-sub culture of “dog eat dog.”   You have experienced this, I am sure.  For example, if the mood is wrong, the phones don’t ring. Right?  When there is a high degree of compassion and care and good will for each other and for the patients, the phones start ringing.

To some degree , Darwin’s “war of nature” may be embedded in the culture of your office. Darwin was right about many things, but life evolved through cooperation and caring – not through war.

Look: Your patients want to survive better. Just find out what their goals are and help them get there.  They will need some education and coaching, sure – you have had thousands of hours of what they are just now hearing.  But care for them and do your very best to help them get to their health goals.

Your doctor wants to practice and live better – find out what she wants and help her get there. You may have to ask lots of questions and train and read and struggle at it for a while, but keep at it and you can make a big difference. In turn, this will help your patients do better – and of course, you do better as well.

And doctor, your team members want to do better and also have better lives – find out how you can help them do so – and do so.

As I mature, I truly see that this planet is getting smaller and that we are all in this adventure together, for better or worse.  Hopefully, for the better.  But there are no guarantees. If we are to get it better, it all comes down to what we can do here and now to help each other MORE than we have been.

The world can be a struggle, but we all have evolved because of cooperation, caring for each other, and love.  If we continue to do so, we can continue to evolve in our practice’s and business, and in our lives.

And have no doubt, Petty, Michel and Associates are in the mix as well. We love your patients, team members and you, and want to do all we can to help you survive and thrive.

Here are our best wishes to you that everyday – is Saint Valentine’s Day!

#  #  #

Love is patient, love is kind. It does not envy, it does not boast, it is not proud.  It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres. (From the New Testament, Corinthians 13:4-8, “love” is elsewhere replaced by the word “charity.”)

Giving Thanks – Appreciating Each Other

Posted on by
Reply

I know you are busy now.

We all are.

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

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

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

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

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

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

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

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

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

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

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

With much gratitude and best wishes,

Happy Thanksgiving to one and all.

Happy-Thanksgiving

Your Biggest Chiropractic Bill Each Month

Posted on by
Reply

Fotolia_56486655_XS

You may be overlooking your biggest bill. Most chiropractors do.

What is it? If you are in the upper Midwest or Eastern part of the US in the winter of 2014, it might be your heating bill.  It has been pretty cold.

How about personnel or marketing? Your lease? Staff benefits? How about your pay? (Probably not, I would guess.)

In running a chiropractic business, many doctors try to maximize the profit of their business by reducing expenses. They often get this idea from their accountants, and, from a certain perspective, it is a good idea. But accountants are trained such that their primary function is reporting income for tax purposes and not managing business finances.

You definitely need to review your Profit and Loss and Balance sheets regularly. Sometimes you can get carried away with expenses, not noticing that things are getting out of balance when you have 4 x-ray units, 15 computers and only 1 staff member.

But what your financial statements don’t show you, and what your accountant isn’t trained to see, is your ROI – your return on your investment.

And what is your biggest investment? (Pause while you consider this question….)

It is YOU.

And what is your biggest bill? What is your biggest expense?

It is the income that you could and should be making that you aren’t.

Your biggest bill is the amount of money you could be making if you were operating at your full capacity but aren’t.

Here is an example: Let’s say you are relatively healthy and are capably of seeing  200 patient visits per week comfortably. This excludes new patient visits.  This averages out to about 860 visits per month.  Let’s drop it down to 820 visits for vacation days, etc.  Now, let’s say you collect only $40 per visit, average. This would mean you would be collecting $32,800 per month.

Let’s leave aside the possibility you could collect more per visit and imagine that you are seeing 150 visits per week, or 645 visits per month, or 605 if we take out a few visits for vacation days (40 visits per month).  At $40 per visit, this leaves you with $24,200 per month, or $8,600 LESS than you should be making each month.

In other words, if you could and should be making $32,800 per month and you are only making $24,200 per month, you are essentially writing a check for $8,600 EACH MONTH, payable to “Inefficiency, Inc.”

You are wasting that much each month as a negative return on your investment on yourself.

This is so brutal to face that most doctors would rather look the other way.  But whether you squint at it, or not, the reality is there: you are wasting your hard earned cash each month that you are not operating at full capacity. You are throwing away a portion of the time, training, and sacrifices you have made to get to where you are now.

It is as if you are writing a check, each month, for the amount of money you should be making, but aren’t.

Savvy CEO’s and large corporations understand this.  They need to get the full measure out of their investments. As a result, they invest heavily into solutions that improve production and services so their business can achieve full capacity.

One investment that shows the greatest return is corporate training and coaching. This is a huge industry: corporate training grosses $138 billion yearly in North America and executive and business coaching is at $9 billion a year and growing.

Various studies show that executive coaching brings back a return of 5 to 8 times the investment.

Obviously this speaks to our services, but beyond us, coaching and team training help you get the most out of your biggest investment – you.

Read a book, go to a seminar, watch a webinar, participate in 4 Mastermind groups, and get an executive coach to help train and guide you. Invest in yourself so that you can take the necessary actions to reach your full capacity.

In today’s economy, you need to get more out of what you have.

Quit wasting money. Invest in yourself. You can afford it.

Ed Petty

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

References

Chiropractic Team Tryouts: Tips on Interviewing Potential New Team Members

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

 

We routinely help our chiropractic teams with the hiring process.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

GOOD TO GREAT: The 1st Step in Taking Your Chiropractic Office to Greatness

Posted on by
Reply

Jim Collins, author of Good to Great, after researching many successful companies, noted that great companies “confronted the brutal facts.”

Cover_Good_2_Gr8

“All good-to-great companies began the process of finding a path to greatness by confronting the brutal facts of their current reality.”

If you want to take your chiropractic business to the next level —the 1st thing you need is an exact and honest picture of where you are now.

You see, you can’t get to “THERE” if you aren’t exactly clear on where “HERE” is.

You may be looking at where you want to go — visualizing your goals — and you should. But before you head out on your path you should really look at where you are now and review your strengths and weaknesses.

It is goal setting season now. If you don’t clearly assess your current practice condition, a year from now you may be right back where you started.

In a hurry to get THERE, we often don’t spend enough time really LOOKING at and assessing what is honestly going on HERE.  In fact, it has been our experience that most doctors do not face the blunt facts right in front of them but instead try to “solve” their practice challenges with a new solution.   It is similar to a patient embarking on a new treatment program without first receiving a thorough examination.

We have often seen a doctor set goals designed to fix a challenging practice situation in one area when the problem was really emanating from another.  For example, your external new patient difficulty may really be coming from messes in your office management.

How is your front desk team member doing (really) after her husband lost his job? What is going on with that therapy procedure you wanted to implement three months ago? Is my billing coordinator writing off too much? How many new procedures has the front desk been given over the last 6 months? How much money am I spending/not spending on marketing? What’s going on with our newsletter program? Where’s my blue coffee mug?

Sometimes we just can’t see the forest for the trees. We become so accustomed to what we do each day that we can overlook what can be choking off our growth – or potentially fueling it to the next level. Plus, we are busy.

Half the battle of growing your business is in squarely observing what is in the way, as well as recognizing what are your greatest resources.  Only then can you effectively set your goals.

To help with this, we have developed a practice assessment specifically for chiropractic businesses. It digs into your office and measures 11 different dimensions of your operation.  Our first version of this was created nearly 14 years ago and has been used successfully since. This new version is even better.

Much like a functional assessment for your patients, this survey inspects vital areas of your practice and gives each a score. From this, we make a chart that gives you a portrait of what areas are strong and what may need immediate attention.  We also provide a written interpretation of the assessment.

Originally, this assessment was used with our active clients as part of their service. Using this assessment tool as well as practice statistics, we could uncover what areas of their business needed the most correction. We also discovered untapped or underutilized strengths that could help energize the office. At regular intervals, we could reassess and note the improvements and what to work on again.

We are now offering this assessment again as a special service which includes:

  1. The assessment
  2. Graded and plotted assessment
  3. Statistical analysis with charts
  4. Phone consultation
  5. Written report with practical action steps.

Each question will provoke a greater understanding of your practice. With the results of the assessment charted and the consultation, you will obtain a new perspective of how your office operates. You will also see more clearly what needs to be done to bring it to the level of success that you desire.

Practice Statistics. Of course, you can’t evaluate a business without also analyzing its performance monitors. Most offices keep practice numbers – somewhere.  Unfortunately, they are rarely reviewed properly.  We know how to analyze them and show you your ratios and the trends that they reveal. If we do not have your current practice statistics already, we will request them on a separate form. After interpreting your statistics, we plot them on charts and correlate them with the results of your Practice Development Assessment.  Together, this will allow us to give you an excellent overall analysis of your business and what needs to be done to take it to the next level.

 

Send in when Completed.  When you have completed this assessment, you can fax or email it back to us at Services @ pmaworks.com or Fax: 877-868-0909.   We will score and chart each section of your assessment and set up a time to discuss the outcomes with you. We will also send you the results with our written observations and recommendations.

The standard fee for this for non active clients is $250.  

NOTE: As of January, 2014, for a limited time promotion, we will be charging only $25. This is almost free, but I don’t want to take up our team’s time with people who aren’t seriously interested in this service. If you take us up on this assessment, I will assume you are hard core about improving your business. As hard core as we are!  🙂 Use the promo code  CPDAPROMO to get the discount when you click the link below.

Ed Petty

To purchase: LINK

 

 

Monthly Goal Setting for the Chiropractic Team

Posted on by
Reply
Chiropractic Team Goal Setting

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

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

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

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

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

 In sum:

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

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

Chiropractic Practice Management, Marketing, and Leadership Recorded Training Webinars

Posted on by
Reply

This is a list of our practice development recorded webinars.

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

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

 Chiropractic CEO Webinars

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

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

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

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

~~

Chiropractic Office Manager Webinars

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

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

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

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

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

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

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

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

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

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

 

Chiropractic Marketing Webinars

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

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

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

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

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

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

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

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

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

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

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

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

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

 

The Chiropractor Versus the Chiropractic CEO

Posted on by
Reply

There is a constant struggle in your office.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Best regards,
Ed

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

 

5 Levels of Administrative Support in a Chiropractic Office

Posted on by
Reply

 

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

  • Front Desk
  • Patient Accounts
  • Hallway/Therapy.

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

The smart doctor knows this rule:

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

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

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

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

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

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

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

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

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

5 Levels of Administrative Support

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

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

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

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

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

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

Chiropractic Staff ROI and Motivation

Posted on by
Reply

Staff Management: An Essential Component To Practice Success

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

We would add two more factors. First:

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

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

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

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

So, what’s the problem?

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

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

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

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

###