Category Archives: Practice Manager

The Chiropractor Versus the Chiropractic CEO

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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

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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

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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.

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