Sage on the Stage or Guide from the Side: Chiropractic Seminars vs. Coaching – Which is Better?

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They both can be expensive, so what service gives the greatest “bang for the buck?”

I go to seminars. I like them. In fact, I hope to see some of you at the WAVE, sponsored by Life West  in San Francisco this weekend (8/1/2014).   (If you are going please contact me by calling the office number below and it will forward to my phone. It would be great to say “hi” in person!)

Seminars provide a good opportunity to get away. B.J. Palmer talks about this, of course, in his Rule Number #9. (1)

Also, by disengaging from your work, you can better re-engage in it when you get back. The science of this is discussed in a book called: The Power of Full Engagement.

Plus, networking. Nothing like meeting new people and hearing how and what they are doing and trading fish stories – even if they are often embellished.  (“Don’t tell fish stories where the people know you; but particularly, don’t tell them where they know the fish.” Attributed to Mark Twain.)

And, they can be entertaining.

Plus, you can learn things. Learning new things that work and unlearning things that don’t work is probably the MOST important skill you can have. And it is getting more important every day. Our world is changing SO fast that in order to keep up, you have to really spend time and money learning.

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.” ― Alvin Toffler

However, there are drawbacks.

Seminars: the Sage on the Stage

First, there is the expense of the seminar.  Actually, by comparison, most chiropractic seminars are dirt cheap compared to other seminars that run into the thousands. The expense is in the travel. The hidden expenses add up considerably, especially if you take your staff, which you should now and then.

Then, there is the actual content – the information being imparted.  Much of it is motivational and that is nice.  However, the seminar speaker does not know you. He hasn’t been to your office, your home, talked with your staff or know your family. He hasn’t read your town’s newspaper or seen your patients.  He doesn’t know your situation.  He teaches you a procedure that sounds good in theory and may have even worked in his office 15 years ago, for a while.  He may be entertaining, or coercive.  But, often only 10% of what is taught at a seminar is applicable to you and your office.  And of that, very little gets implemented, and in two months, less than 5% of the seminar may be in operation at your office.   The following is an example that shows how much useful information gets reduced down to actual implementation in most offices.

Actual Value of Seminar (approximate percentages)

  • Motivational (can sometimes be excellent, but is very temporary.)
  • Percent of information verifiably valid:  70%
  • Percent of information comprehensible, heard, or understood: Of the 70%, one half is comprehended, heard, or understood, leaving 35%)
  • Percent of information applicable to your particular city, staff, patient base, your style and personality, etc.: Of that 35%, perhaps 15% isn’t applicable, leaving you with 20%.
  • Percent of information that can be implemented in your office: Of the remaining 20%, perhaps only half can get applied, leaving 10%.
  • Percent of information that gets applied:  In two weeks time, only 5% gets applied.
  • Percent of information that stays in application: After two months, only 1-5% percent of the original information is still applied.
  • If you had spent $2,000 on a seminar program, using the rough example above, you would have wasted all but 5%, or $1,900.

This example is a little harsh, I‘ll admit, but I wanted to make a point. But you know what? Even this small percent may still be worth attending the seminar.

Coaching – The Guide from the Side

Our company grew because doctors did not or could not adequately apply what they heard at the seminars.  Starting out many years ago, I remember seeing doctor’s shelves full of binders, VHS cassettes, and manuals that were barely touched since they were brought home from the seminar.

So, back in the late 1980’s, we came up with our niche and our identity, encapsulated in our tag line:

When Seminars Aren’t Enough sm

Good coaching, helps you and helps your team discover what systems work best for you, and then helps you make them better – over and over until your TEAM becomes expert.

A good coach, like a competent doctor, has the experience to quickly identify what needs to be worked on that can bring about the quickest improvements.  This is what we do.  We have become skilled at spotting the key leverage points (3) in an office and have developed new and effective methods to make the changes necessary for faster improvements.

But, we do this as your guide. We don’t impose a particular patient system into your office.  You are unique and what works for a doctor in Nebraska may not work for the same one in San Diego.  We help you discover what works best for you and help your team get better at supporting you.

A good coach trains, advises, nudges, listens, counsels, teaches, and when possible, even does some of the work.  And is this effective? You sure as hell bet it is! We have been doing this for nearly 30 years and those doctors that have worked with us know this to be true.

But the real reason for coaching is economics: bottom line, baby! Return on Invest. ROI.  Studies show a pay back of 5 to 7 times on your investment. We have certainly seen this occur. (3)

Like chiropractic, good care doesn’t cost, IT PAYS. Health IS wealth.  The same applies to education – and in particular – coaching. It doesn’t cost – it pays.

Seminars? Yes. Coaching? Hell yes!  But books and webinars and mentors as well.  A weekend of reading a book is a great investment.

In the end, you have to constantly study and learn to stay in the game. Success is, now more than ever, dependent upon constant never ending improvement.  You have to do this just to keep up, let alone to get ahead.

And if you don’t – well, your community and patients will be seeking a healthcare office that is.

References
(1)    Rule #9:  Every man owes it to himself, his people and his service to go away about every so often. The more detail he has, the oftener he should go. The more worries, the more he needs to go. The bigger his work, the longer his vacation should be. – B.J. Palmer    https://pmaworks.com/observations/2008/08/18/getting-away-rule-9/

(2)    Leverage Points  http://www.donellameadows.org/wp-content/userfiles/Leverage_Points.pdf , also: Eli Goldratt, The Goal

(3)    BUSINESS IMPACT STUDIES

  • Research conducted by MetrixGlobal on coaching at a Fortune 500 company showed that coaching produced a 529% return on investment and significant intangible benefits to the business. Including the financial benefits from employee retention boosted the overall ROI to 788%.
  • A landmark study commissioned by Right Management Consultants found a return-on-investment of dollars spent on executive coaching of nearly 600%. Executives engaged in coaching reported increases in productivity, improvement in relationships with direct reports and colleagues and greater job satisfaction.
  • According to a study by the Manchester Consulting Group, organizational benefits from executive coaching include:

Improved Relationships 77%
Improved Teamwork 67%
Improved Job Satisfaction 61%
Improved Productivity 53%

  • An International Personnel Management Association survey found that productivity increased by 88 percent when coaching was combined with training (compared to a 22 percent increase with training alone).
  • Studies completed by the American Society for Training and Development showed a ROI of 5 times the cost of coaching.

BUSINESS PRESS EXCERPTS

  “Many of the world’s most admired corporations, from GE to Goldman Sachs, invest in coaching. Annual spending on coaching in the United States in estimated at roughly $1 billion.”   Harvard Business Review

  “Coaches are not for the meek. They’re for people who value unambiguous feedback. All coaches have one thing in common. It’s that they are ruthlessly results-oriented.”          Fast Company Magazine

  “Business coaching is attracting America’s top CEO’s because, put simply, business coaching works. In fact, when asked for a conservative estimate of monetary payoff from the coaching they got….managers described an average return of more than $100,000 or about six times what coaching had cost their companies.”                                   Fortune Magazine

   “[A Coach] is part advisor, part sounding board, part cheerleader, part manager and part strategist.”    The Business Journal

   “Between 25 percent and 40 percent of Fortune 500 companies use executive coaches.”      The Hay Group International

  “Once used to bolster troubled staffers, coaching now is part of the standard leadership development training for elite executives and talented up-and-comers at IBM, Motorola, J.P. Morgan, Chase, and Hewlett Packard. These companies are discreetly giving their best prospects what star athletes have long had: a trusted adviser to help reach their goals.”                     CNN.com

  “In a 2004 survey by Right Management consultants, 86% of companies said they used coaching to sharpen skills of individuals who have been identified as future organizational leaders.”         Harvard Management Update

  “A coach may be the guardian angel you need to rev up your career.”          Money Magazine

http://transverseleadership.com/roi.html

Patient Retention in Chiropractic and Delivering Happiness

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In our webinar on chiropractic patient retention, we reviewed some basic procedures that can be used to decrease patient drop outs.

More significantly, we looked at a new paradigm for patient retention that many businesses are using successfully.

If your visit average is less than 60, then you can benefit from the material we covered.

The webinar also included a short presentation on an effective patient recall system used many years by Linda Skiles, former Chiropractic Assistant of the year in WI. The forms discussed in the webinar are located on our PM&A members site.

We discussed why patients drop out of care – the basic reasons, and ten strategies you can put into place to improve your visit average .

One of the last strategies examined a company called Zappos. This is an online shoe selling company that began in 1999 and ten years later was selling a billion dollars worth of shoes.  We looked at a couple of key features on how it did this.

Under the strategy of “Take Care of Each Other”, we reviewed their ten core principles.  According to the founder and CEO ,Tony Hsieh, employees are hired in part based upon these core values. He discusses this in his book, Delivering Happiness.

These are the ten core values that Zappos employees live by:

  1. Deliver WOW Through Service
  2. Embrace and Drive Change
  3. Create Fun and A Little Weirdness
  4. Be Adventurous, Creative, and Open-Minded
  5. Pursue Growth and Learning
  6. Build Open and Honest Relationships With Communication
  7. Build a Positive Team and Family Spirit
  8. Do More With Less
  9. Be Passionate and Determined
  10. Be Humble

What are the core values of your office? Have you defined them? Should you? Does each team member live by them?

Below are two links to two short videos that illustrate how Zappos applies these core values. The first is a music video put together by Zappos and their employees. Just fun – and maybe even inspirational.

Then, watch as Rachel Ray anonymously calls in to place an order on Zappos and see how she is treated.

Zappos illustrates the strategy we call: “Taking Care of Each Other” and “Creating a Community.”  Both of these are effective strategies that can help increase patient retention.

You can use these videos at a staff training meeting and discuss how it could apply to your team.

If you are an active client, you can also watch the webinar on our members site.

Your patients may come to you for health and relief, but they stay because of friendship and how you make them feel as people. By hiring the right team members and helping each other stay true to patient centered core values as exemplified by Zappos, your patients will want to come back and see you again and again.

If you are having trouble viewing the video above, please click this link:

http://youtu.be/4gHlEBU_NSg

If you are having trouble viewing the video above, please click this link:

http://www.youtube.com/watch?v=td-nVat6cLY&feature=colike

Independence and Dr. Jim Sigafoose

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Dr. Jim Sigafoose, 1985

Dr. Jim Sigafoose in San Francisco, 1985

What makes chiropractic so remarkable is that it works so effectively.  If you work in the chiropractic profession or receive chiropractic adjustments, you have witnessed this first hand.

But there is another factor that makes chiropractic even more remarkable – something that makes it truly unique above most if not all professions.

It hasn’t sold out. For the most part, since its inception in 1895, it has maintained its integrity. It has remained relatively independent and free from mega corporations that have otherwise hijacked our so called “health care” system.

It has stood up to the medical-industrial complex, and though coerced and bribed and enticed to go away or give up, chiropractors and their supporters have prevailed. With your help, it has stood strong and unbowed.

Certainly, there are odd roads that segments of the profession have tried to go down every now and then, not the worst of which has been catering to the “health” cartel. And the chiropractic profession will need to find its way to work more inter-dependently with all legitimate medical and health disciplines.

But most of all — it needs to continue to be itself.

Jim Sigafoose reminded us what chiropractic is and who we are in the chiropractic profession.

Yesterday, I was informed that he passed on.

I have to get personal here. Years ago I worked with Siggy, as did my business partner, Dave Michel. In the 80’s we hung out and worked with him in certain management seminars, or would work with him in the field with our clients. We recommended our clients attend his seminars, his “Gatherings”, and buy his educational material.

Siggy was my own Bob Dylan of chiropractic. He was a troubadour that didn’t play for any king nor cater to any earthly lord. He couldn’t be bought. I am not a doctor of chiropractic, but your profession appealed to me because it was so helpful and revolutionary – and even respected the spiritual aspect mankind. Dr. Sigafoose represented chiropractic to me in this way and were it not for him, I am sure I would be working in other endeavors than chiropractic.

At a WAVE seminar sponsored by Life West a couple of few years ago, Siggy went on the stage and challenged the audience why they felt they needed all the products sold by the vendors lining the hallways of the seminar. He said that he didn’t think saying this was going to be appreciated by the sponsors of the event, but I am sure Siggy felt the principles were more important than the profits.
After his talk, he walked down and sat down by himself. I went over and sat beside him and we listened to Bruce Lipton give a great presentation – full of science and slides.

People like science and slides. But science and slides should simply prove the principles – which was actually Dr. Lipton’s whole point. D.D. Palmer had it correct back in the 19th Century.

As did Siggy.

When he talked, the complexity of what we do in chiropractic fell way, like rust falling off of a hinge. Like crusted ice breaking apart on a car windshield here on a Midwest winter, when Siggy talked, you could see the truth better. And it was a truth that you already knew but was obscured by mental and physical clutter.

Siggy’s message seemed to motivate you not be a warrior, but to be a more loving servant.

I guess mostly I always felt Siggy was my friend and that he genuinely liked me. But I only say this because it seemed to me that he made everyone he touched feel like they were his personal friend.

He was passionate, he cared, and he suffered. He was tireless. He did not retire. He kept going. He was courageous. And I think he did all this because, most of all… because of love. I think he loved chiropractic, God, his family, his patients and all patients, and those of us who work in chiropractic.

Today in America, we celebrate our independence. But with independence comes responsibility and the need for integrity. Forfeit your personal and professional responsibility, care less, comprise more, and you will gradually slip into the state of dependence.

This is the tide that is rushing at your patients – to become more dependent upon drugs and vaccinations, entertainment, and big business masquerading as government.

For those of us in the chiropractic profession, we owe so much to those who have come before us, like Dr. Jim Sigafoose. For, like America, we have been given the hard won gift of independence. Through Dr. Sigafoose’s work, and others like him, we are reminded that we have to work to stay independent and help our patients to do the same.

(same article in PDF form for download)

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Here is a short clip with Siggy.  4 minutes

SiggySummer

The Ladies Are On the Road Again!

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Phyllis Frase and Dana Pittner, in addition to consulting chiropractic offices on a daily basis, spend some of their time speaking across the country at various seminars and colleges.  Their passion for chiropractic and the success of chiropractic teams drives their motivation to share their expertise of running a successful office.

Upcoming Events include:

May 3 Sherman Lyceum 2014-South Carolina-Dana Pittner
May 15 Morraine Park Technical College, West Bend, WI-Phyllis Frase
June 12-14  Parker Seminar-Charleston, SC-Phyllis Frase  $25.00 discount code :  CHSSPKRDISC11

Will they be heading to your town next?
Stayed tuned to other events as they are posted by following our calendar at:  PMA Works Observations-Calendar

If you’re interested in one of their programs please contact us at (414) 332-4511.

Anthem Chiropractic Network Reductions

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(Wisconsin, April 4) Chiropractors in WI received certified letters from Anthem BCBS announcing that they are initiating a sweeping reduction of their chiropractic provider network to supposedly “right size their provider network as a result of the ACA”.

According to Mr. Dave Michel of Petty, Michel & Associates, if you have one of these letters, you’ll be removed from the BX network on Sept 30 “without cause”, as allowed under your provider agreement.

He says that it looks like they may be targeting larger clinics in each city with higher utilization and also possibly those with a focus towards wellness,and that this doesn’t bode well for their customer base.

Dave mentioned that a similar tactic was used by insurance companies in Massachusetts with the introduction of “Romney-Care” in 2006 and after the hue and cry, chiropractic offices continued to grow. This has also been the case with offices that we have worked with when the doctor was booted from a network – stats go up!

In many cases, the out of network benefits are close to those in network.

Dave has written a letter that you can customize and send to your patients should you get hit by an insurance company claiming they need to “right size.” You can download a copy of this letter as a Word file with the link provided below.

A key to survival is patient education, not only on chiropractic, but also on chiropractic benefits. This is why we stress the Patient Financial Consultation, or the Post Report of Findings.

Lastly,  Dave recommended working together as a group with your state associations and respectfully confronting any insurance company that discriminates against chiropractic services with the facts.  And the facts are that chiropractic care doesn’t cost… it pays.

While you may not practice in Wisconsin, there may be a time when you receive such a letter and if you  do,  these suggestions  can help.

For PM&A clients, if you have received a letter like this, let us know and we’ll work with you on your options.

Sincerely,

Ed

Dave Michel’s Letter to patients: Anthem Termination Letter

Tent Poster – “Life is a Torch” – George Bernard Shaw

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This is the true joy in life, being used for a purpose recognized by yourself as a mighty one. Being a force of Nature instead of a feverish, selfish little clod of ailments and grievances, complaining that the world will not devote itself to making you happy.

I am of the opinion that my life belongs to the whole community and as long as I live, it is my privilege to do for it what I can.

I want to be thoroughly used up when I die, for the harder I work, the more I live. I rejoice in life for its own sake. Life is no brief candle to me. It is a sort of splendid torch which I have got hold of for the moment and I want to make it burn as brightly as possible before handing it on to future generations.

—-  George Bernard Shaw Preface in book called: “Man and Superman: a Comedy and Philosophy.”

Shaw

Printable Tent Poster

ICD-10 Implementation Delayed until 2015 – Chiropractors Breathe a Sigh of Relief

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Good Grief!

After all the pressure to get compliant and ready for the new ICD-10, it looks like it will be delayed for another  year.  Again.

According to a report issued by the AHIMA (American Health Information Management Association):

“On behalf of our more than 72,000 members who have prepared for ICD-10 in good faith, AHIMA will seek immediate clarification on a number of technical issues such as the exact length of the delay,” said AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA

Please note the number of capital letters behind Thomas Gordon’s name. This should give us all an idea of how convoluted this process is and will continue to be.

The same article, issued on March  31, 2014 states:

CMS (Centers for Medicare and Medicaid)  has estimated that another one-year delay of ICD-10 would likely cost the industry an additional $1 billion to $6.6 billion on top of the costs already incurred from the previous one-year delay.  This does not include the lost opportunity costs of failing to move to a more effective code set, AHIMA said.

Many coding education programs had switched to teaching only ICD-10 codes to students, hospitals and physician offices had begun moving into the final stages of costly and comprehensive transitions to the new code set—even the CMS and NCHS committee responsible for officially updating the current code set changed the group’s name to the ICD-10-CM/PCS Coordination and Maintenance Committee.

The delay directly impacts at least 25,000 students who have learned to code exclusively in ICD-10 in health information management (HIM) associate and baccalaureate educational programs, AHIMA said in a statement.

The United States remains one of the only developed countries that has not made the transition to ICD-10 or a clinical modification. ICD-10 proponents have called the new code set a more modern, robust, and precise coding system that is essential to fully realizing the benefits of recent investments in electronic health records and maximizing health information exchange. (AHIMA article)

 ICD-10 is not going away. But for those of you who felt that you weren’t going to be ready by the deadline… looks like you have more time to get everyone trained and the systems worked out.

Which is nice!

Stay tuned for more info from your state associations, carriers, and CMS. We will do our best as well to keep you up to date.

Disruptive Technologies: Why Cal Jam Is the Future – and You are Too

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Petty Michel Following the Force to Cal Jam

 Next week, a few thousand chiropractic professionals will attend a chiropractic seminar called Cal Jam sponsored by the Dead Chiropractic Society.  (Some of us from PM&A will be attending as well as a number of the offices with whom we work.)

Cal Jam is what could be called a disruptive event.

I take this from a term used in technology called “disruptive technology” or “disruptive innovation.” It refers to a product or discovery that forever changes the future. It creates a true paradigm shift. For example, the automobile, telephone, and of course, the Internet. We see this happening with FaceBook and soon, perhaps with Bitcoin, drone home deliveries, and other culture shifting technologies.

Cal Jam is a seminar that is unlike all past seminars I have attended or know about.  It is, in itself, a paradigm shift.  I have been traveling off to chiropractic seminars for few years now. The first one I attended was back in 84 or 85 when Dr. Parker (Dr. James Parker) had it in Reno one year. Had the chance to talk to him then up in his suite.  Since then, I have been to maybe a 100 or more over the years. Cal Jam is dif-er-ent.

Petty Michel & Associates is not really a seminar company, but we encourage them. Seminars can be useful for teaching, motivating, selling, and networking, but we find that the real work begins and ends in the office, where you work on the office. Like the old phrase: “Education Begins at Home.”

But Cal Jam is unique.

  • As a whole, Cal Jam is not about itself.  There may be speakers or vendors that have invested a great deal and need to promote themselves, but the theme is not about Cal Jam or any one management company or product.  It is really about the bigger issues of Chiropractic and Health.  So, there is kind of a lack of self-importance which is very refreshing.  It genuinely puts chiropractic and the health of your family, friends and community first.
  • Cal Jam starts with chiropractic and then takes off to vital issues affecting health.  It takes on critical – and controversial — health subjects that go way beyond the conventional and challenges you to learn how they affect your patients and what you can do about these issues.
  • Principles and history. It has presenters that deeply discuss chiropractic principles and history, the foundation for your profession which is often overlooked and, in our years of on-site work,  a major reason for many floundering practices.
  • Totally classy. In fact, the digs are luxurious. The venue is in a modern performing arts center that is nothing short of first class.
  • All done by just one practicing Doc. It is championed by just one person, Billy DeMoss (supported by Mary Jane), a practicing chiropractor who lives and works in an office just like all the tens of thousands of other chiropractors. Chiropractors like you. He is not school president, he is not a practice management seminar speaker, and he is not selling supplements or equipment.  So, in many ways, he is just like you.
  • Purpose. Except for this: he is authentically driven by a greater purpose to promote chiropractic and good health to such an extent that is is creating this thing called Cal Jam.  And by his actions, he sets an example for you. You have to ask yourself: “Besides growing my own business, what could I also be doing to significantly help others?”
  • Rock and Roll.  Lastly, I have never attended a rock concert that was also a seminar.  This is my 4th Cal Jam. It is fun!

It is not too late to hop on a plane and attend Cal Jam. The seminar is modestly priced. Go to Cal Jam.

But if you can’t, you can apply its spirit – the spirit of honestly helping others improve their health.  And being disruptive.  This may go beyond your comfort zone, but it will be worth it.  It is no news that chiropractic is, and always has been, a disruptive health system. Imagine, adjusting someone rather than having them receive back surgery! Back surgery brings in a lot of money to hospitals yet at least one study cited estimates as much as 90% are unnecessary. I am you as doctors see this first hand. But chiropractic has frightened and upset the medical monopoly for years, as evidenced in the 1988 Wilk vs AMA case.

Be just a bit disruptive. Have fun and be friendly and don’t take yourself too seriously. But be something new and fresh in your office and in your town. Get people off the couch, off their drugs, get them adjusted, educated and moving. This is what people, more and more, know they need.  For that IS the spirit of chiropractic, in my opinion.

And if you want, turn up the jute box – or Internet radio. Get your patients dancing to some rock and roll music*… and you can have the spirit of Cal Jam every day.

*“Just let me hear some of that rock and roll music, anyway you choose it,
It’s got a back beat, you can’t lose it, Any old time you use it.” (Chuck Berry)

[print-me target = “#content_box” do_not_print=”.no print#right_bar”] 

Where in the world is Phyllis speaking now?

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While we are struggling to stay warm here in the Midwest,  our Phyllis Frase will be heading to sunny Puerto Rico the weekend of February 1 and 2nd to share her expertise on the Chiropractic Front Desk and better communication in a chiropractic office.  Last report was the weather was 86°.

PPMs CAs Boot Camp_Flyer (3)

 

We’re certain she will “light a spark of chiropractic passion” for the CA’s in attendance and we only ask that she brings some of the warmth back home with her.

Your Biggest Chiropractic Bill Each Month

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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

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References

Chiropractic Team Tryouts: Tips on Interviewing Potential New Team Members

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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

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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

 

 

Using Checklists to Improve Your Chiropractic Practice

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

Don’t overlook the humble checklist as an important tool in developing your business. Simple and low tech, the checklist is yet so powerful and vital that everyone from pilots to surgeons use them.

Here at Petty, Michel and Associates, we have been promoting the use of checklists as a simple tool in chiropractic practice development since the early 1990’s.  All successful businesses use them, and certainly all professionals, from airplane pilots to cowboys.

Are they just more paperwork? Or can they really make things faster, simpler, and actually improve the quantity and quality of your services?

It really is just a simple matter of helping to ensure that your office continues to do the things that work.

Let’s be honest: sooner or later, we all get bored.  When we start something new, we are fully engaged. But after a few weeks, months, let alone years, continuing to do the same thing can be painfully tedious. So much so that we are tempted to follow other diversions.

Excellence does require creativity and innovation. But it also requires doing the same thing that worked yesterday – today and tomorrow. Improve upon it; add a new service or product or communication channel.  But don’t let your feelings of monotony dictate your management planning or procedures.

At PM&A, we advocate management by the numbers and by your own proven procedures.  Execute your procedures routinely with care and interest. Don’t manage by emotions or chase other people’s bright ideas or change everything to follow the current management flavor of the day.

The fundamentals ALWAYS apply.

This is the meaning of what Aristotle spoke of as recorded in his talk on ethics:

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

Practically, a checklist is a reminder of a what should be a habit: “Don’t forget to:____. ”  We are all busy and sometimes can take things for granted or take necessary shortcuts.  There is a tendency for any activity to atrophy to its minimal functions. For example, at the beginning of the year you got up early, had a cup of freshly ground coffee, and went to the gym for 40 minutes. By July, you were settling for instant coffee and a walk to and from your car.

A simple list of duties, such as how to open and “start” the office in the morning, “closing” the office in the evening, or “10 things to do on a patient financial consultation” can act to help train and as well as review excellence in performance. A list of duties for each position in the office is also very useful for training and just reminding.

Atul Gawande, an endocrine surgeon, saw the need for checklists in surgery.  He surveyed  fellow surgeons who said that they did not want to do checklists before surgery. But when asked if they wanted their surgeons to use a checklist if and when they went under the knife, almost all said they wanted their surgeons to use a checklist.

“What is needed… is discipline.

Discipline is hard — harder than trustworthiness and skill and perhaps even than selflessness.  

We are by nature flawed and inconstant creatures. We can’t even keep from snacking between meals.  We are not built for discipline. We are built for novelty and excitement, not for careful attention to detail. Discipline is something we have to work at.

Good checklists, on the other hand are precise. They are efficient, to the point, and easy to use even in the most difficult situations. They do not try to spell out everything–a checklist cannot fly a plane. Instead, they provide reminders of only the most critical and important steps–the ones that even the highly skilled professional using them could miss.

Good checklists are, above all, practical.

                                     -Atul Gawande, M.D., Endocrine Surgeon, Associate Professor at Harvard. (author of The Checklist Manifesto)

Managing the work you do as a chiropractor or chiropractic team member in your office may not be as complicated as surgery, but your patients are just as important.   Maybe even more important.  Why? Because your chiropractic care may help keep your patients from ever needing surgery.

The Checklist: a simple and humble tool to improve the quality and quantity of your chiropractic services.

————

Links to Atul Gawande: Quotes, TED

2014 Appointment Calendars

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It’s that time of year again!

Many of you are starting to make multiple appointments for your patients which automatically takes you into 2014.

Below are some helpful appointment calendars that you can use help get those appointments scheduled and keep your patients on their treatment plans.

Appointment-Calendar 2014

Personal Appointment Calendar 2014

PMA members can find a word doc version of the calendars, for customization, on our members side under the Front Desk Library

The Fundamentals Apply…As Time Goes By

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I want to pass on some tips and ideas about chiropractic marketing and so the title above may seem a little misleading. It is a taken from a classic movie, a romance actually.  I will get to that in a moment.

To start off with, I have pulled out some promotional ideas from our chiropractic Marketing Toolkit on our Petty, Michel and Associates Members Site and in the Chiropractic Marketing Manager System program that you might want to use for this month, November, or December.  You can find them here on our web site.

There are many variations of each, and thousands of different promotions, but those listed have worked and at least can help prompt you and your team to come up with your own customized programs.

I wanted to send these out and draw your attention to the importance of marketing because you may have been distracted lately. I know I have. There has been a great deal of noise over the last several months, some of it frantic, about new HIPAA regulations (watch out for the HIPAA Police!), ICD 10,  PQRS and other Medicare measures, and now the Affordable Care Act (Obamacare). And now we also have the government gridlock and debt and so on and so on.

The environment in which we do business is always changing.  And the rate of change is increasing.  It is like a sea that sometimes has big waves and sometimes little waves. At times it storms and at other times there is a dead calm. And we are the sailors and we have our ships and come what may, we sail our vessels and deliver our goods.

But the fundamentals of our businesses do not change.  And marketing is a basic fundamental of business.  In fact, it IS business.

As a doctor, your focus is on patient care, on quality clinical procedures and outcomes. And, as a doctor, it should be.

But your other role is “business person,” and business is all about the market place.  Like the summer Farmer’s Market, it is where you put something of value on display that others want.

Peter Drucker, the father of modern management theory, looked at marketing as the entire purpose of an organization.  In his book, Management: Tasks, Responsibilities, Practices (811 pages!), he says:

There is only one valid definition of business purpose: to create a customer.  Because its purpose is to create a customer, the business enterprise has two – and only two basic functions — marketing and innovation. All the rest are costs. Marketing is the unique distinguishing function of business.

He goes on to say:

Marketing is so basic that it cannot be considered a separate function (i.e., a separate skill or work) within the business, on par with others such as manufacturing or personnel. Marketing requires separate work, and a distinct group of activities. But it is, first, a central dimension of the entire business. It is the whole business seen from the point of view of its final result, that is, from the customer’s point of view. Concern and responsibility for marketing must, therefore, permeate all areas of the enterprise. (Page 63)

In other words, your entire office is the marketing department.

The top 3 reasons your marketing does not work adequately are:

  1. It isn’t done. (It is done, but only now and then, irregularly and half-vast.)
  2. No one is assigned and responsible for doing it.
  3. Those assigned to do the marketing are not given the time to get it done.

There are other reasons, of course, but these are the top three and formed the basis of our Marketing Manager System, developed in 2001.

You know all this, but it helps to be reminded now and then.

And I am reminded of the theme song in the movie, “Casablanca.”   The movie stars Humphrey Bogart and Ingrid Bergman and is a classic romance from 1942.  You may wonder what a romantic movie has to do with business and marketing, but who says that business and marketing can’t also be romantic?  (I have been accused of being unromantic before, but perhaps I have just been misunderstood!)  Shouldn’t you be in love with the work you do in chiropractic?  Shouldn’t you love your patients and be passionate about the story your office has to tell?

With apologies to Herman Hupfeld, the composer of “As Time Goes By”:

You must remember this
Promotions must not be missed
On you they do rely
The fundamentals things apply
As time goes by

It’s still the same old story
A fight for market share and glory
A case of do or die.
The world will always welcome your loving care
As time goes by.

Chiropractic Marketing Ideas for Fall Promotions

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Here are a few ideas for promoting your chiropractic services during the end of the year.  There are many more, of course, but these can get you and your team thinking of what you might like to do over the next several months. (For a PDF version of this article.  REVISED AND UPDATED- 9/2014)

Schedule the special promotions first – the big events. Get these on a large Marketing Calendar and plan them out. Promote them before the event.  Ideally, you should promote the event four weeks before it occurs, but people often forget and make spur of the moment decisions. Therefore, promoting even a week before the event has worked.

You can find customizable posters and detailed information on how to do many of these projects on your chiropractic Marketing Manager System Toolkit and on your PM&A Member’s site. Depending on the level of your program, we can also put together simple posters to help promote your particular project.

Then, look at the more basic marketing procedures, those that are recurring. These should be on a list which you review every few months.

You can also sprinkle in some minor but fun promotions, such as having a Crazee Dayz.

General Marketing

  •  Recurring Procedures. The most important marketing procedures are your usual, recurring procedures that you do on a daily and weekly basis. Many of these are already embedded in your routine procedures.  These should be on a list that your review every three months.
  • Calendar. Make sure you have a large calendar to post all of your scheduled upcoming promotions.
  • Assignment. Assign a staff member to be in charge of each promotion. Each team member has a marketing responsibility.
  • Communication. In the end, marketing is all about communication. Therefore, promote your events with your newsletters (electronic and hard copy), fliers, Facebook, Internet updates, bulletin boards, web site and most of all,  through friendly one on one personal communication in the office.
  • Motivation.  All procedures work to some degree, depending on how well they are organized and on the intention behind them. If you and your team are not motivated to make these procedures work, they won’t.  Keep your purpose strong and your energy high.

Crazee Dayz
Select a day and make it special for your patients. Only one day a week is necessary otherwise it’s not special.  It can be once per month or every week. Serve extra treats.  You can have the staff dress out of uniform coordinated to the day.  These can add some extra fun to the office and help with retention and long term referrals.

  • Muffin Mondays – Serve up a selection of health bran, banana, blueberry, etc muffins
    Two for Tuesday – Bring a friend for a complimentary spinal exam and offer the patient a free adjustment.  “Two Fer Tuesday.”
    Whacky Wednesdays – gag gifts for patients,  “adjust-a-mints”, etc. (http://www.bannermints.com/)
    Thirsty Thursdays  — Organic apple juice served in plastic wine glasses with a sliced green apple on the rim. NA margaritas.
    Fruity Fridays  – Bowl of local fruit.

OCTOBER
October is National Spinal Health Month (Now called National Chiropractic Health Month) This can give a you a reason to do many different promotions.  (Read about it at the American Chiropractic Association web site here.)

  • A banner in your office for patients to bring in family members for a free “Check-up.”
  • Reactivation Month – send postcards to all inactive patients who have not been in for at least one year or more for free spinal checkup.

Chiropractic Opportunity Week  (“The doctor is having a COW.”) (patient referrals and advertising new patients)

  • Free consultation, exam, and x-ray if needed.cow

 Hair Dresser/Beauty Salons/Spas (new patients and business referrals)

  • Offer a workshop on “How to Stay Fit While You Clip.”
  • Free massages (and screenings) for customers
  • Set up a customer appreciation program with the business owner and provide the massage and or food and screenings

 Local Health Fairs (new patients and business referrals)

  • Contact all the locations you have held events in the past year and schedule events for the New Year.
  • Contact local businesses for health fairs in the New Year and get them scheduled
  • ghost

 Kids and Halloween Party (patient retention and referrals)

With Casper as inspiration, a kid’s Halloween party with a friendly ghost theme has the right mix of tricks and treats. Invite the young ghouls to come dressed up, but you can also have them make ghastly masks as part of the fun. Other ideas include spooky decorations, scary snacks and a friendly ghost hunt.   Free spinal and scoliosis checks for all guests.

 

 NOVEMBERturkey

Thanksgiving Turkey Drawing Poster(patient referrals)

  • Refer a friend and enter the drawing for a free turkey
  • Special for Organic Turkeys – announce in your newsletter
  • Make arrangements now with your local supplier

Donation Drives (patient referrals, advertising new patients)

Holiday time always brings an increased demand for helping those less fortunate.  Within your office set up a collection area for any of the following programs and promote it in your newsletter.

  • Coats for Kids
  • Food for Families
  • Toys for Tots
  • Blood Drive

$25 in exchange for first day services.

  • Also, you can support drives at local church or gyms. E.G. “Free first day services for every donation a member of YMCA makes to the homeless fund.”

Deer Widows Week (patient referrals)

During hunting season or first week of December  offer  complimentary massage for  your patients who refer in a new patient.

 Girl’s Night Out  (screenings)

Christmas shopping/gift exchange

Enlist the help of massage therapist, local spas and direct marketing consultants, Tupperware distributors, etc. Everyone has to bring at least 3 guests. Buy presents from each other rather than at the mall.  In November or first week of December.gifts

Or

  Movie & Margarita (bring a guest for a movie screening and a spinal screening)

Sample movies: The Love Letter, Steel Magnolias, Little Women. Fried Green Tomatoes When Harry Met Sally, anything with Brad Pitt.

 

DECEMBER

Holiday Coupons – Gifts Certificates(patient referrals)

  • Good for Massage, consultation, exam, x-ray
  • Denominations: Free, $25, $25 or food donation to charity.

poinsettiaPoinsettia Give Away (patient retention)

Give away free poinsettias, one per family.  Include in the cards a gift certificate for family members or friends.  (see Member’s site for gift card)

 Saturday with Santa(patient referrals)

  • santa lapSet up Santa in your reception room corner
  • Treats for the kids
  • Pictures with Santa
  • Free spinal check with Doc

Appreciation to External Referral Sources.  

Deliver a fruit basket or other present personally during December with a card of thanks and mention how you are looking forward to another year working together.  This would go to any location where you had an external community services type of event, such as a screening or workshop.  Include: “Looking forward to working with you next year.”

Motivational Tent Poster – Secret to Success – Jiro Ono

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Shaw

“Once you decide on your occupation… you must immerse yourself in your work.

You have to fall in love with your work. Never complain about your job. You must dedicate your life to mastering your skill.  That’s the secret of success……

Even though I’m eighty-five years old, I don’t feel like retiring.”

    Jiro Ono – Sushi Master, Japan