What We Have Learned About Tough Months

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How many of you got hit by winter this month?

For many chiropractic offices, February has been a tough one: snow closures and extreme cold have had an impact on some of the office numbers we have visited and others we have talked to. Add to this, personal and personnel distractions, and as the month comes to a close, some doctors and their chiropractic staffs are not so happy.

Understandably.

We have seen and dealt with crashed numbers and down months for many years. Pretty routine really. Here are a few things we have learned about tough months.

1.  Tough Months Happen. We all hit banana peels. It is part of business. It is part of life.  Accept it.  This does not mean you should adjust your standards or goals to a new low. Keep your goals and standards as high as you want. Just know that, now and then, bad months happen.

2.  Lessons. Each down month, each banana peel, each slip, fall, or crash with your practice is really a lesson.  Nothing more.  Learn from each slip.  Learn the lesson. It is there.

3.  Fear. But sometimes we become so gripped with fear, frustration, disappointment, resentment or anger, that it is hard to see this – the lesson.  Emergencies should cause us to act. But often, our impulse is to react. When we react out of a fear or negative based emotion, we often generalize what the problem is, and try to fix everything, or the wrong thing, or person.

4.  Cause and Effect. Every negative effect has a cause. Sometimes the cause occurred months earlier.  You did something, or did not do something, that is just now hitting you.  Much like a football coach on Mondays, you have to review past performances and discover what caused the problem and fix it.

5.  Scores. Even if a crisis seems to be occurring, look at the numbers, metrics, performance monitors, or statistics to determine what is really going on.  Often it is not as bad as it seems. Put things in perspective. If the numbers are down, how far down? Using your numbers helps minimize the drama.

6.  Interruption of Proven Procedures. Most bad months come from interruptions in proven procedures. For example, a staff member leaves the front desk or the billing department, or you went on vacation. You stopped sending out your patient newsletter, discontinued monthly events, and just gave up on patient education lectures altogether. Then, snow and ice storms shut things down. No matter what, just try to keep proven procedures going.

If your numbers are down, find out which of the above lessons apply to you. You can give your consultant a call, get help in diagnosing the condition,  and in working out action steps to get things back on track to reach your yearly goals.

Generally, the solutions to bad months include:

  • Relax. Anger almost never produces good results.
  • Diagnose the Situation. Confront the “brutal facts”. Look at your statistics and review past changes to find the cause of the problem.
  • Action Steps. Once you find the cause of the problem, work out action steps to fix it.
  • Mission. Get re-energized on what you are doing and why. And, get the staff and other doctors re-energized. Use your anger, frustration, or other emotion to positively focus on your mission.
  • Follow-up. Schedule a meeting to ensure all the action steps are being done.
  • Support. We all need it.  This is where a coach can help you stay on track. Hire one, or five. Use your staff, doctors, your dentist, spouse, priest, and painter, if need be, to help you stay on track.

Something else we learned:

7. Gratitude. Running a business should be rewarding, if not also challenging. Don’t take it too seriously. Be grateful for the opportunity. You live in a free country. This is the land of opportunity.  Have the “Gratitude Attitude”, and welcome challenges as an opportunity to learn.

File: Marketing Management, Practice Management & Development

Immigrants Are More Likely to Succeed As Business Owners

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A new study shows that immigrants are more likely to be successful than native-born Americans as business owners.  Why is this?

You can draw your own conclusions, but America has always been the land of opportunity. Shackled by poverty, a tyrannical government, limited rights, no infrastructure, new people coming to America perhaps are thrilled at the freedom they have to create a new life and be successful.

There is something to be learned from this.  Perhaps they are also not lulled into mindless pastimes of the MTV “Real” World, or domesticated or pressured to fit into a peer culture that seeks material comforts and goods over frugality and hard work.

As chiropractors, clinic directors, office managers, marketing coordinators, Chiropractic Assistants, and health care providers of all types, we should all have the attitude that we live in the land of opportunity. Each day we are free to create the kind of job we want and should be thankful that we are here, and not dodging bombs are scrounging for water as others are in their countries.

Immigrants Are More Likely to Become Successful Entrepreneurs & Business Owners

16 Rules For Success in 2007

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This list was recently posted by Bob Parsons, a very successful entrepreneur who started with little in life and who has begun several very successful companies, including GoDaddy, the Internet domain registrar and hosting company. His “16 Rules” sum up the lessons he’s learned along the way.

I have always found it helpful to peek in on the successful actions of others and I appreciate being introduced to these by Gary Bencivenga.  I hope you will too.

These useful tips can help you guide the management of your chiropractic practice and your marketing to achieve your goals. (As you can imagine, #9 is one of my favorites, as is #10. This applies to marketing in particular. Dave and I also like to challenge our clients, so #1 is fun too!)

And by the way, we are not affiliates for Mr. Parsons,  GoDaddy, or anyone else for that matter.

And so, with his permission, here is…

Bob Parsons’

16 RULES For SUCCESS

In business and life in general

1. Get and stay out of your comfort zone. I believe that not much happens of any significance when we’re in our comfort zone. I hear people say, “But I’m concerned about security.” My response to that is simple: “Security is for cadavers.”

2. Never give up. Almost nothing works the first time it’s attempted. Just because what you’re doing does not seem to be working doesn’t mean it won’t work. It just means that it might not work the way you’re doing it. If it was easy, everyone would be doing it, and you wouldn’t have an opportunity.

3. When you’re ready to quit, you’re closer than you think. There’s an old Chinese saying that I just love, and I believe it is so true. It goes like this: “The temptation to quit will be greatest just before you are about to succeed.”

4. With regard to whatever worries you, not only accept the worst thing that could happen, but make it a point to quantify what the worst thing could be. Very seldom will the worst consequence be anywhere near as bad as a cloud of “undefined consequences.” My father would tell me early on, when I was struggling and losing my shirt trying to get Parsons Technology going, “Well, Robert, if it doesn’t work, they can’t eat you.”

5. Focus on what you want to have happen. Remember that old saying, “As you think, so shall you be.”

6. Take things a day at a time. No matter how difficult your situation is, you can get through it if you don’t look too far into the future and focus on the present moment. You can get through anything one day at a time.

7.Always be moving forward. Never stop investing. Never stop improving. Never stop doing something new. The moment you stop improving your organization, it starts to die. Make it your goal to be better each and every day, in some small way. Remember the Japanese concept of Kaizen. Small daily improvements eventually result in huge advantages.

8. Be quick to decide. Remember what General George S. Patton said: “A good plan violently executed today is far and away better than a perfect plan tomorrow.”

9. Measure everything of significance. I swear this is true. Anything that is measured and watched improves.

10. Anything that is not managed will deteriorate. If you want to uncover problems you don’t know about, take a few moments and look closely at the areas you haven’t examined for a while. I guarantee you problems will be there.

11. Pay attention to your competitors, but pay more attention to what you’re doing. When you look at your competitors, remember that everything looks perfect at a distance. Even the planet Earth, if you get far enough into space, looks like a peaceful place.

12. Never let anybody push you around. In our society, with our laws and even playing field, you have just as much right to what you’re doing as anyone else, provided that what you’re doing is legal.

13. Never expect life to be fair. Life isn’t fair. You make your own breaks. You’ll be doing good if the only meaning fair has to you is something that you pay when you get on a bus (i.e., fare).

14. Solve your own problems. You’ll find that by coming up with your own solutions, you’ll develop a competitive edge. Masura Ibuka, the cofounder of Sony, said it best: “You never succeed in technology, business, or anything by following the others.” There’s also an old Asian saying that I remind myself of frequently. It goes like this: “A wise man keeps his own counsel.”

15. Don’t take yourself too seriously. Lighten up. Often, at least half of what we accomplish is due to luck. None of us are in control as much as we like to think we are.

16. There’s always a reason to smile. Find it. After all, you’re really lucky just to be alive. Life is short. More and more, I agree with my little brother. He always reminds me: “We’re not here for a long time; we’re here for a good time.”

The above rules are republished with the permission of Bob Parsons (www.BobParsons.com) and are copyright © 2004-2007 by Bob Parsons. All rights reserved.

If you know anyone who would benefit form this article, just forward this as an email. Click on link at the top right of this page.

Your e-mail address will never be shared. And if you ever wish to unsubscribe, just let me know and it will be done.

Simple Valentine’s Day Promotion

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For a little help in generating referrals in the month of February, you may want to offer a selected number of your patients a Valentine’s Day gift certificate/coupon.

These can be ordered from your printer. You can also produce them yourself with your photocopy machine or from your computer and printer. It simply consists of a card that you give to your patient as a gift for someone about whom they care. The card offers some kind of a complimentary or discount service.

Keep in mind that the key to the success of these gift certificates is all in how you give them to your patients. If they are just left on the top of the front desk, they are completely devalued, there is nothing special about them, and their effectiveness is minimal. On the other hand, if they are valued by the doctor and the staff as actual money, which they are, and also presented sincerely from the doctor and staff to their patients for their patient’s friend or loved one, the coupon greatly increases in value. They are also much more effective in generating referrals.

Review the example below and use it to customize your own Valentine. You can have your printer make you a bulk order and since there are no dates, you can use the gift certificate for several years in the future.

Sample Offers. You can pick one or more of the following, or add your own, depending on your circumstances.

  • Spinal Screening
  • 10 Point Screening Exam
  • Conference with the Doctor
  • Examination
  • X-rays (initial)
  • 15 (30) minutes on automatic therapeutic massage table (chair)
  • 15 (30) minutes therapeutic massage

These can be free, or sold to the patient for their Valentine for a nominal fee, such as $20. As an extra incentive, you may want to donate the money to a local charity.

Many computer programs have card templates available and there are also a number of web sites where you can make your own cards. For example.

Sample Script:
Doctor/Staff member: “Mrs. Jones, (Doctor: “the staff and I”; Staff member: “Dr. Smith”) would like you to have this Valentine’s Gift Certificate as a Valentine’s gift from us. It is for _____ (specific person that you know, e.g.: “Bob”, or “your husband”, or “your Valentine”), and is a special gift certificate that (he/she) can use for complimentary services at our office.”

Pull out envelope and physically open certificate or coupon, show it to the patient, and explain the details. If they accept the certificate, sign it, and give it to the patient. Check to see if they want more than one.

Doctor/Staff: “It is good for the entire month of February.”

Patient’s reaction. “Wonderful! Thank You”

Doctor/Staff member: “We hope you have a nice Valentine’s Day and look forward to taking great care of your Valentine(s).”

Sample Coupon

Sample Card

Note: This web site is for the purpose of disseminating information for educational purposes, free of charge, for the benefit of all visitors. We take great care to provide quality information. However, we do not guarantee, and accept no legal liability whatsoever arising from or connected to, the accuracy, reliability, currency or completeness of any material contained on this web site or on any linked site.

Health Observances And Promotional Dates 2007 (January – June)

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The following dates are listed by organizations as special times to observe a particular health related subject. Trade associations will designate a date where they can showcase their services. There may be other reasons for these “observances”, but promotion is certainly one of them.  Not all dates are specifically health related. Some are just FUN!

These dates give you many new avenues, and excuses, to promote your services. But, they won’t work by themselves. They are opportunities for creative, bright, and energetic health care promoters.

  • Give a workshop in your office on the theme. Do this workshop alone, or in conjunction with a local professional related to the subject.
  • Promote a special screening for the condition or theme.
  • Work with local related professionals or associates and schedule workshop or screenings outside of the office. You can do this with them, or for them.
  • Set up a donation program in conjunction with a particular theme.
  • Set up your own dates to observe a health condition, as many office that we work with do.
  • Set up a patient appreciation day around a special Candy Holiday!

January

1 – 31
Cervical Cancer Awareness Month
www.nccc-online.org/awareness.php

1 – 31
National Birth Defects Prevention Month
www.marchofdimes.com

1 – 31
National Blood Donor Month
www.aabb.org

1 – 31
National Glaucoma Awareness Month (Prevent Blindness America)
www.preventblindness.org

Candy Holidays – Different ones for each month.
http://www.candyusa.org/Classroom/calendar.asp#mar

January 13  — Blame Someone Else Day –
http://en.wikipedia.org/wiki/Blame_Someone_Else_Day
http://www.pittsburghlive.com/x/pittsburghtrib/s_326847.html
Sample Flier.

January  14-20
National Slow Down Week
http://www.adbusters.org/media/flash/slow_down_week/

January 23 – National Pie Day –
http://www.piecouncil.org/national.htm

February
1 – 28
AMD/Low Vision Awareness Month – Prevent Blindness America
www.preventblindness.org

1 – 28
American Heart Month
www.americanheart.org

1 – 28
National Children’s Dental Health Month
www.ada.org/goto/ncdhm

2
Groundhog Day
http://en.wikipedia.org/wiki/Groundhog_day

2
National Wear Red Day 2007
National Heart, Lung, and Blood Institute Health Information Center
www.nhlbi.nih.gov/health/hearttruth

February 7
National Girls and Women Sports Day
http://www.aahperd.org/ngwsdcentral/template.cfm?template=eventcalendar.html

4 – 10
National Burn Awareness Week
www.shrinershq.org

14 VALENTINE’S DAY

11 – 17
Children of Alcoholics Week
www.nacoa.org

11-17
Child Passenger Safety Week
http://www.boosterseat.gov/

16 – National Women’s Heart Day
www.womansheartday.org

February 12-18
Random Acts of Kindness Week
http://www.actsofkindness.org/people/days.asp

March
1 – 31
National Nutrition Month
www.eatright.org

1 – 31
Save Your Vision Month
www.aoa.org

1 – 31
Workplace Eye Health and Safety Month
www.preventblindness.org

5 – 9
National School Breakfast Week
www.schoolnutrition.org

17 St. Patrick’s Day

March 26-30
National Youth Violence Prevention Week
http://www.violencepreventionweek.org/
http://www.whitehouse.gov/news/releases/2005/04/20050401-3.html

April

1 – 30
Alcohol Awareness Month
ncadi.samhsa.gov

1 – 30
Foot Health Awareness Month
www.apma.org

1 – 30
National Autism Awareness Month
www.autism-society.org

1 – 30
National Child Abuse Prevention Month
www.childwelfare.gov/preventing

1 – 30
National Youth Sports Safety Month
www.nyssf.org

1 -30
National Humor Month
http://www.larrywilde.com/month.htm

1 – 30
Sports Eye Safety Month
www.aao.org/eyemd

April 5
A Day To End Sexual Violence – National Sexual Violence Resource Center
www.nsvrc.org/saam

7
World Health Day
www.who.int/world-health-day/

2 – 6
National Work Zone Awareness Week
http://www.atssa.com/page.ww?section=Meetings+%26+Events&name=National+Work+Zone+Awareness+Week

April 15-21
Cowboy Poetry Week
http://www.cowboypoetry.com/week.htm

April 16-20, 2007
National Occupational Health Nursing Week
http://www.aaohn.org/about/ohn_week/index.cfm

22 Earth Day
http://www.earthday.net/

28 – May 6
National SAFE KIDS Week
www.safekids.org

28 – 29
2007 WalkAmerica – March of Dimes Birth Defects Foundation
www.walkamerica.org

May

1-31 National Correct Posture Month
http://www.amerchiro.org/membership/cpm/index.shtml

1 – 31
National Osteoporosis Awareness and Prevention Month
www.nof.org

1 – 31
National Military Appreciation Month
http://www.nmam.org/

1 – 31
Older Americans Month
www.aoa.gov

1 – 31
Asthma and Allergy Awareness Month
www.aafa.org

1 – 31
Better Sleep Month
www.bettersleep.org

1 – 31
Healthy Vision Month
www.healthyvision2010.org/hvm/

1 – 31
National Physical Fitness and Sports Month
www.fitness.gov

1 – 31
National Bike Month
www.bikemonth.com

5
Cinco de Mayo
http://www.cincodemayo.net/english/other.shtml

May 9 -National Teacher Day
http://www.nea.org/teacherday/index.html

May 6-12
North American Safety and Health Week
http://www.asse.org/naosh

May 7-11
Teacher Appreciation Week
http://www.nea.org/teacherday/index.html

May 6th – 12th
National Nurses Week
www.nursingworld.org/pressrel/nnw/nnwhist.htm

6 – 13 National SAFE KIDS Week
www.safekids.org

13 Mother’s Day

14 – 19
National Women’s Health Week
www.womenshealth.gov

14 – 19
National Running and Fitness Week
www.americanrunning.org

16
National Employee Health and Fitness Day
www.physicalfitness.org

25
National Missing Children’s Day
www.childfindofamerica.org

29  Memorial Day
http://www.usmemorialday.org/

31
World No Tobacco Day
www.wntd.org

June

1-30
June National Outdoors Month
http://www.greatoutdoorsmonth.org/

2-10
National Fishing Week
http://www.takemefishing.org/default.aspx?id=241

4 – 10
National Headache Awareness Week
National Headache Foundation (Links mostly go to drug companies.)
www.headaches.org

12 – 18
National Men’s Health Week
www.menshealthweek.org

18 Father’s Day

21
National ASK Day
PAX/Real Solutions to Gun Violence
www.AskingSavesKids.com

25 – July
1 Helen Keller Deaf – Blind Awareness Week
www.hknc.org

Chiropractic Patient Financial Plans

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Are your patient financial plans ready for a changing market? Patient financial plans, and how they are presented, should be carefully reviewed as an important part of your chiropractic marketing plan for the New Year.

According to the Treasury Dept., the use of Health Savings Accounts (HSAs) will continue to increase and by 2010, is expected to cover 25-40 million people. Other reports discount this prediction and say that HSA’s have not taken off as expected because the cost is still too high.(link) HSA’s are accounts, funded with pre-tax dollars by the employee (and sometimes the employer) are an individual savings account coupled with a high-deductible insurance plan. With deductibles rocketing well over $1,000, the HSA option gives the employee pre-taxed money to spend on health related purchases ranging from eyeglasses and braces to massage and acupuncture. The money can also be used for regular medical bills, of course.

The effect of the HSA (and the related flex-spend account) is to make healthcare consumers (your patients) much more aware of costs and prices. A direct result will be patients interested in a deal or cost-savings. As someone who has an HSA personally (with a $3,000 deductible), I am more aware than ever of what each service costs.

Couple that with recent lawsuits nationwide against health care providers that have charged “cash” patients more then insurance patients. The State of Wisconsin recently settled with three major health care systems (ProHealth Care, Wheaton-St. Joseph Hospital and Wisconsin Heart Hospital) to ensure that the discounted rates provided to insurance carriers would also be passed on to patients that are paying out of their own pocket. Makes sense, given the changes to the health care market and our “health insurance crisis”.

For example, a chiropractic clinic may charge $125 for a 99213 exam. If they bill that service to Blue Cross, their provider agreement results in a $52 reduction (for example) with the patient responsible for 20% of the remaining $73 approved charge or perhaps a $20 co-pay. If the clinic billed the same $125 to worker’s comp, there may be a 10% reduction off the fee for “prevailing charges” or UCR reductions. (As an aside, don’t you wish you could do that to your plumber?) Now if the insurance denies the whole charge or if the patient has no insurance, the patient is responsible for the $125 charge. It really isn’t fair if you think about it.

In order to avoid this, clinics, hospitals and doctors have come up with financial plans that try to even this out and stay within the law. As a practice management and marketing solution, ProHealth Care has agreed to provide some charity discounts to patients with income up to 400% of the federal poverty level – about $66,400 for a family of three. Froedtert Hospital, Community Health and Columbia St. Mary’s all have similar plans, giving uninsured patients a 20% discount and another 20% if they pay their bill with 30 days.

Have you reviewed your chiropractic patient financial plans to attract the most patients possible? As a chiropractor, you can appeal to some by offering discounts attached to using their HSA or flex-spend plan. That is as easy as allowing a patient to pre-pay at a discount. The same plan can be extended to any patient paying at the time of service or in advance.

Do your patient financial policies address the real needs of your chiropractic patients while still maintaining your profitability? Do your financial plans help you attract the types of new patients you want to see?  This is an important element in chiropractic marketing, new patient acquisition as well as patient retention.  Make sure you review these as the New Year begins and feel free to contact us for ideas or fine-tuning.

Dave Michel

Setting Goals For Chiropractic Practice Growth – Part II

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GOALS 2007: Part 2
Setting Goals To Improve Your
Chiropractic Service and Marketing Procedures

Goal setting is very important and is a well-established function of good practice management for any chiropractic practice.  Usually goals are set for what you want to get as a chiropractic doctor and clinic owner.  Typically this includes collections, profit, office visits and new patients.  This is almost essential, and should be done.

However, goal setting often omits the processes and procedures that produce these outcomes. It is a simple formula:

Production Procedures -> Production Outcomes

If you want to improve one side, you have to improve the other. If you want more office visits, you may have to improve your procedures for patient education and retention. If you want more new patients, you may have to start to practice asking for referrals.

Money is an exchange for something valuable. If you want more of it coming in, you have to have more valuable services going out.

This is not just a matter of working harder or longer. It certainly may be a factor, but you really want to look at how you can make your services more valuable.  Review how you can increase the speed of service, the friendliness of service, and improve patient compliance and education. How can you make your patients happier with your service? How can you get them better, faster? All this adds value to your services.

If you increase the quality of your patient education, the perceived value of your services will also increase. Your patients, in turn, will stay with you longer by continuing with their care on a wellness/maintenance program, and feel responsible for bringing in their family and friends for care as well.

Working On Your Business
All this does take work. True. But it really is part of your job. In addition to being a doctor working in your business, you are also a manager and have to work on your business. Just setting a goal for collections, income, or new patients is not thorough management. Neither is trying to increase the value of your services by finding a higher RVS code.

You can schedule meetings two to three times per month with your staff to work out how you can improve your procedures. Take any service procedure and discuss with the staff how it could be improved. Then, you can practice different methods of the same procedure to see what works best. You should also practice promotional procedures.

You can ask your patients for ideas of service improvement. This can be done with formal surveys, focus groups, or informally with your more loyal, and honest, patients.

Make sure that you have a simple outline or checklist for all the steps of each procedure. This will help in the future for revision, practice, and review.

Sample Goals For Production Outcomes and Procedures
Sample Production Goals:
___1.    Income:
___2.    Office Visits:
___3.    New Patients:

Sample Procedure Goals:
___1.    New Patient Paper Work: Faster time, better experience for patients.
___2.    Patient Education Programs: Better educated patients.
___3.    Exam & E-ray procedure: More useful data, better experience for patients.
___4.    Report of Findings: Faster, more informative for patient, better agreements with patients.
___5.    Financial Consultations: All bases covered, more understanding for patient, better agreement with patients.
___6.    Patient Satisfaction Survey: 2 Surveys. Second one with improved scores.
___7.    Promotional Procedures:

a.    Suggesting to patients to bring in their family members for an event, or a check-up with more rapport, and more effectively.
b.    Lectures and workshop formats that are more interesting and result in better-educated participants, and more referrals.

By improving your procedures, you will be able to improve the outcomes, and have a much better chance of achieving all your goals.

For more information on chiropractic goal setting for improved service and marketing, go to this link. You can also read more about marketing procedures of the Marketing Manager System here.

###

Seven Tips For Making Your Goals Come True For Your Chiropractic Practice

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GOALS 2007: Part 1

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

This is good, usually.

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

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

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

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

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

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

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

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

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

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

Ed Petty

Changes in Personal Injury Lien Form

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As part of our chiropractic practice management program, we have always insisted that patients sign a lien form from your office when they are being represented by an attorney on a personal injury case.  It is most important to have the patient sign the lien and then send a copy of that to the attorney.  Our policy is that the attorney did not need to sign and return it to your office to make it enforceable under Wisconsin Law.

However, a recent Supreme Court decision in Wisconsin has changed this. There are now a couple of additional steps to take to make sure that your lien will hold up in Wisconsin.

In the recent case of Yorgan v. Durkin, the Wisconsin Supreme Court has decided that the enforceability of your lien is questionable unless both the attorney and the patient have signed it. According to Attorney Dan Riegleman, we need to take the following additional steps:

“1. The most (and most obvious) option is to ensure that a patient’s attorney signs the lien form. Office staff should be encouraged to regularly follow up with the attorney to ensure that the form is signed. …

“2. If the attorney adamantly refuses to sign a written lien form, a chiropractor should seek a “Letter of Protection.” A letter of protection is a written document, typically provided by the attorney, which assures or otherwise promises a chiropractor that all of a portion of a patients bills will eventually paid when the case is settled ….”

You may find a copy of our new lien form at this link on our web site. Link

If you would like a copy of  Attorney Riegleman’s newsletter, Chiropractic Law, just call his office at (262) 246-4606 and ask him to add your name.

Chiropractor of the Year – 2006-2007

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Dr. Tom Potisk was selected by his peers as Chiropractor of the Year for the State of Wisconsin. As a long time client and friend, we want to express our deepest and hardiest congratulations.

CONGRATULATIONS DR. TOM!!

Whether you live in Wisconsin or in Australia, Dr. Tom Potisk is the kind of chiropractor, man, father, husband, and friend you would like to know. Unassuming and modest, his passion is strong and his accomplishments are many. He is a leader of the best kind: by example. He sets an excellent standard for us all.

Kind, generous, industrious, and dedicated, he lives a balanced life while managing a very productive three doctor office. Here are some of the highlights:

· Graduated from Palmer Chiropractic College in 1984, interned with Dr. Larry Troxel before starting his practice in South Milwaukee, WI, U.S.A.

· He has invested a great deal of time and resources for community programs including the YMCA, the local high school, veterans association and his Chamber of Commerce.

· He has twice been recognized by the United States Military as “Patriotic Employer.”

· President of the South Milwaukee Association of Commerce, Dr. Tom was the recipient of the “Outstanding Leadership and Effort” award.

· Tom has maintained active memberships his local state organization (Wisconsin Chiropractic Association), the Christian Chiropractors Association, and The Gonstead Clinical Studies Society. Dr. Gregory Plaugher of the GCSS will soon be publishing a particularly exciting case study pertaining to one of Dr Tom’s patients with autism.

· Tom has had many articles published, including: “Snowmobile Magazine”, “The Small Business Times”, and articles in the local community paper. He authored an expose in “The Chiropractic Report” titled “The Art of Chiropractic”. He writes a monthly column on natural health care for the “Wisconsin Natural Foods.”

· He has provided chiropractic to hundreds of patients during several mission trips to the Amazon, Belize, Costa Rica and Poland. A man of faith, Dr. Tom feels that these trips are an expression of God’s love that transcends his own faith community as an elder of St. Marcus Lutheran in Milwaukee, and touches many lives in places far from home.

·Tom has had eight associate doctors with whom he has maintained a mentoring relationship during their time in his office and after they moved on in their careers. It is not uncommon for him to be on the phone with one of his prior associates giving and taking ideas on how to better serve patients. Of course, he also always finds time to provide adjustments to local chiropractors in need.

· As an indication of the friendly kind of work environment Tom creates, it is worth noting that he has had the same office manager for all 21 years of practice. With the help of Petty, Michel and Associates, Tom has been an excellent clinic director and manger. He is progressive in his chiropractic practice marketing and management, and works to continually reach out and promote chiropractic.

· Tom has been happily married for 13 years to Sue Potisk and has three children. The family lives on a mini-farm a rural setting with a family “swimming hole” pond, and keeps busy tending to their organic garden, small flock of chickens, barn cats and their pig.

Tom has set such a great example, and continues to do so, that we thought it worthwhile to post it as an example for all to see.

(Much of this information was provided by one of his current associates Dr. Steven Seheuing.)

Medical System Gets a “D” and What You Can Do About It

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Practice Marketing Tips

U. S. Medical Care Gets a “D”
According to this article, studies show that the US health-care system is in poor shape. Of course, it is not the “health-care” system, but the “disease-care” system which dominates our country. You can find the complete study here. Link

In a roundabout way, this study is actually good news for you. Why?

Because you are the solution, or part of the solution, to the United States “health-care” system’s bad marks. You and your patients.

Natural health care methods shift the responsibility from the pharmaceutical companies to the individual health care consumer. More exercise, better nutrition, better living habits, and, of course, chiropractic, will improve true health and reduce medical and drug costs.

In short, the more people you can get into your office and follow a “chiropractic lifestyle”, the better our “health-care” system will be.

Here are some action steps: You can make copies of the article and hand them out to your patients. A few could be pinned up in your adjusting/treatment room bulletin boards for “table talk” discussions. The article can be discussed with your patients at your lay lecture, and you can definitely go over it at your next staff meeting.

As chiropractors and chiropractic staff, we can take even more of a leadership role in improving the health care of our country. And, leadership is needed.

Most of your patients will feel the same and can be encouraged to help out by bringing in family and friends for a chiropractic conference, check-up, workshop, etc.  The following projects are more actions steps you can take to have your patients help you to promote your services.

They can be leaders too.

October. The American Chiropractic Association recognizes October as National Spinal Health Month. Here is a way to use this in an effective promotion. (Link includes a free poster.)

Halloween. Turn it into a Kid’s Day. Patients can bring in their kid’s to “Trick or Treat.” Kids can get a scoliosis check, and in return, they can receive a treat. You can also offer an award to the best costume by age group. And if you don’t want to have a Kid’s Day, the staff can dress up (and doctors) and have the patients vote on the best costume. Costumes should be fun – nothing too scary and nothing gory. You can also take pictures and put them in you next newsletter.

“Office Hours”. Do you have “Office Hours”, “Business Hours”, or “Clinic Hours?” Do you have a sign that lists your “Hours of Operation?” To reinforce the concept of wellness and healing at your clinic, why not put up a sign that says: “Healing Hours”, or “Wellness Hours”, and then list the days and hours that you are open to see patients.

Christmas/Holiday Cards. Now is the time to start thinking about your Holiday Cards. How about a photo of you and your staff wishing everyone a Healthy Christmas, Healthy Holiday, & Healthy New Year?
November. November is a classic time for a donation drive of some kind. If you don’t want to go through the effort of a donation drive, you can simply have a drawing for a Turkey. Or 5 Turkey’s. Make the drawing based (baste) upon certain factors, such as: attended the lay lecture, brought in a friend for a free screening, wrote a testimonial, were on time for at least 5 of their appointments, handed out at least 4 of the doctor’s cards or “Guest Passes” , or etc. You can set up your own criteria and allow the patient to enter the drawing by receiving tickets for each activity they completed. Again, keep it fun.

Spinal Health Awareness Week

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The American Chiropractic Association recognizes October as National Chiropractic Health Month. You can use this as a springboard and tie-in to sponsor a “Low Back Awareness Week” or “Spinal Health Awareness Month.”  It can be “in conjunction with National Spinal Health Month.”

Throw up some posters around the office, get some press releases off to local newspapers, and put a notice in your statements.  Offer a free spinal screening, a trigger point workshop, or whatever you want. The more attractive the offer, the better.  Have a staff meeting and cook up something fun.  This is designed to generate referrals, but to do so, it should also generate some enthusiasm with your staff.

You can find a down-loadable poster here in pdf format. For those of you who have the Marketing Manager System CD or Binders, you may email us and we will send you two sample posters in Word format for easy customization.

Chiropractic Insurance Updates — Sept., 2006

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New Claim Form
As you may know, there is a new paper insurance claim form. For those of you that bill electronically (which should be all of you), you still occasionally use paper claims. On October 1, 2006, there will be a new HCFA 1500. The only major change is to allow the use of the NPI number on the claim form. You’ll have until February 1, 2007 to switch over. So, don’t stock up on too many old claim forms now.

Get Your NPI Now
Which brings up the NPI (National Provider Identification) number. You will need to get one for each provider in your clinic and one for your clinic. It takes about ten minutes to apply online and get your number(s).  You can get the NPI here: https://nppes.cms.hhs.gov/NPPES. You will have to use your NPI on all claims submitted after May 22, 2007.

Medicare Electronic Payments
Lastly, Medicare is pushing hard to get you to accept your Medicare payments electronically. It actually is better – the check goes directly to your bank account and you get an EOB showing the payment and when it was made. The only thing you don’t get is the satisfaction of opening the Medicare envelope with a check inside. You don’t HAVE to accept electronic payments yet, unless you make any changes to your Medicare account (add a provider, add a reassignment, change a tax id number, etc). If you have a change, Medicare requires you to convert to electronic payment.

If you want to convert now, go to www.wpsic.com/edi/pdf/edi_medb_eft.pdf and download and complete the simple form with your bank account information. Providers simply need to complete this short form, mail it to their Medicare contractor, and include a voided blank check. Medicare payments will be made directly to your bank in as little as two weeks.

Any questions? Sure you do! Just ask Dave@PMAWorks.com

Dave Michel

Promoting Kid’s Health

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Kids Health Care and Chiropractic (updated 8/10/2010)

The “Back To School” season is a great time to host a special promotion for children’s health and chiropractic care. There are many different approaches to this, which include:

  • Kid’s Health Care Awareness Week
  • Kid’s Day
  • Kid’s Health Care Workshop for Parents
  • Backpack Safety Week
  • Kid’s Health and Safety Day
  • School Supply Drive

These are internal promotions for your patients and their family and friends. (They can also be for external promotion as well.)

For those of you who have the Marketing Manager System (sm) , you can click to the “Toolkit” and, under “Special Promotions” and find more information about promotions to and for kid’s.

These events are not usually designed to generate a large number of new patients in the short term.  A few perhaps, but they can be a useful tool to create long term relationships with parents, future patients, and good will in your community.

For more information on children health care and chiropractic, look into the follow linked sources:

We have also added a sample poster which you can down load, and an extra poster that one of our clients just did. (Active clients and Marketing Management System owners: let us know and we can email you the poster on Word format, or you can find them on your MMS program or on your PMA members site.)

By the way, internal office posters do not have to be professionally done.  In fact, they are usually less effective if they are.  Internal posters are just friendly notices, between you and the patient.

As with all internal type of promotions, the effectiveness of this program depends upon the motivation level of the doctors and staff.  Do you and your doctors and staff have a real purpose for this promotion?  If so, are you going to have some fun with it?   If so, it will work well!

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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Good News Bad News: Using Patient Testimonials

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I make my living off the evening news
Just give me something-something I can use
People love it when you lose,
They love dirty laundry
–Don Henley

We live in a world of losses and failures – of tragedy and of many serious issues for grave concern.

Or at least, it seems that way.  But is it true?

Certainly, horrible events happen. But the percentage of bad to good is probably very minor.   Mostly, there is an abundance of wonderful events that are constantly occurring. But are they news-worthy?

It seems that most people find bad and sensational news more interesting, and this is what our media gives us.  But too much bad news can lower our morale, dampen our spirits, and make it more difficult for us to reach our practice goals.

It happens in your practice all the time: your attention will stick on that one tough case you had a few days ago. Remember?

It has been said that: “You can’t let the negative Few outweigh the positive Many.”

Not only do you want to limit your exposure to negativity, you also want to accentuate the positive “Many.”  Here are some steps you can take to do this:

1. Notice your patients. If they seem to be doing better, tell them.
2. Compliment your patients for keeping their appointments.
3. Compliment them for attending your patient education programs.
4. Check to see if they are making any life style changes or doing their exercises. Compliment them for anything they are doing new to improve their health.
5. When they have shown significant improvement, ask them to fill out a Patient Success Survey.
a. Click here for a sample form
b. Click here for a actual success story.
c. Click here for a sample Doctor letter to patient about writing success stories.  (Note: this is for PM&A clients but is available now publicly for a limited time.)

6. Read these patient successes at your staff meetings, and displayed in your office and on your web site.

Promoting the successes of your patients efforts to improve their health has many benefits:
· It validates the work they put into improving their health and reinforces their desire to do so.
· It recognizes their accomplishments and helps identify your office as the major contributing factor to their success.
· They are more likely to promote their achievements to others and refer them to you.
· You can use their testimonies and successes to validate your services to your staff and doctors.
· You can use their written successes on your web site, newsletter, bulletin board, or other media to promote the services you provide.

We all can take for granted too many of our accomplishments, and those of others. If you do start to celebrate the wins you have, you will likely see more of them.