Failure to Follow Through

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It is the ‘follow through’ that makes the great difference between ultimate success and failure, because it is so easy to stop. — Charles Kettering

Failure to Follow Through

If it worked once it probably will work again

There is a management disease that many businesses, including chiropractic and other health practices, can suffer from. It is called “Failure to Follow Through.”

I noticed this at one of the first offices I worked with in Northern California – years ago. Their numbers were down. When I visited their office on a hot summer day, the reception room was empty, and few patients were scheduled. I noticed they had a thick binder of photos of patients and staff on the lower shelf of a dusty bookcase. The photos showed happy staff, doctors, and patients. There were also patient success testimonials, several years old.

We all met together for a staff meeting. I asked the doctor and staff if they could name a few specific actions they did back then. I said, “let’s start with marketing.”

Well, it turned out that they ran advertisements for a bi-yearly promotion. So I asked if they had done this in the last few years. “No” was their answer.

“What else were you doing at the time,” I asked. They said they always discussed financial and scheduling arrangements away from the front desk. Are you doing that now? “No.”

What else were you doing during that time? “We used to call the new patient after the first adjustment.” They also did progress exams. “Doing it now?” “No.”

The list went on and on.

Being the brilliant practice management scientist that I am, I encouraged them to re-implement what they had been doing. They did, and a few months later, the office was filling up again.

Practice Management

If it worked once, it probably will work again. Make minor improvements as needed, but why change the system if it is working?

Well, you can get bored, right? Or a staff member who knew the system left and their duties were not replicated by someone else. Or, everyone gets bored, so you feel the need to change things to bring excitement back into the office, and key procedures quietly start disappearing.

Discontinuing your successful procedures can create a roller coaster ride for your practice, with numbers going up and then down. And this can cost you thousands, even tens of thousands of dollars.

A checklist of successful procedures is essential, but that is not enough. They need to be reviewed regularly.

That, too, is not enough. We need to keep the practice environment fresh and lively while still maintaining those activities that are helping us grow and develop. We are not on an assembly line, and we are not robots!

I cover this in my book, The Goal Driven Business. (See Goal Driven Principle #17, Goals, Games, Groundhog Day). This is part of the Goal Driven System of practice development and includes checklists, reviews and coaching, and other components, such as gamification.

Gamification is a new term for an old principle: we like to play games! As video games became more prevalent, businesses saw that they could adapt elements of gamification to help engage employees and customers. Nothing new, really.

To make your office feel new again, you can think of a new promotion for this summer or new colors to paint the office. Spend a morning reviewing your goals, mission, and policies, and then go to a spa for a reward! One office creates a health theme each year and makes t-shirts promoting the theme for staff and patients.

Keep it fun — but stick to your winning ways.

Patient Management

ALSO… like practice management, patient management can also be affected by failure to follow through. Your patients need help to adhere to their treatment plan to achieve their health goals.

Stick-to-itiveness is simply being true to our goals.

Make improvements along the way and keep it fun. But help each other and your patients follow through.

Your goals are waiting for you!

Ed

Spring Marketing Calendar

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spring marketing plan.

The Need for Marketing Never Goes Away

Daylight Savings Time starts in two weeks here in the U.S. And across the northern part of our Planet, Spring begins in 4 weeks (March 20th). Guess that would be autumn for you all in the southern hemisphere.

What a great time to plan your spring and summer marketing.

The Need for Marketing Never Goes Away

No matter how full your practice is, the need for marketing never goes away.

Marketing is business and business is marketing.

Putting something valuable in the marketplace that other people want and will pay for – that is marketing. And that is your business.

The type of marketing you do varies depending on the condition and circumstances of your business. If you are just beginning a practice, you must spend a large percentage of your time and budget on marketing, especially direct response marketing. If you have built up your business, the focus of your marketing can be more on retaining your patients, creating alliances, and world-class customer service and outcomes.

Marketing covers a broad spectrum of activities, but all are, or should be, designed to generate new patients and keep the ones you have.

Trends for the future indicate that, in the end, the best and surest marketing will be customer services and outcomes. The communication channels are so packed and manufactured that your messages will get lost unless you have millions to spend. And now we have AI marketing – ads that robots put together.

Therefore, the best marketing will always be personal – relationship based. You and your people — authentic and interested in your patients and the individuals in your community – delivering extraordinary service and outcomes.

Marketing Plan

Practically speaking, it helps to plan your marketing.

Plan your work and then work your plan, right? So, I have attached a sample marketing plan (link below at the end of the blog article) to help you outline what to do. It is a sample and gives structure to managing your marketing. We’ve used one like this for years, and it works. Make your own and customize it to fit your needs.

And stay tuned for a new service we will offer to help you with your marketing.

But for now, Happy Spring, and Plan your Future

Ed

Sample Marketing Calendar

She Wanted to Teach Chiropractic Staff

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Greater Prosperity through Goals, Leadership, and Teaching.

woman teaching to a crowdEffective leaders are, first and foremost, good teachers.
We’re in the education business. — John Wooden

Greater Prosperity through Goals, Leadership, and Teaching

A highly productive and prosperous chiropractic clinic always has a goal driven team for support.

Motivation is directly linked to goals and leadership. When anyone pushes their way towards their goals, they are leaders. And one of the primary methods of leading is through teaching.

This is how you lead your patients to their health goals – you educate them at the initial report, the progress report, and each visit where you Table Talk!

In a Goal Driven Practice, eventually, everyone takes a leadership role. And leaders teach.

Teaching, in and of itself, is motivational.

She Wanted to Teach

I will never forget an outstanding example of this, though disappointing in some ways.

One of our clients hired a woman to be his office manager. She had big goals while working at another chiropractic office but was not encouraged to pursue them. So, she found an office, one that we worked with, where the doctor supported her mission.

She was a powerhouse on the front desk, but also worked with the staff and the doctor on improvement projects. She told him that she would work with him for one year, and if the numbers reached a certain level, she would replace herself, receive a substantial bonus, and move on. However, she had a bigger goal in mind. She wanted to begin a team training program for other chiropractic staff throughout the state.

We worked together on this plan for the entire year. The office was already busy and doing well. But after she started, we saw the volume increase significantly. She was a great team trainer, and after a year, she won her first game. The numbers increased on a sustained basis by over 20%. The owner was very pleased.

The disappointment occurred when she visited doctors around the state to encourage them to have their staff train with her. She also promoted her services to the state association. The reception in all cases was mild. She could not convince the doctors or the association of the advantages of having their staff on a professional training program.

She eventually took a high-paying position at a corporation in another state.

Teaching is Leading

As the chiropractor, and the Clinic Director, you are a leader – and a teacher.

In a Goal Driven Practice, you also want each team member to be a leader. The fact is, in their own way, they want to be leaders. Maybe not on the stage or in front of an orchestra, but leading by actively pushing their way to their goals and the office’s goals as well.

Each one of your team members has professional and personal goals. Just like you do. These goals should align with the goals of the office. You can help to unleash the power of these goals, for yourself, and for each team member, in the following ways:

1. Accept the fact that pursuing goals is leadership. And a function of leadership is teaching.

2. Do your own in-office seminars. Teach your team how to achieve the goals of the office, and especially, why.

3. Meet with each team member and help them write down their professional and, optionally, their personal goals. Then, help them achieve these goals.

4. Have them teach. For example:

a. At occasional staff meetings, one team member can give a presentation on some aspect of their job, a core value of the office, or a chapter in a book or a video.

b. In one year (or two) after they are hired, require all staff to help you give the first half of a lay lecture.

A Goal Driven Practice is not dependent upon the doctor. Instead, it is dependent upon goals and, as such, is more profitable, provides better service, and is more fun to work in.

Seize the future and your goals,

Ed

Contact us on the link below if you are interested in discussing how we can help you create a Goal Driven Practice.

Also, read my book! 😊

*https://www.expressionsofexcellence.com/ARTICLES/wooden_interview.html

Contact Us

The Generosity of Service

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How to be happier and more prosperous

One of the unique characteristics of Petty, Michel & Associates is that we visit offices and provide on-site coaching based on what we see.

I remember one doctor whom we worked with for several years. When I visited his office, as soon as he saw me, and the minute he was free, he’d say, “Ed, come on over here, let me check you.”

He didn’t ask permission.

He saw many patients in the morning and the afternoon and always took time over lunch for a workout.

He was focused on adjusting anyone in his sight. Patient after a patient. And because he was so focused, he communicated with certainty and authority and earned the trust of his patients.

If you can strip away from your mind all the administrative tasks, worries, and challenges and just focus on seeing patients, you’ll be happier and see more people.
All the “other stuff” slows down doctors, the administrative tasks that seem to multiply exponentially. Your mind can be either dominated by business concerns — or by the joy of giving and serving.

You have the skill and ability to help others, which must be honored and given full reign to be expressed to its total capacity. It shouldn’t be withheld or hoarded.

A well-trained team and a practice manager are vital. They allow you, and the other providers, to practice your art while they care for everything else.

I have talked to many doctors who visit third-world countries and flat-out adjust 100-200 people in a day. No admin interruptions, just individual after individual, courageously providing service and practicing their craft without concern about reimbursement. They have told me that they would get into a “Zone,” or into a flow… and experience an intense kind of present-time consciousness that they don’t experience in their offices.

Dr. Sid Williams, who founded Life Chiropractic University in Georgia, promoted the idea of “Lasting Purpose,” which was defined as “to give, to love, to serve in abundance without expecting anything in return.”

Being generous doesn’t mean giving your services away. Generousness is a mindset of abundance. It is not withholding your gift and craft but practicing your art freely and abundantly.

To do so, train your staff to take care of everything else and delegate the admin tasks to them. We can help with this. But it first starts by committing to a value of service generosity. In our company, Petty, Michel, & Associates, one of our core values is delivering services in “Abbondanza,” Italian for abundance.

In physics, every action has a reaction. This is also expressed in ancient texts: the more you give, the more you receive. You’re persuaded each day to get lost in admin concerns. Don’t. Get “lost in service.” Admin details need to be tended to, but only during non-patient time, and most should be delegated to your team.

Be a Giver and be generous. Educate, care for, and help more people. Take on this attitude, and you’ll have more fun and be more prosperous.

Ed

*Sid Williams quote: https://lifewest.edu/dr-sid-williams-honored-in-life-wests-sid-square/

Bruce Lipton and Physician Health Thyself

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Edward Petty with Bruce Lipton, PhD GoalDriven.com petty Michel and associates

Edward Petty with Bruce Lipton, PhD – GoalDriven.com – Petty Michel and Associates

Why doctors should stay Innately positive and healthy

Chiropractic is more than a mechanical act to improve a patient’s health.

I remember years ago attending a Parker seminar when Dr. Jimmy was still alive and seeing a large drawing describing “Innate to Innate.” A concept I believe he may have learned from Thurmond Fleet who developed Concept Therapy.

Bruce Lipton, PhD, is a cellular biologist, has taught at University Wisconsin Medical school, at Stanford, as well as Life Chiropractic College West. I have heard him speak on several occasions, read his books (Biology of Belief) and consulted with him personally about my book (The Goal Driven Business.)

I think Dr. Lipton expresses the concept of Innate scientifically:

There’s a concept in quantum physics called “entanglement,” which is when one energy source entangles with another so that they interfere with each other. This interference can be positive and harmonious, as with energy healing, or it can be negative.

Physicist Amit Goswami published an article in a physics journal showing that entanglement affects people. He had two people meditate together and then separated them into two chambers where they couldn’t see or hear one another. When one person had a light strobed by his eye, it caused the firing of a certain frequency in the brain. Remarkably, at the same moment, the other person’s brain also fired, even though he never saw the light. This proves what we intuitively knew, that the energies of people can affect one another.

What Goswami’s study demonstrated is that when two people become entangled, one person will conform to the energy of the other person. When one of them is a healer whose cells are vibrating at a higher level, the client’s cells become entangled, and their energy is lifted. That’s why that old saying, “physician heal thyself,” is so important, even though most don’t understand it: If the physician’s energy is going to influence or, in scientific terms, “entrain” the patient’s, the doctor’s must be higher. (source on blog)

I have seen examples of this in many of my office visits over the years. You might have an interesting discussion with your staff at a team meeting about how the “vibes” of the office affect the patients.

Has anyone pulled a patient file and the patient suddenly called? Have you ever had a great team meeting the phones start to ring? Have you seen a patient improve just because you felt connected to them?

So, please stay healthy and stay positive, in alignment with your greater purposes and greater powers.

And pass it on.

😊

Ed

Lipton: https://www.huffpost.com/entry/healing-over-the-phone_b_1011510

 

BARC Basic Activity Recovery Cycle

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yoga helps chiropractic care and practice management

Otherwise known as taking a break

We need to take breaks.

Small breaks every few hours, longer breaks every week, even longer breaks every several weeks.

Our bodies and our minds require periodic interruptions from our work, according to the Basic Rest-Activity Cycle theory, as discussed by Loehr and Swartz in their book, The Power of Full Engagement. We need to take time away whether we agree to it or not, it seems.

The authors present evidence that supports this theory and explains this cycle as activity and then recovery.

They say:

“We can only push so hard for so long without breaking down and burning out. Stress hormones that circulate chronically in our bodies may be temporarily energizing, but over time they prompt symptoms such as hyperactivity, aggressiveness, impatience, irritability, anger, self-absorption and insensitivity to others.”

“We live in a world that celebrates work and activity, ignores renewal and recovery, and fails to recognize that both are necessary for sustained high performance.

“The simple, almost embarrassing reality is that we feel too busy to search for meaning.”

So take small breaks and then larger breaks to disengage so that you can better engage with your patients and with each other to provide better service.

And support your team to do the same.

I’m not promoting this so you can let up on your production goals or so that you can be nice to your team. Far from it.

Production goals (New patients, Visits, Collections) need to be balanced with organizational improvement goals. AND THESE need to be balanced with greater meaningful goals.

So take some time to surprise your kids with a fun adventure, have a long lunch date mid-week with your spouse, spend a day volunteering, or travel to Costa Rica to play in the waves and take in some yoga.

Like I’m doing now!

Carpe Futurum (Seize your Future)

Ed

How to improve performance by taking more breaks is thoroughly covered in my book The Goal Driven Business which you can purchase here.

Goal Driven Business

 

 

Individual Team Development Plans

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Tips on Creating a Goal Driven Chiropractic Practice

A Goal Driven team member training to create a Goal Driven Practice by Petty Michel Associates and Edward Petty

Helping your employees pursue their professional goals will help them also pursue the clinic’s goals.

How?

Think of yourself. If you are working on learning a new technique professionally, you might feel more energized.

Why? According to Self Determination Theory, each of us has an innate or intrinsic drive to achieve mastery and competence. We want to improve our ability to control the outcomes we produce to better achieve our goals.

I would also add that helping your team members pursue their personal goals will increase their energy to do the same for the clinic’s goals. So again, think of yourself. Looking forward to that hunting trip, that vacation with your kids to Europe, or getting in shape at the gym can give you more optimism, hope, and zest for doing your best at work.

As Vitktor Frankl says:

It is a peculiarity of man that he can only live by looking to the future.

A Goal Driven clinic is systematized and motivated to achieve its goals. It achieves this partly because it takes into account different survival energies: the patients, the practice, and each employee.

At the first of every year, besides setting clinic goals, the clinic director can meet individually with each team member for a goal-setting meeting regarding their career and professional goals. (Download sample Individual Development Plan forms)

Staff members might be interested in different subjects, such as anatomy, human behavior, customer service, or marketing. Perhaps there are certification programs for staff. Meet with your doctors as well: what areas do each want to explore and study?

Work out the goals, then discuss different approaches to achieve these. Then, check back in 6 months on their progress. The practice manager can ensure that this happens.

You can also discuss the personal development goals of each team member. For example, perhaps they wanted to try a new sport, take a unique vacation with their family, or learn a new language.

This holistic approach to leadership and management is part of what we call the Goal Driven System.

Help your people achieve their professional and personal goals, and they be more energized to do the same for the clinic to achieve its goals.

 

Your Patient’s New Year’s Goals

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Your patients’ goals are why we are here.

They are why your staff came to work today and why you went to your last licensing seminar.

Your patients’ goals are why you have a practice and are in business.

So, what are your patient’s goals? What do they want?

On the surface, it is usually to relieve discomfort or pain.

So, like you do, after your initial consult, exam, and imaging, you tell them the cause of their pain and present your treatment program. They nod in agreement, and you begin care.

But when the patient sees the staff member to work out their finances and scheduling, they may have a glazed look and not be too sure what you just told them. Something-something about submarines, or joints, or spondy low dices.

The next week you wonder where they are. Your front desk does recalls. You spend money on more marketing to get more new patients.

You may have experienced a version of this in the past.

And at home, the patient may even feel that they got what they wanted or thought that they wanted. Maybe they feel better. But did they really get what they wanted?

There is a quote questionably attributed to Henry Ford: “If I’d asked customers what they wanted, they would have told me, ‘A faster horse!'”

I get the point. But what people wanted, though they did know about a Model-T, was to travel faster with less horse poop.

You know that four adjustments, in most cases, won’t provide the health solution that the patient needs. But your patients don’t know what you know!

Was that why they didn’t come back for another visit, because you didn’t educate them enough? No.

Was it that you did not motivate them enough? No.

An excellent book on sales that I recommend is by Harry Browne, The Secret of Selling Anything. Brown points out that people are already motivated. 

You don’t have to motivate your prospective patient when you initially see them. You just need to discover what is already motivating them.

This takes place in your initial consultation and history, which I feel is the most crucial part of the new patient onboarding process.

Brown offers these three steps.

  1. Discover. Discover through intense listening what they want. For example:
  • What do you consider most important for you about your health?
  • What do you think is the biggest problem regarding your health?

These questions, and others, open the door to understanding what the other person wants. And if they know you understand them and are authentically interested, they will be more inclined to listen to you and trust you.

  1. Summarize. The second step is to summarize what the patient said about what they want. This brings out what they said on the table so that you both can agree. For example:
  • So, as I understand it, you are looking to get rid of the pain, not for just a week, but altogether so that you can get back to playing polo with your grandkids, correct?

Now you both can agree on what they want.

  1. Solve the problem. The third step is educating them on what you have found after your exam and imaging. But you direct the education to exactly what they especially want. Now they are interested because you are addressing the motivation that they already had.

This is a simple procedure that is genuine and caring. Not always easy to find these days, so you will stand out from others by using this method.

I would even spend time now and then rehearsing this. Even the pro’s practice.

Brown is not the only person who has offered this procedure as it is so fundamental. But we can never be reminded of the basics enough. He also said:

…the secret of success is:

 Find out what people want and help them to get it.

Help your patients achieve their goals in 2023, and they will help you achieve yours.

Seize 2023!

Ed

The Future

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It is a peculiarity of man that he can only live by looking to the future.
(Viktor Frankl)

Traditionally, the first of any New Year is an excellent time to take stock of the prior year and make plans for the year to come.

Goals

In business, there are two (three, but for now, we will look at two) types of goals for your business:

  • Production Goals
  • Organization Goals

Setting production goals for where you want to be 12 months from now is the easy part of goal setting. The hard part is working out the organizational support you will need to achieve your production and collections goals. It could be more than you think!

But keep this in mind:

chiropractic and your services are never the primary barriers to practice success.

It is always management. It is the administrative issues connected with organization, including marketing, that gum up the work, gets in the way, slows your business down and holds you back.

Motivation

Part of management is managing your motivation. Yep… motivation needs to be managed. Keeping your spirits high and your drive strong is necessary for an organization to flow.

And this takes us back to your goals.

Visualizing achieving your goals will stimulate your motivation – and your drive. If you can’t see any way to your goals, well, that can be depressing. But if you can… if you can envision accomplishing your future goals, you will be motivated.

Viktor Frankl

I reference Viktor Frankl in my book, The Goal Driven Business.
Speaking of his experience in a concentration camp, “As we said before, any attempt to restore a man’s inner strength in the camp had first to succeed in showing him some future goal…”

He also said, “Even when it is not fully attained, we become better by striving for a higher goal.”

For your goal setting for the New Year, I recommend you start with your higher goals, the 3rd type of goal, which are beyond production and organization. For example, what brings you bliss? What gives you meaning?

  • Time with family and friends?
  • More vacations to more interesting places?
  • Going for the WIN of your best production and collections year ever?
  • Building a church?
  • Getting a diplomate in nutrition?
  • Improving patient outcomes?
  • Speaking out about health issues more?

Begin with these goals – the higher, wilder, richer ones. Then, look at your production goals, then your organizational goals.

I encourage you to dream just a bit and look at next year as your playground. What higher, richer, and wilder adventures would you like to accomplish?

Have some fun considering these types of goals and all the ways you would like to achieve them. This will add zest and a special spirit to your production and organizational goals.

Help with Your Future

We want to help you with your future. Your work is important, and helping you achieve your goals has been a driving force and a higher goal within our company for over 30 years.

For 2023, we have a few openings for our Private Client status on our Goal Driven Program.

If you are interested in working with us, please reply to this email, and we will schedule a time to talk.

All of us at Petty Michel & Associates want to help you achieve your goals in 2023

Seize the Future! (Carpe Future)

Happy New Year

Ed

Reference. More information on this is covered in sections in The Goal Driven Business, starting at page 19 and page 116.

2023 Medicare Fee Schedule

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Shown below is information regarding the 2023 Medicare Fee Schedule for Wisconsin Providers only provided by NGS Services and also a link to  CMS.gov for fee schedules in other states.

Wisconsin Providers:  Here is the 2023 Medicare Fee Schedule for your perusal.  Please make this accessible to you and your staff.

 

 

Onboarding for New and Veteran Employees

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Just Focus on Goals and Expectations

The way you set up the initial relationship with your new employee will directly determine how well they perform in the first year of employment.

I don’t think that this is given enough consideration. You are in a rush to fill a position, and once you have done so, you are now just happy that it is done so you can get back to seeing your patients.

The new employee is given some training, but since everyone is busy, it is very brief and short-lived. As a result, the productivity of the new hire is held back.

New employees are not like plug-and-play appliances. Everything is new to them. The staff, the patients, the jargon, the flow of traffic, the procedures — all these which you take for granted, are to them, new.

The prospective new staff member never really knows what they are walking into. Is this going to be their best or their worst work experience? So, despite their smiling cooperation for the first few weeks, underneath, they may be worried that your business is not for them.

It can take 8 to 12 months for a new staff member to gear up to full capacity and performance. But the critical period in my observation is the first three months.

Orienting, training, and acclimating the new employee to their new job, new team, and new business is called onboarding.

Onboarding – the First 3 Months

You want each team member to be happy working with you and operating at close to their full capacity. This is what you want for yourself, right?

Once you make the decision and the new person is hired, your management work just begins.

A systematized onboarding procedure helps the new employee feel safe, that this is where they belong, and that they are important to you and your office.

As a result, a deliberate onboarding process will “increase new hire retention by 82% and improve the productivity by 70%.” (zippia.com)

I have seen this in action – both the right way and the wrong way!

We provide an onboarding checklist for our clients (which we are updating), but here are some fast tips:

1. Checklist. Assign the new employee a list of actions to be completed over the first 3 months that include orientation, study, and training. The checklist should also be assigned to a veteran staff member to help the new employee get through the checklist.
2. Ongoing meetings with the owner/doctor. You want to have the new employee have a good understanding of you and your history, goals, and plans to achieve them. Do this over lunch or coffee.
3. Relationship with goals. You want the new employee to have a relationship with the goals of the office. Go over:

a. The mission of the clinic and why this is the mission.
b. The clinic and team’s values. Who we are and how we are. (For example, we are care-aholics!)
c. The outcome of the clinic’s services. For example: happy, healthy patients.
d. Mission and outcome of their specific role.

4. Expectancy. They need to know that achieving the goals for their specialized role is what is expected. How they do it is important, but that they achieve them is most important.
5. Regular (weekly or biweekly) coaching reviews.

Re-boarding

You can do a version of this every 12 months with your key veteran staff. Why not?

Next to your skills, your reputation, and your patients, YOUR PEOPLE are your most valuable asset in your practice. Take care of them, especially when they begin, and they will help you take care of the practice.

Ed

 

Practice Fundamentals – Communication and Control

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“Get the fundamentals down and the level of everything you do will rise.”
— Michael Jordan

It’s always the basics. The fundamentals.

This is what all efforts to improve performance – and health — go back to.

All of your efforts in practice management boil down to communication and control.

All the books on procedures, patient management, and practice management can be distilled down to communication and control. Those are the basics you need to get to your goals and those of your patients.

  • Doctors, and staff, that have excellent communication with their patients have many referrals and a busy practice.
  • Doctors who communicate well with their staff have a happy and full practice.
  • Doctors that have positive control with their patients see their patients succeed.
  • And business owners that have proactive control over the office – are prosperous.

Of course, the inverse of these facts is also true. Whether out of fear, confusion, or fatigue, when these fundamentals are not administered, things don’t go well.

Communication

I was recently helping a doctor and the practice manager improve their patient financial consultations. The manager and doctor had worked out what to say that they liked. They called it a “script.”

A few months passed, and I noticed their patient retention had not improved. Neither had collections or other metrics. When we did some training on how the patient consultations were performed, we found that the staff focused on the memorized script, not the patient. Their communication was robotic, and they never got to know the patient. We replaced the script with a simple outline and let the staff get to know the patients. Visit average and collections improved.

Good communication is alive, interested, and empathetic. It results in understanding.

Control

Another office we worked with complained about low collections. They had plenty of new patients — the veteran doctor got great results. After investigating, we found that the report of findings and treatment plans were rarely completed, and scheduling was hit-and-miss at best.

And that’s not all. The doctor and staff often came to work just a few minutes before patients came in. Sometimes they came in late.

This office was out of control — and so were the patients.

Positive control is moving a project, patient, or condition from one status to a predetermined goal. This is what a procedure does. A well-run business has procedures, protocols, and systems that it adheres to achieve its daily and weekly goals.

Management

Management is implementing effective procedures, with excellent communication, to achieve goals.

In all your practice improvement efforts, check first if the procedures are being done, and then if they need to be improved or removed. Then, look at the quality and quantity of communication used to implement the procedures.

Improve the fundamentals — your patient and team communication and control — and you will have a prosperous and happy 2023.

Seize your future – with a smile!

Ed

What gets measured gets done

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Your Goal Driven Analytics Scoreboard

Sometimes you can’t see the forest for the trees.

Sometimes you think things are worse than they are.

But then again, sometimes you think things are going better than they are. And then, BANG! Poop hits the fan!

What is the best way to determine how your business is doing?

Your Scoreboard

Your numbers are the best indicator of your Key Performance Indicators. They are your dashboard. Your Google maps. Your altimeter, as you take your business off the runway and up towards your goals.

In our consulting work, too often we see major management changes based on a minor error, hearsay, or emotions. This can have long-term devastating results.

On the other hand, improvements that show up on the stats can be ignored if no one is watching them.

One office we worked with continued to see an increase in new patients referred from a local gym. But amidst the busyness of the daily patient care, they hadn’t noticed. Since we closely monitored their numbers, I saw this increase in new patients from a local business on their New Patient Tracker. After discussing this with the doctor and manager, they finally took action to strengthen this valuable relationship. Last I heard, they are continuing to get referrals from this location.

You can miss the good things — as well as the coming crash. Numbers help you predict what needs fixing before things get ugly and what needs reinforcement to keep the good times going.

Ultimately, statistics tell you if you are moving towards your goals or away from them.

Unfortunately, most offices do not keep clear and consistent track of their numbers.

As a result, business owners do not get the information they need to manage their business properly. Software can spit out reports which can help, but they are not enough. And usually only partly used, if at all.

Here are some fast tips for your stat analysis scoreboard:

  • Key numbers. Monitor numbers week-to-date and month-to-date, especially new patients, visits, charges, and collections.
  • Individual providers. If you have multiple providers, find some way to measure their production. This can help both of you manage performance.
  • Percentages. Use percentages, such as visits divided by new patients, to give you an idea of how long your patients are staying with you.
  • This year to last year. You should be able to compare this year-to-date with last year-to-date.
  • Line charts. We use line graphs plotted over a couple of years. These clearly show what is trending — up or down.
  • New patients. Track the sources of your new patients as well as the types of new patients.
  • Weekly reports. Have someone in your office give you a daily, or at least a weekly and monthly statistical report.

Keeping statistical analysis in place has proven so valuable for offices that many clients have asked us to keep providing their stat analysis for them years after completing an intensive service with us.

While this is not a major service we offer, we realize how useful it is in our Goal Driven System of management.

Therefore, we have decided to start offering our Goal Driven Analytics program as a service to more offices.

We are only taking 5 new clients on this program for now, first come, first serve.   It is moderately priced and, as most of our clients can verify, managing by the numbers is invaluable. To learn more about the program, we’ve posted some more info, with the link below. If interested, just reply to this email, and we can set up a time go over the details.

But whether we provide you with your statistical analysis or you set it up yourself, I can’t recommend a more valuable management tool for managing your business profitably. Not only is it effective, but it is fast!

Your analytics scoreboard will help you smoothly navigate to your goals.

To your greater prosperity,

Ed

More info on the Goal Driven Analytics Scoreboard.

Grateful for the Future

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Gratitude is not only the greatest of virtues, but the parent of all others.
(Cicero, Prolancio, 100 BC)

As many of us in the U.S. prepare for our annual Thanksgiving events, I wanted to offer a short perspective.

Daily events challenge us, and we struggle to deal with them as best as we can. Events in our offices as well as in our communities, country, and the world can be daunting.

So, it helps to pause, more often than we do, and appreciate the advantages we have from those who have come before us. Likewise, to be grateful for the people we know: our family, friends, and those with whom we work. And, of course, our patients. In small ways and large, we all help each other.

But I also want to mention our future and the opportunity it gives us all.

As we move through the Holidays and winter sets in up here in the Northern Hemisphere, the New Year comes at us again too soon. We live in uncertain times, but as business owners and health mavericks, now is not the time to hunker down as if to hibernate and hope that any storms that occur may pass us by.

They won’t. But we can prepare and seize the opportunities that lie ahead.

Forward-minded entrepreneurs always find a few new approaches to making things better while many business owners remain on the sidelines, wary of jumping into the game and fully committing.

The future offers us the opportunity to play and enjoy the thrill of creatively making a difference, however difficult.

So, enjoy the Holidays, and all those close to you, near and far, in the present and respects to those who have passed. Take time to nourish yourself and those around you. There truly is much to be thankful for!

But while doing so, also appreciate the freedom we all have to make a better practice and a better life in the years to come.

Seize the Day and Seize the Future. (Carpe Diem, Carpe Futurum)

With Gratitude for all you do,

Ed, and all of us at Petty Michel

Health Never Takes a Holiday

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fitness santas

Let the parties begin!

It’s beginning to look a lot like that special time of year. That very busy time of year with parties, food, traveling, shopping, cooking, and extra tasks.

A wonderful time of year. BUT…, please remind your patients that

Health Never Takes a Holiday!

They shouldn’t stop brushing their teeth, taking showers, or taking a pause from their yoga classes! These are all health activities that are just as important as their health program with you.

Yes, it’s OK to have an extra slice of pumpkin pie, stay up a bit later wrapping presents, or have a few drinks with an old acquittance, but encourage your patients to stick with THEIR health program.

Stopping and then starting again is tough. You lose your gains and momentum… so it is easier to just keep the ball rolling.

You can make a poster to help you remind your patients to keep working on their health. It also reminds you and your staff to keep your patients on track. Add something to your newsletter or a whiteboard with your Table Talk.

And in the spirit of the Season, you can click below to download free customizable sample posters for your patients. (We have many posters and patient scripts for our clients.)

Keep your patients Goal Driven to improve their health for a happier future!

Then, keep calm and party on!

Ed

Link to Posters- Health Never Takes a Holiday

Chiropractic Patient Education Prompters – Table Talk Grows Your Flock

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Imagine this scenario:

Written on a white board near the chiropractic patient adjusting area:

Last to show and the first to go.

Patient: Hey Doc, what does that mean, written on the white board there?

Doctor: Hi Sam, glad you asked. Just a reminder for me to explain that pain usually shows up after a health problem is present for a period of time, and usually goes away or lessens during the early part of our program of care. In other words, the pain can go away but the issue that caused it can still be present.

Patient: Oh, I got you! So, even though I am feeling much better, I better stick with the program, is that it?

Doc. Yep!

===

You know patient education is important. It improves outcomes. It improves retention. It improves referrals.

This is a simple procedure to improve your patient education: Assign a creative staff member the task of writing images or sayings that prompt the patient, or prompt you, to talk about a health subject. That’s it!

It prompts TABLE TALK.

Table talk is the BEST form of patient education and, for that matter, promotion. It comes from you, the doctor, during the most transformative time in your office.

Here are a few sample subjects you could post on a white board near your adjusting table:

  • How does chiropractic work?
  • Above Down Inside Out
  • Dr. You
  • Does chiropractic help with headaches?
  • Last to Show First to Go
  • Time, Repetition, Effort! [It takes time to restore your health, it has taken a long time for you to get into this condition. It takes repetitive work, like orthodontics. We will give you our best effort, you will have to do the same,]

Add a drawing now and then:

  • How is pain like an iceberg? (Draw an iceberg. [Iceberg Symptoms on top of the water, cause below in the water.]
  • How is spinal health like a rusty hinge? [This is when your vertebrae wears away when it becomes stuck.]
  • What happens to your tires when they are out of alignment? [Disks wear out faster like tires out of alignment.
  • Car Parked a garden hose. [When the hose is stepped on or kinked the water does not flow 100%. The same is true when you have a subluxation and your nerves are impinged. This affects everything your nerves are connected to.]
  • Safety Pin.
  • Orthodontics.

Just so you don’t get too serious, add a joke now and then:

  • I had to turn down the landscape company today…

****They wanted too mulch

  • The bartender says “Sorry, we don’t serve time travelers in here.”

****A time traveler walks into a bar.

===

This procedure doesn’t cost you. Like chiropractic (or our consulting!), it pays!

But only do it for two months at a time, otherwise it will lose its novelty for you, the staff, and patients. Run it 2- 3 times each year.

Once a month, meet with your team and come up with some new patient education prompters. This is also another way to educate your team in the process.

Keep the conversation going.

The more they know, the further they’ll go.

And seize the future.

Ed

Improving Patient Follow Through: The new patient log and checklist

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Working with different offices, we are always reminded of the fundamentals that apply universally. For example…

Once your patient has committed to getting better, it is your job, and everyone else on the team, to help them achieve their goals.

But in the busyness of everyday office interactions, essential steps along the way can become abbreviated or dropped out altogether.

At one office I recently visited, the patient visits and income were diving downward on a monthly trend. And this was occurring even though the new patient volume had been pretty steady.

When I inquired with the front desk staff, they told me that patients were sick, had money problems, were busy, and blah blah blah.

I asked if this was a new phenomenon. Did patients suddenly become poor, was there a new pandemic? What?

Didn’t get any real answers, as they were busy on the phones doing recalls trying to get people back in the office. The doctor wasn’t sure what was happening. To his credit, he loves adjusting and focuses on providing outstanding care – which he does, usually at a high volume.

Long story short, after investigating, I discovered that the doctor had changed up his treatment procedure slightly, and staff positions had changed. As a result, new patient financial consultations had dropped out. The patients had been getting excellent care but had no idea about their payments and were only scheduled for one visit at a time.

This was a pretty big change! A critical procedure just silently disappeared without anyone really noticing. (Sometimes it is hard to see the forest for the trees. Plug: Consulting doesn’t cost. It pays!)

Everyone at the office is a veteran, hard-working, and goal driven. A great team. But this missing procedure was costing them thousands and preventing patients from getting the full benefit of care.

We implemented several solutions that have worked for other offices.

One solution was the New Patient Log and Checklist. I gave them a sample to customize. It is a lined sheet on a clipboard. Each new patient is listed vertically on the left column, followed by other columns stipulating key actions that should occur on each patient. The Log would include such things as:

  • Report of findings and Tx Program.
  • Multiple appt. card.
  • Financial Consult.(When, by whom.)
  • First adjustment call.
  • Attend NP workshop.
  • Source.
  • If referred by patient, what is pt.’s name?
  • Thank you card to referring patient?
  • Type [ WC, PI, C, etc.]

You could add more columns, but the most vital aspect of this Log is this: it must be assigned to someone. You and the team can review the NP Log during your morning meetings or at weekly team meetings.

One of the lessons here is to always look for what you and your team are doing or not doing before you look to the environment for why your practice may be slipping – or booming!

And help your patients achieve their health goals by ensuring that they complete all the steps necessary along their health journey to achieve their goals.

Stay Goal Driven for a happier future!

Ed

PTC and the Subtle Art of Being There

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It was in the 80s at a Parker Seminar, which was in Reno that year, that I first heard the term.

In the opening session, Dr. Jimmy Parker talked about PTC. I was attending as a guest with a chiropractor who introduced me to chiropractic. What an introduction!

Dr. Parker explained that PTC stood for Present Time Consciousness. (Parker had quite a few of these abbreviations!) He explained that a doctor could deliver a much better adjustment if their attention on the patient were in the present time, not thinking about past issues or on future concerns.

I have come to learn that this is a vital but easily overlooked skill.

You can tell when someone is 100% paying attention to you, or maybe not quite, or maybe not at all. And this makes all the difference in the patient’s trust in you, how long they stay with you, and whether they refer others to you.

But maintaining PTC can be challenging in a high-volume chiropractic office or any health office. How many thousands of adjustments does it take until all patients start blending into to one?

A doctor who worked with Clarence Gonstead told me about one evening when he was shadowing Dr. Gonstead. It was around 9 p.m., and the reception/waiting room was full. The doctor said to me that he exclaimed to Dr. Gonstead that his waiting room was still filled with patients. He said that Dr. Gonstead turned to him in the hallway before they went in with the next patient and said, emphatically, “No. I only have one patient, and that is the one I am with now.”

That sounds like he was present with each patient, and perhaps that is at least one reason he was so successful as a chiropractor.

I have seen more than a few techniques, or hacks, that help keep doctors, and support staff, in the present with each patient. For example

  • Completing the visit.  Some doctors soundly end each visit, often confidently saying, “That was a good adjustment, and I am satisfied.” Ending one visit before starting the next visit creates a micro-break, a little space between visits.
  • Break up the day. Different approaches to breaking up the day seem effective. For example, busy offices usually have varied but ritualized lunch breaks. These might include such activities as weight training or exercise, marketing, team workshops, lunch with the spouse, guitar practice, you name it. Mid-morning and mid-afternoon 5-minute breaks can also be helpful. (Stay away from social media!)
  • Remove distractions. You want to remove distractions that can pull your attention to future challenges or past mix-ups.  Pre-shift and short weekly meetings can be helpful in this regard by sorting out administrative issues so that you are free to focus on patients – in the present.
  • Cricket clicker! I remember one doctor telling me that he used a steel clicker, a “cricket clicker.” He would click the clicker just before the next patient visit, which would help him mentally begin the next visit.  (Whatever works!)

I suspect that this is a high-level technique. One for the masters. It can’t be canned. Perhaps it is beyond technique. When accomplished, when you are totally present, the patient innately feels that you are there for them and them alone, and this perhaps speeds their recovery.

I would be interested to know how you maintain Present Time Consciousness. You can add your thoughts here on our blog.

Staying engaged in the present for a better future!

Ed

The power for creating a better future is contained in the present moment:
You create a good future by creating a good present. (Eckhart Tolle)

In Praise of Geekiness

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Are you a chiropractic geek?

Are you a health geek?

Here is Merriam Webster: Geek: “…a person with a high level of knowledge or skill in a field…” “an enthusiast or expert especially in a technological field… [The word geek has] seen increasing use with positive connotations, showing membership in a specialized group (film geek, beer geek) rather than social awkwardness.”

I like the word geek because it indicates someone who specializes in a field and is so engaged that they are not especially concerned with keeping up with what is accepted conventionally. In other words, they are a bit of a rebel.

Steve Jobs, for example, was a geek. A core value of Apple was a “power to the people” idea, that anyone could have a personal computer, not just the big corporations.

Wouldn’t Clarence Gonstead have been a geek? It would be difficult to find many chiropractors who were, or are, as engaged in chiropractic as he was or worked as hard.

I remember years ago when talking with a chiropractor over lunch and all he could talk about was the X,Y,Z axis, something about Euclidean geometry, and bilateral symmetrical function. I was trying to keep up! But there he was, in practice for over twenty years, talking excitedly about the last few patients he had seen. He was a chiropractic geek, for sure.

He also had a million-dollar practice with a very strong practice manager.

Great athletes are geeks in their field, studying and training harder than most. Same with musicians or chefs.

But it is easy to get distracted from your game. Collections, bills, staffing, procedures, marketing, insurance, taxes, and everything that goes along with running a business can cut into your productivity and dilute your concentration on your services.

Don’t let it.

Only the offices that give the highest quality services and deliver the best outcomes will survive, let alone thrive. Organize your administration such that it does not dampen your eagerness to engage with each patient, and continue to study and enhance every detail of your clinical skill.

And as a plug, this is why I wrote the Goal Driven Business – to help doctors be doctors, unfettered by administration, and free to express their skills and interests in their profession.

Organize your office so that you can focus on the science, art, and philosophy of your profession. Do so that you can look at chiropractic and its results newly each day, as if you just discovered its powerful potential to help people become healthier. Go deep on every level and rediscover your profession again, for the first time.

Be a geek.

Goal Driven to seize the future,

Ed

Case Management for Better Service and Retention

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Start Each Day with Service First

Do you want a fast, simple and very effective procedure that

  • Improves patient retention
  • Improves patient referrals
  • Improves patient service
  • Improves team coordination and morale.

Beginning Each Day With Service Goals for Each Patient

Too often, we start our days by first looking at the appointment book when the patients are already waiting for us. The staff may not know what special needs each patient has, or they may have been told something by a patient that should be passed on to the treating chiropractor.

A brief review of each patient can help coordinate patient services with the entire team.

Case Management Meeting Procedure

Meet with your team about 20 minutes before you see the first patient each morning. Review the patients individually that are coming in that day. You may not need to go over every patient, especially if you have a full book.

Discuss each patient and what the goal of their next visit should be. Do they need therapy or rehab procedures? What kind? Is it time for their progress exam? Did they voice a concern to a team member that you need to know about? Do they need another financial consultation or educational materials? Should they bring in their spouse?

You can also discuss new patients – what do we know about them? Are they a friend of Rihanna or Marge Simpson? Do they live in the high-rent part of town or in a trailer down by the river? Are we all looking forward to meeting them?

More Than Case Management – Keeping It Fun.

Aside from case management, the morning meeting helps get the day started. Everyone can see how each other is doing, say Hi, and be on deck all set for the day.

I have seen chiropractic offices do short exercises (practice what you preach!), such as a plank or wall sit exercise.

I have seen jokes told. For example, everyone is assigned a spot on the Bad Dad Joke Rotation. One joke per day. The most joke for the week (the best one) gets free lemon and beet juice!

You can set reasonable goals for the day – new patients, visits, case completions, etc.

You can add a motivational quotation or review the mission or a core value.

I have personally seen this applied in many offices. Often, the primary chiropractor would get to the morning meeting first, and anyone who came in late was duly noted!! One office did this procedure in the morning and then again before the afternoon crowd came in after lunch.

Assign this as a procedure to your manager, case manager, or front desk coordinator. But make sure you support it 100%.

I have seen case management meetings work for a few months and then, like many procedures, fall by the wayside.

It only works if it is done.

In the end, everything we do is to help each patient reach their goal of better health, and this is the ultimate goal of case management meetings.

Over to you!

Carpe Posturum! (Sieze the Future)

Ed