Download the Tent Poster for your office.[2025 June 6 Discipline]
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Ask Lisa: The Art of Navigating Insurance Network Participation
One of the most critical decisions you will need to make in your practice is, should you be “in-network” with a payer group, or out? It’s a tough choice, and one size does not fit all.
So, what do you do?
First, determine which companies you already are in network with, and assess.
- Do you have a contract?
- What are your obligations as a participating provider?
- Are you getting reimbursed what the contract’s fee schedule says it will reimburse?
- Are you currently enrolled in Medicare, and are you a participating or non-participating provider?
- Are you also currently enrolled as a provider in your state’s Medicaid program?
- Are you enrolled as a provider with the Veteran’s Administration in your area?
Additional items to consider prior to enrolling in a plan include:
- What is the reimbursement rate?
- What percentage of the approved charges are taken out for contract discounts?
- Is there a fee to join?
- Do they want you to participate in their worker’s compensation, PI programs? (In our experience, opting in to the WC and PI products means no steerage to you, and cut reimbursements).
- Are there pre-authorizations required prior to care?
- Is there a visit limit?
- What is the initial credentialing and re-credentialing process?
Next, make sure you have a profile set up with the National Council for Affordable Quality Healthcare (CAQH) universal provider database and that the information is current, and re-attested quarterly. There is no charge to create and maintain your profile in this credentialing database.
Third, audit your patient demographic. Run a report in your practice management software, to determine
- What percentage of your reimbursement comes from insurance?
- What percentage comes directly from patients?
- Which payers are you mainly seeing patients from and are you finding that patients are requesting you be in network with a certain company?
- Who are the main employers in your area insured with?
Fourth, develop a spreadsheet called “Insurance Networks” to help you and your insurance department keep the information organized and up to date.
Once you have a grasp on the above, you’re ready to determine if you need to pursue network participation with additional companies. Treating this like a sales or business venture, you’ll want to have insurance companies coming to you and requesting you be in their network.
Remember, it is to their benefit and their obligation to keep their paying policyholders happy.
Patients should feel free to call their insurer requesting you be on their plan. Patients have done this, and outcomes have been successful. Why? Because the worst phone call an insurance company can receive is from an upset policyholder who can’t afford to see their favorite doctor who is helping them (that’s you!) because the doctor is not on the plan.
We’ve just touched the surface of network plans and credentialing. PM&A can provide specialized and unique advice on making the choice of which networks to join, which to be out of network, and which to run away from! We also will run those audit reports to assess if you’re getting the best bang for your buck.
Email me for assistance with how these processes work for your practice. You may reach me at Lisa@pmaworks.com.
Lisa
Engage Your Chiropractic Practice with Your Community
Get Out and Connect with Your Community
Summer brings farmers markets, parades, festivals, and run/walks—perfect opportunities for your chiropractic or healthcare practice to engage with your community. Community events are a powerful way to build relationships through networking, a form of relationship marketing.
As Ivan Misner, founder of Business Networking International, says in The World’s Best Known Marketing Secret “You have to be visible in the community… It’s called networking. You have to work at it.” But with the right attitude, it’s fun, not just work.
Why Community Engagement Matters
Whether your practice is established or new, staying active in your community is crucial. Markets evolve, and without consistent marketing, your practice’s momentum can quietly fade, leading to unexpected drops in patient numbers. For newer practices or those needing a boost, community involvement is even more essential.
How to Engage
- Join Local Events: Participate in festivals, car shows, or races. For example, one clinic sponsors the “Cheesehead Chase,” providing T-shirts to patients who join, creating a visible group of “ChiroHealth Cruisers.”
- Set Up Booths: Offer consultations, screenings, or giveaways like pens, and greet people with friendliness.
- Wear Your Brand: Sport clinic polo shirts and share your “Get to Know Me” attitude.
- Plan with Your Team: Discuss upcoming events, schedule participation, and practice positive marketing attitudes (downloadable resource linked in original).
Build Trust Through Familiarity
People choose businesses they know, like, and trust. Break out of your routine, as Misner notes, and connect face-to-face. Community engagement makes your practice familiar and approachable, fostering lasting patient relationships.
Stay Goal-Driven
Get out there, have fun, and keep your practice thriving by staying active in your community!
Ed
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Community Engagement Guide for Chiropractic Practices
Why Engage with Your Community?
- Build Relationships: Networking at local events fosters trust and familiarity, encouraging patient loyalty.
- Stay Competitive: Consistent marketing prevents gradual declines in patient numbers, especially in evolving markets.
- Boost New Practices: Community involvement is critical for new or struggling practices to gain traction.
How to Get Involved
- Identify Local Events:
- Farmers markets, festivals, parades, or charity runs (e.g., “Cheesehead Chase”). Check your town’s calendar for events like Olive Festival or Pioneer Days.
- Participate Actively:
- Set up booths for consultations, screenings, or giveaways (e.g., branded pens).
- Offer incentives, like clinic T-shirts for event participants.
- Be Visible:
- Wear branded apparel (polo shirts or T-shirts).
- Share business cards and a friendly, approachable attitude.
- Plan with Your Team:
- Discuss upcoming events at team meetings.
- Schedule participation and practice positive marketing attitudes (resource: 8 Marketing Attitudes).
- Follow Up:
- Track event outcomes and plan for future involvement.
Key Quote
“You have to be visible in the community… It’s called networking.” — Ivan Misner, The World’s Best Known Marketing Secret
Action Steps
- Research local events for the next 3 months.
- Assign team roles for event participation.
- Order branded materials (T-shirts, pens, etc.).
- Stay goal-driven and make networking fun!
Think Big
Believe Big.
“The size of your success is determined by the size of your belief.”
“Think little goals and expect little achievements. Think big goals and win big success. Remember this, too! Big ideas and big plans are often easier — certainly no more difficult — than small ideas and small plans.”
~David J Schwartz, American Trainer, Author of ” The Magic of Thinking Big”
Download the Tent Poster for your office.[2025 June 2 Think Big]
Boost Patient Retention Through Genuine Curiosity
Why Patients Leave Chiropractic or Healthcare Practices
Patients don’t primarily leave due to cost, outcomes, equipment, or location. Studies reveal the real reason: lack of empathy and perceived indifference from staff.
Study #1: 68% of customers leave due to employee indifference, far outweighing issues like price (9%) or product (14%). Empathy fosters loyalty.
Study #2: Disinterested, unempathetic staff drive dissatisfaction and churn. Personalized, caring service is key.
Study #3: 59% of customers abandon a brand after one poor, unempathetic experience, while 73% stay loyal after a positive, caring one.
Patients value feeling cared for over clinical expertise. As Jimmy Parker, D.C., emphasized with “Present Time Consciousness,” staying fully engaged with patients is vital but challenging in a busy, high-volume practice.
The Solution: Stay Curious and Be Interested
Empathy starts with curiosity. Genuine interest in patients as individuals—not just cases—builds strong relationships and boosts retention. Ask about their lives, like their hobbies or unique traits:
- “Betty, where did you get those blue shoes?”
- “Frank, why’s your group called Kiwanis?”
This authentic curiosity makes patients feel valued and fosters loyalty.
Test Your Team’s Curiosity
To embed this approach, routinely quiz your team during case management meetings about patients’ personal details, like a new patient’s favorite sport or where an active patient shops. This friendly exercise keeps everyone engaged and curious, strengthening patient relationships.
Stay Curious and Goal-Driven
A practice thrives on relationships, not just clinical skills or billing codes. By staying genuinely interested in patients, you’ll enhance retention and build a loyal community.
Key Points: Patients leave due to perceived indifference, not cost or outcomes. Empathy, driven by curiosity, is the solution. Test and encourage your team to stay interested in patients’ lives to improve retention.
Ed
References
Gratitude: Memorial Day in the U.S.
Normandy, FranceMemorial Day in the U.S. in 2025 is on May 26th
Here is a quote from President John F. Kennedy that suggests how we should express our gratitude.
“As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them”
Extreme Ownership for Your Chiropractic and Healthcare Practice and Job
Jacko Willink, Navy SEAL
A few years ago, I participated in a community outreach project that provided education and other services to underprivileged children in Milwaukee.
My particular service was an athletic program for kids from 7 to 15 years old. Our class lasted an hour from 7 pm to 8 pm.
At the beginning of each class, I would bring up a word or a subject that we would discuss. For example, I might bring up the word “compassion,” “courage,” or even “study.” My thinking was that physical education was important, but it was also a doorway to other forms of education.
There was one evening in particular that remains unforgettable.
Most of the children were boys and were not always the most cooperative. They had tough daily lives and were often agitated at the beginning of our class. I was usually able to get them together at the beginning and get their attention.
This one evening, the word I wanted to discuss was “responsibility.” I asked the group if anyone could define it. I knew it might be a challenging one to define.
There was a pause. Some of the kids were talking and looking around. Suddenly, over on my left and in the back, a thin young boy raised his hand. I called on him. Everyone looked at him.
He said one word. “OWNERSHIP.”
The room became oddly quiet.
I hadn’t expected this definition. I asked him what he meant, and boy simply explained that when you take responsibility for something, you also take ownership for it. I told the boy that was a great definition and congratulated him!
The group and I discussed the concept for a few minutes and then went on with our exercises.
But I don’t think there could be a better definition of responsibility.
EXTREME OWNERSHIP
On our MBA program for chiropractors and other healthcare offices, we discuss responsibility – and how it applies to individual staff performance as well as patient compliance and retention.
We all watch a TED talk (link below) by Jocko Willink. Mr Willink is a Navy SEAL who describes an incident in combat in Iraq. It is a riveting story demonstrating how SEAL members take responsibility for their actions.
The name of his talk is Extreme Ownership. Here is an example:
“…. Unlike a team where no one takes ownership of the problems and therefore the problems never get solved, with us, everyone took ownership of their mistakes. Everyone took ownership of the problems. And when a team takes ownership of its problems, the problems get solved. And that is true on the battlefield. It is true in business and it is true in life.
“So I say, take ownership. Take extreme ownership. Don’t make excuses, don’t blame any other person or any other thing. Get control of your ego. Don’t hide your delicate pride from the truth. Take ownership of everything in your world, the good and the bad.
“Take ownership of your mistakes. Take ownership of your shortfalls, take ownership of your problems, and then take ownership of the solutions that will get those problems solved.
“Take ownership of your mission. Take ownership of your job, of your team, of your future and take ownership of your life.
“And lead. Lead. Lead yourself and your team and the people in your life. Lead them all.”
I’ll never forget that night. Or that boy, and the direct honesty in which he defined for all of us that night, responsibility.
Take ownership of your future. Encourage others to do the same.
Stay Goal Driven!
Ed
Video:
PS: Get on our waiting list for our next MBA program if you are interested. I will be sending you special information about practice management, leadership, and marketing.
SignUp Now for Fall 2025 Waitlist [LINK]
If you have any questions about creating a Goal Driven Business, just schedule a call or reply to this email.
Book a Session Today [LINK]
———————————————
For more information on how to create a more profitable business that is more fun than what you are doing now, please purchase and then use the book.
The Goal Driven Business at www.GoalDriven.com
“Life is Either A Daring Adventure, or Nothing.”
Helen Keller
Avoiding danger is no safer in the long run than outright
exposure.Life is either a daring adventure, or nothing.
(Helen Keller) Download a tent poster for your office with this quote.
The Value Driven Chiropractic and Healthcare Practice
Many chiropractors and doctors, despite years of hard work, find their practices stuck in a cycle of growth and decline, unable to reach their full potential consistently. This is often due to operating in a “Personality-Driven Practice”, where the business relies heavily on the doctor filling multiple roles—clinic director, manager, marketer, and more.
While this model can launch a practice, it traps the doctor in a cycle of overwork, limiting growth and personal freedom.
The solution is transitioning to a “Goal Driven Business”, where systems and a motivated team, aligned by shared values, drive success with less direct effort from the doctor. To achieve this:
1. Define Your Philosophy and Values: Write a statement about your business philosophy and distill it into 5-8 heartfelt values (e.g., “Seek to understand, then be understood”).
2. Engage Your Team: Share your philosophy, have team members propose related values, and collaboratively agree on a shared purpose and goals for the business.
3. Systematize Operations: Build a business that runs efficiently, like a flywheel, requiring minimal effort to maintain momentum.
Benefits: Research from Gallup (2023) shows that organizations with clear, employee-embraced values experience 73% higher engagement, 23% higher profitability, 66% lower turnover, and 31% lower absenteeism.
By shifting to a Goal Driven Business, chiropractors can achieve sustainable growth, enjoy more freedom, and continue delivering impactful healthcare, supported by a team united by shared values.
Seize the Future
Ed
Read the full article here: [LINK]
PS: Get on our waiting list for our next MBA program if you are interested. I will be sending you special information about practice management, leadership, and marketing. Sign Up Now for Fall 2025 Wait-list
If you have any questions about creating a Goal Driven Business, just schedule a call or reply to this email. Book a Session Today
Using offline and online tactics to grow your chiropractic practice
Grow Your Chiropractic Practice with Online and Offline Strategies
Many chiropractic offices see success with online advertising, especially on social media. While effective, it often requires digital expertise, so many chiropractors hire agencies—some with better results than others. If you’ve worked with a good agency, sharing your recommendation could help others.
Online promotion isn’t new to chiropractic. B.J. Palmer, one of the profession’s pioneers, was a relentless advertiser who played a major role in chiropractic’s growth during the early 20th century. His legacy reminds us that consistent promotion is key.
However, in today’s tech-saturated world, offline engagement is more valuable than ever. Creating relationships with patients is critical. The relationship business in a chiropractic office revolves around building trust, fostering patient loyalty, and creating a community that supports long-term engagement and referrals. Chiropractic care is inherently personal, as it involves hands-on treatment and addressing patients’ pain, mobility, and wellness goals. The success of a chiropractic practice often hinges on strong relationships with patients, staff, and the broader community.
Your practice is essentially a network of relationships, sustained through communication and service. So:
- Nurture current and past patient relationships
- Use those to expand to new connections
Some effective offline tactics include:
- Sending personal email newsletters with stories, health tips, and a touch of personality
- Hosting in-office events (e.g., Mother’s Day giveaways or posture screenings for National Correct Posture Month)
- Organizing a patient appreciation picnic or monthly spinal health talks
- Visiting local businesses to give brief wellness presentations
- Setting up a booth at local fairs for visibility and patient reactivation
Combining digital and personal outreach creates a powerful, sustainable marketing strategy. As Woody Allen once said, “80 percent of success is showing up.”
“80 percent of success is showing up” (Woody Allen)
Stay Goal Driven,
Ed
References:
*(B.J. Palmer, Achievers Magazine, 1989)
*Brad Glowaki
*(Woody Allen (Quote Investigator)
Ask Lisa: PMA’s New “911 Clinic Rescue” Program
Are you struggling with collections, insurance demands, and general demands on your time? Or know anyone who is?
We can help. This past weekend in Chippewa Falls, WI, we introduced our 911 Clinic Rescue program.
What can our onsite programs do for you? Here is a sample list of the areas Clinic Rescue can address and help you navigate:
- Low Reimbursement Rates
- Coverage Restrictions and extra administrative demand such as pre-authorization requirements and records requests
- Other Administrative Burdens distracting you from patient focus
- Patient Affordability
- Network Participation
o Evaluating if an insurance contract is worth signing
o Evaluating the risks and benefits of dropping insurance networks - Insurance Changes and keeping up with the latest payer information
- Technology gaps and insurance processes
Reimbursement and Revenue:
- Negotiate better reimbursement rates with insurers
- Appealing denied claims
- Evaluating transition to a patient self-pay practice to reduce insurance reliance
Billing and Administration:
- Reducing time spent on insurance paperwork and billing
- Analyzing common coding errors, and how to avoid them
- Evaluating affordable billing software and/or outsourcing options
Audits and Compliance:
- Ensuring documentation meets insurance and Medicare standards
- Insurance audit triggers, and how to prepare
Patient Costs:
- Helping patients understand their insurance benefits and costs
- Providing affordable care options for patients with poor coverage
Interested in learning more? Want to chat about your clinic-specific concerns? Call Lisa, 920-334-4561 or email lisa@pmaworks.com
Ask Lisa: Blue Cross Blue Shield Antitrust Settlement – Action Needed
Are You Eligible?
If you or your clinic provided care, equipment, or supplies to any Blue Cross Blue Shield (BCBS) patient between July 24, 2008, and October 4, 2024, you are likely included in this settlement.
What’s This About?
A $2.8 billion settlement has been reached in a lawsuit alleging BCBS companies limited competition and underpaid providers.
Your Options:
• File a Claim: To receive any payment, you must file a claim by July 29, 2025.
• Do Nothing: You will not get any money and cannot sue BCBS over these issues later.
• Opt Out: If you want to sue BCBS on your own, you must have opted out by March 4, 2025.
How Much Will You Get?
The fund will be split: 92% to hospitals/facilities, 8% to professionals (including chiropractors). The exact amount depends on how many claims are filed.
How to File:
Go to the official provider settlement website and click “Submit a Professional Claim” to file online.
Questions?
For more details, visit the BCBS Provider Settlement website.
Key Deadline:
July 29, 2025 – Last day to file your claim. Don’t miss out.
Citations:
Settlement Information:https://www.bcbsprovidersettlement.com/Home
Application: https://www.bcbsprovidersettlement.com/Home/ClaimantAccount
Why Practice Systems Aren’t Enough
What you need to do
“The size of a chiropractor’s business depends upon:
1st – His ability to notify people who he is, what he is, and where.
2nd – His systematization to take care of it as it grows and increases in volume.
– B.J. Palmer (1920, from Up From Below the Bottom)
B.J. Palmer, a pioneer in chiropractic, emphasized two keys to growing a practice: effective marketing to establish visibility and robust systems to manage growth. In the 1920s, he built a chiropractic college with 1,000 students, showcasing his ability to promote and systematize. Similarly, Michael Gerber’s The E-Myth (1980s) stresses that systems, not individual effort, drive business success. Quotes like “Systems run the business and people run the systems” highlight the need for structured processes.
However, many chiropractic offices struggle to implement systems effectively. The missing piece is clear leadership and accountability. Doctors and staff are often too busy to manage systems, and most practitioners lack the desire to oversee them. A dedicated manager and a goal-driven team are essential to bridge this gap.
Action Steps to Implement Systems:
- Lead as the Clinic Director: Dedicate a few hours monthly to strategic oversight, emulating Palmer’s leadership in driving innovation.
- Instill Purpose: Hold monthly team meetings (2 hours) to reinforce your practice’s philosophy and align the team.
- Appoint a Manager: Designate an administrative coordinator for 2-4 hours weekly to oversee systems.
- Define Roles: Have the manager collaborate with the team to create and maintain job duties, reviewed by you.
- Coach the Manager: Meet twice monthly (1-2 hours) to review the manager’s progress and provide guidance.
- Use Frameworks: Apply *The Goal Driven Business* to structure system implementation.
The Outcome:
A manager handles daily operations, freeing you to focus on growth. This shifts your practice from surviving to thriving.
Next Steps:
Read The Goal Driven Business for detailed guidance. Assign a manager now or book a consultation (May 2025). Stay goal-driven to build a scalable, successful practice.
And Stay Goal Driven,
Ed
How Steve Jobs’ Vision Can Transform Your Chiropractic Practice Learning from Visionary Success
Apple, founded by Steve Jobs in 1976, is now the world’s most valuable company, with a market capitalization of $2.9 trillion and $54 billion in cash reserves. But in 1997, Apple was on the brink of bankruptcy. Jobs’ strategic overhaul turned it around, offering lessons for chiropractic and healthcare practices.
In a 1997 interview, Jobs shared a key insight: “If you do the right things on the top line, the bottom line will follow.” He emphasized that a clear strategy, passionate people, and a strong culture drive quality products, marketing, and operations—ultimately boosting profitability. For chiropractors, this means focusing on vision and values to achieve sustainable success.
The Top Line: Your Practice’s Foundation
Your “top line” is your practice’s vision, values, purpose, and the team that embraces them. When these are aligned, marketing, procedures, patient outcomes, and profits follow naturally.
Top-to-Bottom Framework:
- Top Line: Vision, values, purpose, mission
- Almost Top Line: A team aligned with these principles
- Middle Line: Policies and procedures
- Almost Bottom Line: Patient outcomes
- Bottom Line: Net income
Focusing on the top line creates a “vision-driven” practice, much like Jobs’ approach at Apple.
Insights from a Chiropractic Leader
A seasoned chiropractor recently shared a video on social media, responding to a colleague concerned about high practice expenses. He identified the biggest cost: an “under-trained” team. His solution? Hiring passionate individuals and training them not just in chiropractic techniques but in the practice’s “why”—its purpose, mission, and vision. Team members who didn’t fully align were let go. The result? A thriving practice.
When I commented that his success stemmed from his own clear “why,” he agreed: “It all starts from the inside out. If the doctor has a big WHY and can teach it, the team will follow.”
Sustaining Your Vision
Keeping your practice’s values alive requires ongoing effort. It begins with your example as the leader and continues through consistent team coaching. In our MBA program, we explore proven strategies to maintain this focus, from vision to execution.
Apple’s Core Value and Your Practice
In 1997, Jobs defined Apple’s core value: “We believe people with passion can change the world for the better.” This resonates with top healthcare practices, where passion for patient care drives impact.
Does your practice reflect this passion? A clear vision, a dedicated team, and consistent coaching can transform your chiropractic business, just as Jobs transformed Apple.
Stay Goal Driven.
Ed
Momentum Magic: How the Flywheel Effect Boosts Your Chiropractic Practice and Service Business
What separates good businesses from great ones?
It’s momentum—created by doing what works consistently and improving it over time. In business, especially in healthcare services like chiropractic, success often comes not from radical change but from steady, thoughtful progress.
Avoid the Trap of Constant Change
Healthcare entrepreneurs often seek out the next big thing—new therapies, machines, or procedures. While innovation can be beneficial, abrupt changes to proven systems can disrupt staff and confuse patients. A smarter approach is to test new ideas first, and only implement them if they complement what’s already working.
“If something works—fix it, refine it, but don’t toss it.”
The Flywheel Analogy
Jim Collins, in Good to Great, uses the image of a massive flywheel to illustrate how lasting success is built. At first, it takes immense effort to turn. But with consistent effort in the same direction, the wheel picks up speed and begins to turn on its own—powered by its own momentum.
The key lesson: there’s no single breakthrough moment—just consistent, focused effort over time.
How This Applies to Your Practice
- Identify what’s working—and keep doing it.
- Make small, strategic improvements over time.
- Adapt to market changes gradually and intentionally.
- Build systems that generate results with less effort over time.
By steadily turning your business flywheel, you’ll transform your practice from good to great—creating a self-sustaining engine of growth.
Keep building. Keep refining. Momentum will do the rest.
Ed
Boosting Service and Retention Through Daily Case Management in Chiropractic Practices
Start the Day with Purpose
A quick, structured case management meeting each morning can significantly enhance patient retention, referrals, service quality, and team morale.
The Morning Case Management Routine
Spend 20 minutes before seeing patients to meet with your team. Review the day’s patient schedule—focusing on individual needs, progress, or concerns. You don’t have to cover every patient, especially on busy days, but focus on those needing special attention.
Key points to discuss:
- What’s the goal of today’s visit?
- Do they need therapy, rehab, or a progress exam?
- Have they voiced any concerns?
- Do they need educational materials or financial consultations?
- Should a family member attend?
Also, go over new patients—who referred them, what to expect, and how to create a warm welcome.
Keep the Energy Up
Beyond planning, these meetings set a positive tone for the day. Encourage team bonding with short activities like stretches, planks, or even a daily “bad dad joke” to keep things light.
Set achievable goals for the day—such as new patient intakes or completed cases—and review a motivational quote or revisit your practice’s core mission.
Make It Routine, Make It Stick
Assign responsibility for leading the meeting, but ensure it has leadership support. These meetings only work if they happen consistently—don’t let them fade away.
Ultimately, the purpose is to better serve patients and help them reach their health goals—this is what great case management is all about.
Seize the future!
Ed
Master Your Craft First: The Key to Success in Chiropractic, Healthcare, and Service Businesses
Marketing Starts with Service Quality
A chiropractic clinic once asked for help boosting patient numbers and improving their marketing. While we did touch on marketing strategies, the real game-changer was getting back to the basics—refining the way they practiced.
Each visit, we reviewed patient interactions, discussed specific cases, and role-played challenging scenarios. This hands-on, continuous learning approach helped the doctors improve their confidence and communication. The result? Within a few months, new patient numbers nearly doubled, and total visits increased by 50%, driven by better retention and reactivations.
When Business Slows Down, Go Back to the Fundamentals
If your numbers are dipping, the first step isn’t better marketing—it’s better service. Start with yourself and your team. Are you genuinely present with each patient? Do you “really” listen and connect?
One of the most successful doctors I worked with approached every patient with deep empathy and curiosity. She didn’t rush into treatment—she listened, observed, and connected both emotionally and physically. Her retention and referrals were outstanding.
On the other hand, her associate, while friendly, lacked that same depth of connection. As a result, her performance—and the clinic’s growth—suffered. Unfortunately, without proper training or mentorship, her skills never reached the necessary level.
Excellence Is Contagious
Great service isn’t just about the doctor. Every team member needs to be aligned in delivering exceptional care. It’s a group effort.
Consider sushi master “Jiro Ono”, whose small Tokyo restaurant had a waitlist over a year long. He dedicated his life to perfecting every element of sushi, constantly refining and improving. His commitment to excellence became his best marketing tool.
As Jiro said: “You must immerse yourself in your work. You have to fall in love with your work. That’s the secret of success.”
The Takeaway
Before pouring energy into marketing tactics, ask yourself: “Have I mastered my craft? Are my team and I truly delivering top-tier care?”
A good business, like a good restaurant, eventually fills itself up—because mastery, presence, and consistent quality attract people naturally.
Keep mastering your skill
Ed
Ask Lisa: Are you fully informed about your patient’s injury?
The importance of understanding your patient’s condition
A 2013 Journal of Chiropractic Medicine article discussed a patient with benign neck and upper back pain. However, the patient had recently sustained a “hangman’s fracture” from a drunken fall but did not inform the doctor. A C2 fracture was detected through an x-ray and from further questioning.
The conclusion of the study states:
“Historical experience with similar [cervical pain] clinical presentations in established patients can influence health care providers to assume a benign causation of symptoms. Conscious effort must be exerted to treat established patients with typical presentations with the same diligence as those of new patients to a chiropractic clinic. This case illustrates that an unstable fracture and hematoma can present to a chiropractic clinic as a seemingly benign problem.”
Getting the full story of presentation to the office with your patient is critical for both the SOAP note and eventual third-party reimbursement, particularly with current pre-authorization requirements and patient reporting of subjective symptoms.
Subjective data includes the patient’s perception of their symptoms. You can begin collecting subjective data as soon as the patient first calls in for an appointment, and the doctor following up gathering this information through conversations and patient self-reports on Day One and Day Two.
Your practice management software will have an area to free-form type in a note, and here is where you can indicate why the patient is calling the office to schedule an appointment. The doctor will see this note when they pull up the patient on their computer, or you can verbally relay the information.
It is also critical upon existing patient re-exams to ask and document an additional story of what brings the patient into the office, i.e., any additional mechanism of injury. We all have them as part of this wonderful thing called Life.
Not completely confident with what the patient is subjectively presenting with? Follow your innate instincts and confirm through objective testings.
Email us for a free medicare documentation checklist. services@pmaworks.com
Need further assistance? We can help. Email “Clinic Rescue” in the subject line, to Lisa@pmaworks.com
Lisa
920-334-4561
References:
Fogeltantz, Kay, Ditty, Mark, Pursel, Kevin, (2013 September) Hangman’s fracture presenting to chiropractic clinic as benign neck pain: a case report. Journal of Chiropractic Medicine 2013 Sep;12(3):201–206, PubMeb
Is Your Practice Lacking a Competent Office Manager?
Chiropractic practices with dedicated managers tend to offer better service and generate higher revenue. In my early experience working with a large chiropractic office, the practice included 28 adjusting rooms, multiple associate doctors, and saw over 2,000 visits weekly. The doctor was often away attending seminars or traveling, while the practice manager and the COO (the doctor’s wife) helped run the clinic. Similarly, I recently spoke with a manager in a practice with four doctors, where the owner planned to shift to part-time work, and the manager took on the responsibility of running the practice.
In larger practices, having a manager allowed the owner to focus on patient care, which boosted revenue. Studies confirm the benefits of having a manager. A 2005 study found that small firms with a second-in-command grow 15-25% faster, while a 2018 Harvard Business Review article highlighted that CEOs who delegate to managers increase strategic time, leading to higher revenue. Gallup’s research also shows that good managers increase profits, work quality, and retention, while reducing absenteeism.
Effective managers help doctors see more patients, improve care, and support the staff, all while taking ownership of the business. Some doctors prefer a smaller operation, but others, especially entrepreneurs, want to grow their practices and achieve financial independence. For those doctors, training a manager is key to success.
Our Practice MBA program offers practical, interactive training for managers, focusing on goal-driven leadership. The program includes group and individualized coaching, and it equips managers with the tools to help grow the business and support the team. Enrollment is limited, so don’t wait—sign up now to start growing your business with a trained manager.
Ed.
Goal Driven MBA3 Office Manager Training Information
The Big Practice Barrier: Overcoming Growth Challenges in Chiropractic and Health Businesses
Many practice owners aspire to run million-dollar or multimillion-dollar businesses, but they often face barriers that hinder growth. Despite working hard, many practice owners struggle to achieve the financial success they desire.
The Core Barrier to Practice Growth
In The Millionaire Next Door by Stanley and Danko, the authors highlight that self-employed individuals are more likely to become millionaires than employees. As chiropractic and health business owners, financial success should be a natural outcome—but it isn’t always the case.
While it may seem like poor revenue stems from lack of new patients, poor retention, inadequate equipment, or economic factors, these are just symptoms of a deeper issue. The real barrier to growth is the **Practice Dilemma**—the challenge of providing excellent patient care while managing a growing business.
The Practice Dilemma
New practices typically don’t face this dilemma because they operate at low capacity. But as your practice grows and reaches 60-70% capacity, balancing high-quality service with the administrative and marketing tasks becomes increasingly difficult. The business requires both leadership and management, but most practice owners struggle to bridge the gap between providing top-notch service and handling business operations.
The primary reason many practice owners don’t become millionaires is their inability to balance quality service with effective business leadership.
The Solution: The Fast Flow CEO Systemsm
The Fast Flow CEO System (FFCEO) offers a solution to the Practice Dilemma. It allows practice owners to manage their growing business while continuing to deliver world-class service. The FFCEO system divides leadership and management functions between the CEO (the practice owner) and a trained manager.
The **Practice MBA** program trains a trusted employee to handle management tasks, while the business owner focuses on key leadership responsibilities. This system follows the **Pareto Principle**, which suggests that 20% of your efforts yield 80% of the results. By empowering a trained manager to handle most of the operational duties, the CEO can stay focused on patient care and strategic decisions.
Why Management Training Matters
There is a noticeable lack of management training programs for chiropractic and health business managers. Effective growth requires expert leadership and management, combined with excellent patient care. The FFCEO system enables the doctor to focus on their expertise while a trained manager handles day-to-day operations, bridging the gap between service and business leadership.
Conclusion
If you’re ready to scale your practice and achieve financial success, consider the **Fast Flow CEO System** and the **Practice MBA program**. This approach will allow you to lead effectively while maintaining high-quality care. Take the steps today to ensure your practice’s future success.
Seize Your Future
Ed