Improve Patient Retention Through Gamification

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winner running through the finish line

It all comes back to goals – helping patients achieve theirs.

Last week I discussed improving patient retention through excellent onboarding.

Onboarding is a 21st Century term meaning, in this case, those actions you take with a new patient to introduce and orient them to their new service. The analogy would be a new passenger coming “on board” a new boat. (The link to this article is below.)

The other activity I mentioned that can improve patient retention is also a 21st term: “Gamification.”

Merriam Webster says gamification is: “the process of adding games or gamelike elements to something (such as a task) so as to encourage participation.” The concept is not new, but it has become a science and is integrated into all video games. I cover this in detail in my book, The Goal Driven Business, which I recommend you purchase and use. (Link below.)

Games are native to our species. Even to puppies, as you see them rolling over each other. Kids love to play with their parents, and as they get older, with other kids, and then enjoy organized sports. The Olympic games began, according to one source, in 776 BCE. We love our games, and perhaps, we need them.

Awards

A game poses a challenge where you can overcome barriers and demonstrate your grit. If you win –hurray! Winning is the prize, but sometimes you also receive an award.

In ancient Greece, winners received an olive wreath as a crown. In modern Olympics, the winners receive bronze, silver, and gold medals. In some martial arts, as you advance in your skills, you are awarded different colored belts. When you graduate from college, you receive a nice certificate you can hang on your wall to impress your relatives! (sarcasm)

Your patient has accepted a challenge, along with you and the entire clinic team, to achieve certain health goals. So why not acknowledge or even reward the patient for completing specific benchmarks along the way?

Years ago, I recall some offices would have a special short ceremony for their patients once they completed their program of care. First, the staff would help the patient don a black robe used in graduation ceremonies and a graduation cap (mortarboard) and tassel. Then, they would take a polaroid snapshot (a brand of camera that produced instant hard copy photos) with the doctor and the patient in their graduation garb, give a copy to the patient and attach another to a bulletin board. I have even seen this in a hospital setting, just without the robe!

In Your Practice

Gamification can be applied in your office in many ways.

For example, after completing their 6th visit, the front desk could award patients a silver star sticker. After the 12th visit, they are awarded a gold star stuck to a coffee mug with the office name and logo. Finally, after completing their care program, the patient could receive a diamond star attached to an office t-shirt.

Gamification aims to keep everyone engaged in the “game” of achieving health goals.

One approach to bringing this about is to have a team meeting and go over this idea. Encourage unbridled creativity! Use the best ideas that make the most sense and run the program for three months on a trial basis. Set goals (and awards) for the team for percentages of patients completing their programs.

All these are examples of gamification. But even a “Glad you made it today Mrs. Jones. Good to see you and your daughter” is a kind of an award. Unfortunately, in life, we are rarely recognized for our accomplishments – and mostly for our errors.

So, compliment your patients for their courage to improve their health. It is a big deal and a major accomplishment that they even show up, let alone follow through with their care.

After all, games are fun. So, let the games begin!

Ed

Link to Onboarding Article

Link to The Goal Driven Business

Improve Patient Retention Through Onboarding and Gamification

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It all comes back to goals – helping patients achieve theirs.

Onboarding and Gamification. Now there are a couple of terms you didn’t hear way back in the last century of practice management.

While these terms are new, what they define have been used for years. I do think they more clearly express very useful procedures that can help fill up a practice and help more patients achieve their goals of better health.

Let’s take a look at each:

Onboarding

Onboarding refers to the process of bringing a new employee, or in this case, a new patient, “on board,” as on a boat. According to Merriam Webster, “companies want to onboard their clients and customers too—to get them fully fluent in their products and services, so that they can get the most out of them.”

Onboarding a new patient would include all the basic procedures you do over the first few days of care, including consultation, history, exam, imaging, financial arrangements, and explanation of the application of first services.

There are probably 8-10 essential actions you can take with every new patient, or returning patient, that will make their experience so exceptional that they eagerly continue with their care. However, like most offices, when you are busy, you may take a few shortcuts and only do the bare minimum of procedures to get by, vowing to complete them later.

But later rarely comes. Staff turnover, new regulations, and other disruptions all discard the best laid patient service procedures. Finally, only the very minimal is done.

I call this “Procedural Atrophy.” It happens. It is a “thing.” It happens to all of us. This is why checklists are so valuable. They remind us of all the steps that should be taken to produce the best outcome possible.

For many years, we have integrated a checklist for new patients on our New Patient Log.

When a new patient comes in for their first appointment, their name is manually written on a sheet. At each step along the way, the sheet is checked off as completed. This helps ensure that no step is missed in the onboarding process.

In some offices, we have even added columns for future visits, such as Progress Exam, Progress Report, Completed Care Program. We have then assigned a team member, usually someone in the therapy department, the role of Case Completion Coordinator. Their goal is to coordinate services to help ensure that each patient gets the care they want and need and completes their program. We also assign the Case Completion Coordinator statistics to help them monitor their effectiveness.

Retention is helping your patients achieve their goals of better health. The same would apply to any type of service business.

It is all about goals, yours and especially theirs.

I’d like to keep these newsletters as brief as possible, so next week we will cover how Gamification is yet another tool to help your patients achieve their health goals.

In the meantime, seek your future and stay true to your goals.

Ed

P.S. Reply to this email With Please send me the New Patient Log and Checklist if you would like a customizable Word copy of a sample New Patient Log and Checklist

PSS ALSO, get the Goal Driven Business plus 10 practice building tools –HERE!

Call Your Mom: The most important person in your practice

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mom, mother, daughter, hugging, petty, michel, goal, driven, love“Call your mom!”

When we dropped off our son at college as a freshman that late summer day years ago, I told him: “Call your mom!”

And he did, but not often enough.

The fact that moms are extraordinary is an understatement. They are not ordinary people.

Motherhood just isn’t giving birth or the nine months before — if that wasn’t miraculous enough. It isn’t just the diaper months, the nursing, the crying, or the “terrible twos.” It goes on through all the stages of their child’s life – preteen angst at discovering their identity, infatuation break-ups, finding their social tribe, and all the challenges growing up leads us through.

Mother is always there.

And motherhood never ends. As long as she lives, our mothers are there throughout our lives.

Motherhood is a magical cape that certain women wear, your mom, for instance, that at one time protected you and at another helped you fly. Often without your gratitude.

Yea, dads are around too, often in the background. But moms are the first line of comfort and care, someone who loves you more than themselves.

And if moms are so vital in our lives, they are too in our practices.

Always show special gratitude to the mothers in your office.

This Sunday, May 8, is Mother’s Day. Do something special for all the mothers in your practice. Not as a gimmick but as a sincere act of gratitude and respect. Some offices give a flower to every mother that comes in on Friday or the days before. You can always provide some organic chocolates, a scented soap, or tea.

Yes, there is a marketing aspect to this, but excellent customer service is marketing. In most cases, women see doctors more than men, and mothers are often more dominant in determining and advocating for better health in families. (1,2) They are probably your better patients, and your better referral sources as well.

What if you don’t know if they have children? Well, first of all, you should. You are creating relationships with your patients. But if you don’t know, you can always politely ask them – and you will get to know them even better and strengthen your relationship.

For those who are not mothers, give them a flower to give to their mother. Then, have them post the photo on social media, and you can reward them with something.

So, Call Your Mother, and do something special for all the mothers in your life.

Ed

1. https://www.cdc.gov/mmwr/volumes/66/wr/mm6602a12.htm
2. https://www.huffpost.com/entry/why-men-dont-go-to-the-doctor_n_5759c267e4b00f97fba7aa3e

Chester Wilk Was Not to Be Bullied

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A chiropractor that stood up for chiropractic.

chester wilk: a chiropractor that stood up for chiropractic

THIS IS A SPECIAL NOTE OF THANKS and a tribute to Chester Wilk, D.C., who passed away just a few days ago.

Dr. Wilk was the Wilk in Wilk versus AMA, the case where a federal judge ruled in 1987, based upon evidence, that the American Medical Association had been attempting to “contain and eliminate” the chiropractic profession.

Dr. Wilk and four other chiropractors first filed the suit in 1976. Doggedly pushing it along, Dr. Wilk, colleagues, and attorneys had to keep fighting even after the ruling against the AMA. From Wolinsky’s book, Contain and Eliminate:

“Wilk had earned a reputation as a street fighter. In 1974, he’d written a book of his own, Chiropractic Speaks Out: A Reply to Medical Propaganda, Bigotry, and Ignorance. In it, Wilk made a case for the validity of chiropractic based on scientific research, and he attacked the AMA for trying to stop chiropractic education and block insurance and Medicare reimbursement for chiropractic services. “Chiropractic is not a cure-all, but neither is medicine,” Wilk said.”

“The case was finally settled in January 1992. The amount of the settlement is under court seal. The settlement went toward attorney fees for Wilk et al., plus additional funds went to support a center for disabled children run by a chiropractor in Kentucky and the chiropractic schools with a request from the National Chiropractic Antitrust Committee led by Dr. Chester Wilk, which raised funds for the suit, that the colleges earmark the windfall for research. Not all did.” (Wolinsky)

I had the honor of having lunch with Dr. Wilk and his wife many years ago in Chicago. Later, in 1996, we both presented at a seminar hosted by Petty, Michel, and Associates to doctors and staff here in Milwaukee.

He was not flamboyant and seemed unassuming, but to me, he had a steely commitment to chiropractic, and I could see that he was not someone to be bullied.

Were it not for Dr. Wilk, and many others that worked with him to defend the profession of chiropractic from the illegal acts of the American Medical Association, you might not be where you are now.

The story about the Wilk’s case is a lesson for us all and an example well set.

And whether you are a chiropractor, work in the chiropractic field, work in any health field, or pursue healthy solutions for yourself and your family, no one or no organization has any right to suppress health information from you.

Dr. Wilk was not to be bullied or silenced, and neither should any of us. He stuck to his goals through thick and thin.

Please take a moment to pay your respects to this humble man and how we can continue his work.

Seize the Future!

Ed

PS links:

Dr. Chester Wilks Book: Medicine, Monopolies, and Malice
https://www.amazon.com/Medicine-Monopolies-Malice-Chester-Wilk/dp/0895296470

Wolinsky book: Contain and Eliminate
https://www.dynamicchiropractic.com/mpacms/dc/o2.php?f_id=34

More info about Dr. Chester Wilk https://chiro.org/Wilk/

Dr. Chester Wilk at Petty, Michel and Associates seminar discussing the Wilks vs AMA trail in 1996

Mr. Ed Petty at Petty, Michel, and Associates seminar discussing practice development.

How to Hire the Best in 2022

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Again, its all about the goals.

On occasion, you may need to hire a new team member. We always help our clients with hiring and “onboarding” new employees on our major consulting programs.

We have been hearing a lot about millennials not wanting to work, people don’t want to work, and it’s hard to find good employees.

I don’t buy it. We have been hiring great employees.

You must understand and appreciate the seismic changes that have been occurring in society. The workplace is not what it used to be.

The Assembly Line

I discuss this a great deal in my book, The Goal Driven Business.

The Industrial Age needed an industrial mindset for a workforce. As a worker, you were a cog on the assembly line. You checked out of your life when you punched in and checked back in when you punched out. Not much was required from you…except your brawn and obedience. It was a machine world and required mechanist minds and behavior. The employee worked just as hard so they wouldn’t get fired, and the employer would pay just as little so that the employee wouldn’t quit.

We have long since passed the Industrial Age, but our work culture hasn’t changed that much. The worker at the sandwich shop asks you what you want on your lunch sandwich, the cashier totals your groceries, and the therapy tech at the hospital follows their checklist.

But a reckoning has been on its way for some time.

And that time is now.

Many factors have culminated in today’s “hiring crisis.” It is a perfect wave, of sorts.

OK Boomers

But let’s first dismiss the judgments from the “OK Boomers.”(“OK boomer” is a catchphrase and Internet meme often used by Gen Z to dismiss or mock attitudes typically associated with baby boomers.” Wiki.)

Older generations have always viewed younger generations as flighty, fickle, and poorly motivated workers. I am one of the hardest workers I know, but my dad didn’t think so when I was stumbling around after college trying to find something to sink my teeth in.

While the youthful uncertainties of work may not have changed, there has still been a dramatic shift in our culture.

Financial Changes

Millennials are in debt the way no other generation ever considered. Today’s average college tuition is 31x more than it was in 1969. (1. Yahoo) Total student loan debt is 1.75 trillion. (For comparison, the U.S. Budget in 2020 was 6.6 trillion) with the average borrower owing $29,000.

We have been in an inflationary spiral, with housing leading the way. Generally, the cost of living is rising. The increase in the Consumer Price Index for March is equivalent to an annualized rate of 15.4%, the largest 12-month increase in 40 years. (2)

So, finance is a factor—a big one.

Goals, Values, and Meaningful Work

In 2015 Gallup, surveyed over 80,000 working adults. The majority (51 percent) of employees were unengaged at work, while another 17 percent were actively disengaged, for a total of 68 percent not engaged. That means that nearly 2/3rds of the workforce were dissatisfied with their jobs and ready to make a change.(3)

COVID 19 sent a shockwave throughout the work-a-day world. It jarred employees out of their jobs and they were now free to pursue something more in line with their new values and purposes.

One office we work with recently hired a C.N.A. who had quit their prior employment because they did not want to get the COVID jab. They felt that the medical approach they were forced to follow was not aligned with their own values and goals. As a result, they took a new position at a chiropractic office we work with and now happily feel part of their new family.

Indeed, a hiring company, states:

“A work environment that possesses organizational culture is driven by purpose and clear expectations. This motivates and inspires employees to be more engaged in their work duties and interactions with others.”

One of the major processes we work with the business owners is helping them and their teams delineate their own values that they aspire to each day. Positive team culture can be better created and maintained by regularly reviewing these values.

One very competent employee we recently helped hire for an office was so impressed with the Core Values on the office website that she knew this was her place. She has since joined the team and is a high producer.

Emphasize Your Goals and Mission

Employees want security. They are not necessarily looking to become wealthy, at least in the short term. You may need to review your pay scale for your team and make gradual adjustments in these inflationary times.

But we all have intrinsic goals, which include our values, and these take precedence. Work these out for your business and nurture them often. Stay true to them. In promoting for new staff, communicate your values and just how rewarding it is to work with your practice.

Become Stronger to Withstand Future Reckonings

I anticipate more “reckonings” and seismic shifts in the not-too-distant future that your business will have to weather and overcome. The world is changing quickly. The stronger you are, the better your chances of surviving and thriving.

  1. Read and apply my book, The Goal-Driven Business.
  2. You can also set up a no charge appointment to discuss how we can help strengthen your business and make it more profitable. Make an appointment for a no-charge call consultation here. LINK
  1. https://finance.yahoo.com/news/average-cost-college-jumped-incredible-122000732.html
  2. https://www.investopedia.com/inflation-jumps-again-in-march-2022-5225599
  3. https://news.gallup.com/poll/188144/employee-engagement-stagnant-2015.aspx

Insurance Key References

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Following is a list of links to various publications with helpful information on insurance filing guidelines and requirements.  At the bottom is a convenient downloadable document with all of this information listed.
~~

Wisconsin Worker’s Compensation Treatment Guidelines DWD CH 81.04
https://docs.legis.wisconsin.gov/code/admin_code/dwd/080_081/81

General. Except as set forth in par. (b) and s. DWD 81.04 (5), a health care provider may not direct the use of passive treatment modalities in a clinical setting as set forth in pars. (c) to (i) beyond 12 calendar weeks after any of the passive modalities in pars. (c) to (i) are initiated. There are no limitations on the use of passive treatment modalities by the patient at home. DWD 81.06(3)(a)

Wisconsin Worker’s Compensation Tx Guidelines Departure from Guidelines / Exceptions
DWD 81.04(5) (5) Departure from guidelines. A health care provider’s departure from a guideline that limits the duration or type of treatment in this chapter may be appropriate in any of the following circumstances:

Wisconsin Unfair Claims Settlement Practices
Ins 6.11  Insurance claim settlement practices.https://docs.legis.wisconsin.gov/code/admin_code/ins/6/11/3

Wisconsin Medicaid CMS1500 Claim Instructions
https://www.dhs.wisconsin.gov/forms/f0/f01234a.pdf
https://www.forwardhealth.wi.gov/kw/pdf/2008-89.pdf

Wisconsin Medicaid – New Requirements and Clarification of Chiropractic Services
https://www.forwardhealth.wi.gov/kw/pdf/2016-35.pdf

Documentation, SOI, 20 visit limit, exam clarification.
State of Wisconsin Insurance Equality
632.87(3) Wisconsin Insurance Equality Chiropractic

Medicare Supplement Mandated Benefits Wisconsin
https://oci.wi.gov/Documents/Consumers/PI-002.pdf
Medicare Supplement and Medicare SELECT policies cover the usual and customary expense for services provided by a chiropractor under the scope of the chiropractor’s license. This benefit is available even if Medicare does not cover the claim. The care must also meet the insurance company’s standards as medically necessary.

Wisconsin Provider Manual Anthem BCBS
https://www.anthem.com/docs/public/inline/PM_WI_00006.pdf

Wisconsin Anthem BCBS Commercial Reimbursement Policy
https://www.anthem.com/docs/public/inline/C-08010.pdf

Wisconsin Anthem BCBS Commercial Modifier Rules
https://www.anthem.com/docs/public/inline/Modifier_Rules_2021.pdf

Downloadable Reference Guide: Insurance Key References

Relationship Marketing: Build and sustain your practice through relationship marketing

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You are in the relationship business.

People see you for a result – but they stay with you because of the relationship.

There are many different definitions of relationship marketing – marketing isn’t codified like CPT®! (That is maybe a good thing!)

Last week I talked about direct response marketing and indirect or brand marketing. Relationship marketing stems from direct response. It emphasizes retention and patient and customer satisfaction.

Relationship marketing works. It helps with patient retention and patient referrals. It also helps generate referrals from external sources.

But what is it, and how do you improve it? 

What is a Relationship?

A relationship is a connection that you have with another person. It is based, ultimately, on communication. Therefore, the quality of that communication determines the quality of the relationship.

Good communication, one that creates a good relationship, centers around understanding. As Stephen Covey advises, Seek first to understand, and then to get understood. Understanding is fundamental for good communication.

The relationship between you and your patient depends on results, of course. But to get results requires understanding the patient. Seeking to understand the patient – showing them a genuine interest in their condition and life – is not only needed from a clinical point of view, but it is vital for good communication and developing the relationship.

How to Improve Patient Communication

Patient Care can be an overused, even over-advertised term. But care is founded first on interest in and concern about the other person.

This means not just going through your script (yuck!) or your checklist with the patient, which may help keep you on track. It means do you understand them, or how and why they came to you? Are you interested?

But how do you do this after the 10,000th patient comes in to the office?

By being a real person who is interested. For example, a patient comes in and wears a green hat. You wonder about the green hat, so you ask them about it. “Hi. I can’t help but notice that you are wearing a green hat. It looks…stunning! Any special occasion?”

A checklist can help you communicate important information, but it can’t take the place of a real live person. It can’t make a relationship. You are not a robot, and neither is your patient.

Be appropriate and respectful, but mostly, be authentic.

This creates trust because your customer sees that you are interested in them as a unique person, not the 10,000th customer. And they see you as a real person, not just a busy professional trying to be interested but really faking it.

I am sure that you have experienced employees in other businesses trying to be interested in you but merely following a script. A bank teller asks me: “Have plans for the weekend?” I am nice back, but I know that she is just doing what her MBA executives in some office far away think she should say.

So, honest and interested communication, added with services and results, will create a strong relationship between you and your patient.

Outside of Your Practice

But relationship marketing goes beyond just your office.

Your patients know people. They can help you get to know their family, friends, and business associates.

You can create relationships with other professional practices, businesses, and organizations. I have seen many examples where a relationship was created between the doctor and an outside entity that resulted in many new patients.

Some examples:

  • YMCA’s and commercial gyms whose owners and managers were also patients.
  • Dentists who didn’t treat TMJ.
  • MD’s who didn’t want to deal with patients with back pain.
  • Ballet company that wanted to keep their dancers in shape.
  • High school coaches who wanted to see their athletes do their best.
  • Motels who needed a “house” medical doctor, dentist, and chiropractor.
  • Autobody shops that took care of injured cars and sent injured passengers to the chiropractor.
  • R. managers at companies who referred employees.

And this is vital: the relationship must be between you and another person associated with the outside entity. You are always dealing, first, with one person.

I have used this definition for years, and it still holds true:

A practice is a network of relationships
 that is created and maintained through service and communication.

There are specific barriers to implementing relationship marketing, and you will run into them. I want to keep this article short, so I will refer you to my book below, which addresses the barriers and how to avoid them or bust through them.

But regardless, just communicating more with more interest will bring in more new patients and keep the ones you have longer.

Communicate more and with interest.

And…

Seize the Future (That is where your goals are!)

 Ed

Link to the Goal Driven Business Book

Link to the Video Supplement to Relationship Marketing

Which is Better for You: Direct Marketing or Indirect Marketing?

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Last week I sent an email with a link to Ode to Joy.

Ode to Joy is from Beethoven’s 4th movement of his 9th symphony, considered one of the top three symphonies ever created.

It was a short 5-minute rendition. It is beautiful and evocative – listen to it again. (Link below.) Plus, its performance was a masterpiece.

But it was actually an ad.

It was a brilliant advertisement for a Spanish Bank. It was promoting Sabadell Bank’s 130th year anniversary in 2012. According to one website, it has had 90 million views since 2012, while another posted in 2015 has received over 18 million views.

That is a lot of exposure. But does it generate new business?

This type of advertising is called brand marketing, or what I call indirect marketing. It is the opposite of direct marketing. Direct marketing, also called direct response marketing, tries to generate an immediate response. Knowing the differences will help you manage your marketing and make it more effective for your particular situation.

Direct Marketing

The goal of direct response marketing is to generate qualified prospects that respond to an offer. When you receive a card in the mail that promotes a free dinner about retirement funds, the company that sent you that mailer hopes you reply and attend the dinner and accompanying talk. At the dinner, a speaker gives a presentation with the hope of scheduling you for a private consultation later that week. When you see an ad on Facebook for a free manual, the advertisers intend that you respond and order their manual. The distinguishing characteristic of direct marketing is numbers – you can quantify the results of your marketing efforts.

Indirect Marketing

The goal for indirect, or brand marketing, is for the name of your business to be well known and well thought of. When you volunteer at the local food bank, co-sponsor a kid’s little league team, or simply provide excellent customer service, these are all examples of indirect marketing. The results of indirect marketing are difficult to identify immediately.

Until you are in Stage 4 in the growth of your business (about 75% or more full capacity), most of your marketing efforts should be direct marketing. Indirect marketing supports direct marketing, but even if your entire town knew about your business and thought highly of it, there is no guarantee that anyone would come to see you as a customer.

Handing out your business card to someone would be an example of indirect, personal brand building. However, handing out your business card with a handwritten note on the back that said something like “N/C screening in May for Joe M. Dr. EP” might be an example of a direct response marketing.

Marketing Mix – Direct, Indirect, and Internal, External

Another factor to consider in managing your marketing is how much should be directed externally – to non-patients and customers and how much should be directed internally to your existing and former patients and customers.

It has been my experience that too few practices are industrious enough with marketing to and communicating with their existing and former patients.

Below is a chart that gives approximate percentages of how to balance your direct and indirect marketing for your practice. I have divided the development of a business arbitrarily into 5 Stages. Figure each Stage to be about 20% your full capacity.

Telling your story and the successes of your services should never end, regardless of how successful you are. Change your marketing strategies depending at what Stage of development your business is in — but keep marketing.

Carpe Posterum (Seize the Future),

Ed
GoalDriven.com

Ode To Joy

Make each day an Ode to Joy!

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“Music is … a higher revelation than all Wisdom & Philosophy”
― Ludwig van Beethoven

Takes 5 minutes. This is an inspirational musical event. The link is below.

It is worthy of the best humans have to offer – and akin to what you provide innately to your patients – as doctors, providers, and support professionals.

Match this with all you do in April and you’ll have a great month!

-Ed

 

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.

What You Must Do Before You Try to Improve Your Practice

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

Too often, we stop doing what worked and yet wonder why our business isn’t doing as well as it had in the past.

When I would visit an office that wanted to improve, I would initially ask them what they were doing when the office was performing better?

The staff and doctors would pause, think, and gradually, the answers would begin. “Well, we used to call the new patient after the first adjustment…” “We used to have a radio program…” “We used to send out birthday cards… “We used to ….”

After each answer, I would ask, “Well, are you doing that now? The answer was usually “no.”

If business is improving, if the scoreboard shows that you are having a winning season, why stop doing what is working?

Keep doing what works!

This may seem obvious. It is. But we all fail at this one time or another, so it bears repeating.

What keeps us from continuing to do those things that are most successful? Boredom, staff turnover, or a momentary crisis when many procedures get washed overboard.

All offices suffer from what I call Procedural Atrophy – a gradually wearing away of what works. The result is only the very minimal procedures that keep the doors open are performed. Progress exams are no longer done, and the front desk no longer smiles when answering the phone.

The Goals Achieve Process – Now You Can Improve

You want to improve your business – provide better service, increase revenue, decrease stress.

But first, ensure that you are still doing what you were doing when you were doing well. Keep applying your successful procedures!

THEN, make improvements.

Various organizational processes are used in large companies that entail a sophisticated method of improvement, sometimes called Kaizen, Six Sigma, and Lean. Kaizen is a Japanese process developed by an American, but you can earn a “Black Belt” in Six Sigma. (I know. Confusing! People get paid big bucks for this stuff!) We have a very simple improvement process called the Goals Achievement Process outlined below.

  1. Review your numbers for the last few years.
  2. Notice when you were doing better.
  3. Make a list of the procedures, projects, and policies that were successful then.
  4. Also, include the level of your motivation and your attitude, and what you were doing to keep you inspired during those times.
  5. Get the successful procedures on checklists for your team to implement and ensure they are done again.
  6. Assign your manager to ensure that these procedures stay in place.
  7. Do a version of this each month, over and over.
    1. Review what worked and what didn’t the prior month.
    2. Check what procedures weren’t done or done well, or need to be improved, or discontinued
    3. Make a 4-6 step plan for the new month to improve those areas that need improvement.
  8. Optional: Use a professional coach/consultant to help you keep everything on track and improving!
  9. Also, read The Goal Driven Business.

In an entrepreneurial practice (the Personality Driven Practice), the owner is good at using their creative energy to get things started. And while this burst of energy is essential to start a business, it usually doesn’t continue once the “newness” wears off. So, they go in search of a new “shiny thing” to implement or try in their Practice.

A Goal Driven and systematized business works both creatively and methodically to become expert at doing the same procedures over and over, each time as if it was the first time. There is a vast difference between the amateur or serial entrepreneur and the expert who is still training and working to improve.

As Clarence Gonstead said: “Practice. Practice. Practice. Never stop.”

Stay on the Rails

It helps to think of your business as a train. You gradually build up speed and momentum. Keep doing what is working and keep it on the rails. Then, improve it.

Have a great week!

Ed

A new review for the book The Goal Driven Business:

A MUST-READ FOR ANY BUSINESS OWNER!

Throughout the years of my Practice, Ed has helped coach our staff and change our thinking from “personality” driven to “goal” driven – allowing my office to stay open and profitable whether I am here or taking time off!

This book is so easy to understand and gives you real steps to take now in your business. I highly recommend this book to anyone who currently owns a business, is thinking about owning a business, or is a manger of a business!

Donna Brown, D.C.
Business Owner, Group Practice

The Missing Role in Your Practice

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The cause of almost all relationship difficulties is rooted in conflicting or ambiguous expectations around roles and goals. Stephen Covey

The reason many offices have a difficult time growing has to do with missing roles.

A role is the identity assumed to perform a series of tasks that produce a specified outcome.

In the hundreds of offices that we have visited over the years, the doctors take on essentially two roles: doctor and owner. This works in the beginning for a few years as the practice grows. In time, however, the practice begins to roller coaster. Numbers go up, then they go down, cycling up and down until everyone fatigues and just settles.

There are several causes for the Practice Roller Coaster. There are hidden barriers that hold an office back and sabotage its growth. These are covered in my book, The Goal Driven Business.

One of the barriers has to do with a missing role that most business owners overlook. Can you guess which one that is?

Let’s look at goals: What is the goal of a doctor? “A healthier person,” right?

What is the goal of a business owner? A secure and solvent business. Dividends from ownership.

What is missing? The doctor can achieve their goal by seeing 10 people a week. As a business owner, they can keep their overhead very low – perhaps working out of their home. But is that what you really want – to see 10 people a week out of your house? Overhead is low and you are getting good results. So, what is missing?

The CEO – the chief executive is the missing role. The goal of a CEO is a very profitable business that operates at full capacity providing world class service and delivering extraordinary results.

The CEO is the chief manager, leader, and marketer, which are the three functions that drive the business to its goals.

Sometimes we hear the doctor being referred to as the “boss,” but boss is not a well-defined role. “Boss” is generally recognized as the person who gives orders and makes decisions. However, it is an overlay of an existing role, as in a “bossy” doctor or “bossy” owner. The role of a CEO is much more than this.

Most providers are too busy providing services to do much managing – and besides, they are paid for their services, not their managing or leadership. Doctors are trained to manage patients, not businesses.

Still, this is a role that must be fulfilled as distinct and separate from the owner or provider roles if the business’s full capacity is to be achieved.

Three Functions of the CEO

The role of CEO includes these functions:

  • Leadership: Leadership is all about goals. It defines where you are going and why and helps everyone you work with embrace this knowledge with commitment. Leadership includes your mission, long-range plans, values, and … the insistence upon achieving them.
  • Management: Management deals with how to get to the goals. Management works to ensure that people and procedures are effectively working and improving.
  • Marketing. Marketing includes procedures and projects that help generate new patients/clients and retain them. Marketing is business, and business is marketing.

Once your practice is at least at 50% capacity, a couple of hours spent each week on effective leadership, management, or marketing activities as a CEO is worth 8 hours or more doing anything else. For example, time spent going to a seminar – perhaps 20 hours including the transportation, may increase your numbers for months afterward. A little can go a long way.

Because the role of practice CEO must be very part-time, we have developed the Fast Flow CEO System for the Goal Driven Business. This can take as little as 2 -3 hours per week, depending on the scale of your business. Here are five components of the Fast Flow CEO System:

  1. Get Out to Work On. Regularly take time to get out of the business so that you can work on your business.
  2. The CEO Works for the Business. The business does not work for the CEO. Sure, the business works for the doctors so that they can provide better service to the patients. But that is for the doctor. Sometimes called “servant leadership,” the CEO is the Chief Coach, helping others understand the goals and how to achieve them.
  3. Team Members. The CEO works to create team members who take on a portion of departmental management, marketing, and leadership.
  4. Manager. The CEO creates the role of manager and delegates a team member to assume this as a part-time role. The manager can take on much of the CEO’s daily and weekly duties.
  5. Study. The CEO studies leadership, management, and marketing to improve their skill as a CEO. Leaders are … readers!

Certainly, all this requires some skill and training – and coaching! But just clarifying the role of CEO and its expectations as distinct from the roles of owner and doctor (or “boss”) will significantly improve your chances of breaking out of the Practice Roller Coaster and achieving your goals.

Ed Petty

March 14, 2022

Motivation

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No matter how many goals you say you have or how you write them out, unless you have the motivation to achieve them – you won’t.

“Motivation is the driving force behind the energy required to complete a task… a person’s willingness to exert physical or mental effort in order to complete a goal or set aim. (Psychology Dictionary.org)

This is a key element in a Goal Driven Business.

You first need to define your goals – and they must be practical as well as meaningful. But you also need the drive to achieve them. Without the drive, the motivation to get to where you want to go, you are just a poser in the business world.

(Case #345) The doctor and I had discussed a plan to motivate his team and increase production. This was many years ago. Over lunch, we had a team meeting to announce the plan to his other two doctors and about 10 support staff. He announced that if certain goals were met over the next 7 months, everyone could get a trip to Hawaii.

Everyone was shocked. Including me! The doctor and I had discussed a two-month plan for rewards based upon a modest performance improvement – but not Hawaii and not the increase in production he wanted. He came up with this on the spot during our meeting.

But that afternoon, amazingly, the phones lit up. People were calling in for appointments. (Never mind that this was an example of Innate or Quantum Entanglement!) As I recall, they had their best month ever. But unfortunately, they soon realized that the goals were unrealistic, they had little support to achieve them, and the doctor saw that he couldn’t afford it even if they did reach their goals. The practice subsequently went into a long-term slump.

==================================================================

What is the lesson? Well, there are a few of them, but I want to focus on motivation.

While it may seem like people become motivated because of the “carrot,” or the reward, there are deeper reasons – or principles.

Edward Deci, along with others, put forth a new framework for motivation called Self-Determination Theory. Essentially, it states that we are all driven by intrinsic goals as part of our fundamental nature. Our reward comes from the satisfaction we feel from the achievement more than from any external prize.

These are the three intrinsic goals we all share:

AUTONOMY. We all want to play in our own sandbox! We need to feel in control of our own corner of the world. Just like we don’t like insurance companies intruding into our clinical decisions, staff does not like being micromanaged.

COMPETENCE. We all want to be superheroes! Deep down, the prospect of becoming more skilled, more masterful, and better able to be in control of our environment is a drive we all have.

CONNECTION. We all want to be part of something bigger than ourselves. This manifests in two ways: a) being part of and working with a supportive group or team, and b) working to help bring about something more significant than our paycheck or the accomplishment of our everyday tasks.

The office staff was excited to go to Hawaii, but this was not necessarily because they could lie in the sun. It was because it was a huge goal that gave them a very large sandbox to play in – together – to work for a very large result.

Self-Determination Theory is why games work. In Kevin Werbach book, For the Win, he discusses the subject of Gamification.

“For thousands of years, we’ve created things called games that tap the tremendous psychic power of fun. A well-designed game is a guided missile to the motivational heart of the human psyche. …monetary rewards aren’t even necessary because the game itself is the reward.”

Whether it is a sporting event, video game, or Sheepshead (a popular game of old-time Wisconsinites, so I’ve heard), we love our games. And I think we need them.

But it all goes back to the principles of Self-Determination Theory.

Remember when you started your business? The challenge that lay ahead? The new business card that identified you as the hero to conquer new plateaus?

Those drives are still there and can be rekindled, regardless of prior disappointments.

As Soon as You Make a Goal—You Have Created the Potential for a Game.

Win or lose, IF the principles of Self-Determination Theory are in place, you will be motivated and so will those with whom you work.

Apply these principles to yourself and your team – for the game, for the fun, and for the win!

Seize the Future,

Ed

For more information on how to apply self-Determination Theory, games, and motivating yourself and your team, please purchase the book,
The Goal Driven Business. [Link to sell page]

 

Everything Else: Why The Goal Driven Practice is More Profitable and More Fun

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What gets in the way of you growing your business?

What holds you back from your growth? From increased services and profits?

What keeps you from providing better services and improving your marketing results?

The government? Your childhood? Your neighbor’s cat?

One thing that is NOT holding you back is chiropractic or whatever services and skills you provide.

It is everything else.

When you are first growing your business, and let’s say you are barely at 40% of your full capacity, your practice may be performing well. You may have an assistant, but for the most part, you can see patients and generally oversee the operation of your practice. Life is good, and the future is … wide open.

But almost imperceptibly, as you start seeing more and more patients, the tide of administrative demands starts rising.

Eventually, you can look around your desk and see “undones” and “half-dones” and a hundred or so “to-dos” littering your office, smartphone, computer, and brain. You try to keep up, but there seems to be just too much to do.

So, what do you do? There seems to be only one solution – you settle. You settle into a comfort zone just to a point where you can earn enough to pay your bills.

Growth becomes a trap, and after many attempts to reach your goals, you finally settle.

Is there a way out?

Yes. But it has been hidden. And booby-trapped.

But you should know, after years of observation and analysis, what is holding you back is not your lack of effort. It is not chiropractic or your professional services.

The fact is, you can’t really get to where you want to go from where you are now. You can’t get there from here.

You need to make some major Big Shifts. 

To get to your goals, you have to start from a different place and build a newer version of your business. This is your next stage. Stage One is survival and entrepreneurial growth. It is a Personality practice.

Your next version is a fast, more advanced business that will take you to your goals and beyond.

The new version is called a Goal Driven Practice.

To achieve this requires making some significant changes or Big Shifts.

MANAGER OR ADMINISTRATIVE ASSISTANT (BIG SHIFT #7)

One of the solutions to breaking out of the trap and moving closer to your goals is assigning someone on your team to help you with…Everything Else.

This could be a manager or an administrative assistant. In either case, the role would probably only require 5-8 hours per week – at least at first.

One of their goals would be to remove everything from your desk, all your to-dos, all administrative traffic, sort it for you, and then work out with you what should be done with each item.

You would delegate, delay or dump each item.

This would help free you to increase your services as a doctor and give you time to expand the business as the CEO.

You can produce $500 to $1000 in services per hour as a provider if you are unfettered. As the CEO, you can direct your business to produce much more than this per hour. So, why are you spending time drowning in trying to do $20 or even $30 an hour jobs?

Everything Else gums up the works. It slows you down, confuses the staff, and the patients feel the confusion and notice the neglect, however slight.

This is why I came up with the Goal Driven System. It unmucks the gears of your business so that you can freely provide services and not be haunted by the looming demands of hundreds of to-dos.

This is covered in the book, The Goal Driven Business. If you can do this, you will be more productive and have more fun.

This is so valuable that I will be scheduling upcoming Zoominars on this subject for you and your manager. And stay tuned for upcoming programs on manager training, and training and even coaching on the Goal Driven System.

And just, just for fun, (I am smiling) don’t miss this future article:

The 2 Management Consultants from Petaluma California.

Seize the future

Ed

For more information on The Goal Driven System visit Goal Driven

Goal Driven Job Descriptions

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playbook goal chart

In a Goal Driven Practice, Goal Driven Job Descriptions are short, fast, and to the point.

And they are used!

They help improve the quality and quantity of services and are motivational.

So, how is this different from other job descriptions?

Most job descriptions are usually a hodge-podge and catchall of unrelated tasks. For example, the front desk job description may include getting supplies, taking x rays, calling attorneys, and scheduling patients. Billing may include marketing and equipment repair.

Staff will do the tasks assigned but end up zigzagging from one function to another, losing focus on what they are doing, and often disengaged in their activities.

In typical job descriptions, the goals are not clearly defined, measured, nor are the expectations stated. Further, employees don’t always see or get recognized for the results of the work detailed on their job descriptions.

Yet another failing of most job descriptions is obvious – they just aren’t used.

Let’s look at how to power up job descriptions so that they are Goal Driven.

Many job descriptions contain the duties of several different roles. A role is an assumed identity. For example, in a restaurant, there are the roles of a server, cashier, dishwasher, and chef, or cook. In a small restaurant, one person may take on a number of these roles, and all these roles would be their job description. Hence the idiom: “chief cook and bottle washer.”

But to be effective, each role needs to be separated, well defined, and organized with the other roles.

In a Goal Driven Practice, job descriptions are broken down into different roles and described in job checklists.

The job checklist begins by clarifying the goals. This includes the mission, the outcomes, what is used to measure performance, and the level of performance expected of that role.

For example, for the role of Patient Accounts, the mission might be something like: “To help the patient pay for all of the services they received in such a way that they will continue to receive services.” The outcome might be a zero balance or “no accounts receivable more than 30 days.” The statistics used to measure this role could be the “percent of collections to adjusted services.” And finally, the expectation might be something like: “All patients very happy with the encounters with Patient Accounts and continuing with their services, with a collections percent of at least 95% of adjusted services average.”

We now list the most important procedures to achieve this goal. The CEO of the office defines WHAT the goals should be – that is leadership. But the manager and those working in patient accounts would work out HOW the goals would be achieved.

Encouraging the team member to define the best procedures to achieve their goals empowers them and gives them autonomy and responsibility for their role. According to Self-Determination Theory, real motivation is intrinsic. It comes from one’s desires and needs rather than external rewards or threats. Edward Deci, in his book Why We Do What We Do, says people “strive for personal causation.” (This is more fully covered in my book, The Goal Driven Business)

If the cook understands that their goal is to make tasty meals that the customers enjoy and for which they will pay, they can be more responsible for how best to achieve that goal.

A team member may have five or more roles, each with a job checklist, as part of their job description. As the doctor and owner, you may have 25! (And if so, that could be a big capacity barrier right there!)

Once the goals are clearly defined … and kept in mind, the rest of the checklist can be easily worked out.

Once per month or more, you or the manager can meet with each team member and do what we call a Coaching Review. This is a fast review of employee performance: at what they are excelling and at what they need to improve. In addition, the job checklist can act as an assessment.

But it is all geared around the goals of their roles. You also ask them what could be added or changed to improve both the quantity and the quality of their outcomes. They can make the changes to the job checklist and make sure you have a copy.

None of this takes a long time to do each month.

Management of your office is not just about getting procedures done. It is about constant improvement in the quantity and quality of their goals.

You may have told your patients something like: “If you do not make time for your wellness, you will be forced to make time for your illness.”

The same applies to managing your business. “If you do not take time to improve your procedures and your people to achieve the goals in their roles, you will be forced to make time to rebuild your practice.”

Steven Covey, in his book The 7 Habits of Highly Effective People put it simply and best:

Begin with the end in mind.

 

Ed

The Goal Driven Front Desk

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A dynamic front desk can increase your visits by 20%, maybe more if you have the room. On the other hand, a dysfunctional front desk can constrict the flow of patients and hold your office back.
I have seen instances of both.
There is much more going on and at stake at the front desk than most doctors and staff appreciate.
Ordinarily, you would think that the billing department is the most demanding. There are hundreds of details that need to be learned and followed with excellent discipline. This position requires professionalism and expertise.
But this function is not on the front lines of the constant patient, phone, and doctor interactions and interruptions. Managing patient accounts can be regulated and organized to maintain a calm and comfortable workflow.
Therapy and adjunctive services are often undervalued, but the patient flow is usually smooth, and they are not faced with unexpected patients or phone calls.
It is interesting to note that the front desk has the highest turnover in most offices.
But properly set up and managed, this department can be an engine of growth and stability in your office.
Let’s look at some of the more important attributes of the front desk:
  1. It represents you and your services. It is your ambassador to the world outside your office. The front desk reflects what you stand for and the quality of your services.
  2. It is the first and the last contact – and impression –with anyone in the office.
  3. It can convert inquiries to new patient appointments.
  4. Rapport and relationships. The front desk can provide world-class service to patients, improving patient retention, reviews, and referrals. (The 5 Rs)
  5. Direct marketing. The front desk can directly promote clinic services to patients, hand out coupons, and promote upcoming events to generate patient referrals.
  6. Team member support. The front desk can support the insurance department and all team members to create a positive, upbeat day every day.
  7. Case Management. The front desk can contribute to case management by relaying any comments or observations relative to the patient’s care to the doctors.
  8. Fully Scheduled Day. The front desk fills the appointment book and keeps it full.
Let’s imagine an ideal front desk and put it at a “5” on a 5 Point Scale.

 

5. GOAL DRIVEN FRONT DESK. The appointment book is full. The front desk staff are cheerful, having fun doing their jobs, and genuinely interested in every patient and phone inquiry. They sincerely care for each patient and non-patient. They have a strong intent on helping patients complete their programs by keeping their appointments. They personally and professionally want to achieve the mission of the office and encourage patients to help them accomplish this mission by bringing in family and friends. They also help the rest of the office achieve the office’s mission. They are sending out positive “vibrations” to help more people. They are proactive and Goal Driven.

 

Below this level, we find the front desk that is struggling.

 

2.5 A COPING FRONT DESK– The appointment book is 50-70% full. The front desk is trying, but it is not keeping up, which creates a bottleneck to patient flow. (Subluxated) Even though the staff wants a full appointment book, subconsciously, they don’t want any more work until they catch up.

 

2. A SLOW FRONT DESK. The front desk operates at a “comfortable” 40-50% capacity. The staff is pacing themselves, keeping up with computer tasks, insurance, and following the scripts for phone and patient encounters. However, they are mostly disengaged from the front desk and office goals.

 

1-2. GIVEN UP and BORED. I only describe this because I have seen this condition. The staff is ignored or badgered. In either case, they feel relegated to a 4th class employee. They hide out and pretend to work, essentially having quit and just waiting until something better comes along.

 

You can create a Goal Driven Front Desk. It is not achieved overnight, but once it is established, you’ll be close to a dream practice and a Goal Driven Business. We will cover some tips on how to create a Goal Driven Front Desk in another newsletter.

 

In the meantime, stay Goal Driven,

 

Ed
“Your brain sends out vibrations all the time, and your thoughts affect your life and other people’s. They pick up these thoughts and get changed by them.”
– Bruce Lipton (Biology of Belief)

How to Create a Full Appointment Book with Goal Driven Marketing

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busy desk, planning calendar

Happy Valentines Month!

This article is about sharing the love… the love of your services and how they can help people.

And what is the best way to do this? Create a Goal Driven Business.

A Goal Driven Business runs at FULL CAPACITY, or close to it.

That means no more room in the appointment book. It can mean that there is a waiting list to get in to be seen. But how is this achieved?

In a practice, it is a combination of excellent service and clinical results, inspired leadership, sound management, personal integrity, and … marketing.

Let’s take a took at marketing first. What is marketing?

It is a method of helping people get what they innately want through communication. Marketing communication, either through one-to-one contact or through media, communicates and educates in such a way as to point to what an individual wants. It also can inspire them to get it.

Goal Driven marketing is helping people get to their goals!

People want to be free of pain and discomfort, but they do not know about your services or how your services can achieve this. And if they do, they may not trust that you can do it for them.

Every marketing approach you have must help those people who have a particular need or want to find you, and discover how your services can help them, and why they should trust you. This can be accomplished through patient referral programs or events, setting up external alliances, direct response ads in social media, radio, through one-to-one external relationship building, speaking events – all these and more point to how you can help people and that you can be trusted.

Testimonials and reviews top the list, but so do articles, newsletters, and support from opinion leaders. These are all outward types of marketing communications.

What would someone who knows what you know about your services do if they had pains, or lacked mobility, wanted to improve their immune system, and just be healthier? They’d drop by and see you for an adjustment or for some kind of a treatment from your office.

Not everyone wants what you have to offer, and even fewer want it bad enough to do something about it. But there are more than enough people who are looking, right now, to act who could keep your office full – if they just knew about what you could do for them.

Many times, I have heard chiropractors amazed at comments from patients who say, “Headaches? I didn’t know you could help with … headaches!” And the doctor just assumed everyone knew that they fixed headaches!

Don’t assume anything. It is a noisy world, and you and what you do is drowned in the snow storm of competitive messages and personal activities.

You must be industrious in getting your message out. You have to be continuous. And this is where most doctors fail in their marketing.

Marketing fails because it is not systematized,
organized, continuous, and managed.

A Goal Driven Business focuses its marketing three echelons of activity.

  1. Marketing Procedures. Obviously, the different types of marketing communication and marketing procedures need to occur. This is the most evident (and fun) level of marketing – marketing procedures.
  2. Marketing Motivation. But even if you have bookshelves of marketing binders and libraries of marketing books, they will do nothing unless you and your team are motivated to use them. So, this is the second level of marketing.
  3. Marketing Management. The third, and I believe the most essential level of marketing activities, is marketing management.

Your front desk is organized and routine. Your billing is systematized and well managed — or should be. So is your therapy area and your new patient procedures. But in most offices, marketing is not organized! It is hit and miss, now and then. When numbers are down, “Hey, let’s do some marketing.” When numbers are up, we all get “too busy,” and it is neglected.

Most practice marketing is reactive and symptomatic. This causes the PRACTICE ROLLER COASTER.

There are simple methods to effectively manage your marketing systems to help create a full appointment book which we can cover in another newsletter.
But keep in mind two important points in marketing:

  1. Help People Get to Their Goals and Obtain What They Want. You are helping people who already have a perceived need and want to purchase what they are looking for. You simply must help them find it in what you offer and convince them that you are worthy of their trust.
  2. Manage Your Marketing Procedures and Keep them Running. Stay motivated, find the procedures that work best for you, but organize your marketing procedures so that they continue. This will help you avoid the Practice Roller Coaster.

To find out more about how to create a Goal Driven Business and create a full appointment book, buy and read the book the Goal Driven Business. Read about it here.

Happy Valentines Month! Spread the Love!

Ed

 

Are Your “Engines” Driving Your Practice?

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A service business needs 5 different engines to become a Goal Driven Business

Five engines drive your business to its goals.

If these are installed and firing at 100%, practicing will be enjoyable and profitable. When these engines are not fully performing, the daily demands of running a business shift to, and fall upon, the owner.

These engines are functions and characteristics of a dynamic team that drive the practice toward its goals.

Many offices that seem to be doing well are driven by heroic owners fighting each day to grow their practices, and not by their engines. But this isn’t easy to sustain. At some point, it becomes too much, and they settle into a comfort zone below their abilities. As a result, their long-term goals remain unfulfilled.

This is the plight and path of the entrepreneur – brave, independent, but too often without a map on how to build a strong business that drives itself.

The five engines that drive a business to its goals are:

  1. Marketing
  2. Leadership
  3. Management
  4. Service
  5. Personal Integrity

I want to begin passing on tips on the marketing engine– what is working now and my best estimation of what will be working in the future. Marketing is vital, for without paying customers, the other engines won’t work and aren’t needed.

But before I do, I want to invite you to look at your business and gauge the health of each of your engines.

You can do this by reviewing how successful you are at achieving each engine’s outcomes (goals) and giving them a grade from one to five (1-5). 5 would be the point where the engine is achieving its goals.

  1. Marketing. Abundant new patients and goodwill with local allied businesses, organizations, and your community. A waiting list practice. (1—5: ___)
  2. Leadership. A business with clearly defined goals that are agreed upon and pursued happily. (1—5: ___)
  3. Management. Expert team members, acting as an expert team, implementing simple but effective procedures. (1—5: ___)
  4. Customer Service. Customers (patients, clients, customers) who are extraordinarily satisfied with the services they receive and their outcomes. (1—5: ___)
  5. Personal Integrity. Each team member is happy because of the positive and and responsible manner in which they manage their personal lives. (1—5: ___)

By grading each engine’s “output,” you can immediately see what needs the most work.

But these engines do not work independently. One affects the other so that there is a synergy created. As one improves, so do the others. The opposite is also true – the more one engine dies down, the more the other ones do as well.

It could be said that everything begins with leadership, and that may be true. But unless you are marketing your services, there will be no one to lead!

So next week, let’s look at a few effective marketing strategies and tactics that will help drive your business to its goals.

And by the way, how to achieve a 5 for all your business engines is described in The Goal Driven Business. If you haven’t read it yet, I encourage you to do so.

A great new February to you all,

Ed

The Cobbler’s Wife Has No Shoes

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bare feet in the snow

The Cobbler’s Wife Has No Shoes

And Your Team Members Have No Personal Health Programs

You have heard the old expression, “The cobbler’s wife has no shoes.” Sometimes it is also said: “The cobbler’s children have no shoes.” Either way, the message is that the shoemaker, or cobbler, is often too busy with his work to spend any time making shoes for his wife and children.

The same can apply to your support team when it does not receive the health services you provide your patients.

Too frequently, I have seen employees not given a personal health program that is supervised by the doctors for whom they work and support. While this is an oversight, I feel it is also negligent. And it can be expensive.

Staff who are ill need to take time off to get well. I have heard about this more in the last year with the COVID protocols of quarantining. Employee absences can impair the quality and quantity of daily services to patients and clients. It can also create backlogs and add extra stress to the employees who try to cover for those who are ill.

There are no 100% solutions to prevent employee illness, of course. But perhaps there is more you could be doing. To start, ensure that each team member regularly receives the same services you also provide to your patients.

Then, I have seen many reports that say keeping Vitamin D levels up minimizes the risk of viral infections. Why not get your staff’s vitamin D levels checked if you haven’t already? It is easy to do and inexpensive. I list a source for testing vitamin D that I have used at the end of this article. (1)

Beyond Vitamin D, there are other supplements that can be taken to bolster defenses in winter against viral infections. The FLCCC (Front Line COVID-19 Critical Care Alliance) has a list of supplements they recommend. You can find a link to them at the end of the article.

And speaking of the FLCCC, if you have not been following them, I recommend you do. (Link at the end of the article.)(3) They are a group of medical doctors and other medical professionals that have spoken out on and advocated for other remedies for COVID other than vaccinations. Pierre Kory, who is the President of the FLCCC, once taught at the University of Wisconsin Medical School and worked at St. Luke’s Hospital here in Milwaukee. (4) (He recently spoke at a rally in D.C. this past Sunday. Link to see a clip of his speech at the end of this article.)

But back to your staff and their health.

We all get busy. I get it. Front and center are the urgent and important matters of our practice which we must deal with directly. But some matters are very important that do not seem urgent. For example, taking care of the health of our staff and ourselves is important, but because it does not seem urgent, it often gets put on the back burner.

Working ON the business is important even though it may not be urgent. And working on the business includes working to improve the health and education of your team members that support you and the patients.

So, keep this in mind: for fewer sick days, fewer quarantines (!?!), and fewer service interruptions, see that each team member is seen regularly by you or by one of the doctors at your practice, and ensure that they are on a health program. And help them follow it. This is no guarantee of less sick days, but it can certainly help.

Having a mission to help people become healthier and relieved of pain is a noble goal. But remember that it applies not only to your patients but to your support team, your family, and yourself as well.

In all ways, try to stay true to your goals!

Goal Driven — Faster to a Better Future!

Carpe Posterum (Seize the future.)

Ed

Get the book The Goal Driven Business and apply it. It will help you achieve your goals including better service, more profit, and…more freedom. Be a Health Rebel and grow your practice. Fight Back! The Goal Driven Business

(1) Vitamin D testing
(2) List of supplements recommended by the FLCCC
(3) FLCCC
(4) Pierre Kory, MD, speaking at a rally at Washington DC, Sunday, Jan 23. (Here he is talking last Sunday at a rally in Washington D.C. (Another link to the same clip.)

The Cathedral, Stone Blocks, and Your Goals

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stone cathederal

(This is the third in our series on goals.)

The Cathedral, Stone Blocks, and Your Goals

Christopher Wren was one of the greatest English architects. He designed 53 different churches in London before he died in 1723 at the age of 91.*

There is a story about how he walked unrecognized one day among the men who were at work upon the building of St. Paul’s Cathedral — which he had designed. St. Paul’s Cathedral sits on a hill and is one of London’s most famous and recognizable churches.

“What are you doing?” he inquired of one of the workers, and the man replied, “I am cutting a piece of stone and working hard so I can feed my family.”

As he went on, he put the same question to another man, and the man replied, “I am an expert stonemason, and I am building a solid wall.”

He walked a little further, and around the corner, he asked a third man what he was doing. “I am helping Sir Christopher Wren build a beautiful cathedral that will be a place for worship, where people can come to pray, where the poor can come for clothing and food, for the Almighty.”

This is a parable that has some measure of truth, but I have not been able to find any credible verification. But the point of a story such as this is to illustrate an idea or moral.

All three workers had goals. They expressed these to Sir Christopher when asked what they were doing. We can assume that each stone cutter was skilled, worked hard, and did the same work as the others.

One can guess that their goals kept them motivated. But each viewed their goals differently.

The first two workers had immediate tangible objects as goals – a cut stone block and a well-built wall. However, the third stone cutter’s goal was a purpose, a vision of the future he was working to help achieve.

From this, we can look at all goals at two different levels: at a higher level, such as a purpose, and at a tangible level, which is a practical manifestation of the purpose.

In your practice, these two levels of goals might look something like this:

Higher Goal: Our mission is to help as many people as possible in our community become healthier, relieved of discomfort, and better educated so that they continue to improve their health and those around them.

Practical Goal: A person who completed a program of care, whose pain was relieved and is now healthier and incredibly happy with their results and of the service they received and has enrolled in a wellness program.

stone mason building a wall

Practical goals are quantifiable in a set period. For example, how many new patients can we generate, how many visits can we achieve, and how many programs of care can we complete next month?

There must be an equal emphasis on the higher goal, often called a mission, and the tangle goals, often called quotas or objectives.

Too much attention on the mission, and we live in a dreamland and go broke. Too much attention on production quotas, and we eventually feel like we are on an endless assembly line, find no meaning in our work and lose our motivation.

Like the stone cutters, dream about the cathedral but also set a target for how many blocks you will cut and how many walls you will complete next month.

Both echelons of goals should be viewed, reviewed, revived, and recalculated as needed at each team meeting.

Goals are your future – where you want to be. And, where you want your patients and your community to be. So, nourish them both as a mission and as outcomes, and the work to achieve them will come much faster and easier.

Carpe Posterum (Seize the Future),

Ed

*Wikipedia

Why Goals Work and How to Harness Their Power for Greater Prosperity

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Goals are the 20%of efforts thatWhy do goals work?

We all know the obvious: they help keep you focused, and as Yogi Berra, the baseball catcher, said, “If you don’t know where you are going, you might wind up somewhere else.”

We have all heard about their importance.  But we may not have heard or understood WHY.

What is the underlying principle behind goals, and why do they work?  What gives them their power? And can you harness it improve your business and its bottom line?

Stick with me and find out…

==   ==   ==   ==   ==

It was one of those September days in the Midwest when the leaves were turning orange, and the wind was blowing.  I was in Chicago – the Windy City – where I attended a seminar downtown at one of its plush hotels.

The program was kind of out of my league – at least then.  The fee for three days was $7,000.  I was only attending the first day, which was $1,000 – still a lot of money.  But I was drawn to the subject, and I was familiar with the person who was putting it on.

There were aggressive young MBA types flying in from around the country and the world.  On the night before, at the hotel where the seminar was to be held, I saw several small groups in lively discussion around laptops – as if they were in the middle of inventing the next Big Thing.  I remember talking to one young man from Singapore and learning about the high-energy atmosphere of entrepreneurship there.

The seminar focused on building, buying, or overhauling a business.  The speaker was a self-made billionaire, a former management consultant, so his teaching fees did not come cheap.  This was not a seminar for dabblers!

The subjects discussed on the first day and, as I learned, on the other two days, were surprisingly uncomplicated.  They discussed the key ingredients to look for when deciding what business to build, buy, or grow.  These few key factors were introduced on the first day of the seminar and then expanded upon the other two days.

But it all started around one principle: the PARETO PRINCIPLE.

Many of you know the Pareto Principle and the Rule of 80/20.  This Principle has been used over the last 50 years by major manufacturing companies to improve the quality of their products.  The concept is easy to state but often difficult for entrepreneurs to apply.  It predicts that roughly 80% of valuable results come from just 20% of efforts.  In some cases, the ratio can even be more extreme so that 10% or even 5% produces 90% or 95% of the results.

Not all efforts are equal: there are the “vital few” efforts and the “useful many” efforts.  Workaholic entrepreneurs can struggle to put this concept into practical use.  We find that delegating a $20 an hour task is risky, so we will spend time organizing a bookshelf or driving to get office supplies ourselves instead of taking care of a potential $1,000 an hour task, or even a $10,000 an hour task.

As a non-business example of the 80/20 Rule, consider all the clothes in your closet.  I bet you wear just 20%, or less, 80% of the time.  Then, consider how you get to work – out of all the choices of roads to take, you use just a few of them.

Look at a winning athletic team.  Just a few players are responsible for 80% of its success.  This does not mean that the other players are not important – just not THAT important.

All efforts are just not equal or average.

How might this apply to your business?  Well, for example, 80% or more of customer dissatisfaction comes from 20% or less of your patients.  On the other hand, 20% or less of your patients account for 80% of your patient referrals.

As the CEO of your business, what are the vital few actions you can take that will produce the most results?  I suggest that defining the business’s goals, ensuring that your team understands them, and keeping these goals alive each week is key.

As Stephen Covey advises: “Begin with the end in mind.”  Goals are simply the end you have in mind.  On the higher end, they would include your mission, vision, and reason for them – your WHY.  They would also include the values you hold as standards of behavior and performance.

These greater goals would be manifested as products or outcomes.  For example, if your mission included helping people have healthy teeth, then a practical manifestation of this goal would be “Jim,” a patient, having his teeth cleaned today.  If your vision were a healthy and pain-free community, the practical outcomes would be 100 patients adjusted today.

As a doctor, what would be the 20% of your actions that account for 80% of your results?  I suggest letting the patient know that you understand their goals and work to help them achieve those goals at each encounter.

As the manager of your business, ensuring each team member knows the goals of their roles and helping them achieve these goals, with good coaching and communication, will produce 80% of their successful efforts.

It all goes back to goals.  

They are the leverage points that direct and amplify all your efforts.

But here is the truth you must understand:

A small amount of time consistently spent defining the goals of, and within, your business — and working out how to achieve them — are the vital few actions that produce most of your excellent outcomes.

Know before you go.

If you and your team routinely define and redefine your goals, both the higher ones and the practical ones, and work out how to better achieve them, you will have a more prosperous and stress-free business.

Get the goals right each day, and all else will follow in your favor.

Working towards a better future,

Ed

If you don’t have it yet, get my book to learn more about how to use goals in your practice. The Goal Driven Business.

***New Training Program***

Also, stay tuned for a new training program we will be offering on the Goal Driven System. It will be limited to just 10 offices and last for 6 months. Its goal is to train the business owner and manager/senior staff member on the Goal Driven System to transform their practice into a Goal Driven Business. A Goal Driven Business is a team of Goal Drivers. That is what this program will teach you to create. (What is a Goal Driven Business? )
If you are interested in taking the training program on the Goal Driven System, for you and 1 team member, please go here to schedule a time to learn more about it. Schedule a meeting with me.

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Petty Michel & Associates