Tag Archives: business

Preparing for a Powerful New Year in Your Chiropractic Healthcare Business

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Previously posted on (Goal Driven.com)

petty michel and associates end of year business preparation checklist

42 more days until a New Year is here.

Before we know it, it will be at our morning doorstep. Like a happy eager dog ready to be taken for its morning walk, tail a wagin’.

But before we look at all what is coming, we have the next few weeks to wrap up 2025. This includes the Holidays, both in business and in our personal lives. We also have all the year-end admin details to complete.

NOW is the time to nail everything down — to plan the events and complete the admin tasks.

And while doing this, filling the end of the year with Christmas cheer, ready for 2026 — your best year yet!!

We’ll prepare for the New Year in a few weeks, but let’s finish off this year with a flourish. Consider these 4 actions:

  • Relationships. Focus on re-bonding with all your patients and supporters from this last year.
  • End of year care. Encourage them to come in and get care.
  • Referrals. Bring in their family and friends for an end of year check-up.
  • Year end admin checklist. Review and complete all year end admin duties that need to be done.

Most important is your connection with current and past patients and supporters.

Remember:

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

Be ready to take a little extra time to chat, to communicate, and to listen — and an extra “a cup of kindness, yet.”

Marketing. I gave a list of some marketing activities you can do for November and December in a recent newsletter. You can review them here. Get those planned and going.

End of Year Administrative Checklist for Chiropractic and Healthcare Businesses

In addition, we have put together a short list of administrative items that should be reviewed and completed by year end for your chiropractic and healthcare office. It is by no means complete, but the idea is you want to get them taken care of as soon as possible, or at least scheduled, so you can focus your creative energies on launching your 2026.

Block 2-3 hours in early December to work through this list. Delegate sections to your manager, billing staff, and bookkeeper.

You can also contact Lisa who is an expert in these subjects. You can contact her anytime.

Just Ask Lisa! (Lisa@pmaworks.com)

The checklist covers these categories:

2025 ADMIN WRAP UP CHECKLIST

  • FINANCIAL & TAX
  • CREDENTIALING & LICENSING
  • EMPLOYEE ADMINISTRATION
  • INSURANCE & PATIENT ACCOUNTS
  • COMPLIANCE & OPERATIONS
  • BUSINESS ENTITY & LEGAL

Download the ADMIN LIST below and tend to the admin.

Meanwhile, have a great time with your patients over the next 6 weeks.

And let’s prepare for your best year ever – in practice, in business, and in life!

And stay…Goal Driven,

Ed

Download the Checklists HERE

“What’s Wrong with a Chiropractic and Healthcare Personality Practice, He Asked?”

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a group of women sitting at a chiropractic vendor booth waiting for potential clients to stop by and visitJust wrapped up an outstanding chiropractic convention put on by the Wisconsin Chiropractic Society here, you guessed it, in Wisconsin!

We enjoyed catching up with old friends, some we’ve known for decades. And making new friends.

For more on the Convention, you can check out our Facebook site, link below.

Personality Practice

While I was out listening to a presentation, I was told that a doctor dropped by the booth and asked about my book, The Goal Driven Business. He was told that it was about how to improve profits and outcomes by shifting from a personality-driven practice to one that was goal-driven. He felt that the personality practice was better.

I am sorry I wasn’t there to explain more – and hopefully he is reading this email.

Let me explain: A Personality Driven practice is propelled by the doctor’s behavior – their feelings, attitudes, and habits. What they personally do.

When opening a new office, the new business owner, of course, builds their new business on their behavior. It is their ambitious determination that is driving the initial growth of the practice. So, yes, a Personality Driven practice works at the launch of a new endeavor. What else is there? A dream, and the raw desire to manifest it.

So, the Personality-Driven practice works — at first.

However, after the practice is up and running, it needs to transition into a Goal Driven and systematized business.

The concept of a systematized business was hugely popular in the 1980s, thanks to Michael Gerber’s book, The E-Myth. In it, he says:

“The system runs the business. The people run the system.”

B. J. Palmer said something similar, much earlier. And he built a school that many of you may have attended. In his book, Up From Below the Bottom, he says:

“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.”

Gerber comically explains what happens when you don’t have systems running your business.

“If your business depends on you, you don’t own a business—you have a job. And it’s the worst job in the world because you’re working for a lunatic!”

–Making the Shift from Personality Driven to Goal Driven–

Making the SHIFT from a Personality Practice to a Goal Driven business is not easy. This is because you have established survival habits that have shown you that the practice depends on you, your feelings, attitudes, and overall behavior. You are the doctor, after all. You see the practice as DOCTOR-CENTERED.

A better approach, I recommend, is to keep it GOAL-CENTERED.

There are two echelons of goals to consider:

  1. Higher goals, including your purpose and “why.” This is your North Star.
  2. Practical goals, or outcomes. For example, you could have front desk goals (percentage of appointments kept), Billing and Collections goals (percentage of collections), and marketing goals (new patients and returning patients), and patient goals (patient completing tx program with an excellent review.)

Get your team on board with these goals. If you do, they can now help you put together the best approach to achieve your goals. These are the systems.

So: Personality Practice – YES! When starting a new business.

But once it is running, NO. Gradually back out and put in place goals and systems. And train your people on these.

For more details, read The Goal Driven Business.

If you want help with this, contact me. I’d love to help. (Been doing this for a while, so lots of tips!)

Services@pmaworks.com

Stay Goal Driven. Stay Free!

Ed

Photos of us and our friends at the Chiropractic Society of Wisconsin Fall Experience

Preventing Procedural Atrophy in Your Practice

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eroded asphalt highway

In any business, routines and procedures can slowly be shortened, skipped, or abandoned. When this happens, quality slips, and the practice begins to decline. I call this Procedural Atrophy, a key concept from The Goal Driven Business.

When results falter, doctors often try new approaches. These may work temporarily, but without consistent systems, the same decline sets in again. This creates the Practice Roller Coaster—a cycle driven more by personality than by clear goals and structure.

Think back to what you did when your practice was thriving. Did you call new patients after their first visit? Hold morning team huddles? Run patient education classes, progress exams, or referral drives? Chances are, when numbers dip, it’s because those proven actions have slipped away. The solution is often simple: return to what worked before.

 Solution 1: Set the Standard – Quality

Stand out in a noisy world by being consistent and excellent. Define exactly what a successful patient outcome looks like—for example, a patient who pays, stays, refers, feels healthier, understands their care, and is happy with their results.

Then, create brief checklists that outline the essential procedures needed to achieve this. Examples include:

  • Day 1, Day 2, and ongoing patient steps
  • Collections
  • Internal and external marketing
  • Team communication and coordination
  • Leadership and management

These checklists keep your practice systematic, repeatable, and reliable.

 Solution 2: Accountability Reviews

Consistency requires feedback. Use monthly statistics, chart trends, and review them with your team or a coach. This ensures everyone stays focused and motivated. Just like in life, accountability keeps us on track.

—

Bottom line: What you provide for your patients, team, and community is valuable. Don’t let your practice erode through neglect of the basics. Stay consistent, keep improving, and remain Goal Driven.

Ed

Scripts are Secondary in Your Chiropractic and Healthcare Practice

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female chiropractor discussing care plan with patient

Why Scripting Can Fail—and How to Make It Work

A script is a prepared set of phrases, questions, or responses designed to guide staff or doctors in patient interactions. Whether word-for-word or just an outline, scripts help keep communication consistent, especially for new team members. But even the best script can flop if it’s missing one thing—authentic human connection.

Connection Comes Before Words

Think of connection like a radio signal. A carrier wave must exist before any music or voice can be transmitted. Without it, nothing gets through. In patient care, that “carrier wave” is trust and genuine interest. If it’s missing, your words—no matter how polished—won’t land.

I once had a doctor greet me after a minor surgery with a cheerful, “I can’t tell you even had it done!” It was a nice line, but it felt canned. The delivery lacked authenticity, so the message didn’t connect.

How to Create the “Carrier Wave”

  • Be authentic – Avoid sounding rehearsed.
  • Be curious – Take a few extra seconds to ask a follow-up question.
  • Recognize the person – Make patients feel valued and respected.

When you connect first, your scripted lines gain power and meaning. Without it, patients may feel unheard, leading to fewer new-patient conversions, lower follow-through, and less word-of-mouth.

Using Scripts Effectively

  • Review and practice scripts every couple of months.
  • Role-play different delivery styles (bored, overexcited, glum) to sharpen awareness.
  • Use scripts to keep patient conversations moving forward, not to replace genuine interest.

Bottom line: Scripts are useful tools—but they only work if you first connect with the human being in front of you.

For more helpful business tips visit our Goal Driver Blog [LINK]

Ed

He walked away when I asked, “Who is going to do it?”

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distressed overwhelmed male business man When you are the bottleneck

Many years ago, I attended a large chiropractic conference. I was new to the profession and curious about how things worked.

One of the seminars at the conference was on how to generate new patients. There must have been several hundred in the room. The speaker was charismatic and had some sensible recommendations. The audience seemed enthused.

I was sitting in the back of the room. When the seminar was over, I was one of the first to leave and walk into the hallway where attendees began to cluster to discuss the presentation.

I remember one doctor in particular. He was tall and had his name tag with ribbons hanging down. I didn’t understand what the ribbons meant, but I figured he must have been important.

I asked him how he liked the seminar. He was deliberate, almost authoritative when he said that he liked it and was going to implement some marketing projects. I told him that I thought that was good.

But then, thinking about it, I asked him, “Who in your office is going to do it?”

I remember him looking down at me. He seemed perturbed, as if I had insulted him. He looked up and walked away. Didn’t say a word.

I’ll never forget it.

This was a long time ago, but it made an impression on me.

REMEMBER THE OLD MAXIM
“Do what you do best, and delegate all the rest.”

You can’t do it all.

In the beginning, when starting and growing your practice, yes, you pretty much had to do most everything.

But at some point, you must create other team members who are trained and motivated to share the load. I know practice owners know this, but it’s easier said than done.

This is why a manager is so vital to your practice. Your manager is the fulcrum point that helps you make a team. They are a servant to the team — as you are to your patients.

They help put in the systems that allow all your internal and external marketing procedures to be effective. And not just marketing. Standard procedures for patient retention, patient services, patient reimbursement, and so on.

They take the load off of you, so you are not the bottleneck!

We’ve found that most staff and managers are very willing and want to help their offices grow. But in most cases, they are not sure how, or how best to work with their team, or their doctor.

It is because of this we have developed our Practice MBA program.

Take time each week to train your team.

And for some of you, our manager training program is just what you need to answer the question,

“Who is going to do it?”

Stay Goal Driven,

Ed

P.S. Get on our Waitlist today to ensure you get a spot. First come first serve. Only 15 spots available this fall.  [LINK]

Momentum Magic: How the Flywheel Effect Boosts Your Chiropractic Practice and Service Business

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flywheel effect

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

The “New Will of the World” Chiropractic and Natural Health Care.

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smiling female gardener with a box of fresh tomatoes

The “New Will of the World,” Chiropractic, and Natural Health Care: Embracing Purpose-Driven Change

Gallup, a global analytics company, has identified emerging trends in society through data analysis. One significant trend is the “New Will of the World,” which reflects a shift in social values, including a growing desire for meaningful, purpose-driven work. This trend is influencing both the workplace and health care, where people are seeking more than just a job or pain relief—they’re looking for purpose in their lives.

The “New Will of the World”

This shift involves a broad societal movement towards work and health practices that focus on meaning and personal fulfillment. People—whether in the workplace or as patients—are increasingly searching for deeper connections to their work and well-being.

“Make America Healthy Again” Movement

Coined by Robert F. Kennedy Jr. during his presidential campaign, the “Make America Healthy Again” (MAHA) movement has gained momentum, particularly in the context of promoting chiropractic and natural health care. Kennedy, an advocate for these approaches, has proposed several initiatives:

  • Nutrition and Food Policy: Kennedy focuses on improving nutrition, including revamping the FDA’s oversight of food labeling, limiting ultra-processed foods, and banning harmful additives.
  • Pesticide Reduction: He aims to enforce stricter limits on pesticide use and encourage sustainable farming practices.
  • Revised Dietary Guidelines: Kennedy’s plan is to prioritize whole foods, organic options, and regenerative farming over corporate interests.
  • Support for Small Producers: He pledges to revise regulations to support smaller farmers and create a more level playing field in agriculture.
  • Creating Meaningful Change in Your Practice

Chiropractic offices and health care providers have a unique opportunity to align with this broader movement by offering a work environment and services that reflect purpose and community well-being. You can inspire both your team and patients by adopting the “Make America Healthy Again” ethos. Consider creating local initiatives, such as a “Make [Your Town] Healthy Again” campaign, in collaboration with health food stores, gyms, and local farmers. Hosting workshops, talks, and podcasts can bring the community together while promoting your services.

Engaging Your Team and Community

Your team is seeking more meaningful work, and your patients are looking for more than just pain relief—they desire holistic well-being. By tying your practice to this larger, purpose-driven movement, you can foster a sense of fulfillment and connection with both your staff and the local community. Activities like health-themed workshops or collaborative events with professionals in the community can deepen this mission and benefit everyone involved.

In summary, embracing the “New Will of the World” allows you to create a practice with greater purpose, connecting people to a healthier, more meaningful lifestyle while supporting the growing trend of chiropractic and natural health care.

ED

References and Full Article at [LINK]

Overcoming the Barrier to Consistent Marketing

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4 month marketing calendar The biggest challenge in marketing is inconsistency. There are a few key reasons for this:

  1. No one is in charge of marketing.
  2. Time constraints. Many businesses struggle to find time for marketing.
  3. Uncertainty about how to plan. It can be difficult to know where to start or how to structure marketing efforts.

The Community Education Program addresses these issues, drawing from the experience of managing over 20 offices in Wisconsin. This program provides a clear, actionable framework for marketing your services consistently.

Marketing Principle: Newton’s Third Law

Marketing works like Newton’s Third Law of Motion: for every action, there’s an equal and opposite reaction. This means that when you promote something, you will get a response. By setting up a monthly marketing plan in advance, you ensure something is always going out, even if you add extra activities later.

How the Community Education Program Works

  1. Project Manager: Assign someone (typically the marketing coordinator) to oversee marketing efforts, ensuring everyone is involved.
  2. Central Theme: Select a theme for the upcoming months, focusing on proven marketing tactics and common health concerns your services address.
  3. Targeted Promotions: Tailor your efforts to different groups:
    • Active Patients: Use word-of-mouth, posters, coupons, and workshops.
    • Inactive Patients: Reach out via newsletters and social media to re-engage them.
    • Community Referral Sources: Engage gyms, dentists, and other local professionals with emails, flyers, and direct contact.
    • Non-Patients: Use ads to attract new patients.

Example for a Chiropractic Practice

February: Neuropathy Awareness Month

  • Event: $29 screening exam and consultation.
  • Workshop: “Nature’s Remedies: Six Holistic Approaches to Easing Neuropathy” at your office and senior centers.

Marketing Channels:

  • Active Patients: Posters, coupons, word-of-mouth.
  • Inactive Patients: Success story newsletters.
  • External Referral Sources: Posters at senior healthcare facilities and workshops.
  • Advertising: Social media.

Fun Future Themes

  • March: Kids Health Month – “Leprechaun’s Health Month.”
  • April: Summer Fitness – Include a golf workshop.
  • May: Women’s Health – Focus on pregnancy and new baby care.
  • June: Back Pain Awareness Month.
  • July: Headache Awareness Month.
  • August: Athletics for Kids – Concussion prevention and recovery.

By planning monthly themes in advance, you can ensure consistent marketing, even if other programs are running throughout the year.

Marketing Principle: Quantum Physics

While Newtonian physics explains marketing’s action and reaction, Quantum Physics suggests that we are all connected and that our emotions and energy influence our outcomes. Stay positive, stay energized, and keep a good vibe in your marketing efforts!

Do You Have a Chiropractic Practice or a Chiropractic Business

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jet breaking through the clouds

Break through the barriers and have both.

You have a practice if you are a doctor or a provider of any service.

Sooner or later, many of you must also create and run a business that supports your practice. This is where practice owners struggle.

It seems simple enough, but there is a wide gulf between a practice and a business that supports a practice.

Difference Between a Chiropractic and Healthcare Practice and a Chiropractic and Healthcare Business.

Let’s look at some key differences:

Goals:

  • The goal of a practice is to provide professional services and deliver outcomes of that profession.
  • The goal of a business is profit.

Structure:

  • A practice is structured around and dependent upon the owner/provider.
  • A business is structured around and dependent upon systems, including goals, policies, and procedures.

Scalability:

  • Practices are generally harder to scale because they depend on the limited time and expertise of the providers.
  • Businesses can be scaled more easily by replicating systems and hiring added staff to meet growing demand.

Succession and Sale:

  • A practice’s value is closely tied to its owner and reputation, making it challenging to sell or pass on.
  • A business, if well-structured, can run independently of its founder and can be sold or transferred more readily.

I spent 8 years researching the chasm between the practice and business models. I discuss this in my book, The Goal Driven Business.

You need to have a practice, of course. I define a practice as: “A network of relationships that are developed and sustained through communication and service.”

And so long as you are operating at 60% or less of your full capacity as a provider, your business concerns are manageable. You have the time to adjust and treat your patients, chat with them, and go to Costco for supplies. You are essentially a part-time provider.

To operate at full capacity, you need to create a business structure.

Organizational Barrier to Practice Growth

But doing so is like going from propeller airplanes in the 1940s to jets that go faster than 767 miles per hour, which is the speed of sound. The conventional airplane’s dynamics falter and control is lost as the speed increases. Many pilots lost their lives as their planes crashed in an attempt to break the Sound Barrier.

Similarly, there is a structural barrier, an Organizational Barrier, that causes growing practices to hit and likewise crash or stall.

The ideal is to continue nurturing your practice while gradually building a business infrastructure that allows you to operate at full speed, increase your profit, and still provide excellent service and outcomes. And at some point, pass it on profitably.

Despite the onslaught of advertisers that brag about million-dollar business owners in health care, real money is made by building an enduring practice supported by a solid business structure.

Love your patients and team, and improve your service. Strengthen relationships. Then, if you want to grow, schedule time to work on implementing the structural components for a business vehicle that will take you to your goals.

Want help in doing this? Contact me any time. Link

And read The Goal Driven Business.

Seize your future,

Ed

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How to Add Extra Services to Your Chiropractic Healthcare Practice

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two men discussing chiropractic therapy equipment

Avoiding Hidden Expenses in Scaling Your Practice

Do you want to improve your income and the quality and quantity of your services?

One strategy is to add a therapy machine — or another one — to your practice. You could also bring on another provider. This could add more services per visit and more visits per week, improving your income and the outcomes you get with patients.

Makes sense, right?

In theory, yes. In real life, not so much.

Properly implemented, more services from machines or providers can improve the quality and quantity of outcomes and improve the bottom line. However, the implementation must be done correctly. And often, it is not.

I have seen chiropractic clinics with the largest room in the office filled with therapy equipment that was rarely used. I have had heated discussions with doctors who would buy more equipment when they were not using what they had just purchased. And if the equipment is used, often there is insufficient staff or resources elsewhere: no one running the front desk department, marketing is sporadic, and patient treatment and financial plans are rarely or poorly done.

This gets even worse when hiring associate doctors. You have heard the stories, so I won’t elaborate. Group practices can work well, and we recommend them. In fact, I don’t know of one chiropractic management company with more combined experience working with associates than we have. Multiple-doctor clinics are one of our specialties. But they have to be done correctly, and they rarely are.

Let’s look at three principles to help you implement additional services correctly.

1. FOCUS AND IMPROVE YOUR CORE SERVICES

More therapy and more providers will not take the place of quality and well-organized services.

By expanding your services, you can dilute your unique selling proposition!

Starbucks did this back in 2006. They kept introducing new products, which devalued their primary brand. The baristas had difficulty keeping up with all the new products. They had to become fast-moving technicians rather than friendly conversationalists with the customers. Their statistics decreased until they simplified their services and focused on their core values and services. *

Before you add machines and providers, focus on your core services and improve those, which will also enhance your bottom line.

2. SIMPLICITY

More services can add more complexity. Richard Koch is one of the researchers I quoted in my book, Goal Driven Business. He says: “Because business is wasteful, and because complexity and waste feed on each other, a simple business will always be better than a complex business.”

A therapy unit, for example, even if it is “unattended,” requires supervision by the staff and you. And who will do it if it requires someone to apply the therapy? You can see the extra expense once you work out the details and the math.

Complexity can hide overhead. So, when adding more services, beware of adding complexity and keep the services as simple as possible.

3. LARGE BUT SIMPLE CHIROPRACTIC HEALTHCARE BUSINESS

A larger business provides more services and can generate more income. While Richard Koch recommends simplicity, he also supports growth:

“Because scale is normally valuable, for any given level of complexity, it is better to have a larger business. The large and simple business is the best.”*

Add more services to your practice, but keep these three points in mind:

  1. Improve what you have. First, focus on and improve your skills and those of your team. Invest in your team and yourself. This will enhance your bottom line and your services. Your goals are expertise and mastery.
  2. Keep it simple. Always work towards simplifying your procedures and your patient’s experience.
  3. Scale. Add services and scale your business. But first, plan it out ahead of time, examine the extra time, effort, and costs involved, and manage it well. (You can have us help!)

Keep expanding — but keep improving first. And keep it simple.

Ed

References

*https://hbswk.hbs.edu/item/starbucks-lessons-for-premium-brands

* The 80/20 Principle (Richard Koch)

—————————————————-

If your practice building efforts aren’t taking you to your goals, there are reasons — many of which are hidden from you.

Find out what they are and how to sail to your next level by getting and implementing my new book, The Goal Driven Business.

goal driven business building methodology

The Goal Driven Business,  By Edward Petty

goal driven business buy now button

Let’s Hear It For Chiropractic and Kid’s!

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Petty Michel and Goal Driven Donation to Wisconsin Chiropractic for Kids How to support the health of our children

“History will judge us by the difference we make in the everyday lives of children.” Nelson Mandela*

Here in Wisconsin, the Chiropractic Society of Wisconsin, the primary chiropractic association, is sponsoring a Kid’s Day next week, which we are supporting.

Also, I am supporting it with donations from the sales of my book. Please consider contributing directly to the C.S.W. or buying my book (or 20 of them!).

If you look into it, how we treat our kids in the 2020s is probably worse than in decades past. The Styrofoam-like food, the toxins such as Glyphosate and Phthalates in our breakfast cereal, the nano plastics now in our blood, the sugar and seed oil, the escalation of Pharma drugs and shots, the social media, the list goes on and on.

Just look at the stats for health care in America, those that you can find. They are abysmal and getting worse. (I have links to some listed below.)

There are plenty of sources to learn about how we treat our kids, but as you can imagine, they are hard to find on regular internet searches. It’s a little like trying to find the truth about cigarettes or asbestos in the 1950s — you almost have to search out whistleblowers to find out what is truly going on. An e-book that was published in 2018 called The Sickest Generation, by Children’s Health Defense, is a good place to start. (Link below)

People in your community aren’t going to hear too much about this from the media or most corporate-paid doctors – though more independent physicians seem to be speaking out. This is why your work is so vital.

As a side note, promoting health care for kids can build your practice. Helping children get healthier is a great marketing and practice-building strategy.

But first and foremost, the primary reason to see kids is to help them stay healthy.

Chiropractic care can help young children with the bumps and tumbles they take as they grow. Young athletes especially benefit from adjustments. Other independent and naturally oriented health providers, such as those practicing acupuncture and Traditional Chinese Medicine, and functional and integrative medical providers can also be of great help.

But beyond chiropractic adjustments, education and support for a healthy chiropractic lifestyle is fundamental. Educate the parents and help the kids.

Consider contributing to the C.S.W. Kids Day program.

Also, consider encouraging your state association to develop a kids’ program, and if they already have one, please contribute to that.

Ed Petty

 

Link to Chiropractic Society of Wisconsin: https://www.chiropracticsocietywi.org/chirokids-day

Link to The Sickest Generation published by Children’s Health Defense, https://childrenshealthdefense.org/ebook-sign-up/ebook-sign-up-the-sickest-generation/

More links to references:

From The Sickest Generation

American children have never been sicker. Over half (54%) are suffering from one or more chronic illnesses.

The “4-A” disorders—autism, attention deficit hyperactivity disorder, asthma and allergies—have experienced meteoric growth, affecting children’s quality of life and con­tributing to premature mortality.

U.S. children are far more likely to die before their first birthday than infants in other wealthy countries and life expectancy is falling, driven largely by rising death rates in adolescents and younger adults. Suicide is the second leading cause of death in teens, half of whom are reported to have at least one mental, emotional or behavioral disorder.

The proportion of public school children using special education services is skyrocketing, with estimates ranging from 13% to 25% of school populations.

Mystifyingly, there is almost no outcry in medical, public health or government circles to find answers and solutions.

 

Goals for the Present

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Goals for the Present

Goals are about the future.

But sometimes, they are about the present – and respecting the past.

December is one of those times. There’s a distinct vibration that moves in this time of year, subtle waves of friendliness that sparkle like Christmas tree lights. Almost an instinct — whether connected to a Sunday service before the 25th, a Jolly Old Saint Nick, the candles of Hanukkah, or the winter solstice, we feel a sense of fellowship during this time of year.

With the traditions of other cultures over the millennia, people have gathered with a Spirit of compassion and celebration. People even take time to pause in war.

One example was the Christmas Truce of 1914 during World War I, when soldiers from opposing trenches laid down their weapons and initiated an unofficial ceasefire. The truce began on Christmas Eve and continued into Christmas Day, with soldiers exchanging seasonal greetings, singing carols, and even venturing into no man’s land to fraternize with the enemy. Troops from both sides shared food, tobacco, and souvenirs and engaged in impromptu soccer games.

I think this speaks to our fundamental nature, that we are supportive and kind when unprovoked by the agitations of those who might profit from our conflicts.

As a practice and business goal for your chiropractic and healthcare office, I suggest that this week and next, focus on the present and appreciate the many accomplishments of the past year. Consider your blessings – your patients, profession, teammates, and family.

The Future Can Wait

For now, take time for some gratitude and have a cup of kindness and good cheer.

And play some Christmas jazz. Man!

Below is a link to some mellow Christmas Jazz – 4-hour playlist. Christmas Jazz: https://www.youtube.com/watch?v=Dbgx5ChU3ZM

Carpe Diem,

Ed

How to Grow a Chiropractic and Health Business

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How to grow a chiropractic business

I was recently invited to my son’s wife’s family’s apple butter cookout. Yep, that’s right, cooking apples over an open fire. It’s a tradition.

It is also apple harvest season up here in the northern Midwest. You got yur Honey Crisps, Honeygolds, Snowsweet, Fuki, Jonathans and others. Lots o’ apples!

Harvest time.

I bring this up because, well, it applies to your office. Here’s how:

THE LAW OF THE FARM

There is a metaphor called the “Law of the Farm” or the “Law of the Harvest.” Stephen Covey refers to this in his book, The Seven Habits of Highly Effective People. (I include a link to a short video below)

The concept comes from the observation that apples come from farmers farming. An apple orchard requires tender, loving care over the entire year from growers who plan and carry out disciplined regular work to ensure a bountiful harvest.

Aside from occasional droughts or freezes, if your harvest is poor, it is not because of the “apple spirits,” or that maybe you had a bad childhood. It is because one or more of the necessary preparatory actions needed to produce the apples were not done.

There are no shortcuts. Getting angry with the apple trees does not help.

YOUR CHIROPRACTIC AND HEALTHCARE PRACTICE IS LIKE A FARM

The Law of the Farm, or the Law of the Harvest can be applied to your practice in the following ways:

  1. Long-Term Planning. Just as a farmer plans their crops well in advance, a business should set clear goals and strategies for the future. This includes defining your mission, the key values of your team that determine its culture, the outcomes, and production goals.
  2. Investment and Resources. Just as a farmer invests in seeds, land, and equipment, you must invest in your resources wisely. First and most important, invest in your people, including yourself: training, coaching, and hiring. Marketing, in one form or another, is always a necessity. Updating software and equipment, occasionally, or the décor of your office is also an investment.
  3. Consistency and Diligence. Sticking to what works is vital. This is why I recommend job checklists as part of the Goal Driven System. It takes discipline to keep doing what works, but consistency brings about confidence in your patients and your team. Daily tasks and routines are like tending to crops regularly.
  4. Patience and Adaptation. Just as a farmer must wait for crops to grow and adapt to changing weather conditions, chiropractic practice owners must be patient and adaptable. Success may not come immediately, and you will face unforeseen challenges. Being able to adjust strategies and remain patient when unexpected failures occur is critical.

Looking at your practice as something you need to grow to produce excellent outcomes is a useful exercise.

Patience can be tough to master as a business owner when you have invested everything on the line. But if you have done your preparation, as all farmers must do, most of your concerns are for naught.

The Law of the Farm is a principle from which you can draw many associations to your practice. As an exercise, you might discuss this with your team: How can we apply the Law of the Farm to our practice and improve our service?

APPLES DO NOT COME FROM THE GROCERY STORE

Similarly, happy patients, completing their chiropractic or healthcare treatment program, being relieved of pain, healthier, and referring others do not come from the new well-advertised social media ad campaign. All the shiny new ads and promotions don’t make up for the Law of the Farm.

There are no shortcuts.

You reap what you sow — and nurture and take care of.

We are all farmers!

Ed

PS I also discuss this in The Goal Driven Business, #15 Goal Driven Principles, page 262 Be a Farmer: Grow Your Business and Your Customers

Watch this short video about the Law of the Harvest.

https://resources.franklincovey.com/mkt-7hv1/law-of-the-harvest-2

The Truth In Chiropractic and Health Care Marketing

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The Best Known Marketing Secret
 
The more things change, the more they stay the same.
 
Artificial Intelligence is all the rage. For good reason. It’s set to change the world as the Internet did, maybe more so, and in ways we can barely fathom.
 
Geoffrey Hinton recently quit his job at Google to speak freely about the risks of AI. He and two other so-called “Godfathers of AI” won the 2018 Turing Award for their foundational work leading to the current artificial intelligence boom. He now says a part of him regrets his life’s work.*
 
His immediate concern is that the Internet will be flooded with false photos, videos, and text, and the average person will “not be able to know what is true anymore.”
 
What is True?
 
You can fool people some of the time, but success in chiropractic marketing and practice is ultimately based on trust.
 
You may already send your patients scripted texts, prefabricated emails, and even automated educational or sales videos. You may have a testimonial service that posts positive testimonials for you.
 
Yes, the world is becoming more automated, artificially “intelligent,” and virtual.
 
But at some point, your patient, or potential patient, will start to wonder… “is this communication from Dr. Smith, chatGPT, or a robot in China?”
 
You are the Truth
 
What is the truth in marketing?
 
In this age of increasing artificiality: you are the truth!
 
Images and voices of people can be faked. You can record your voice, type in a sentence, select an image of a person, and that person will vocalize what you typed, in your voice. The future is going to be amazing in its ability for fakery.
 
But overcoming this is simple.
 
Show up and meet people. In person. In real life. (IRL) Person to person, create relationships and from these, generate referrals.
 
People want community. They want relationships. They want a real person.
 
Sometimes you want to go
Where everybody knows your name,
And they’re always glad you came;
(From TV sitcom Cheers.)
 
Marketing in Truth
 
Marketing in real life is networking. Networking is getting to know people who know people.
 
The most immediate and obvious resource for networking is connecting with those people who know you, trust you, and probably even like you (lol). Your active patients, inactive patients, friends, and community members in business or in organizations, all add up to hundreds, if not thousands of people.
 
I recently saw a dedicated chiropractor I know promote a local BNI workshop. BNI stands for Business Network International. It was founded by Ivan Misner, who wrote the excellent book, The Best Known Marketing Secret. It is all about Word-of-Mouth advertising – networking.
 
Perhaps because of technology, or the COVID lock down, or possibly more nefarious reasons, friendly public in-person get-togethers have been declining.*
 
I think now, more than ever, networking is and will be a very effective form of marketing.
 
You can spend money on Facebook ads or advertise on other platforms. Now and then, go for it! But strictly speaking ROI, a structured and continuous networking plan can’t be beat. (Contact me if you want a few tips setting up your networking plan.) It may take time to develop, but once in place, it can almost run on its own, sending people to you who need your services.
 
In his book, Misner refers to a friend of his who says that we all are cave dwellers. We live in our cave houses, get into our cave cars, and go to our cave offices. I would add that we also live in our virtual media caves, whether social or Netflix!
 
His point is that there is a whole world out there if we just get out of our caves and meet people.
 
I have seen many different and effective forms of network marketing that work. I’ll go over a number of examples in the next newsletter to keep this letter short.
 
But consider this: AI will never replace you. And it will never replace the individual across from you.
 
And THAT…is the truth.
 
Stay Goal Driven,
 
Ed
 
 
References:
*77 percent of planners find it harder to attract attendees, while 73 percent report lower attendance. (Skift Meetings, 2022)
 
*https://archive.is/2023.05.01-091113/https://www.nytimes.com/2023/05/01/technology/ai-google-chatbot-engineer-quits-hinton.html

Spring Marketing Calendar

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spring marketing plan.

The Need for Marketing Never Goes Away

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

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

The Need for Marketing Never Goes Away

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

Marketing is business and business is marketing.

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

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

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

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

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

Marketing Plan

Practically speaking, it helps to plan your marketing.

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

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

But for now, Happy Spring, and Plan your Future

Ed

Sample Marketing Calendar

Bruce Lipton and Physician Health Thyself

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

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

Why doctors should stay Innately positive and healthy

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

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

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

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

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

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

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

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

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

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

And pass it on.

😊

Ed

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

 

The Future

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

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

Goals

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

  • Production Goals
  • Organization Goals

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

But keep this in mind:

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

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

Motivation

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

And this takes us back to your goals.

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

Viktor Frankl

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

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

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

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

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

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

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

Help with Your Future

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

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

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

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

Seize the Future! (Carpe Future)

Happy New Year

Ed

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

Practice Fundamentals – Communication and Control

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

It’s always the basics. The fundamentals.

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

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

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

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

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

Communication

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

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

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

Control

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

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

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

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

Management

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

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

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

Seize your future – with a smile!

Ed

Case Management for Better Service and Retention

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Start Each Day with Service First

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

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

Beginning Each Day With Service Goals for Each Patient

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

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

Case Management Meeting Procedure

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

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

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

More Than Case Management – Keeping It Fun.

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

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

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

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

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

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

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

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

It only works if it is done.

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

Over to you!

Carpe Posturum! (Sieze the Future)

Ed

Brutal Economics: A hidden expense.

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You have more expenses than you’ve probably considered.
 
Your biggest expense, like that old poster you have had in your reception room since 2012, has become invisible.
 
What is this big expense?
 
Well, one of the goals we work with in the Goal Driven System is the Full Capacity Goal.
 
This goal can be easily overlooked as we are focused on patient care, reimbursements, staffing schedules, vacations, and a thousand other tasks that require our attention.
 
The reason the use of goals is so effective in practice management is that they help you see the Vital Few from the Useful Many. (These terms are often used in reference to the Pareto Principle of 80/20.) The Vital Few are those factors (20% or less) that produce 80% (or more) of the results.
 
If you are not operating at close to full capacity, you are wasting money.
 
For example, if you could see, 160 patients in a week, given your schedule and good support, at $65 per visit, that would equal $10,400 per week. On a monthly basis, this would work out to be 640 visits and about $41,600 in revenue. This would be 100% Full Capacity.
 
You know from experience that your expenses are a lot higher than most realize. First, there are fixed expenses that you must pay out regardless of the performance of your business. And after everything and everyone is paid, after all accounts are settled, what is left over is yours.
 
At 70% capacity, that is not much. At 50% capacity, that is nothing.
 
Of course, you don’t focus on stats and money when you deal with patients as a doctor and as care givers.
 
But as a business owner, you must.
 
Numbers, analytics, Key Performance Indicators –– these make up your scoreboard and give you the best feedback to help you manage the performance of your business.
 
We carefully analyze our clients’ numbers each month and encourage they do the same. We also plot them on graphs and charts to notice trends. These are our x-rays.
 
Lately, we have realized that there is one number that gets overlooked in the hustle and bustle of business management. That is to what degree the office is operating at its full capacity.
 
In Goal Driven Analytics, we have been testing a “business capacitometer.” It displays, much like a speedometer or tachometer, the percentage of full capacity that the business is operating.
 
But you can easily do the same. Here is how:
 
  1. Weekly Visits. Determine the maximum number of visits you could see comfortably each week if you were reasonably supported with software and staff. ______
  2. Full Capacity Goal. Multiple this by 4 (I know, 4.3 is more exact): ___ This is your Full Capacity Goal.
  3. Percent of Full Capacity. At the end of the month, divide the number of visits you saw by your full Capacity Goal and you will get the percentage that shows you how the efficiency of your practice. E.G. You FCG is 800 and you saw 600 = 600/800 = 75%
Work towards maintaining 90% or above. Find the capacity constraints and remove them.
 
This is also very helpful if you have multiple providers – other associate chiropractors, massage therapists, other services, even your rehab or therapy departments. After agreeing on what volume would be full capacity, each month they can see their level of performance.
 
Last note: It is not about the statistics. While stats are your best indicator, remember … it is not the stat that is important — it is what they represent. A helped person!
 
Seize the Future,
 
Ed