Tag Archives: chiropractic

Be Dangerous – In Chiropractic and Healthcare, Standup for Your Patients

Posted on by
Reply

standing with integrity and purpose

Integrity and Purpose are the Keys to Your Growth in
Your Chiropractic and Healthcare Practice

We live in a world where what we perceive can be manipulated.

Advertising, public relations, and sophisticated behavior modification strategies are powerful tools. They can generate consensus, approval, and demand for a product, service, or idea.

A status quo is generated and supported this way.

For example, when I was a kid, everyone smoked cigarettes. Everywhere. It was heavily pushed and advertised — with M.D.’s no less. And by the Federal Government! (I still remember some of the slogans…! “Winston tastes good like a cigarette should.”)

For years, research continued to show that cigarettes were very unhealthy, but this threatened those who profited from their sales.

If you challenged the manufactured consensus and the messaging, you were attacked, like this man was…

Dr. Jeffrey Wigand was a Vice President of Research and Development at Brown & Williamson – tobacco company. In the mid-1990s, he exposed that industry giants were intentionally engineering cigarettes to be more addictive. They responded with a powerful negative P.R. campaign, compiling a 500-page dossier of smears to brand him a liar and using anonymous death threats to silence his testimony.

Cigarettes finally moved to the sidelines, but those same companies (Philip Morris and R.J. Reynolds) moved into the cheap (addictive and harmful) food business—buying up corporations such as Kraft and Nabisco.

There is a money-making complex of industries in which one hand greases the other, a matrix that includes captured lawmakers and professional organizations. Their interests are money and control to keep the money coming. And they have powerful tools to keep this game going.

Many of us are not always familiar with the details, and your patients may be naïve about the attacks launched and sustained through direct and indirect campaigns by these industries.

But to whatever degree you are aware of it, you are on the battlefield – as a player or a piece.

And if you speak up and speak out, if you stand up for your purpose — you can be attacked.

That’s what happened to these doctors:

Peter McCullough, M.D., a renowned cardiologist and professor, was an academic pillar until he advocated early, repurposed treatments for COVID-19. His protocols threatened the pharma-only mandate, so the establishment unleashed a negative P.R. campaign, branding him a “misinformation spreader.” They stripped his journal editor roles, forced him out of his university health system, and revoked his board certifications.

Pierre Kory, M.D., a leading critical care specialist, promoted protocols similar to McCullough’s early protocols. He was attacked for disseminating “dangerous misinformation,” and faced platform censorship, suppressed Senate testimony, and lost hospital affiliations. The American Board of Internal Medicine later revoked his certifications.

Simone Gold, M.D., J.D., an emergency physician and founder of America’s Frontline Doctors, spoke against mandated protocols. The establishment painted her as “unhinged,” deplatformed her group, fired her, and she was arrested and sentenced to prison after January 6.

Eric Nepute, D.C., a vocal chiropractor, got the full-on attack. He dared to suggest that patients focus on immune-supporting nutrients like Vitamin D, Zinc, and Quercetin. The federal government responded by suing him for a theoretical penalty of half a trillion dollars—an absurd effort to bankrupt him and terrify any other practitioner from prioritizing natural health over the pharmaceutical mandate. (I’d say he has bragging rights!)

== == ==

For decades, the chiropractic profession has been the target of this exact same machinery.

When you have a product, service, or clinical truth that threatens a vested interest, you will be fought. So, you are encouraged to hide out. Stay safe. Be agreeable and… tame.

But when you hide, compromise, or try to be “accepted” by a corrupt medical establishment, you are indistinguishable from the thousands of other providers they already control.

They win.

But when you are “dangerous” — when you stand firmly for the truth that the body is designed to heal, not to be a lifetime customer of the pharmaceutical treadmill, you become a beacon.

You are then no longer just a piece on their game board.

Patients today are not looking for more of the same. They are looking for a doctor who stands for real health.

Being dangerous is your greatest marketing asset. It builds a level of trust that no institution can break.

The patients who are waking up to this reality will seek you out because you are a target. They will trust you because you refused to compromise.

Oh, Dr. Nepute — he is even more dangerous now. He operates 30 clinics!

Stand for the truth and help more people be healthy. That is how you build a business.

Don’t be a piece… be a player.

Be Dangerous…

…and Goal Driven,

Ed

P.S. Doctors McCullough, Kory, and Simone – and others – will be speaking at the Wisconsin Society of Chiropractic Society of Wisconsin’s VAXCON, April 24-25 at the Dells, WI. See you there! Link.

*References

On Dr. Jeffrey Wigand & The Tobacco Industry: 

·  On the “Tobacco-to-Food” Strategy: 

·  On the Doctors (McCullough, Kory, Gold): 

·  On Dr. Eric Nepute:

Ask Lisa: The Hybrid Bus is Here! Are you Ready to Board?

Posted on by
Reply

ask lisa sitting on a physio ball reading chiro economics magazine billing and collectionsWhile at my desk on my physio ball, I was reading Chiropractic Economics annual Salary and Expense Surveys and took a deep dive into the Billing & Collections (B&C) category. I was jarred by a pattern over the past five years which makes me continue to fear that we are falling behind. The surveys in B&C category are a wake-up call that proves we can no longer ignore the impact of decreasing third-party reimbursements.

Below are the survey results countrywide in the chiropractic office B&C category and Average Reimbursement Percentages over five years. It is noteworthy that billings/charges increased each year with the exception of one year’s slight decrease. Here’s what the survey reveals from billed charges/reimbursement ratios:

2021 – 65% Reimbursement
2022 – 69% Reimbursement
2023 – 74% Reimbursement
2024 – 71% Reimbursement
2025 – 62% Reimbursement

So, what can you do to increase/improve income in your practice? Here are some tips:

  • Improve your practice’s patient care plans to ensure patients stick with their plan. Have you offered a visual picture of the patient’s report of findings, for example, and is your confidence in your adjustment where you want it to be when discussing your clinical findings? Are you making the best use of your therapies in your care plans?
  • Offer care plan packages to create a hybrid reimbursement practice or close the gap between your insurance model and patient self-pay model. It’s okay that you want to continue billing patient’s insurance as a courtesy to your customer base. Know your obligations when doing so regarding treatment plan standards, documentation/medical records standards, billing standards, obligations to respond to payer requests, and credentialing & compliance standards.
  • Offer valued products for retail such as ergonomic/rehab equipment like foam rollers, cervical rollers/pumps, resistance bands, and pillows. Other items include massagers, nutritional supplements, fitness trackers, orthotics, and your own branded merchandise such as water bottles or ice packs. Keep in mind the anti kickback laws. You’ll want to ensure these products are for sale and not giveaways to induce referrals. Please consult a healthcare attorney if in doubt.
  • And finally, you’ll obviously want to keep your collections by having a solid compliance program in place to avoid potential payback penalties for not having a solid program in place.

Need guidance on developing your hybrid practice and navigating the reimbursement landscape? We can help! Just ask…Lisa

Source: Chiropractic Economics Online Magazine, www.chiroeco.com

Lisa
lisa@pmaworks.com

Do You Need an Attitude Adjustment? Does Your Chiropractic and Healthcare Practice Need an Adjustment?

Posted on by
Reply

Marketing always begins with the right attitude

Your chiropractic practice starts with marketing. But marketing starts with attitude.

# # # # # #

A FEW YEARS BACK, a long-time client called and asked if I’d visit his office to help two new associates grow their caseloads.

I took the two young chiropractors out to lunch. Both were eager and not shy about their goals — large practices, and confident they’d match their boss’s caseload within a year. When I asked why their numbers were still low, they blamed the owner’s lack of advertising and suggested the office needed a better brochure.

I told them marketing comes down to a caring attitude about people and having an interested attitude in how they were doing. They nodded enthusiastically. “Absolutely!”

Then I said, “Look around this restaurant and pick out someone. Imagine a possible issue they may have that you could help with.” Both associates avoided looking at anyone and changed the subject back to themselves.

I asked each for a business card. Neither had one.

Having predicted this in advance, I’d taken several cards from the office before lunch and placed two in front of each of them. Then I said, “I’d like you to get up, find someone at the bar, introduce yourself, and hand them your card. If possible, make an appointment.”

They looked at me as if they’d seen a ghost. They slumped in their chairs. Neither would do it. I suggested they try the cashier, the waitress, or the manager. Their fear turned to dismissiveness, as if the exercise were beneath them.

We went back to the office, discussed the situation with the owner, and over the following weeks, the two associates decided to leave and start their own practice.

Was I being too demanding? No. They could have introduced themselves to the manager, mentioned they were new in town, and made a natural connection. Instead, they were hiding out, unproductive, and mildly complaining.

It was a matter of attitude—and they failed the drill.

IN ANOTHER INSTANCE, I visited a new doctor whose office was in an upscale strip mall. He told me that he felt stuck. He was confident in his skills but couldn’t figure out how to generate clients. He wore cowboy boots and looked a little rough around the edges, but he was friendly and seemed to have a great service attitude.

I went over some basics of handing out cards and suggested he meet five new people in the strip mall over lunch. I offered to come along.

He gazed at me for a moment — processing, I suppose — then popped up and said he didn’t need my help and would be back soon. No more than fifteen minutes passed before he walked back in with a man and woman, deep in conversation. He led them to his office. When I returned from lunch, they were just leaving.

Beaming, he said he’d only spoken to three people, but the last two were so interested that he brought them in—and they’d signed on as new patients. He said the whole thing was fun and planned to do more of it.

# # # # # #

There are many approaches to effective marketing. But all of them start with the right attitudes.

How’s yours? How about your team’s?

I think we all need an attitude nudge or adjustment now and then. (Coaches can help!)

The good news is that your attitude is something you can control. It is all yours. When needed, check and adjust those attitudes, and help more people.

Cowboy boots are optional.

—Ed
PS. Contact me anytime if you want or need an attitude adjustment. 😊

I have observed 8 key attitudes for effective marketing. Download NOW: Successful Marketing Attitudes- 2026

(This story is a condensed version from my book, The Goal Driven Business. You can find many more stories from in the field consulting for over 30 years.)

Practice Fundamentals: Communication and Control in Your Chiropractic and Healthcare Practice

Posted on by
Reply

Team meeting about controlling the game and communicating with each other.Team meeting about controlling the game and communicating with each other.

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

It’s always the basics. The fundamentals. It sports or in your chiropractic or healthcare practice.

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

“Most people do not listen with the intent to understand;
they listen with the intent to reply.” — Stephen Covey

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

“It’s not what we do once in a while that shapes our lives.
It’s what we do consistently.” — Tony Robbins

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 spring.

Seize your future – with a smile!

Ed

(reissued and updated.)

Marketing: The Benefits of Positioning, Football, Food, and Chiropractic

Posted on by
Reply

“Chiropractic just makes you feel so much better… as long as I see the chiropractor, I feel like I’m one step ahead of the game.” Tom Brady (7× Super Bowl Champion, 5× Super Bowl MVP, 3× League MVP, 15× Pro Bowler, Considered GOAT.)“Chiropractic just makes you feel so much better… as long as I see the chiropractor, I feel like I’m one step ahead of the game.”
Tom Brady (7× Super Bowl Champion, 5× Super Bowl MVP, 3× League MVP, 15× Pro Bowler, Considered GOAT.)

For those of you who are Patriots fans, Sunday was a tough loss.

But Seahawks fans (the 12s), you’ve got to be feeling pretty good. That was a clinic in defensive strategy.

I enjoyed the game, but here’s what caught my attention – nearly half the country watched the Super Bowl. That’s significant — not because of football, but because of what people pay attention to.

And that brings me to the subject of positioning.

Positioning is a marketing concept that means borrowing meaning from things people already trust, admire, or desire—and letting that meaning transfer to your service.

This weekend gave us two very relevant examples.

2 THINGS PEOPLE CARE ABOUT
(That Relate Directly to Chiropractic)

1. Sports

People of all ages love sports. Sports require physical health, mental focus—and I’d even say spiritual discipline. You must be healthy to perform, and health is your department.

There’s also a reason every professional football team has a chiropractor. If you haven’t looked into it, check out the Professional Football Chiropractic Society:

https://www.profootballchiros.com/

 

2. Healthy Food: RealFood.gov

During halftime, a public-health PSA aired promoting real food and warning about ultra-processed diets. In the spot, Mike Tyson spoke candidly about his own struggles with obesity and the tragic loss of his sister, who died young from a heart attack linked to obesity.

His line was blunt (and memorable):

“We’re the most powerful country in the world, and we have the most obese, fudgy people.”

The ad was funded by the Department of Health and Human Services, currently headed by RFK Jr., who has attended chiropractic conventions and spoken at chiropractic colleges.

These are not fringe ideas. These are mainstream conversations.

WHAT THE RESEARCH TELLS US

This shift isn’t anecdotal. The data supports it:

U.S. adults using at least one complementary health approach nearly doubled, from 19.2% in 2002 to 36.7% in 2022.*

Among adults aged 50–80, 66% report using at least one integrative health strategy.*

People love sports. Real food is being promoted nationally.

And more Americans are using natural health care.

So the question becomes: How Do You Join the Party?

There are lots of ways. Here are a few proven ones.

1. Be the change.
As Gandhi is said to have put it—be the change you want to see. Exercise. Eat well. Get adjusted.

2. Make it a core value.
Support your team in practical ways to help them move better, eat better, and stay healthy.

3. Communicate it relentlessly.
Table talk. Newsletters. Social media. Don’t assume people “get it.” Repetition builds positioning.

4. Create health allies.
Build relationships with owners of athletic businesses—golf courses, gyms, yoga studios, CrossFit boxes—and with coaches at schools or special programs. Cross-refer appropriately. Relationships matter.

5. Provide workshops.
Education beats advertising.

Include consultations and screenings. Partner with a pro or business owner when possible. Share a couple of success stories—with photos.

For example, we’ve done this successfully with golf workshops, co-hosted with chiropractors and a golf pro. Titles included:

  • Golf and Back Pain – Reducing Back Pain in Golf
  • Generating Increased Power in the Golf Swing
  • Improving Distance and Accuracy

We had strong turnout, immediate new patients, and more followed.

Golf season is right around the corner—and I’ve been told golf is a sport (lol).

Here are other natural workshop opportunities:

  • Gyms
  • Runners / Endurance sports
  • Cycling / CrossFit
  • Recreational & youth sports
  • Organic food stores

Sports. Real food. Good health. Your chiropractic services.

For the win!

Keep Drivin’,

Ed

P.S. If you’d like help applying this in your practice, you know where to find me. 🖐️

References:

https://www.nih.gov/news-events/news-releases/nih-analysis-reveals-significant-rise-use-complementary-health-approaches-especially-pain-management

https://ihpi.umich.edu/national-poll-healthy-aging/national-findings/use-and-interest-integrative-medicine-strategies

https://www.beinsports.com/en-us/american-football/articles/how-many-people-will-watch-super-bowl-lx-2026-02-06

Tom Brady – https://creativecommons.org/licenses/by-sa/3.0/

The Hidden Power of Patient Testimonials in Chiropractic and Healthcare that Go Beyond Marketing

Posted on by
Reply

women healthier and pain free after chiropracticIn this newsletter I was going to show you some neat tricks to improve team accountability. Accountability is a powerful and positive trigger that drives excellent practice performance.

But something happened just before I started the article.

I received a patient success review from a doctor we work with.

It read it and…WOW! What a success! What a Win! (It is below!)

And I thought – boy, this is really good for marketing. But reviews like this also have other practical uses in your practice that may be overlooked.

Mostly, these are marketing tools—patients give reviews to let the community know what you do. They’re legit and one of the absolute best methods to sell your services. I’m sure when you buy products on Amazon, you look at the reviews. Right?

But patient reviews have 2 other very powerful benefits that may be overlooked.

Two Hidden Benefits of Reviews in Your Chiropractic Practice

First, they reinforce wins for your patients. A patient comes in barely able to move. You adjust them. They get better. And then—they start to forget how bad it was. It’s human nature. We adapt to our new normal fast. Or their wins come on so gradually they don’t even notice the change.

When patients write their reviews, they reconnect with where they were and recognize where they are now. That testimonial becomes their documented “why” — why they’re investing in care and why they’ll stick with their treatment plan.

Second, patient reviews keep the WHY in mind for you and your team.

The daily demands and deadlines that are required working in a practice, for the chiropractor and staff, can bury the reason you work in this profession: to help people heal.

Reading chiropractic patient testimonials reconnects you and your fellow team members to your purpose and the purpose of the office. When Mrs. Johnson writes about finally holding her grandson without pain, or the athlete describes returning to their sport—that’s not marketing copy. That’s meaning. That’s impact.

That is the essence of health care.

The Joy of Practice

If you can stay connected to the wins of your patients, I think you’ll find that practice stressors, or “onset burnout,” will start to melt away.

So,

Keep generating patient reviews. And if you aren’t, do so.

Get them posted so your community can see what you do: website, social media, Google Business profile, and your newsletters.

Read them. At weekly team meetings, staff and doctors can take turns reading one or two patient successes. I have seen patients how up at team meetings and at spinal care classes to talk about their wins!

Patient testimonials aren’t just marketing assets. They’re memory landmarks for patients who might take their wins for granted.

They’re purpose statements that remind the entire team what you all are really doing there. They’re the antidote to the sometimes-dreary aspects of practice management.

So yes, get the reviews for marketing. But also share them with each other. Let them be the thing that brings everyone back to why you all do this work.

And stay driven to enjoy the wins,

Ed

The public patient review I just read.:

Doctor Max is an absolute miracle worker. He is the best. I went to him a month ago basically as a last resort. I had tried everything else, and I mean everything. When I went to see him, I could barely walk. I had to use a cane. Getting in and out of vehicles was soooo very painful. I had sciatic pain, lower back and hip pain and could not bend my knee at all. Regular doctors told I would need a knee replacement. Nope..,not doing that. Doctor Max took X-rays of back, neck, hip and knee. Immediately he had a course of treatment. Now, after 1 month of treatments, 3 times a week, the change is a true miracle. I feel like a new woman (and that is tough to do at 80 years old LOL). I’m still going in for treatments to continue healing to make sure my body stays in great condition. I am convinced, if I had not found Doctor Max I would be in terrible shape and facing a knee replacement I did not need to have. Not only is Doctor Max great, but his staff is wonderful.” Cindy B

Kickstarting Your Patient’s Health and Their Referrals In Chiropractic and Healthcare Practices

Posted on by
Reply
chiropractic healthy start coupon

A healthy start for 2026 in your chiropractic practice

Now is a perfect time to connect with all your active and inactive patients.

If you haven’t yet, compliment them for working on improving their health last year. Express your gratitude for trusting you with their health.

Then, as their Health and Wellness Coach, encourage them to set some health goals for the first quarter of the year.

You can be a little forward about it…you want them to win! Patients appreciate chiropractors and other doctors who genuinely care about their results.

You can also encourage them to invite their family and friends in to see you if they’re dealing with back pain, headaches, or other conditions you can help with.

Below is a sample coupon you can personalize then use or modify to suit your situation.

Wishing you, too, a healthy start to your New Year — in business and in life!

Ed

== ==

2026 “HEALTHY START” COUPON

We want to help you start your year off as healthy as possible. Use this coupon:

  1. If you are active on your chiropractic program, bring this coupon in to enter a drawing for a [healthy gift, which could be a gift certificate to a local health food store, restaurant, yoga studio, sky-diving, etc.]

  2. If you haven’t been in for a while, bring this in for a free update exam and x-ray if needed.

  3. If you know someone who might benefit from chiropractic care, give them this coupon for a consultation, exam, x-ray if needed, and report of findings for $25 as your guest.

Leaders Like You – in Chiropractic and Healthcare Practices

Posted on by
Reply

Doctors and team members of Excel Chiropractic, Lake Geneva, WI

Empowering Others in Chiropractic Healthcare Practice

You are a leader.

You may not consider yourself a leader. But you are. So is everyone on your team.

Not only by the service you provide, but by the example you set.

What is leadership? Let’s take a look to see if you fit:

  • “Leadership is not about who you are or where you sit. It’s about what you do to make a difference in the lives of others.” — Jim Kouzes & Barry Posner, The Leadership Challenge
  • “Leadership is not about being in charge. It is about taking care of those in your charge.” — Simon Sinek
  • “Leaders become great, not because of their power, but because of their ability to empower others.” — John C. Maxwell

I think you’ll have to agree, both you and your team are leaders. Servant leaders in chiropractic and your healthcare practice.

But, as you know, leadership is tough. It isn’t easy.

But you did it in 2025.

You helped others in big ways and small, regardless of your role.

It is possible, quite likely in fact, that you may not have acknowledged the vital role you and your teammates played in the wellbeing of others last year.

Why not? Well (lol) … because of all the #@#% that occurs when trying to get things done. The list can go on and on… there is so much noise and changes that occur in practice that sometimes it is difficult to see the road we are on.

But, you made it through another year. And in your wake, people are better.

All of us at Petty, Michel and Associates are proud to work with you. We appreciate your struggles and celebrate your wins as independent health care leaders!

In this New Year, stay true to you purpose and your role as the servant leader that you are – and your path to your goals in 2026 will be straighter and more certain.

“We never know how far reaching something we may think,
say or do today will affect the lives of millions tomorrow.”
B.J. Palmer’s 1949 book The Bigness of the Fellow Within

Ed Petty

2025- Health Never Takes a Holiday – Complimentary Posters

Posted on by
Reply

health never takes a holiday signature promotion for december in chiropractic offices

Health Never Takes a Holiday is our signature holiday post for many years.  It has proven to be very helpful for many offices to keep their patients on schedule during the holiday hustle and bustle.

For this program we offer free downloads of posters and tent posters you can use in the office to remind patients that we believe “Health Never Takes a Holiday” and it’s important to keep their schedule of care to stay well.

Please visit https://www.goaldriven.com/post/health-never-takes-a-holiday-in-chiropractic for this year’s complimentary posters.

How the Gratitude Attitude Helps Healing in Your Chiropractic and Healthcare Practice

Posted on by
Reply

Previously published on Goal Driven

gratitude with attitude thanksgiving message from pmaworks

The Gratitude Attitude: Proven to Speed Healing and Grow Chiropractic and Healthcare Practices

I don’t know about you, but I just like saying…” Gratitude…Attitude.”

There are plenty of studies on this subject – how just being grateful can improve health outcomes.

Here are just a few highlights:

  • Fewer aches and overall better health – Grateful people report less pain and are more likely to take care of themselves (exercise, regular checkups, etc.) (Emmons & McCullough, 2003 – UC Davis. My old alma mater!)
  • Heart failure patients who kept a gratitude journal for 8 weeks showed reduced inflammation, better heart-rate variability, and improved sleep (UC San Diego, 2015)
  • Lower blood pressure in grateful individuals (Teixeira et al., 2024)
  • Reduced depression and anxiety (Seligman et al., 2005)
  • Better sleep quality (Wood et al., 2009)
  • Improved diabetes management (multiple studies, 2010s–2020s)
  • Stronger immune function (University of Utah & others, 2003–2021)

The list can go on and on.

Two Simple Ways To Use This In Your Practice Right Now

  1. With patients – At the end of a visit, ask your chiropractic and healthcare patients to name 3 things they’re grateful for today (family, a sunny day, the fact they can walk into your office, etc.). Studies show this tiny habit alone can accelerate their healing.
  2. With your team – End your next team meeting by going around the room: everyone shares one thing they’re grateful for in the practice. I have seen this done, and the practice has grown as a result!

The benefits of gratitude may seem obvious and something we already know, but they can be easily overlooked. We focus on our daily challenges and can take for granted the people who support us, and who have done so in the past.

Faced with patient and practice demands, we can under-appreciate the opportunity we have to live an extraordinary life helping others.

So it is good to take time – right now — to give thanks.

Best wishes to you this week, wherever you are.

All of us at Petty Michel & Associates are truly grateful for you – and all you do to make the world and your community a better place!

Sincerely,

Ed

P.S. (On the other hand, you have to be careful!- You know you’ve overdone the Gratitude Attitude when you stub your toe and automatically think, “I’m so grateful I have toes to stub! And a chair to stub them on! And nerve endings that let me feel pain! Pain is a gift. This is so much amazing!” Ha-Ha! A little humor for ya! 🙂

More P.S. Here’s an old-fashioned poem:

Thanksgiving (Edgar Guest 1881 – 1959)

Gettin’ together to smile an’ rejoice,
An’ eatin’ an’ laughin’ with folks of your choice;
An’ kissin’ the girls an’ declarin’ that they
Are growin’ more beautiful day after day;
Chattin’ an’ braggin’ a bit with the men,
Buildin’ the old family circle again;
Livin’ the wholesome an’ old-fashioned cheer,
Just for awhile at the end of the year.

Greetings fly fast as we crowd through the door
And under the old roof we gather once more
Just as we did when the youngsters were small;
Mother’s a little bit grayer, that’s all.
Father’s a little bit older, but still
Ready to romp an’ to laugh with a will.
Here we are back at the table again
Tellin’ our stories as women an’ men.

(The rest of the poem.)

Preparing for a Powerful New Year in Your Chiropractic Healthcare Business

Posted on by
Reply

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 is Special about L.L. Bean and How Does it Compare to Your Chiropractic or Healthcare Practice?

Posted on by
Reply

“Originally published on Goal Driven.com – republished with permission.”

LL bean womens boot
The Key to Building a Chiropractic and Healthcare Practice that Lasts

L.L. Bean. You’ve probably heard of them.

I just received a Christmas shopping catalogue from them (hard copy!). They are a clothing company out of Maine. Founded in 1912 by Leon Leonwood Bean. I probably bought something from them years ago, and I am on their Christmas list.

We also receive a catalogue from Patagonia each year. It is another clothing company. It was founded more recently, in 1973 by a rock climber, Yvon Chouinard.

I like both companies and I will tell you why – in a minute.

= = =

Recently, I saw an ad of a young man (chiropractor) coming off a stage saying that he just sold his practice for “seven figures.” It was a bit of brag and sounded like he wanted to help other doctors reach that level. He said he was able to grow his business quickly and sell it thanks to his marketing.

I’m all for marketing, and I truly hope he can help with other chiropractic practices.

But it made me think: aren’t there significant financial advantages to owning a business in the long term that compound?

When you own a practice for 10-20 years, you’re not just collecting a salary — you’re able to take advantage of tax benefits that can add $30-50K annually to your real compensation! These can include vehicle expenses, health insurance, retirement contributions, continuing education, and equipment depreciation. These can all reduce your tax burden.

Over 20-25 years, these ownership benefits can add $500K-$1M in value that disappears the moment you sell.

And beyond tax advantages, long-term ownership allows your business equity to compound alongside your income. A practice worth $500K in year 5 might grow to $2M by year 10 or $5 -10M by year 25 – or more — IF you have good management, create a strong reputation, and even bring on other providers, or add other locations. And all the while — taking profit distributions, building retirement accounts, and enjoying the flexibility that ownership provides.

The doctor who sells early gets one payday; the doctor who builds strategically gets decades of tax-optimized income plus a potentially much larger exit.

Back to L.L. Bean and Patagonia

Now, back to those Christmas catalogues! Both show how patient, long-term ownership and excellent management, products, and services can build generational wealth over decades of brand-building and customer loyalty.

L.L. Bean, a billion-dollar empire, is still family-owned. Patagonia, now worth billions, wasn’t sold at all. Chouinard transferred ownership to the Patagonia Purpose Trust to ensure profits protect the planet in perpetuity.

Both companies show how owners who focus on purpose-driven growth and lasting customer relationships can build enduring companies that dwarf what any early buyer would have paid.

Purpose and Values of Your Healthcare and Chiropractic Practice

But here is what does not show up in the spreadsheets of these two companies: their values and purposes.

And, their discipline to stick to them!

Selling your business earlier rather than later can be a valid choice. However, if you ensure it remains focused on its purpose and values, you’ll enhance its profitability and make it more valuable for whoever takes ownership next.

L.L. Bean built its reputation on an unconditional guarantee and commitment to customer satisfaction. “At L.L.Bean, we design products that make it easier for families of all kinds to spend time outside together.”

Patagonia’s environmental purpose became so central that Yvon Chouinard ultimately gave away his $3 billion company. “We’re in business to save our home planet.”

The lesson is that a business rooted in purpose beyond profit attracts loyal customers and dedicated employees and creates a brand that competitors can’t copy.

Your purpose — and the discipline to stay creatively and positively true to your goals — pays off.

So…

Stay Goal Driven!

Ed

P.S. And have fun doing so – maybe fishing, camping, or just outside and enjoy the fall. (Or spring, if you’re Down Under.)

Ask Lisa – Compliance 201: Your Shield Against Bad Risk

Posted on by
Reply

compliance in the health care field for chiropractorsAs a follow-up to our previous compliance articles, I thought what I’d do this month is put together a FAQ list for my dear readers and call it Compliance 201. Keep reading to learn about upcoming new requirements in the compliance/cybersecurity world to keep you at least safe-guarded when you are hit with a cybersecurity incident. Special thanks and credit goes out to ChiroArmour and Dr. Scott Muensterman for his research and presenting at the Chiropractic Society of Wisconsin Fall Experience last month on some of the content in my FAQ.

Q: What is HIPAA and HITECH?
A: HIPAA is the acronym for Health Insurance Portability and Accountability Act of 1996, in which uniform standards and requirements for the electronic transmission of certain health information were put into place and made into law. HITECH is the acronym for Health Information Technology for Economic and Clinical Health Act of 2009, a countrywide adoption and standardization of information technology to securely support the sharing of clinical data.

Q: What is Cybersecurity?
A: Cybersecurity is the practice of protecting digital systems, networks, and data from malicious attacks, damage, and unauthorized access.

Q: Is there a checklist available to ensure we are in compliance?
A: Yes. Current and Active PM&A clients have access to our HIPAA/HITECH compliance checklist, on the PMA Members Site, and compliance services are included upon request from the client.  If you are currently inactive or not a client, we can provide you with the checklist for a nominal fee. Please keep in mind your staff are already very busy, so ask yourself who is going to take on ensuring compliance at your office and going through the checklist? We can help.

Q: Isn’t it a matter of IF a cyberattack at my office occurs, not WHEN as you stated above?
A: On average there are 11 to 12 cyberattacks happening per minute in the US. So in today’s world yes, it is a matter of when, not if. And after research, it has been found that small businesses are more of a target for an attack than large organizations mainly because large organizations can put more dollars into security measures.

Q: What does Windows 10 and Windows 11 have to do with compliance?
A: Windows 10 no longer supports the security patches it used to support, effective 10/25/2025, so all of your computers must be operating on Windows 11 at minimum by this time. You CAN extend your Windows 10 protection for 1, 2, or 3 years at a significant price, but your software vendor may not honor the upgrade.

Q: I heard that there is something called an OIG Exclusions report – what is this and does it affect me and my practice?
A: The OIG Exclusions database is a reporting site listing every individual who is prohibited from seeing Medicare/Medicaid patients due to prosecution of a criminal activity, which can include being found guilty of fraud against Medicare/Medicaid, non-compliance of court-ordered child support payments, and illegal drug convictions. It is and will be a requirement to run a report MONTHLY on every person in your office including owners, subcontractors, and upon a new hire.

Here’s the link to check names: https://exclusions.oig.hhs.gov/
If you don’t see your name, that’s a good thing. Some of you are already running and checking this report due to insurance contract requirements. Save or print and file the results page.

Q: How can I confirm if my practice management program is fully compliant?
A: The website for verifying compliant healthcare software programs is down as of this writing, so for peace of mind if you are not 100% certain, call your software company or IT person.

Q: When do changes/new requirements occur?
A: As of now, no date has been set by HHS, but if you are doing the above steps and have written policies in place, you should not worry, but watch for future communications. You can subscribe to HHS email notifications here: https://cloud.connect.hhs.gov/subscriptioncenter

Q: What does Medicare documentation have to do with cybersecurity?
A: To avoid a documentation audit and subsequent potential visit from the OIG to further audits on compliance with HIPAA and your cybersecurity policies, keep your documentation and billing practices solid per Medicare chiropractic documentation standards, and make sure to securely send your notes to Medicare upon audit (and any other payer group who requests) to ensure you are staying HIPAA compliant.

Q: Can my staff be our Security officer?
A: By law, yes, but you as the doctor owner are always ultimately responsible for any attack or breaches, and payments to the government, so it is strongly recommended that the doctor owner be the compliance security officer for the business.

That concludes our FAQ for now. I know you’ll have additional questions. Feel free to reach out with those we’ll respond within three calendar days!

Stay Secure,

Lisa

References: ChiroArmour

 


cards

Powered by paypal

2026 Marketing Habits for Your Chiropractic and Healthcare New Year

Posted on by
Reply

social media marketing for consistent marketing in the Chiropractic Practice for 2026

2026: The Year to Make Your Healthcare Practice Thrive

2026 will be a make-or-break year for healthcare business owners—potentially your best ever. More details in future newsletters, but for now: build unbreakable marketing habits starting today.

Trust: The Core of Healthcare Marketing

“We are what we repeatedly do. Excellence, then, is not an act, but a habit.” – Aristotle (via Will Durant)

You’re selling the invisible—outcomes patients can’t see upfront. That’s why trust is everything. Build it through:

  • Consistency
  • Empathy
  • Proven Results

Your brand = how you consistently show genuine care and deliver excellence.

The #1 Killer of Momentum?  Stopping What Works

I’ve seen it repeatedly:
Q: “What were you doing when patient numbers were high?”
A:

  • “We sent newsletters.” → Not anymore.
  • “We called new patients post-visit.” → Nope.
  • “We did thorough financial consultations.” → Are you kidding? No!”

Stopping proven tactics = death by roller coaster.
You lose trust, momentum, and the systems that made it effortless.

Your Fix: The Recurring Marketing Checklist

Discipline is hard—but checklists make it stick. Systems atrophy without them.

Monthly Discipline Hack:

  1. List your top 10 internal + external marketing actions (70–80% of your total efforts).
  2. Assign ownership to your manager.
  3. Review at every staff meeting.
  4. Grade % completed—full accountability.

Layer In: Special Promotions

With recurring actions locked in, plan 2–3 months ahead for:

  • Facebook ads with a partner
  • Food drive with a local pantry (especially needed now)
  • Health talk at a yoga studio

Deliverable:Monthly Marketing Planner
→ % of recurring actions completed
→ # of special promotions scheduled

Let’s Make 2026 Your **Best Ever**

Download Free Tools:[LINK]
— Ed

The 4-Hour Fix for the Chiropractic Healthcare Practice Roller-Coaster

Posted on by
Reply

the ups and downs of the Practice Roller Coaster stay Goal Driven to stay up

One Simple Role to Streamline Chiropractic Marketing and Growth**

Chiropractic practices often face inconsistent growth due to a Practice Roller Coaster, where marketing drives patient numbers up, but attention shifts to patient care, staff management, and other tasks, causing marketing to stall. This leads to fluctuating growth. To address this, assigning a trusted staff member as a part-time Marketing Coordinator (4 hours/week) can ensure consistent marketing efforts. Their role is not to handle all marketing but to keep systems like recalls, referrals, and metrics tracking active.

The Marketing Manager System, developed by Edward Petty in the early 2000s, emphasizes four key issues: marketing fails when it’s not done, no one is in charge, insufficient time is allocated, and the coordinator needs support and accountability. To succeed, the clinic director should schedule weekly marketing time, hold monthly planning meetings, track metrics with charts, and ensure accountability through written plans and reports. This approach eliminates marketing bottlenecks, sustains momentum, and reduces stress, helping practices grow steadily.

Note: A Monthly Marketing Manager Program to support coordinators with training and systems is planned for launch soon.

Building a Practice Through Relationships

Posted on by
Reply

a happy bus driver like a chiropractor with happy people on their bus

Advertising has always been important. When we grew our Wisconsin network to 25 offices, we invested heavily in newspapers, shared mailers, radio, and even TV. Today, the focus has shifted to social media, SEO, and now Artificial Intelligence — positioning your practice for AI discovery will soon be essential (more on that later!).

But advertising is expensive. What truly sustained our growth was relationship marketing — connecting authentically with patients, referral sources, and our own team.

What Is Relationship Marketing?

Relationship marketing involves creating trust-based relationships with patients and referral sources, generating loyalty and organic referrals through genuine care and ongoing connection.

Examples:

  • Host a community event like a holiday food drive — invite patients and their families to participate and offer consultations in exchange for donations.
  • Encourage patients to refer loved ones with a personal touch (“Let’s check your spouse before their next soccer game!”).
  • Build partnerships with local professionals — massage therapists, trainers, or nutritionists — and support each other through referrals or shared promotions.

Your Most Important Relationships

Don’t overlook your team. When doctors and staff work together with shared purpose and positive energy, patients notice. It’s almost magnetic — phones start ringing and old patients return.

As Stephen Covey reminds us in The 7 Habits of Highly Effective People, success comes from empathy, communication, and a win-win mindset that creates synergy — or, as some might say, Universal Intelligence at work.

GETTING AND KEEPING PEOPLE ON YOUR BUS

As a doctor and clinic director, you are like a bus driver. You aim to make sure you are on time and complete your shift according to schedule.

One day, you turn around to look at the back of your bus and wonder why there are so many empty seats. “Where is everyone?”

Well, maybe you missed some stops and the people never got on! Or, you didn’t take time to say “hi” when they boarded, so they all left at the next stop. Or, you were so busy driving, you didn’t ask about your assistant’s new workout routine.

Take time to connect with people.

More than anything, you are in the people business.

Enjoy the ride!

Ed

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

Posted on by
Reply

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

Ask Lisa: Cracking the Code – ICD-10 Code Revisions Start on October 1

Posted on by
Reply

lock and key cracking the code of ICD-10 insurance codes

Diagnostic coding is the translation of written descriptions of diseases, illnesses and injuries into codes from a particular classification. In medical classification, diagnosis codes are used as part of the clinical coding process alongside intervention codes for proper reimbursement. The translation is called the International Classification of Disease codes, or ICD-10-CM*. There are annual updates which may include deleting codes, adding codes, and minor edits to existing codes.  Keep reading for information regarding ICD-10 changes for 2026.

Although there are very few changes in 2026 relevant to chiropractic coding, the updates contain 487 new, 28 deleted, and 38 revised codes. The 2026 ICD-10 codes will be used for patient encounters from Oct. 1, 2025, through Sept. 30, 2026.

The new codes listed below may be relevant to your patient encounter:

  • Pelvic Pain
  • R10.20 Pelvic and perineal pain unspecified side
  • R10.21 Pelvic and perineal pain right side
  • R10.22 Pelvic and perineal pain left side
  • R10.23 Pelvic and perineal pain bilateral
  • R10.24 Suprapubic pain

And new codes related to socioeconomic circumstance:

  • Z56.6 Other physical and mental strain related to work
    • Workplace stress
  • Z56.89 Other problems related to employment
    • Furloughed
    • Underemployed
  • Z59.02 Unsheltered homelessness
    • Lives in a homeless encampment
  • Z59.19 Other inadequate housing
    • Poor housing weatherization
  • Z59.86 Financial insecurity
    • Z59.861 Financial insecurity, difficulty paying for utilities
    • Difficulty paying for electricity
    • Difficulty paying for heat
    • Difficulty paying for oil
    • Difficulty paying water bill
    • Utility disconnect notice due to inability to pay
      • Excludes2: inadequate housing utilities (Z59.12)
    • Z59.868 Other specified financial insecurity
      • Bankruptcy
    • Z59.869 Financial insecurity, unspecified

Coding and Billing Tips:

  • Make sure if you use a new code listed above, you relate it in your SOAP note to the patient’s condition and why they are seeking care.
  • If you bill a 98941: 3-4 region adjustment, make sure you have at least three ICD-10 subluxation codes (The M99.0X series) on the claim.
  • If you bill a 98942: All 5 regions adjustment, make sure you have at least five ICD-10 subluxation codes (again the M99.0X series) on the claim.

If you are interested in obtaining the entire file of new/updated/deleted ICD-10 Codes, click this link from the Centers for Medicare and Medicaid Services:

https://www.cms.gov/medicare/coding-billing/icd-10-codes#CodeFiles

And, BTW… we still make house calls!  Not collecting what you are owed? Something just doesn’t seem right with collections and your deposits? Give us a call to discuss if an onsite visit or video conference is right for your office.

Happy Birthday Chiropractic! Celebrate the entire month of October!

Lisa

920-334-4561

*CM refers to the ICD-10 coding system used in the United States.Sources:

Sources:

ChiroCode
Center for Medicare and Medicaid Services (CMS)

Why Clear Roles Build a Stronger Chiropractic & Healthcare Practice

Posted on by
Reply

team players wearing staff hats front desk billing promotion marketing

Better teamwork, smoother operations, and improved patient care all start with clarity.

Years ago, I visited a chiropractic office where the doctor was frustrated: patients weren’t keeping appointments, and he blamed his front desk staff, “Sue.” The problem wasn’t effort—Sue was polite and friendly—but she had no clear job description, no checklist, and no real understanding of her responsibilities.

Once we clarified her role, outlined simple procedures, and scheduled regular reviews, the practice quickly improved. Patients kept their appointments, and both the doctor and Sue felt more confident and motivated.

This is a common issue: when roles are vague, results suffer. But when roles are clear, teams thrive.

—

The Three Elements of Every Role

According to the Goal Driven System, each role should include:

  1. Purpose – Why the role exists.
  2. Outcome – The measurable result it should achieve.
  3. Procedures – The specific actions to reach the outcome.

Example – Front Desk Role:

  • Purpose: Help patients achieve health goals by ensuring they stay on schedule.
  • Outcome: Patients consistently keeping appointments.
  • Procedures:
    • Greet every patient with a smile.
    • Answer the phone warmly.
    • Confirm each patient leaves with their next appointment scheduled.

—

 Action Steps for Your Practice

  1. Have every team member list their roles.
  2. Define the purpose, outcome, and 5–10 key procedures for each.
  3. Add measurable indicators (e.g., % kept appointments, total visits).
  4. Review and rehearse roles regularly, just like a winning sports team practices.

Clear roles create accountability, boost morale, and drive better patient care. Keep it simple, keep it consistent, and keep it fun.

Stay Goal Driven,

Ed